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",[32,76],[511,542,1523,1547],{"_uid":512,"content":513,"component":541},"0acd010e-04e3-438a-9369-8babe041c7ed",[514],{"_uid":515,"content":516,"component":540},"0099247a-d0cc-4c20-979e-47ecc626d98e",{"type":12,"content":517},[518,530,535],{"type":15,"attrs":519,"content":520},{"textAlign":53},[521,523,528],{"text":522,"type":299},"We worked with essential care partners and patients",{"text":524,"type":299,"marks":525},"1",[526],{"type":527},"superscript",{"text":529,"type":299}," to bring evidence to life and to busted myths through stories that show how essential care partners benefit care, experience, safety and outcomes, including during COVID-19.",{"type":15,"attrs":531,"content":532},{"textAlign":53},[533],{"text":534,"type":299},"An essential care partner is a person who provides physical, psychological emotional, and spiritual support, as deemed important by the patient. This care can include support in decision making, care coordination and continuity of care. Essential care partners can include family members, close friends or other caregivers and are identified by the patient or substitute decision maker.",{"type":15,"attrs":536,"content":537},{"textAlign":53},[538],{"text":539,"type":299},"Essential care partners are different to general visitors; they have a vital role in a patient’s care plan, including during the pandemic.","simple-richtext","wysiwyg-program",{"_uid":543,"items":544,"title":1514,"component":1515,"description":1516},"6a4da9fd-265f-4242-b350-fb1e862d0478",[545,867,978,1053,1341],{"_uid":546,"title":547,"ctaLeft":548,"ctaRight":549,"component":550,"columnLeft":551,"columnRight":597},"57d437de-e033-4082-a645-c3ba04d90018","How Might We Bring Them Back",[],[],"accordion-item-columns",{"type":12,"content":552},[553,567,592],{"type":15,"attrs":554,"content":555},{"textAlign":53},[556,561,563],{"text":557,"type":299,"marks":558},"MYTH ",[559],{"type":560},"bold",{"text":562,"type":299},"- Presence of Essential Care Partners increases infectious disease transmission.",{"text":564,"type":299,"marks":565},"[1]",[566],{"type":527},{"type":15,"attrs":568,"content":569},{"textAlign":53},[570,574,576,580,582,586,588],{"text":571,"type":299,"marks":572},"FACT ",[573],{"type":560},{"text":575,"type":299},"- Essential Care Partners often learn to conduct medical procedures at home such as suctioning and administering medications. They also learn to carry out infection prevention and control procedures. Essential Care Partners are often eager to participate in safety training",{"text":577,"type":299,"marks":578},"[2,3] ",[579],{"type":527},{"text":581,"type":299},"as they are invested in the health and safety of their loved ones and for themselves. Essential Care Partners do not play a significant role in transmission.",{"text":583,"type":299,"marks":584},"[4,5] ",[585],{"type":527},{"text":587,"type":299},"They can safely be present if infection prevention and control protocols such as masking and screening are in place.",{"text":589,"type":299,"marks":590},"[6-9]",[591],{"type":527},{"type":15,"attrs":593,"content":594},{"textAlign":53},[595],{"text":596,"type":299},"Hôtel-Dieu Grace Hospital in Windsor has welcomed essential care partners since March 2020. More than 750 people have gone through the orientation. Lisa is a Patient Advocate at HDGH and involved in setting up and running their Designated Care Partner program. Read Lisa’s story.",{"type":12,"content":598},[599,605,610,618,623,628,633,638,643,648,653,658,663,668,707,712,717,722,727,732,737],{"type":600,"attrs":601,"content":603},"heading",{"level":602,"textAlign":53},4,[604],{"text":547,"type":299},{"type":15,"attrs":606,"content":607},{"textAlign":53},[608],{"text":609,"type":299},"I wasn’t sure if I could even imagine it – no family presence or visitation. How would this work? How will families trust their loved