Better Healthcare Through Community and Stakeholder Engagement, 2015 Webinar (FULL SLIDESHOW)

1. BETTER HEALTHCARE THROUGH COMMUNITY & STAKEHOLDER ENGAGEMENT Complete slides from live webinar presented April 30, 2015 with the Conference Board of Canada Paul W. Gallant, CHE, PhD(c), MHK, BRec(TR) www.GallantHealthWorks.com © 2015 Gallant HealthWorks All Rights Reserved

2. Overview • Community engagement & stakeholder engagement • Assessing needs of multi-stakeholder communities • Prioritizing the needs of multi-stakeholder communities • Tools that support engagement • Mitigating risks • Lessons learned • Resources • Questions 2

3. Speaking from experience with… • Acute care • Hospice • Senior’s • Mental health • Community • Education • Research • Governance • As a patient • Business development 3

4. Roles include: Past • Allied health clinician (multiple areas), Operations Leader Provincial Mental Health (acute) • Founding Chair, Task Force on Understanding Community Diversity, urban hospital Present • Specialty consulting in Canada, China, USA & beyond -project leadership, strategic planning/advising, needs assessments, B2B • Partner in creating patient generated health data & applications (pain) • Patient experience advocate & conduit • Advisory Board, Canadian Association for People Centred Health • Chair & 2014 Distinguished Service Award CCHL, BC Lower Mainland Chapter • Member: 4

5. Community Diversity Task Force • Where: Large urban Canadian hospital • Need: create more culturally sensitive approaches to care -Response to concerns voiced by patients, local community, staff • What/How: Comprehensive needs assessment & planning processes weaved throughout hospital departments & services -outreach focus groups, internal surveys/multiple languages • Results: 80+ % response rate with ALL staff & patients (excluding ICU). • Lessons Learned: omitted from this version and part of the complete presentation 5

6. Time: mid 1990s • Issues discussed at multi-stakeholder task force reporting to VP • Focus groups, neighbourhood advisory committee, First Nations communities, others • Increased sensitivity and working together with community • Establishing greater trust • Greater openness to health & wellness practices of First Nations & non-Western medicine • 80% response rate • Increased mutual respect • Incorporating needs and improving services for many patients: including gay, lesbian, non- English speaking, people with disabilities, mental health • Translation and interpretation services, visual communication boards • Triage & Admission process improvements Training • Teamwork & immense sense of accomplishment by staff, community • Policies created 6

7. Setting the Context The health of a community is a shared responsibility of all its members. Although the roles of many community members are not within the traditional domain of “health activities” each has an effect on and a stake in a community's health. As communities try to address their health issues in a comprehensive manner, all parties—including individual health care providers, public health agencies, health care organizations, purchasers of health services, local governments, employers, schools, faith communities, community-based organizations, the media, policymakers, and the public—will need to sort out their roles and responsibilities, individually and collectively.Weinstein et al 2005 Primary Care Clinics in Office Practice. 7

9. Triple Aim 9

10. 10

11. Engagement: What is it? Community engagement Stakeholder engagement the process by which organizations and individuals build ongoing, permanent relationships for the purpose of applying a collective vision for the benefit of a community. the process by which an organisation involves people who may be affected by the decisions it makes or can influence the implementation of its decisions. 11

12. Organizations’ motivations for stakeholder engagement in health care 1. More relevant services 2. Ensure that issues that are identified and prioritized are important 3. Ensure that money and resources are not wasted 4. Ensure that outcome measures are important to the end-user 5. Help identify & access priority populations 6. Help disseminate information, products, or services 7. Building a culture of customer service 12

13. Engagement STEPS • Determine the goals • Plan who to engage • Develop engagement strategies • Prioritize those activities • Create an implementation plan • Monitor your progress • Maintain those relationships 13

14. Guiding Principles • Participate at a level that you feel most comfortable/remain present • Ask questions about what is presented/discussed if you are uncertain • Listen to others' contributions & any time constraints within the session • Meet others: as many people as you can during our session • Use common language: avoid using jargon, abbreviations or acronyms (ED) • Create a safe place & respect confidentiality • Create a bike rack/parking lot for other ideas, comments, questions 14

15. Summary of an Ideal Process From Consult 101 15

16. Another Overview of Stakeholder Engagement 16

17. Example: Your Voice Counts Working with health authority leaders, patients and public to plan for change together. 17

18. Your Voice Counts: Why we’re here AIM: To provide patients and those who work in healthcare (providers) with the support, information and skills they need to better work together as partners in their health and healthcare. Prototype workshop 18

19. Your Voice Counts The session focused on three topics identified through interviews with health leaders, surveys and community consultations: 1. How to talk about your health care 2. How the health care system works and the challenges it faces 3. How to use your experiences to improve the health care system. http://ehealth.med.ubc.ca/2011/10/17/first-of-its-kind-workshop-brings-citizens-and-providers-together-to-talk-health-system-redesign/ 19

20. Example of doctors & a community: Assessing Needs • 150 + family doctors in a diverse & large city • Outreach into community • Including 100 face to face surveys or interviews with people at risk of homelessness- compensated • Youth at risk, seniors and new immigrants at health & community centres (gift cards $15) • New immigrant health interviews with providers • Card drop to ALL households in the community and businesses -draw for prizes 20 x $50 gift cards • Media awareness • Public survey created with public input • Physician survey created with family doctor, emergency doctor input • Medical office assistant (MOA) survey with MOA input • 1:1 meetings with sample of the above • Meaningful discussions and processes to discuss and work through results • Compensation for doctors, MOAs, some honorariums to representatives, meals 20

21. “Meaningful engagement is needed.” Meaningful change in the health system - that will ensure an affordable system with the best patient experiences and best health outcomes, can only happen when we all work together. 21

