RESPECT, TEAMWORK AND COLLABORATION

By Michelle DiEmanuele, President and CEO of Credit Valley Hospital

Hospitals are huge and can be intimidating institutions, not just for the patients, but for a new CEO such as myself. I am quite frankly overwhelmed by the amount of teamwork and collaboration that exists here at Credit Valley and beyond our doors with our health-care partners. This is great news, for if we are to move forward with our quest to deliver patient and family-centred care and to ensure equitable and sustainable access for all, we must forge even stronger relationships. And we’ll do so if we make teamwork, collaboration and partnerships our top priorities.

Gone are the days when hospitals competed with one another for scarce financial resources in order to duplicate programs and services at each facility. What’s critical is the idea of mutual respect - within the hospital and broader health-care environment recognizing the significant role each facility, each program and each individual plays in the overall delivery of good patient care. It is critical to maintaining that community connection and understanding as we build and reform the system.

The spirit of cooperation has been accelerated through design and demand of the various regional health systems across the country. Even before the formalization of such systems, there have been many informal and spontaneous examples of co-operation among health-care facilities. I’m hugely impressed by these initiatives that often begin at the community and grass-roots level.

Here at The Credit Valley Hospital in Mississauga, Ontario, we are working closely with our neighbouring hospitals and other health-care partners to offer our patients more comprehensive and coordinated services, each through our own regional specialities. The patient experience is further improved because in many instances, they no longer have to travel to Toronto or Hamilton or other larger centres for their care, reducing their travel costs and anxiety.

In order for this collaboration to work, we have all put new resources into making sure our patients are being informed and navigated appropriately to find the care they need, where and when they need it. It’s not always where they thought they might get it. In fact, it may not even be in a hospital environment. That’s asking a lot of our patients. Doing our best to make the move between facilities and caregivers as seamless and painless as possible is paramount to a good patient and family-centred experience. One way we do that, is through the REACH web portal.

The collaboration initially between six physical hospital sites in Peel and Halton regions (Credit Valley, Halton Health Care and William Osler Health Centre) means all of our clinicians have instant access to patient health information stored electronically at any of the hospitals through a secure network called REACH -- Rapid Electronic Access to Clinical Health information. The web connectivity is growing between more hospital sites which will allow even more physicians to access clinical data from disparate systems through one unified view. This allows physicians to easily review their patient’s records, lab results, cardiology images, diagnostic (PACS) images, transcriptions and progress reports. Because the ehealth record shows their patient’s entire health history, important information such as medication allergies will be revealed even if the patient inadvertently forgets to mention the allergy at the time of a visit to any of the health facilities on the REACH network.

Within our own four walls at Credit Valley, the team approach to problem solving has made significant improvements toward patient and family-centred care, most recently in our regional cancer centre. Cancer patients have spent seemingly endless time between appointments for tests and treatment in the same building. The Stream Team, made up of oncology doctors and nurses, clerks, lab, pharmacy and information systems with input from staff, patients and volunteers, set out to redefine their patients’ experience. They charted every step, every process, every wasted minute and after several months, they had streamlined ten processes to seven and decreased the patients’ waiting time by almost two hours! Nurses and doctors collaborated on patient assessments; volunteers took on responsibility to ensure patients moved smoothly from one process to the next and now, there’s the potential to see even more patients each day.

I believe leadership happens at every level within an organization that values and respects the roles of every individual – not just the caregivers – but the patients and families we are here to serve. I saw that first hand as I worked alongside the men and women cleaning stretchers in our emergency department; as I sat beside the charge nurse who was more like an air traffic controller as she juggled patients, personnel and stretchers throughout her shift. I believe the role of leadership is to create the conditions for success not just in terms of the hospital, the system or even the government. Everything we do, every decision we make, should be prefaced with the question, “what’s best for the patient?” This isn’t easy. It’s takes a sense of respect for everyone at that table and the courage to push the traditional boundaries and norms to embrace innovative solutions. But without that respect, the kind of changes our hospitals need will be too slow for what our patients deserve – and increasingly, demand. Respect, teamwork and collaboration have and will make the difference in elevating patient care.

Is that respect there? You bet. Having re-entered the health-care sector, I’m humbled daily by the unbelievable dedication on the part of doctors, nurses, clinicians, and administrators who put their patients first in a system where that isn’t always easy.

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Michelle DiEmanuele is the President and CEO of the Credit Valley Hospital in Mississauga Ontario.

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