Fraser Health Authority – Response to HC 1 Leader Post 7.1

Jessica’s post can be found here: https://create.twu.ca/jessicalaugsawatzky/2018/11/12/hc-1-leader-post-7-1/

Thank you, Jessica, for your post. I have been away from the Fraser Health Authority region for just under a year, but still maintain a working relationship with some of the project leads. I can relate to your story of conflict and interdepartmental communication.

I am not sure if you have heard of CommuniCARE. According to Findlay & Merkel (2014), CommuniCARE is a process to identify patients in acute care who live in Residential Care and Assisted Living sites. The intent of CommuniCARE was to “standardize written and verbal communication tools and processes” (Findlay & Merkel, 2014). Examples include standardized sheets for transfers to and from the hospital, pink wristbands to identify residential care patients, and daily calls from the residential care nurse to the acute care nurse for updates and discharge planning. These processes were supposed to solve the complaints from residential care nurses of a lack of communication from the acute care department, as well as helping acute care nurses understand the needs of residential care to facilitate a smooth transfer back to residential care.

Unfortunately, CommuniCARE worked poorly during my time within the Fraser Health region. I worked in an affiliated residential care home and received multiple complaints from my nurses about the worsening lack of communication from acute care, mainly due to acute care nurses saying “I’m busy, I can’t talk to you right now” during the daily calls. Similarly, discussions from acute care members gave the impression of CommuniCARE being merely a “make work” project.

I discuss this example because acute care, residential care, and home support are three parts of the same organization, with the same mission, vision, and values, but with wildly different foci. I agree with Warkentin (2018) when he cites Lepsinger (2010) regarding the need for collective objectives. In the case of Fraser Health, the collective objectives should align with its purpose, stated as “to improve the health of the population and the quality of life of the people we serve” (Fraser Health Authority, n.d.)  One way of thinking about collective objectives is to adopt a mindset of the continuum of care model, defined as “a system that guides and tracks patients over time through a comprehensive array of health services spanning all levels and intensity of care.” (Healthcare Information and Management Systems Society, 2014) This system may cover care from birth through end of life. Fraser Health is in a great position to cover an individual through all life stages.

You stated the importance of playing to individual strengths. This is a great idea, and I believe it could be extended further to holding each department accountable for their strengths. If acute care, residential care, and home support understood each other’s roles, scope, and capabilities, this shared understanding may lead to greater cooperation as everyone could hold each other accoutnable for their part in client / patient / resident care.

You also state the importance of education for all staff to address conflict resolution. This is a great idea. Part of conflict resolution includes the alignment of interests and the establishment of common ground (Lepsinger, 2010, p. 170). In the CommuniCARE example above, nurses from acute care and residential care failed to understand the benefit of effective communication for the coordination of a resident’s care, thus resulting in conflict. I suggest future education be held with a mix of acute care and residential care employees in attendance, with mixed groups working together throughout the day to understand each other’s roles and challenges. In the case of your home support example, I recommend a 10-minute workplace huddle with “respectful workplace” as one of the standing agenda items. These huddles could address minor conflicts before they balloon into massive blowups.

I’m looking forward to your response. Thank you.

References:

Findlay, E. & Merkel, M. (2014). CommuniCARE improving patient information sharing and discharge planning [Powerpoint]. Retrieved November 13th, 2018 from https://www.slideshare.net/bcpsqc/communicare

Fraser Health Authority (n.d.). About Fraser Health. Retrieved November 13th, 2018 from https://www.fraserhealth.ca/about-us/about-fraser-health#.W-vJf5NKiUk

Healthcare Information and Management Systems Society (2014). Definition: Continuum of Care. Retrieved November 13th, 2018 from https://www.himss.org/file/1307141/download?token=ny_X7URU

Lepsinger, R. (2010). Closing the execution gap: How great leaders and their companies get results. San Francisco: Jossey-Bass.

Warkentin, M. (2018). Discipline that Restores – Thought on HC 1 Leader´s Post 7.1. Retrieved November 13th, 2018 from https://create.twu.ca/marcelowarkentin/2018/11/13/discipline-that-restores-thought-on-hc-1-leaders-post-7-1/