We had a problem.
One of our organizational key strategies was having trouble getting traction. After two years of broad public consultation and the anointing of a steering committee there was still very little action beyond engagement and planning.
Although the Patient First strategy is one of four pillar strategies within Alberta Health Services (AHS), and even though it was central to health services becoming more patient and family centred, many staff and leaders expressed confusion about what Patient First was, and what it meant. Direction and planning was done by a select few people across the organization.
It was clear something had to happen. Success depended on broad engagement from staff and patients to help make services better.
For most of human history, the rules of power were clear: power was something to be seized and then jealously guarded. This “old power” was out of reach for the vast majority of people. But our ubiquitous connectivity makes possible a different kind of power. “New power” is made by many. It is open, participatory, and peer-driven. It works like a current, not a currency–and it is most forceful when it surges.
Enter New Power thinking.
It was a bold step to disband the steering committee and other working groups that were initially struck to guide change initiatives, but one that the AHS leadership team knew had to happen. The intention was to create a movement where many staff and patients, together, were striving to create a more person-centred health system.
The first thing we did was hold three large co-design events. We made a big splash. We announced that we were looking for passionate staff and patient advisors to join us to solve the complex problem of how to become more person-centred.
We de-emphasized that this was because of the Patient First strategy, and rather simply said that we needed everyone’s help. It worked.
250 people – including 30 insightful and committed volunteer patient advisors – joined us for the co-design days. Instead of the traditional method of a few people coming up with broad sweeping tactics, we wanted to crowd source the actions that needed to be taken to advance our organization.
At the end of the co-design days, the group had selected 13 pitches, and everyone was invited to volunteer to help make any of those 13 pitches a reality. Nearly everyone signed up.
We knew we needed to work out loud. We had to openly share any and all activities that were bringing the Patient First challenge alive. We started using twitter and a digital newsletter to let people know what was happening.
We knew that there was a risk that the pitches may get lost in formal bureaucracy, so we attached a mentor to each team to support group navigation through the organization, and to build a prototype for testing.
After three months, it was obvious which of the 13 pitches were showing promise. One was an app for patients to give real-time feedback to frontline clinical teams (like Yelp for patients). Another was a social media campaign called “What matters to you?” and encouraged frontline staff to ask patients this vital question and then share their reactions and stories broadly across the organization on campaign day, which was June 6th. “Leader Rounding” gained traction too, encouraging administrative leaders to go into clinical areas to specifically ask patients what can be improved upon.
All three successful pitches were crowd-sourced and developed by cross-functional teams, and had the support of both administrative and clinical leadership to be tried – and shared – widely both within and without the organization.
We created a proclamation that outlined what the strategy hoped to achieve. A proclamation – or manifesto – is a common approach for customer oriented organizations but not very common in healthcare. We wanted to formally declare to the public and our patients what we wanted to achieve. The proclamation replaced a lengthy and cumbersome strategy plan previously shared with stakeholders.
It was a year filled with engagement, activity and positive change. By no means are we done, but we have started and there is open involvement by staff and patients.
This is now the new norm of working.
This year, several sites are launching a new campaign called “Breaking the Rules for Better Care”. This campaign invites staff and patients to identify rules or customs that they think need to change in order to provide better care for our patients. Again, this is crowdsourcing and opening the dialogue with many, another New Power way of working.
The Patient First strategy continues to morph and grow along with its growing group of participants.
Openly inviting staff and patients to participate has worked. Creating platforms where people can submit and exchange ideas is the future that Heimens and Timms call "new power tactics". Their book does a wonderful job of describing how movements are built, and how ideas catch fire in a hyper-connected world.
Lynette Lutes, Senior Program Officer, Quality and Healthcare Improvement @Lutes_L
Marlies van Dijk, Design Lab, Quality and Healthcare Improvement @tweetvandijk
Alberta Health Services @AlbertaPFCC
Patient First Poster - winning submission for the Innovation Stream at the 2017 Quality Summit
Moving to Action in Alberta - Slideshare presentation