It’s Patient and Resident Experience Week, an annual world-wide event in recognition of health care staff who make a positive impact on the patient and resident experience.
We’re spotlighting eight projects across Providence that prove that a person-centred approach to care can make a tremendous impact on the care experience of patients, residents and their families.
Internal Overdose Prevention Site
We know that when patients are in hospital it is often not the right time for them to stop using substances and with the current climate of fentanyl circulating in the community, these patients are at a high risk of overdose. With the knowledge that the existing Overdose Prevention Site (OPS) trailer outside was moving elsewhere, the internal OPS was created to provide a safe space for patients to use their own substances, with nurses present to support, provide education and intervene when necessary.
Evidence shows these sites reduce harms and save lives. While there have been challenges with putting it in the hospital, overall there has been a lot of positive feedback from patients and staff. This service demonstrates that we respect our patients and that it is ok that they are using; we want to support them in being as safe as possible. This program truly meets people where they are at in their own healthcare journey and supports them with care and compassion for a patient population that is often overlooked and stigmatized.
Led by Carlin Patterson, CNE, Urban Health and Sam Gill, CNL, RAAC, the team has been able to collect feedback from patients and implement changes. The team is hoping to expand the hours of operation. Opening the OPS inside the hospital has allowed PHC to support the diverse circumstances of people that access the site in an open and safe environment for patients to go without judgement and trust.
The team is in early stages of tracking overdoses and code blues, but they are working on a data collection process. Since they opened they have had 23 overdoses all reversed with Naloxone.
Surgical Day Care – Hard of Hearing Bin
After a patient that was hard of hearing made a complaint that she couldn’t understand anyone because she usually reads lips and everyone was wearing masks, the Surgical Day Care team brainstormed how to deal with this issue for people who read lips.
Surgery team member Virginia Carlton reached out to the BC Chapter of the Canadian Hard of Hearing Society and they were able to provide her with a hard of hearing toolkit for the team at St. Paul’s. Virginia took this kit and built on it, creating a Hard of Hearing Bin and a unit policy to support the practice moving forward. The bin contains pen and paper, hard of hearing stickers for the patient chart, Communication Tips for nurses, and a hard of hearing communication form for the patient to fill out to provide information about how they communicate. The team also utilizes an Ipad to communicate that is able to translate, provide lip reading and sign language tools.
This project demonstrates how we can use patient feedback to improve the experience for others and shows respect for the patient to be able to communicate in a way that works for them.
The patient that provided the initial feedback came back after the toolkit was implemented and found the difference was amazing. A small complaint lead to such a big impact to so many others.
Let Us Eat Cake Podcast and Snack Time
Ali and Hannah are two dieticians in the Provincial Eating Disorders Program, based at St. Paul’s Hospital. Two years ago they started a podcast about the most polarizing topics in order to demystify common diet fad myths.
Ali and Hannah started an Instagram page to spread the word about their podcast and create a platform to share and connect. When the pandemic hit and all patients in the Inpatient Eating Disorders Program were sent home to continue their recovery virtually, Ali and Hannah realized they needed to find a way to stay connected with their patients and the community, especially considering how isolating mental health issues and eating disorders can be.
Ali and Hannah started a daily Instagram Live session called “Snack-time and Chill”, every Monday to Friday at 3 pm PST, thanks to the help of producer/Occupational Therapist Lauren Jennings. Each session they eat a healthy snack, chat in a light hearted place where people can come and share what they are going through. They have around 1000 views per episode, with snackers from around the world tuning in.
Instagram handle: @eatcakepod – Snack time and Chill
“Let us eat cake” podcast: Available anywhere you download podcasts.
Acute Care for the Elderly – Group Exercise and Tea Time
The Rehab team on the Acute Care for the Elderly (or ACE) unit at St. Paul’s has implemented a group seated exercise class Monday to Friday. They’ve been able to utilize the gym space on 9C/D to allow for social distancing while promoting physical wellness and social connection among the patients, doing seated strengthening exercises, stretches and games. Rehab assistants Brynn, Kim and Jhon work to make sure it’s inclusive so those with cognitive impairments can be involved as well. With the current COVID restrictions they have 8 people in the sessions at time, safely spaced and wearing masks.