ones would be okay? How will patients know they haven’t been abandoned?",{"type":15,"attrs":611,"content":612},{"textAlign":53},[613],{"text":614,"type":299,"marks":615},"How might we bring them back?",[616],{"type":617},"italic",{"type":15,"attrs":619,"content":620},{"textAlign":53},[621],{"text":622,"type":299},"I placed myself in their shoes and all I could think about was the emotional distress this would create.",{"type":15,"attrs":624,"content":625},{"textAlign":53},[626],{"text":627,"type":299},"I began to frantically search for research, evidence and the “how to” for supporting essential care partners to come into hospital, despite the pandemic. This was important.",{"type":15,"attrs":629,"content":630},{"textAlign":53},[631],{"text":632,"type":299},"I found white papers that spoke about the emotional harm people had experienced after the first SARS pandemic. This couldn’t happen again.",{"type":15,"attrs":634,"content":635},{"textAlign":53},[636],{"text":637,"type":299},"I phoned a friend who is an epidemiologist, asking for any information that would support the importance of care partners supporting their loved ones in hospital during the pandemic.",{"type":15,"attrs":639,"content":640},{"textAlign":53},[641],{"text":642,"type":299},"At the same time, my phone was ringing off the hook; family members were missing their loved ones, they were concerned and they were feeling left out. They repeatedly expressed how unfair they believed the restrictions were. They were concerned about their loved one not understanding the separation and feeling abandoned; worried about their loved one being alone; concerned about their care needs being unmet as they (care partners) had been assisting with care. They were feeling anxious and it was difficult not being present – feeling in the dark. I empathized. I provided encouragement as much as possible, to comfort and put their minds at ease. Despite my efforts, I don’t believe their minds were ever at rest.",{"type":15,"attrs":644,"content":645},{"textAlign":53},[646],{"text":647,"type":299},"I had read the term, “essential care provider” and used it whenever I could. One day, I must have said it to the right person at the right time. “Essential care provider”, they said. “I like that”. The door was open and I stepped inside. I further explained the role and how critical it was for essential care providers to be supporting their loved ones.",{"type":15,"attrs":649,"content":650},{"textAlign":53},[651],{"text":652,"type":299},"A few days later, I was part of a team that was writing a guidance document for visitation during COVID-19. We were on our way.",{"type":15,"attrs":654,"content":655},{"textAlign":53},[656],{"text":657,"type":299},"Our family presence policy, written before COVID-19 used the term “Designated Care Partner.” This was chosen to reflect the patient’s choice as well as leaving the care and support provided, up to the patient and their care partner.",{"type":15,"attrs":659,"content":660},{"textAlign":53},[661],{"text":662,"type":299},"“How might we reintegrate designated care partners?” Asking staff and patients, both were equally afraid. How could we do this safely and without additional risk?",{"type":15,"attrs":664,"content":665},{"textAlign":53},[666],{"text":667,"type":299},"The answers included:",{"type":669,"content":670},"bullet_list",[671,679,686,693,700],{"type":672,"content":673},"list_item",[674],{"type":15,"attrs":675,"content":676},{"textAlign":53},[677],{"text":678,"type":299},"Guidelines for health and safety, to ensure everyone was following all related site policies and public health measures",{"type":672,"content":680},[681],{"type":15,"attrs":682,"content":683},{"textAlign":53},[684],{"text":685,"type":299},"Education and training for Designated Care Partners (DCPs)",{"type":672,"content":687},[688],{"type":15,"attrs":689,"content":690},{"textAlign":53},[691],{"text":692,"type":299},"ID