Improving the Patient's Experience, Mental Health, Collaborative Stakeholder Approaches

Improving the Patient’s Experience with
Mental Health Services
Through Collaborative Stakeholder Approaches
October 1, 2015
Paul W. Gallant, CHE, PhD(c), MHK, BRec(TR)
Principal, Gallant HealthWorks & Associates
Exec. Director, Western Canada, CAPCH
(Canadian Association for Person-Centred Health)
www.GallantHealthWorks.com
Twitter: @HealthWorksBC
© 2015 Gallant HealthWorks
All Rights Reserved
1
www.GallantHealthWorks.com Twitter:
@HealthWorksBC

2
What do mental health services
“look” like?
www.GallantHealthWorks.com Twitter: @HealthWorksBC

Overview
• Mental health services
• Experience of patients
• Personal to population level examples (micro to macro)
• Outcomes
• Collaborative & different examples include:
• Experiences of men
• Assessment of a city’s population needs for mental health services
• CAPCH (Canadian Association for People Centred Health)
• Youth Mental Health
• Journil Solutions
• enterprise application = person generated data/diary + video conferencing + reports
• Health Choices First resources/network
3www.GallantHealthWorks.com Twitter: @HealthWorksBC

The Triple Aim
(Refresher)

Defining “Collaborate”
“Collaborate”
• is currently in the top 1% of lookups
• is the 53rd most popular word on “Merriam-Webster.com”
• Meriam Webster dictionary
• to work with another person or group in order to achieve or do something
• to give help to an enemy who has invaded your country during a war
Collaborative
• adjective: produced or conducted by two or more parties working together.
• E.g. "collaborative research"
The Webster’s (Sept.,2015)

Difficulty accessing health services
may: delay treatment, increase the risk of
complications & reduce quality of life
• Many people living with a mental illness report that the
stigmatization of mental illness causes them more suffering than
the disease itself
• Males: reluctant to seek help/support for any medical condition,
particularly mental illness
• As many as 1 in 3 cases of eating disorders occur in males (MWED
= males with eating disorders)
• The shame of having a “female problem” deters some MWED
from recognizing, disclosing & seeking help
• The false belief that eating disorders self-inflicted >> stigma

Males with Eating Disorders (BC)

CKNW Radio Clip
• https://soundcloud.com/cknw/eating-disorders-in-men-the-jon-
mccomb-show-sep-3

Example Males with Eating Disorders

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.
Weinstein et al 2005 Primary Care Clinics in Office Practice.

Addressing health issues
comprehensively
As communities try to address their health issues in a comprehensive
manner, all parties will need to sort out their roles and responsibilities,
individually and collectively, including:
• individual health care providers
• public health agencies
• health care organizations
• [patients, consumers, customers] purchasers of health services
• local governments
• employers
• schools
• faith communities
• community-based organizations
• the media
• policymakers
• and the public

Organizations’ motivation for
stakeholder engagement in
mental health services
1. More relevant services
2. Ensure that issues identified & prioritized are the important ones
3. Ensure that outcome measures are important to the end-user (the
patient/family)
4. Help disseminate information, products, or services
5. Build a culture of “customer service”

Discovery Phase
8 months
Planning Phase
9 months
(overlap 4)
Surveys:
GP, MOA,
Public
Key
Informant
Interviews
Environmental
Scan
Advisory
Committee
Input
Data
Analysis
Data
Gathering
Implementation
18 months
Member
Meetings
Agreed upon
Priorities &
Plan
Board
Input
Series of
stakeholder
engagement
sessions with
parallel Advisory
Committee
meetings
Example: BC Non-Profit - Community Organization 175 Doctors
www.GallantHealthWorks.com Twitter: @HealthWorksBC 16

© 2015 CAPCH.
EXAMPLE GP’S & ADVOCATES/PATIENT ENGAGEMENT
17
• 175 GP’s, plus specialists, medical office assistants working with health
organizations for a common purpose, better primary health in this mid-size
city.
https://plus.google.com/109141364800545167231/videos

“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.