ACE rehab assistants are also running a Tea Time program, Monday to Friday, with 8 people. The rehab assistants run these sessions that work for a range of abilities, different cultures and cognitive levels. They have tea and cookies, play games (i.e. Bingo), watch musical concerts, and incorporate seasonal activities. It’s an opportunity for patients to work on their mobility, motor skills and coordination. The team has also noticed that people have become more responsive to their care plans as a result.
One creative game is the Fishing Game – the rehab assistants made fishing rods with strings and a “hook” and there are sea creatures they catch and move into baskets. The game is fun for all levels and has been a wonderful way to bring joy to the patients.
CSICU – Virtual Family Visits
The CSICU went through a challenging time when they had an outbreak on their unit earlier this year, had to close the unit completely to all visitors while they managed the outbreak. To facilitate virtual visits with families, the leadership team purchased iPads.
Since then, as the unit has started offering virtual visits to all families, and with increased flexibility. Video “chatting” with a patient when they were still sedated is often comforting for the family members, even though the patient isn’t awake. People are starting to get used to using virtual methods and have adapted well to this different and unusual way of checking in on their loved ones after heart surgery.
The CSICU team has also been able to including patient and families in rounds over video chat and have family meetings. Some of the challenges with using technology has actually allowed for the team to build rapport with the families. This method also allowed people to see their families without masks on and they families are comfortable in their own home.
Volunteer Resources Hummingbird and Fish Tank Initiatives
These Volunteer Resources initiative focused on the beauty of the natural world that exists throughout PHC sites. In the midst of the impact of COVID throughout the past year, one element of our work sought to remember that small details can bring comfort and joy in the midst of hard times. Our focus on the plants and animals of Providence was meaningful to many, yet also easily overlooked.
The Hummingbird Program, supported by volunteers, ensures that the hummingbird feeders outside of patients’ rooms at St. John Hospice are full, which in turn brought these beautiful birds to the windows of our residents, day after day. Volunteers rotate and goes once a week to clean and prepare the nectar for the birds. There are 9 feeders at the hospice. Volunteers also maintain, care for and feed the beautiful tropical fish in the Palliative Care Unit at SPH. This large tank provides colour, gracefulness, and a sense 0f peace for patients, families and staff.
As we’ve entered spring the volunteers have recently started to return to our garden spaces, as they prepare them and plant seeds for spring. Later in the season these areas will be lovely spaces for a break in the day. The hope is to encourage patients, staff, residents, volunteers and visitors back to these inviting, pretty outdoor spaces to safely gather, share memories, and create new ones.
Patient Oriented Discharge Summaries
The Patient Oriented Discharge Summary (PODS) project on 7CD aimed to improve the patient experience of hospital-to-home discharge, by improving patient confidence about discharge, overall patient experience, ability to manage health at home, and hospital readmission rates.
The PODS is a simple, standardized form and set of processes that were co-designed by Patient Family Partners (PFPs) and health care providers. The team, led by Aggie Black and Meghan MacLeod, implemented an evidence-based Care Transition Bundle that included the PODS form, teach-back methodology, involvement of family caregivers in discharge teaching, and post-discharge follow-up phone calls.
Evaluation results reported that 87% of patients who received PODS reported it was helpful, with 79% of patients feeling adequately prepared for discharge, a large increase from previous surveys. Nearly half of providers surveyed reported PODS helps them to be more effective in their job. 30-day readmission rates decreased slightly.
Part of the PODs bundle is a post discharge follow-up phone call. With this phone call staff found patients were very appreciative that we took the time to check-in and answer any questions they may have.
One patient’s feedback on PODS forms: “The form was really good. After the stroke, paperwork sends me into a tailspin, so the form was really helpful.”
Facial Recognition Project
With the increased use of proper Personal Protective Equipment (PPE) such as face shields and masks, a new problem has sprung up: the caring smiles we provide to our patients and residents, often a source of comfort during uncertain times, are hidden.
Recognizing who is caring for you, and seeing their smile, is fundamental to providing compassionate, person-centred care. And, at Providence, it’s what we’re always striving to do.
With the support of the St. Paul’s Foundation and Professional Practice Office, the Speech-Language Pathology team received funding to produce staff photos that show names, roles and a smiling photo of the care team member’s face so our patients know who is caring for them.