22. Who Was in the Room • Health Authority Leaders • Front-line workers: allied • Patients, clients, family • Non-profit & community organizations including recreation, mental health, seniors, youth • Doctors: family doctors and specialists • Association members • School Board • Board/Staff/contractors • Government, elected councilors • RCMP 22

23. Example: Phased Plan 23

24. Discovery Phase Nine Months Planning Phase Six months Surveys: GP, MOA, Public Key Informant Interviews Environmental Scan Advisory Committee Input Data Analysis Data Gathering Implementation 16 months + Members Meetings Evidence- based lnitiatives Board Input Series of stakeholder engagement sessions with parallel Advisory Committee meetings (more detail on next slides) 24

25. Planning Phase 25 • Reviewed priority areas • Generated and prioritize ideas for each area • Outcome: 3-4 broad-level concepts per priority area

26. Visual Recordings 26

27. Planning Phase 27 • Reviewed proposed concepts • Identified key questions /recommendations • Identified decision- making criteria for future prioritization

28. Planning Phase 28 • Input into concepts • Develop each concept in greater depth • Outcome: Mid-level plan for all concepts

29. Planning Phase 29 • Review mid-level project plans • Prioritizes N= __projects for further development • Gives feedback on prioritized projects

30. Planning Phase 30 • Report back on Advisory’s decisions • Input and feedback into prioritized plans • Outcome: strong plans, clear understanding of prioritized plans and community commitment

31. Planning Phase 31 Further activities: • Confirm implementing partners • Develop detailed project plans • Working groups with key populations

32. Planning Phase 32 Implementation Plan Submitted to funders Evidence-based addressing the key goals of the initiative Pre-planning

33. Priority Setting Decision-making Criteria 33 • Goals • Impact & effort rankings • Low-high impact x low to high-effort • Priority areas & specific problem statements with evidence supporting need • Buy-in: • Members (doctors) • Health Authority • Board & Advisory

34. Decision-making Criteria Include: 34 • Sustainability • Breadth • Depth • Realistic • Organizational capacity • Use of existing resources • Risk

35. Four Priority Areas Mental Health with a family doctor 35 Mental Health without a family doctor GP Education Frail Seniors

36. AGM of Members: Level of Support for each initiative 36

37. Engagement Examples Community Engagement: radio talk show brief audio clip https://www.youtube.com/watch?v=wyF16_SWQ7M IAP2: Collaborate Stakeholder Engagement (Males with Eating Disorders): https://www.youtube.com/watch?v=ctlGqM0ekOY IAP2: Involve & Empowerment 37

38. Mitigating • Have a risk management plan • Have clear & articulated roles for staff, working group & governance • Create an emotionally safe setting for dialogue, discussion • guiding principles, trained facilitators, resources, evaluation feedback, privacy compliant • Set realistic goals: to be reached & successful in the next ___months or __years • Monitor & modify with stakeholders • Clearly communicate expectations, limitations, unforeseen findings or processes & debrief • Remain transparent and true to the process 38

39. Lessons Learned – Across Multiple Experiences Meaningfully engage People ARE committed including those not working in community engagement/stakeholder engagement….eventually Help those typically in power (health executives, managers, physicians, politicians, etc) to listen non-judgementally & encourage others to do the same  Be realistic and do not set up false expectations Past experiences do not necessarily equal present & future outlook "I assumed as I didn’t get a reply 3 years ago- they weren’t interested.“ 39

40. Lessons Learned – Across Multiple Experiences (continued) Agendas, be aware everyone has one or more Plan for flexibility (added time, added stakeholders, delays, detours, scope) Go to the community & to stakeholders, wherever possible Support participation fairly: honorarium, gift card, transportation, meals, parking Enable Others to Act towards achieving goals (vs micro-managing) Grow champions What is Your priority may not be Others‘ priority Walk in the other person’s shoes Celebrate accomplishments as they occur 40

41. RESOURCES Joanna Siegel (2012). Innovative Methods in Stakeholder Engagement: An Environmental Scan. Agency for Healthcare Research and Quality. http://www.effectivehealthcare.ahrq.gov/tasks/sites/ehc/assets/File/CF_Innovation-in-Stakeholder- Engagement_LiteratureReview.pdf IAP2 Canada. International Association for Public Participation (Canada). http://iap2canada.ca Katharine Partridge et al (2005). From Words to Action. The Stakeholder Engagement Manual. Volume 1: The Guide to Practitioners’ Perspectives on Stakeholder Engagement. By Stakeholder Research Associates Canada Inc. & contributions from United Nations Environment Programme http://www.accountability.org/images/content/2/0/207.pdf Thomas Krick et al. (2005). VOLUME 2: THE PRACTITIONER'S HANDBOOK ON STAKEHOLDER ENGAGEMENT Wallerstein (2006). What is the evidence on effectiveness of empowerment to improve health? Copenhagen, WHO, Health Evidence Network report; http://www.euro.who.int/Document/E88086.pdf Weinstein, Plumb, & Brawer (2006). Community engagement of men. Primary Care Clinics in Office Practice. 33: 247-259. Abstract http://www.primarycare.theclinics.com/article/S0095-4543%2805%2900107-7/abstract www.GallantHealthWorks.com 41

42. Thanks for participating! Have a question after this webinar? Contact or connect with me… https://www.linkedin.com/in/paulwgallant https://twitter.com/HealthWorksBC Paul@GallantHealthWorks.com Direct: 604.999.9164 www.GALLANTHEALTHWORKS.com https://www.facebook.com/GallantHealthWorks 42

Better Healthcare Through Community and Stakeholder Engagement, 2015 Webinar (FULL SLIDESHOW)

Better Healthcare Through Community and Stakeholder Engagement, 2015 Webinar (FULL SLIDESHOW)

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