badge for DCPs",{"type":672,"content":694},[695],{"type":15,"attrs":696,"content":697},{"textAlign":53},[698],{"text":699,"type":299},"Infection Prevention and Control (IPAC) education for DCPs",{"type":672,"content":701},[702],{"type":15,"attrs":703,"content":704},{"textAlign":53},[705],{"text":706,"type":299},"Screening for safe entry and minimizing risk.",{"type":15,"attrs":708,"content":709},{"textAlign":53},[710],{"text":711,"type":299},"The DCP program was out of recognition that family and friends are integral to the patient’s care and healing. Family is defined by the patient and DCPs are trusted and valued members of the care team. DCPs are distinct from casual visitors because they know their loved one best and are uniquely familiar to subtle changes in their health or the way they feel.",{"type":15,"attrs":713,"content":714},{"textAlign":53},[715],{"text":716,"type":299},"The patient or substitute decision maker chooses the DCP. Once selected and the DCP commits to this role, they attend a 90 minute orientation. This session includes a review of the DCP roles and responsibilities, guidelines for safe entry and IPAC education. DCPs learn about the value of their partnership and their role as a member of the care team; they are informed that their responsibilities mirror some of the same responsibilities as staff, and understand the risk of exposure to COVID-19 and are asked to be mindful of this risk when at home or in community.",{"type":15,"attrs":718,"content":719},{"textAlign":53},[720],{"text":721,"type":299},"The IPAC portion includes information and interactive activities on proper hand hygiene, virus transmission, how to wear a mask and face shield, donning and doffing personal protective equipment.",{"type":15,"attrs":723,"content":724},{"textAlign":53},[725],{"text":726,"type":299},"Unit social workers meet the DCPs at the end of the session as a warm welcome to the unit.",{"type":15,"attrs":728,"content":729},{"textAlign":53},[730],{"text":731,"type":299},"The in-person orientation sessions offer DCPs a chance to ask questions and is foundational to establishing an on-going relationship.",{"type":15,"attrs":733,"content":734},{"textAlign":53},[735],{"text":736,"type":299},"DCPS are partners in the journey with their loved one and the vision is for the DCP program to continue beyond the pandemic.",{"type":738,"attrs":739,"content":741},"ordered_list",{"order":740},1,[742,749,768,783,797,811,825,839,853],{"type":672,"content":743},[744],{"type":15,"attrs":745,"content":746},{"textAlign":53},[747],{"text":748,"type":299},"Guzzetta, Cathie. “Family presence during resuscitation and invasive procedures.” Critical Care Nurse 36, no. 1 (2016).",{"type":672,"content":750},[751],{"type":15,"attrs":752,"content":753},{"textAlign":53},[754,756,766],{"text":755,"type":299},"Toronto Region COVID-19 Hospital Operations Table. “Access to Hospitals for Visitors (Essential Care Partners): Guidance for Toronto Region Hospitals (Acute, Rehab, CCC) During the COVID-19 Pandemic.’ October 2020. ",{"text":757,"type":299,"marks":758},"https://www.oha.com/Documents/Access%20to%20Hospitals%20for%20Visitors%20-%20 Oct%206.pdf",[759],{"type":760,"attrs":761},"link",{"href":762,"uuid":53,"anchor":53,"custom":763,"target":764,"linktype":765},"https://www.oha.com/Documents/Access%20to%20Hospitals%20for%20Visitors%20-%20Oct%206.pdf",{},"_blank","url",{"text":767,"type":299},".",{"type":672,"content":769},[770],{"type":15,"attrs":771,"content":772},{"textAlign":53},[773,775,782],{"text":774,"type":299},"Alberta Health Service. “Community-based Service Resource Manual.” (2020), ",{"text":776,"type":299,"marks":777},"https://www. albertahealthservices.ca/assets/healthinfo/ipc/hi-ipc-community-based-services-resource-manual.pdf",[778],{"type":760,"attrs":779},{"href":780,"uuid":53,"anchor":53,"custom":781,"target":764,"linktype":765},"https://www.albertahealthservices.ca/assets/healthinfo/ipc/hi-ipc-community-based-services-resource-manual.pdf",{},{"text":767,"type":299},{"type":672,"content":784},[785],{"type":15,"attrs":786,"content":787},{"textAlign":53},[788,790],{"text":789,"type":299},"Munshi