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Jack Davis, President & CEO (1999-2008) of the Calgary Health Region |
Jack Davis, former President & Chief Executive Officer, Calgary Health Region, Calgary, Alberta, Canada
Jack Davis, President & CEO (1999-2008) of the Calgary Health Region (CHR) in Calgary, Alberta, Canada, was a keynote speaker at The 3rd International Conference for Patient- and Family-Centered Care in Seattle, Washington. To an audience of approximately 1000 people, Jack offered his perspective as the CEO of a large publicly funded health region committed to patient- and family-centered care.
Jack described two major events that occurred in Calgary-the creation of a new Children's Hospital and a clinical tragedy-that led to the same conclusion: "We need to really listen to our patients and families."
Design of the New Alberta Children's Hospital
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The child advisors, working on their concept of how the new Children's Hospital should look. |
In 2002, the Calgary Health Region broke ground for a new Children's Hospital. Given the history of engaging families in advisory councils for pediatrics, the CHR included families and patients in the planning of this new facility. A family leader served on the project's steering committee. CHR sought input from not only parents of patients, but also from the patients themselves. According to Jack, the kids were told, "the sky is the limit" by the architects, and one young person involved in the process insists, "The entire architectural structure is completely different from the original plan just because of what the kids wanted."
To the delight of the patients and families on the working groups, the end design incorporated much of their input. Some of the features in the new hospital influenced by patients and families, include:
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- A welcoming, cheerful exterior;
- Covered parking to make the transition from the car to the hospital easier in winter months, and rainy weather;
- A place for parents to sleep in the child's room;
- A Resource Center for families & staff;
- A pet room for children to visit with their pets to maintain a connection with what is familiar to them; and
- A sacred space designed for use by all faiths for special religious occasions as well as for use by patients, families, and staff who desire sanctuary in a peaceful place.
What is the Calgary Health Region?
The Calgary Health Region is one of the largest fully integrated, publicly funded health care systems, serving 1.2 million people in Calgary, Canada, and the surrounding area, with an annual budget of over $2.5 billion.
CHR provides a continuum of care:
- Acute Care (12 acute sites, both urban and rural, with over 2000 acute beds);
- Urgent Care (3 health centers with urgent care);
- Long Term Care;
- Home Care; and
- Community Services & Public Health (24 public health & community health centers).
Tragedy Strikes in 2004
In March 2004, a tragedy occurred at the Foothills Medical Centre in the Calgary Health Region: a medication error that led to the death of two adult patients. According to Jack, this event "sent shock waves through our system" which led not only to internal and external reviews, but also to a change in leadership attitudes from "name, blame, and shame" to "fix the flawed system." The leadership put a premium on listening rather than blaming; implementing structures to listen to and learn from staff, patients, and families; and decision-making that included the perspectives of patients and families. This change shifts the distribution of power, incorporating vital input from patients and families, both publicly and privately, which results in improved safety in the delivery of health care.
As a part of this process, the CHR also changed its vision, mission, and values. Its vision became one of "Healthy Communities" with a mission of "leaders in health—a partner in care." CHR embraced the values of quality, safety, accountability and "caring, respectful relationships"—by providing patient- and family-centered care—showing respect, equality, fairness, being compassionate, maintaining dignity, and valuing contribution.
Creation of the Position of Patient Experience Senior Vice President
In 2005, CHR added a new Senior Vice President of Patient Experience, reporting directly to, President and CEO, Jack Davis. The Senior Vice President, Dr. Bob Johnston, has a small and capable staff that talks with patients and families, individually and in committees, and champions system change to improve the patient experience.
The purpose of this newly created department, called a portfolio, is to "enhance the experience of care by looking at the Region's services and facilities 'through the eyes of the patient and family'... The provision of care is not the same as the experience of illness-both perspectives are needed."
Imperative to the change process is engaging patients, families, and staff. The Calgary Health Region invited two outside organizations to partner and assist in this process: The Institute for Family-Centered Care and Planetree.
CHR has over 40 regional councils and committees and uses various structures to serve different purposes, throughout the Region. For example, some councils are primarily composed of patient and family members; others are primarily staff members; some are site-based, such as at Alberta Children's Hospital; others are system-wide, based on subject, such as the Regional Patient/Family Safety Council. Still other councils are community-based. Flexibility and good communication are crucial to the success of this system for including the voice of patients and families.
Goals of the Patient Experience Portfolio
- Consistent regional understanding of patient- and family-centered care;
- Region's policies and practices support patient- and family-centered care;
- Staff, patients, families respect each other; communicate (listen and inform); negotiate involvement in care; and
- Involvement of patients and families in health services planning and improvement.
The Calgary Health Region's Principles of Patient- and Family-Centered Care
CHR adopted three principles of Patient- and Family-Centered Care which are based on the foundational work of the Institute for Family-Centered Care:
Respectful relationships: dignity, trust, and respecting perspectives are vital to forming and maintaining respectful relationships.
Communication: Open communication is fundamental. Staff members need to listen and value the views of patients and their families and provide useful information for them.
Collaboration: A healing alliance between the staff, patients, and families, with negotiated involvement in care, service planning and evaluation are crucial.
New Patient- and Family-Centered Initiatives
The Patient and Family Safety Council initiatives include:
- Input into new safety policies such as the disclosure of harm;
- Advising on the implementation of safety practices, such as the rapid response team; and
- Speaking at safety conferences, modeling collaboration.
Looking to the Future
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The new Children's Hospital |
The Calgary Health Region is looking towards the future of creating—together with patients and families—the New South Health Campus on 44 acres. This large acute and ambulatory care facility will be radical in its appearance and operation. Not only will the hospital's physical environment be different, but patients and families will be encouraged to get more involved in their own health care, including wellness, and chronic disease management. The new facility will foster partnership with patients rather than simply be a place to go to be "fixed." Phase One is expected to open in 2010 /2011.
Twenty patient and family members with a broad range of service experience are actively involved with the designers and project leaders. The Council's involvement is multi-faceted, including but not limited to, the design and review of the master concept plan, acute care unit plans, and room mock-ups.
Other future plans for the Calgary Health Region include: enhancing the coordination of care, electronic health records with patient access, supportive policies around expanding family presence (eliminating the concept of families as visitors), wider opportunities for patient and family engagement, and promoting wellness initiatives to support staying healthy.
In Conclusion
As Jack Davis said in his address at The 3rd International Conference for Patient- and Family-Centered Care: "Good staff, good intentions, and hard work are not enough. . . .To make and sustain progress in patient- and family-centered care you need to have a system-wide approach, the right foundation-including resources, staff, policies, structures-and leadership. A system that consistently includes patients and families will be safer and will provide a better experience-for patients, families, and staff. . . . There is a change coming-it's really a question of are we going to be behind it, or are we going to be out in front of it?"
The commitment and passion of the people-health care providers, patients, and families-with whom he works inspires Jack Davis to work for the greater good.
You can listen to Jack Davis' remarks on-line.