The personal side of scale and spread
May 8, 2019
Andrew Neuner, Chief Executive Officer, HQCA
My parents live in Penticton, British Columbia. My mother has been facing increasingly challenging health issues in recent years. She has always managed the details for my family. Now, my father is learning to look after her. Our family provides additional supports in a variety of ways. I find it difficult to feel like I am doing enough from a province away.
I have no doubt that many of you are in similar situations, looking after loved ones and wondering if you are doing enough and doing it well. We take it one day at a time, and some are better than others.
We talk regularly and, as you can imagine, I always ask about my mom’s recent healthcare appointments. I am met with half-answers. My dad remembers some details, my mom fills in some blanks. There are still gaps. Gaps that make me worry. I know my mom’s providers are giving her sound advice and carefully considering her care, based on their discussions. However, much of the direction and recommendations shared in those increasingly critical appointments is lost after the interaction is over. Those gaps create risk that our family won’t be able to support my mom to the best of our ability.
This year, as part of our Patient Experience Awards selection process, I was particularly struck by one initiative: the My Care Conversations smartphone recording app. While this initiative was not selected, I felt a connection to this work because it immediately made me think of my parents. I know that tools like this have been used in other jurisdictions for some time, however the true value of a tool like this really resonated, given my mom’s and family’s current circumstances.
Then, the healthcare leader switch in me flipped and jumped to questions about privacy and confidentiality, specifically around consent to record a consult. In reaching out to the My Care Conversations project team to learn more, they addressed my questions about privacy and my focus moved on to scale and spread. What would it take to get more widespread acceptance and adoption of using this technology?
At this point in my thought process, doubt starts to creep in. In 2011, Dr. Ross Baker and Dr. Jean-Louis Denis released a report that concluded healthcare systems in Canada have experienced difficulties in creating and sustaining large-scale improvements; local initiatives are difficult to replicate and spread, and improvement efforts are often limited in scale.
Eight years after the release of this report, I see the pattern here in Alberta: excellent pilot or proof of concept at a local or sector-specific level that fails to gain traction elsewhere. So, how can we work together, to make sure that meaningful work like that done by the My Care Conversations team realizes its full potential? Because I feel, from personal experience and observations as a healthcare leader, this tool has applicability well beyond cancer care.
There are many great resources that offer evidence-based suggestions about how to overcome barriers to achieving scale and spread. A few that come to mind are:
- NHS Scotland Quality Improvement Hub’s The Spread and Sustainability of Quality Improvement in Healthcare
- East London NHS Foundation Trust’s Scale-up and Spread resources
- Health Quality Ontario’s Spread Primer
- (Behind a paywall, however worth seeking out if you can access) From pilot project to system solution: innovation, spread and scale for health system leaders review.
If you have others that readers should be accessing, please pop over to my Twitter feed and add your suggested resources to this thread. Because patients and family members deserve to reap the benefits of these leading practices that support information continuity and overall continuity of care.
Follow Andrew on Twitter @HighNeun
HQCAMatters is published monthly and presents perspectives on topics or issues relevant to healthcare in Alberta the HQCA considers valuable.