At SickKids: From the President
Spring 2011
Health care is about more than making diagnoses and delivering treatments. It’s about people – the intricate, dynamic relationships that grow between health-care professionals and patients and their families. A strong and positive relationship builds the trust and communication which are so necessary to create the respectful environment needed for the best health outcomes.
With the recent launch of our Child and Family Relations service, and corresponding Values and Expectations, SickKids has taken another step toward strengthening the partnerships that are central to our ideal of family-centred care.
The Child and Family Relations service and Values and Expectations fulfill the requirements of both the Excellent Care for All Act and the Occupational Health & Safety Act. Both acts provided SickKids with an excellent opportunity to take a step back and look at how we are delivering service and what we could do differently to improve the experience for our patients and families.
Replacing the Patient Representative Service, the Child and Family Relations program offers patients and families a way to voice and resolve their concerns. The service is based on a transparent, timely and collaborative process, developed through consultation with patients, families, staff members and considering the practices of other hospitals in North America and the United Kingdom.
Child and Family Relations will play an important role in coaching and educating SickKids staff through the resolution process, and providing guidance and assistance to staff when requested or required.
The foundation of our new Child and Family Relations service is evident in our refreshed Values and Expectations. The Values and Expectations outline both the role of SickKids and the roles patients and families play in achieving a beneficial care experience. It recognizes that each party has a responsibility to the other in creating an open and respectful environment where the best care can be provided and positive health outcomes actively and mutually pursued.
Through the monitoring of trends and issues, Child and Family Relations will also be able to provide essential data in identifying larger, hospital-wide concerns.
The service is based on a proactive model of managing most issues at the point of contact with appropriate pathways for escalation. Every concern or compliment will be seen as an opportunity for learning that will contribute to continuous quality improvement, and an exceptional patient and family experience.
Winter 2011
SickKids is privileged to serve patients and families who come to us from around the world. Toronto is a multi-cultural city, with over 190 languages spoken in the GTA. As a hospital committed to providing quality, family-centred care, it is our duty to ensure we continually enhance our interactions with patients and their families in a way that recognizes and embraces the diversity of linguistic and cultural backgrounds and beliefs. In fact, our recent review by Accreditation Canada made particular note of our efforts to promote cultural competence – a service excellence accomplishment I am very proud to report.
In 2009, Citizenship and Immigration Canada funded the SickKids New Immigrant Support Network (NISN). Focused on two key priorities, cultural competence training for SickKids staff and the translation of many of our core health and consent documents, the work done by the NISN in collaboration with AboutKidsHealth and others has helped SickKids to become a leader in how cultural competence can be implemented in the health-care environment.
This month, we launched our new multi-lingual website for AboutKidsHealth.ca. We now provide patients and their families with accurate health information in English, French and Chinese (simplified character set). About 300 specific patient education documents will also be available in Arabic, Chinese (traditional character set), Portuguese, Punjabi, Spanish, Tamil and Urdu. Over the coming months, we will also be introducing eight on-site state-of-the-art touch-screen kiosks with directional information to guide visitors to SickKids in all of the above languages.
About 2,000 SickKids staff have attended workshops to deepen their understanding of health inequity and health disparities, the social determinants of health and stressors experienced by new immigrant families. But the workshops go further than just understanding: participants have learned about the role that culture plays in interactions between health-care staff and patients and families. Self-reflection exercises and written commitments to change have helped us to apply what we have learned in the workshops in our relations with patients and their families.
Research has shown that education about cultural competence works. Since the NISN project launched its cultural competence workshops, we have seen a significant increase in relevant metrics, including patient satisfaction. Asked “Were hospital staff members sensitive to your (your child's) special cultural needs or concerns?” in our patient satisfaction survey, respondents’ approval has increased from 70 per cent in 2009 to 76 per cent in 2010.
To share the cultural competence resources developed at SickKids, we are offering train-the-trainer workshops for health-care organizations across Ontario that wish to implement similar programs in their own environments. A high level of interest has been expressed in these workshops and we have added more dates to accommodate the organizations interested in sending representatives.
Our health-care system is complex, a daunting network of care locations, specialists and medical interventions. For new Canadians who may also be struggling with the burden of language and cultural barriers, it can be overwhelming.
At SickKids, we do our best to embrace the diversity of all the families we serve, to ensure a positive care experience. After all, healthier children do make a better world.
