SUN's Patients and Families First Initiative
SUN Offers Two
$10,000 Awards for
Patient-Centred Care
(February 2010 SUNSpots article)
“Nursing care is a highly valued aspect of quality health care
delivery for Saskatchewan patients…I applaud SUN for embracing
patient- and family-centred care as a guiding principle as they respond to
my report recommendations.”
Tony Dagnone, Commissioner of the Patient First Review
“SUN’s Patients and Families First Initiative is an example of the kind of leadership we need to ensure
the patient care being delivered is what patients need and want. The knowledge and
experience nurses have will be a crucial part to improve the patient experience. SUN’
s decision
provides important energy and momentum for ‘Patient First.’ I’m very optimistic about what we’re all
going to be able to accomplish together.”
Don McMorris, Minister of Health, Government of Saskatchewan
“Nurses have a unique and important role to play as we reorganize our health system around the needs of
patients. We welcome the opportunity to work with union leadership and with frontline nurses to make care
better and safer for Saskatchewan patients.”
Marlene Smadu, Chair, Health Quality Council
Why has SUN launched a “Patients and Families First Initiative”?
“I always regarded the health care system with pride and trust and good faith. I felt assured and assumed that the care, should I ever need it, would be nothing less than the best. However, my past experience over the last 18 months or so has proven to me how naïve I was. I was a patient, but I did not have a voice. Things were happening to me that I could not control and I felt that I had no active part in that process - neither was it
encouraged or welcomed.” Patient responding to Patient First Review
“I feel like even when I do ask a question, they are brushing me off. They look at me like …why are you asking me these questions?”
Patient responding to Patient First Review
While nurses can be proud of their dedication to high quality patient care and patient safety, patients are speaking out about Saskatchewan’s worst kept secret - often our system fails patients, and more often fails to involve them in important decisions about their care.
Does anyone remember the 2002 case where a Regina woman set off the metal detector at security
screening at the Regina airport? Since abdominal surgery four months earlier, she had been
walking around with a 12 inch surgical retractor as a secret souvenir. Errors, patient safety and
infections are serious problems in the system. Commissioner Dagnone’s report documents that
Saskatchewan people want more than safe care - they want support to navigate the system and
responsive avenues for recourse when treatment concerns arise.
Nurses face a unique dilemma. On the one hand, they have a professional and ethical responsibility to protect the interest of patients. On the other hand, they are expected to provide high quality care in circumstances where a lack of resources, equipment, staffing, or uncoordinated care or other system communication failures makes that impossible.
I’ve worked for SUN since 1980, the year the SUN annual meeting passed a resolution to develop a
professional accountability form so that nurses could document circumstances where patient safety or the quality of care was compromised. Since SUN’s inception in 1974, most work stoppages by SUN members have been triggered by patient safety issues.The strike of 1988 won nurses the right to have documented patient safety issues reviewed by an independent assessment committee of registered nurses. The strike of 1999 achieved binding decisions of those committees. Nurses have always been more passionate about patient care issues than other collective bargaining issues. For decades, SUN has employed full time staff to assist nurses to resolve professional practice concerns.
SUN’s Patients and Families First Initiative, launched on December 9, 2009 continues SUN’s tradition of
supporting nurses who are trying to improve patient care, and is a direct response to the challenge issued by Tony Dagnone, Commissioner of the Patient First Review - “I call upon health system
leaders and health care providers to adopt and practice the values that support a truly patient- and family-centred health system.”
Like SUN’s decade long campaign to persuade politicians, employers, and the public of the urgent need for action on the nursing shortage, the Patients and Families First Initiative is the first public step in
aligning the interests of nurses, patients and the public to ensure we are providing the best possible care. We want to promote and directly support new ideas and innovations in patient-centred care and patient safety initiatives led by patients, and by RNs, RPNs and RN(NP)s.
Why is SUN offering two $10,000 awards for patients and SUN members who improve patient care?
Most attempts to change the health care system are driven from the top down. This award will reward great ideas that come from those most directly involved in patient care - patients and nurses - without requiring applicants to go through a complicated and demanding application process.
While SUN’s Patients and Families First Challenge is designed to encourage the implementation
of great ideas, we recognize that patients, patient advocacy groups and nurses
may not have the resources or power to actually implement an idea, depending
on its complexity.
Accordingly, an innovative idea that can’t practically be tested may still win the
Challenge if those judging the award determine the innovation has such potential
that it could be implemented and widely adopted by Saskatchewan’s health
care system.
Of course, we are encouraging all those considering the Challenge to actually
implement and test the idea. Innovations will be judged based on “patient-centredness,” spreadability, sustainability, impact, degree of collaboration
achieved, and originality.
A $20,000 investment will provide a huge amount of publicity and word-of-mouth
communications at a fraction of the cost of newspaper, radio or television ads. In fact, our SUN
Patients and Families First Challenge was reported by radio, television, as well as The Leader-Post, StarPhoenix, and the Health Quality Council news clipping service. Free news coverage is extremely effective and reaches a huge audience. SUN’s announcement of the Patients and Families First Challenge at the recent WINN (Workforce Integration of New Nurses) conference in Winnipeg, received a lot of national attention, including a request from a representative of the Canadian Student Nurses’ Association to become involved.
Do you have an idea on how to improve patient care? SUN is offering
two $10,000 awards,
one specifically for SUN
members, in its Patients and Families First Challenge.
