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Time well spent
Deer Lodge Centre team says collaboration on communication will lead to better care
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By Mike Daly
Jan/Feb 2019

While collaborative care training has been used in many completed projects and improvements, there are also a number of initiatives currently under development.

These include the "Time Well Spent" initiative at Deer Lodge Centre, a long-term care and rehabilitation facility providing a variety of in-patient, out-patient and outreach programs to the community. Deer Lodge Centre serves adults with complex needs who require rehabilitation and specialized care for long-term health concerns.

A four-member team from Deer Lodge Centre is in the initial stages of a project aimed at improving communication between geriatric rehabilitation unit staff, patients and their families, and allied health professionals. (Allied health professionals provide a range of diagnostic, technical, therapeutic, and direct patient care and support services that are critical to the other health professionals they work with and the patients they serve. Their ranks include professionals such as diagnostic staff, dietitians, medical technologists, occupational and physical therapists, social workers, respiratory therapists, and speech language pathologists, to name a few.)

"Sometimes, there's a bit of a disconnect between the allied health staff and unit staff, where the communication isn't flowing optimally in both directions," says team member Cara Windle, Clinical Service Lead - Physiotherapy. "That can lead to all sorts of challenges. We need to make sure we're all on the same page and work toward all team members having a full understanding of every patient's care plan."

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While a solution to the problem is still in the initial planning stages, Windle says the team has already completed staff and patient surveys that will help the Deer Lodge team more accurately gauge the issues.

Among its many findings, the survey showed that, in the estimation of staff, only 56.9 per cent of patients and their families understood the goals of rehabilitation. When asked if they felt they were given the chance to provide input on what's important to them, the response from patients was 66 per cent. While both results are anecdotal in nature, it's clear that there is ample room for improvement.

"Our primary focus is now on finding ways to improve communication among members of the health-care and allied health teams, and between the health-care team, patients and their families," Windle says. "Our goal is to spend our time in communication most effectively, so that we better understand each other. We want to reduce duplication, and have a way of everyone being on the same page."
Collaborative care training is helping to provide a means of getting there, says team member Sheena Warkentin, an occupational therapist.

"We really need a grassroots approach, where this is starting from the front-line staff and going outwards," Warkentin says. "We feel the rehab team has the solutions, they just need tools and some facilitation to make lasting improvements. We're meeting with staff to share results of both the staff and patient surveys, and using tools from collaborative care training to help us find a solution."

The team intends to begin with a tool called appreciative inquiry.

"Appreciative inquiry involves exploring and capitalizing on the things we already do well. It's an exploration of all the positives and potential," Warkentin says. "We are working with great teams, and just have to get the ideas flowing. We can get off to a positive start by realizing we have strong teams who do a lot of things really well."

Photo of members of the Deer Lodge Centre collaborative care team
Members of the Deer Lodge Centre collaborative care team, from left: Clayton Carriere (recreation co-ordinator), Cara Windle (physiotherapist), Jessica Danforth (speech language pathologist), Sheena Warkentin (occupational therapist).

The team will also employ the aptly-named "Fear in a Hat" tool, which gives team members an opportunity to anonymously list their concerns as they begin work on the project. A typical fear listed by many participants is the fear of having solicited patient input, but being unable to meet those expectations. Another tool called "Wagon Wheel" helps identify positive traits and skills shared by various members of the team.

Warkentin, Windle and the other members of the team plan to take the survey results and what they've learned in their collaborative care training back to the larger front-line team at Deer Lodge for action. The entire team will develop solutions, and work on ways of garnering patient and family input.

"We can sit in our offices and imagine that we have the perfect solution, but we wouldn't get the same buy-in," Windle says. "It's about listening to the front-line people who do the work. That's why we work with the team. As they develop ideas, we help facilitate the implementation. Staff will tell us what they feel they need to implement, and, thanks to our training, we can give them some valuable tools and information on what other (Region) units have tried."

Using that approach, the team expects to launch a pilot of the solution(s) in one of their four geriatric rehabilitation units sometime around March.

The team's collaborative care training will help them as they work to find solutions in a health-care system that's quickly transforming.

"There's always change happening in health care, and we're not always in control of everything that happens," Warkentin says. "Collaborative care training gives us the tools to help the team move through some of these challenging situations so that we can look at things from different perspectives. It helps us to plan and adapt while continuing to provide the best possible care to the patients we are working with. We're here for one reason, and that is to provide quality care to the patient."

Mike Daly is a communications specialist with the Winnipeg Regional Health Authority.