Fall 2010
“A hundred years from now it will not matter what my bank account was, the sort of house I lived in, or the kind of car I drove...but the world may be different because I was important in the life of a child” Forest E. Witcraft
Today, we pause to officially recognize and thank our myriad of donors who support and serve SickKids. Each of them is important in the life of a child and, indeed, great, because, as Martin Luther King once said, “Everyone can be great because everyone can serve.”
Service to others is considered highly personal – donors must find the way that is right for them. At its core, philanthropy represents a direct effort to help others in need, offering help and hope, serving a greater good. It’s also about choices: the choice to give, the choice of how to give, and the choice of where to give.
Seven-year old Jack Yeilding is all about giving. The Oakville boy was diagnosed at the age of one with intractable epilepsy, a form of the disease that does not respond to medication. He has been a patient at SickKids for several years, and you could say that this is where he found his service mission.
On a visit to SickKids a few years ago, Jack saw another child in the hallway. He asked what was wrong, and then and there decided he wanted to do something to help. He set up a lemonade stand outside his home to raise money for other SickKids patients, and rallies his community every year to help other kids. Last January, he underwent brain surgery to try to stop his seizures. He hasn’t had a single one since, and he is just as committed as ever to his philanthropy. At last count, he had raised more than $150,000 and doesn’t plan to stop there.
What Jack’s story tells us is that each of us has the capacity to do things that are important and world-changing, to make a contribution that has impact. Each of us can find a way to offer support for the greater good, whether through time, talent or funding.
But offering that support and matching the right cause to the right individual can be challenging. Clearly, giving should be positive, it should be meaningful, it should make a difference. And for many of us, like Jack, it’s about a personal connection.
SickKids has a unique transformational power for our children and their families. Through every era of our history, through every advance in our understanding of child health, SickKids has been defined by a clear and simple vision that yields heartening – often astonishing – results. Healthier Children. A Better World.
The SickKids experience remains superb – medically, intellectually, personally – and our impact is global because we can count on our community. And philanthropy is democratic. From seven-year old Jack and his now-famous lemonade stand to Myron and Berna Garron, whose historic gift honours the dedication and care their son Michael received as a patient at SickKids over 35 years ago, our supporters each makes an extraordinary difference. Their philanthropy enables and enhances our capacity to provide outstanding care, to offer both help and hope.
We are grateful that philanthropists understand that what makes people rich is not what they take, but what they give. Quite simply, giving makes a profound difference in the life and the future of this extraordinary child health centre and the children we serve at SickKids and the world over.
Earlier this week through our Foundation, we were thrilled to launch our latest fundraising campaign, Together We Will. Together, with our wonderful community, we will continue on our important journey towards Healthier Children. A Better World.
Summer 2010
What makes a good health-care leader? When you’ve been a leader in the sector for more than 25 years, you can imagine how often this question is asked of you.
Leadership is a critical success factor in any great organization. Professor Henry Mintzberg of McGill University, has spent most of his career teaching leadership and he comes to the conclusion that leaders “…can be born or taught, but either way, good leadership cannot exist in a vacuum.” I understand this to mean that leadership shines in the right context, in those individuals who have a personal understanding of what it means to lead, a deep knowledge of their discipline and a passion to make a difference.
With the unique complexities and ambiguities in the health-care sector, successful leaders are entrepreneurial, strategic visionaries who have a hands-on management style, who embrace challenges as opportunities with optimism and confidence. Strong leaders cultivate a sense of urgency, motivate, galvanize and inspire high performance.
SickKids has a legacy of success, including our ability to attract and retain experienced professionals who bring both discipline-specific knowledge and leadership to be change agents in child health – people who have the courage and skills to challenge old ideas, and who believe in improvement and change passionately enough to make it happen.
Our leadership team was strengthened this spring with several new appointments who bring these qualities to SickKids:
Denise Arsenault is our new Chief Financial Officer. A chartered accountant, she joins SickKids from the Ontario Agency for Health Protection and Promotion, where she was Vice-President and Chief Administrative Officer with responsibility for finance, human resources, information technology and facilities. Previously, she was Vice-President, Program Support, at Hamilton Health Sciences, Vice-President, Business Services and CFO at Chedoke-McMaster Hospital and Vice-President, Finance, and CFO at The Toronto Hospital.