19
Capturing the Experience & Needs Through
Visual Recording

20
Demonstrating Support Across Collaborative
Projects: Edited Example

Patient Steering Committee
• Video clip YouTube

Implementation of a person-centred
model for system reform with Youth
and Adolescent Mental Health as
the exemplar
“Patient to Person – Designing systems from the person
out.”
Boeckh Youth & Adolescent Mental
Health Project
in the Ottawa Biosphere
Overview and Case for Support

A Person Centred Health system, evolving with
the expectations of an informed and empowered population
To lead the transformation of health care and systems around
a person centric vision and principles across the continuum of care.
To be guided by and support the four principles of health
(responsibility, autonomy, informed health management, partnerships)
with integrity, honesty and a commitment to put the needs of the people first
CAPCH VISION, MISSION, VALUES
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Patient to Person – Designing systems from the person outwww.GallantHealthWorks.com Twitter: @HealthWorksBC

© 2015 CAPCH.
Primary Care
Home &
Community
Care
Acute /
Emergency
Care
Stakeholders
 People and their Circle of Support
 Acute & Emergency Care
 Primary Care
 Home & Community Care
 Mental Health
 Community Design
 Technology
Project Criteria
 Person Centric Vision & Principles
 Not for Profit / nonpartisan
 Sustainable Funding Plan
 Optimization of Scope of Practice – Team Based
 Silos to Collaboration across continuum of care
 Institutions to Home & Community
 Comprehensive Educational and
Communications Strategy supported by Social
Networking
 Measurement: Quality, Safety, Outcomes
 Enabled by Technology
CAPCH: THE BIOSPHERE BOECKH PROJECT
Key Stakeholders for Y&A Mental Health across the continuum of care
27

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Enterprise Solutions Created WITH people, organizations
& non-profits
Diary + Video Conferencing + Reports
www.Journil.com
enabling solutions

Person-Generated Health Data
Internet connected devices enable
persons/clients/patients & their
designated supports to generate
health/social data that can be
shared with others, enabling
significant improvements in living
connected to supporters
30

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Use Journil for:
Communication with
client/friend & family
supports/
appointed caregiver
and others in the
Provider Network
Journil Users: Example with Senior
PERSON
MEMBER
PROVIDER
NETWORK
Use Journil for:
Health tracking,
communication with
support network;
guardian may assist
in Diary completion

32
DIARIES
Customized
to provider
organization
requirement;
data is
entered via
desktop,
laptop or
mobile
computer.
REPORTS
Auto-generated into
aggregated monthly
summaries
TABLES
CHARTS
Journil Example – Diary & Reports
Export data
as PDF for
inclusion
with EHR
records.

Journil Example – Video Conference:
Across the Miles
33
Select Meeting Room
(e.g. Room 1 at
2:00pm)
Practitioner,
with
permission of
person,
selects
Diary/Chart
for review
Practitioner
& Client
review chart

34
• http://www.healthchoicesfirst.com/topics/mental-health
• Mental Health to date includes:
• Free to access video resources, with experts in multiple professions,
customized to local geography

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/

Lessons Learned – Across Multiple
Mental Health Service Experiences
Meaningfully engage patients & providers simultaneously to improve the
patient experience
Nudge those “typically” in positions of power to learn listening skills
Grow champions (patients & providers)
Be realistic & do not set up false expectations

Lessons Learned – Across Multiple
Mental Health Service Experiences (cont’d)
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

“I” replaced by “we”
• Wellness vs Illness

Links/Networks
• www.GallantHealthWorks.com
• http://www.slideshare.net/paulwgallant SlideShare PowerPoint slide
resources
• www.Journil.com Journil (enterprise solution: diary+video+reports)
• http://www.capch.org/ Canadian Association for People Centre Health
• https://twitter.com/HealthWorksBC (Paul Gallant on Twitter)
• http://www.healthchoicesfirst.com/ (Resources for patient and providers)
• Mental Health Linkedin Group
• Eating Disorders Linkedin Group
• PCH Person Centred Health Linkedin Group
• Contact Paul@GallantHealthWorks.com Cell: 604.999.9164 (Vancouver)

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Editor's Notes