Change to the health care delivery system requires leadership and commitment. SUN is
demonstrating that commitment by action - not just words. SUN has also joined a quality improvement leadership program hosted by the Health Quality Council (HQC) and is supporting an HQC program called “Releasing Time To Care: The Productive Ward™,” which is designed to increase direct care time with patients.
SUN President Rosalee Longmoore describes SUN’s Patient First Challenge this way, “Nurses put patients first - that’s what we’re here for. We also know the system often fails patients. SUN’s Patient First Initiative is designed to support nurses, patients and members of the public who are trying to change the system, and find ways of improving the system from the people who know best. Our goal is first to highlight the great ideas of our members and patients and then to have them implemented to improve service, and to deliver the best possible care, in a way that patients want and need."
Patient First Commissioner Tony Dagnone states in his report that,“There is great potential in this province for an alignment of patient-provider interests that could have a profound impact on how health care is modeled and delivered.”
Since 1974, SUN and its members have used collective bargaining to try to give nurses more of a voice to protect patient safety. We’ve spent the last decade convincing the public, politicians and
employers about the need for action on the nursing shortage, and we’ve succeeded. Reaching out to the public and offering a collaborative relationship with government produced the SUN/Government Partnership, with funding for 800 new nursing positions, collaborative joint retention and recruitment committees, and a new collective agreement that makes Saskatchewan competitive with other
provinces - for the first time in SUN’s history. The province is 70 per cent of the way towards
achieving the hiring targets.
After all these years of struggling alone, SUN and its members now have an unprecedented
opportunity to partner with government, employers, the Health Quality Council, other health providers, nursing educators, researchers, professional associations - and most importantly patients and the public - to support genuine reform of how patient care is delivered.
Sandy Keating, SUN Board member who has been appointed to help guide the SUN initiative, sees it this way, “I believe the ability to work in an environment that supports and enables nurses to provide quality care is a goal shared by all nurses. Our ability to respond to patients’ needs in a
comprehensive, timely manner has become increasingly challenging due to such things as the
nursing shortage, a decrease in experienced nurses and heavier, more complex workloads. Putting patients first can begin to build the bridge that leads to a system of high quality, timely and
sustainable health care for all. My vision is stakeholders working collaboratively to achieve a common goal of providing the best health care possible.”
Janis Hall, also a SUN Board member working on the SUN Patients and Families First Initiative says, “Nurses have
witnessed many changes to the delivery of health care. Too often change has occurred but without resulting in real improvements to the system. Nurses are often frustrated because there never seems to be any evaluation of the effect of change; one change just seems to lead to another. Patient-centred care has long been the “buzz word” but has the patient really been first and foremost throughout all the restructuring and reform of recent years? Somehow the patient has become lost in all of this, as nurses continue to see patients not receiving the care they need.
“Putting the patient first in all decisions regarding access and delivery of health services should be
basic and fundamental. It is exciting to think that if we all maintain this focus, we could actually
change our health care system to one of exceptional quality. I am excited at the opportunity for SUN to be involved in working toward achieving this goal.”
Our Patients and Families First Initiative isn’t just about the $10,000 cash awards to patients and nurses. We
already know nurses and patients aren’t really motivated by money. So, is the Patients and Families First
Challenge the right way to spend time and money supporting change? Confirmation for me came when I got a call from a patient who read about the SUN Patients and Families First Challenge in her local
newspaper and wants to participate.
Jeanette C. asked that her identity be protected because “you learn to be quiet otherwise your care suffers.” Clearly, Jeanette knows exactly what patient-centred care is: “Patients with a long term
condition know what’s missing from their care, and we want to help manage our own care. If nurses don’t ask me what I need, what you provide may not be what I need most. Often I have to tolerate a kind of deaf and blind care - care that I don’t need or want that makes my situation worse, in order to receive the one thing I know I need.”
For those of us tempted to comfort ourselves in the face of Jeanette’s criticism by saying that she doesn’t understand the system - Jeanette is a former nurse, now too ill to work. She knows exactly where her nursing care falls short of being patient-centred.
I was excited when Jeanette said she has a long list of ideas to improve care she intends to submit. But, she offered even more. Jeanette volunteered that, “Although I am actually anti-union, I was so impressed to see a union working for ordinary people like me, using their power as a vehicle for
positive change - now I have a different perspective. What impressed me most was SUN asking us - the people who really are at the front line, patients and nurses - what we need to change. When I was nursing, it was always some doctor, or academic, or other bigwig who was being paid or bowed to, or listened to - not nurses and patients. It’s about time someone asked for my viewpoint - the view from the other side of the bed.”
Nurses often report the special intuition that comes with years of experience - that nagging hunch that a particular patient may be drifting into trouble, despite the fact that everyone is carefully following the care plan, only to discover their intuition was dead-on. When Jeanette shared her excitement, I knew that our intuition was dead-on about the SUN Patients and Families First Initiative and Challenge being an effective way to reach out to nurses and patients.
Join SUN’s Patients and Families First Initiative and accept the Challenge. We have received many questions about the Initiative, and the cash award. We are happy to answer yours. Just e-mail us at kathe.lerner@sun-nurses.sk.ca or visit the SUN web site at www.sun-nurses.sk.ca or call the SUN office at 306-525-1666 (toll free:1-800-667-7060).
Lawrence (Larry) LeMoal,
SUN Director
Patients and Families First & Government Relations