Dr. Stanley Zlotkin OC, joined the Executive team as Vice President, Academic & Medical Affairs. He previously served as Head of the Division of Gastroenterology and Nutrition, Medical Director, nutrition support program and Senior Scientist at SickKids. He has active research in Canada, Ghana, Mongolia, India and China. He was recently named an Ashoka Fellow, the national Knowledge Translation Award of the Canadian Institutes of Health Research, for his Sprinkles Global Health Initiative, which ensures that children in rural areas of the developing world receive Sprinkles, a tasteless powder in a single serving packet which includes all the nutrients a child or adult needs to fight anaemia.
Dr. James A. Whitlock was appointed as Head, Division of Haematology-Oncology July 1. He joins us from Vanderbilt University School of Medicine, where he was Director of Pediatric Hematology-Oncology and the Craig Weaver Professor of Pediatrics. Dr. Whitlock’s research interests include the biology and treatment of childhood acute leukemias, the development of new drugs for the treatment of childhood cancers, and the biology and treatment of histiocytic disorders.
Dr. Stephen C. Porter joins SickKids as Chief, Division of Paediatric Emergency Medicine, from Children’s Hospital in Boston. Dr. Porter is a board-certified pediatric emergency medicine specialist and clinical informatician whose research bridges the gap between health services and medical informatics. A central tenet of his research is that “the history as told by the parent has value” and his work examines just how valuable patient-derived data can be for improvements in quality and safety at the individual and system level.
I am also delighted to announce the re-appointment of Dr. Janet Rossant as SickKids Chief of Research. A world leader in stem cell research who plays an integral role in setting Canada’s public policy and international guidelines, Dr. Rossant’s pioneering research is improving lives – from discovering regenerative medicine therapies that give new life to vital organs, to helping to regulate the heart and lungs, to finding new treatments for pregnancy disorders.
Finally, and in some ways most importantly, we salute our upcoming leaders, the young men and women who will lead child health in the future. As we strengthen our leadership capacity, we continue to nurture new talent – people like Dr. Niraj Mistry and Dr. Julie Johnstone, who have been appointed co-chief medical residents for a one-year term.
It is through the commitment, talent and passion of a great team and the guidance of these respected leaders who are dedicated to Healthier Children. A Better World, that SickKids is poised for an exciting future.
Spring 2010
We hear a lot about quality – as a personal trait, as a distinguishing characteristic, as a degree of excellence. In health care when we talk about quality we’re talking about safe, timely, effective, efficient, equitable, and patient-centred care. Quality encompasses the availability of care, the patient’s experience when receiving care and perhaps most importantly, the outcome of the care received. In paediatric health care, quality is about enabling children to achieve their greatest potential, about communities effectively promoting children’s health and well-being, and our society achieving these results with equality and without waste.
Across the country we’re developing a deeper understanding of the nature of quality in health care. We’ve seen evidence of the gap between what science demonstrates is effective practice and what the usual practice has been. We’re asking the question: How often does something happen, when, and how is it supposed to happen?
We know from experience in our own and in other sectors that complex systems can perform better. Measurement plays a crucial role in identifying gaps and variation in care, tracking success, and in communicating to the public and each other how well (or how poorly) we’re doing. Systematic application of scientific knowledge is a key mechanism for enhancing quality and safety. Collaboration and working with our health-care partners is another way that we can accelerate the change and improvement process.
Health-care professionals contribute to quality by gathering data, assessing systems and implementing improvements. We can point to dramatic successes, to programs that are making significant improvements.
While it’s important to reflect on what contributed to these successes, we must also keep our eye on the goal: Healthier Children. A Better World.™
We know that the overall performance of the health-care system for children must continue to make dramatic strides forward. We must be able to confidently assure a parent that their child will receive evidence-based treatments in a way that is consistent with family preferences and cultural values. We want to deliver on our promise to families that their child will not be exposed to unnecessary harm from medication errors or hospital-acquired infections, and that all of the important aspects of their care will be communicated across the boundaries of home, hospital, and school, accurately and on a timely basis.
What will it take to get us from here to there? We need a greater focus on the design of an ideal health-care system for children and families, one that results in better promotion and maintenance of health. This will include integrated planning of health, education, social support, and health-care services and shared accountability across these systems.
We have made tremendous advances. We are minimizing error and improving quality. So while we continue to refine both measurement and quality improvement approaches, we must also define the system changes that will lead to better outcomes, identify the policies that will promote the adoption of this system, build the coalitions and seize the opportunities to move these policies into practice.
High-quality health care matters for all children. And because the foundation of health in adulthood and old age is laid during childhood and adolescence, high-quality paediatric health care is important for us all.