et al. 2021. The case for relaxing no-visitor policies in hospitals during the ongoing COVID-19 pandemic. CMAJ. ",{"text":791,"type":299,"marks":792},"The case for relaxing no-visitor policies in hospitals during the ongoing COVID-19 pandemic | CMAJ",[793],{"type":760,"attrs":794},{"href":795,"uuid":53,"anchor":53,"custom":796,"target":764,"linktype":765},"https://www.cmaj.ca/content/193/4/E135.short",{},{"type":672,"content":798},[799],{"type":15,"attrs":800,"content":801},{"textAlign":53},[802,804],{"text":803,"type":299},"Ontario Science Table. 2021. Impact of hospital visitor restrictions during the COVID-19 pandemic. ",{"text":805,"type":299,"marks":806},"Impact of Hospital Visitor Restrictions during the COVID-19 Pandemic - Ontario COVID-19 Science Advisory Table (covid19-sciencetable.ca)",[807],{"type":760,"attrs":808},{"href":809,"uuid":53,"anchor":53,"custom":810,"target":764,"linktype":765},"https://covid19-sciencetable.ca/sciencebrief/impact-of-hospital-visitor-restrictions-during-the-covid-19-pandemic/",{},{"type":672,"content":812},[813],{"type":15,"attrs":814,"content":815},{"textAlign":53},[816,818],{"text":817,"type":299},"Wee et al. 2021. Containment of COVID-19 and reduction in healthcare-associated respiratory viral infections through a multi-tiered infection control strategy. ",{"text":819,"type":299,"marks":820},"Containment of COVID-19 and reduction in healthcare-associated respiratory viral infections through a multi-tiered infection control strategy - ScienceDirect",[821],{"type":760,"attrs":822},{"href":823,"uuid":53,"anchor":53,"custom":824,"target":764,"linktype":765},"https://www.sciencedirect.com/science/article/abs/pii/S2468045120300882",{},{"type":672,"content":826},[827],{"type":15,"attrs":828,"content":829},{"textAlign":53},[830,832],{"text":831,"type":299},"Nguyen et al. 2021. IMPACT OF VISITATION AND COHORTING POLICIES TO SHIELD RESIDENTS FROM COVID-19 SPREAD IN CARE HOMES: AN AGENT-BASED MODEL: Controlling COVID-19 in care homes. ",{"text":833,"type":299,"marks":834},"IMPACT OF VISITATION AND COHORTING POLICIES TO SHIELD RESIDENTS FROM COVID-19 SPREAD IN CARE HOMES: AN AGENT-BASED MODEL: Controlling COVID-19 in care homes - ScienceDirect",[835],{"type":760,"attrs":836},{"href":837,"uuid":53,"anchor":53,"custom":838,"target":764,"linktype":765},"https://www.sciencedirect.com/science/article/abs/pii/S0196655321004624",{},{"type":672,"content":840},[841],{"type":15,"attrs":842,"content":843},{"textAlign":53},[844,846],{"text":845,"type":299},"Wee et al. 2020. The impact of visitor restrictions on health care-associated respiratory viral infections during the COVID-19 pandemic: Experience of a tertiary hospital in Singapore. ",{"text":847,"type":299,"marks":848},"The impact of visitor restrictions on health care-associated respiratory viral infections during the COVID-19 pandemic: Experience of a tertiary hospital in Singapore - American Journal of Infection Control (ajicjournal.org)",[849],{"type":760,"attrs":850},{"href":851,"uuid":53,"anchor":53,"custom":852,"target":764,"linktype":765},"https://www.ajicjournal.org/article/S0196-6553(20)30990-1/fulltext",{},{"type":672,"content":854},[855],{"type":15,"attrs":856,"content":857},{"textAlign":53},[858,860],{"text":859,"type":299},"Passerelli et al. 2021. Asymptomatic COVID-19 in hospital visitors: The underestimated potential of viral shedding. ",{"text":861,"type":299,"marks":862},"Asymptomatic COVID-19 in hospital visitors: The underestimated potential of viral shedding - International Journal of Infectious Diseases (ijidonline.com)",[863],{"type":760,"attrs":864},{"href":865,"uuid":53,"anchor":53,"custom":866,"target":764,"linktype":765},"https://www.ijidonline.com/article/S1201-9712(20)32261-X/fulltext",{},{"_uid":868,"title":869,"ctaLeft":870,"ctaRight":871,"component":550,"columnLeft":872,"columnRight":899},"84b3a039-8ccd-4473-a2db-91ba7a511243","Find the Helpers",[],[],{"type":12,"content":873},[874,882,894],{"type":15,"attrs":875,"content":876},{"textAlign":53},[877,880],{"text":557,"type":299,"marks":878},[879],{"type":560},{"text":881,"type":299},"- Presence of Essential Care Partners is nice to have, but doesn’t impact quality or safety",{"type":15,"attrs":883,"content":884},{"textAlign":53},[885,888,890],{"text":571,"type":299,"marks":886},[887],{"type":560},{"text":889,"type":299},"- Having essential care partners present is a key part of patient and family centred care, which recognizes the mutually beneficial partnership between patients, families and healthcare providers. Patient- and family-centred care means recognizing the importance of family and caregiver presence and their participation in the care, quality and safety of patients.",{"text":891,"type":299,"marks":892},"[1,2]",[893],{"type":527},{"type":15,"attrs":895,"content":896},{"textAlign":53},[897],{"text":898,"type":299},"Hôtel-Dieu Grace Hospital in Windsor has welcomed essential care partners since March 2020. More than 750 people have gone through the orientation. HDGH plans for their Designated Care Partner program to continue beyond the pandemic as they continue to value and recognize the essential role of care partners. Read this story from Janice Kaffer, CEO at HDGH.",{"type":12,"content":900},[901,905,910,915,920,925,930,935,940,945,950,955],{"type":600,"attrs":902,"content":903},{"level":602,"textAlign":53},[904],{"text":869,"type":299},{"type":15,"attrs":906,"content":907},{"textAlign":53},[908],{"text":909,"type":299},"HDGH has been on a journey for a number of years to ensure that patient voice, family presence and a robust patient and family advisory culture (PFAC) is a foundation of our decision making, planning and service delivery. We have made great strides with a solid family presence policy crafted in partnership with our Patient and Family Advisory Council (PFAC), voting PFAC membership (2 members) on our Board of Directors which also has PFAC voice in our Board Quality of Care committee and numerous other improvements including family surveys and PFAC members as a resource to our inpatients and their families.",{"type":15,"attrs":911,"content":912},{"textAlign":53},[913],{"text":914,"type":299},"All of that is something I, as the CEO and also as a nurse for almost 40 years, have taken great pride in. It was my passion and my vision for what HDGH could be that gave rise to this evolution at our hospital and I am so pleased with the people, processes and the changes we’ve introduced to our organization and to our community. Don’t get me wrong, I have not done this alone – far from it – but leadership is about vision, about courage to do the right thing and the confidence to know that we’re headed in the right direction. Then the pandemic came and all of this was suddenly and without warning cancelled.",{"type":15,"attrs":916,"content":917},{"textAlign":53},[918],{"text":919,"type":299},"Cancelled family presence",{"type":15,"attrs":921,"content":922},{"textAlign":53},[923],{"text":924,"type":299},"Cancelled visitation",{"type":15,"attrs":926,"content":927},{"textAlign":53},[928],{"text":929,"type":299},"Cancelled caregivers who were with their loved ones every day ensuring their well-being on every level; physical, emotional, psychological and spiritual.",{"type":15,"attrs":931,"content":932},{"textAlign":53},[933],{"text":934,"type":299},"Cancelled.",{"type":15,"attrs":936,"content":937},{"textAlign":53},[938],{"text":939,"type":299},"I cannot tell anyone how hard that was to do. I, as the CEO who intentionally brought in patient families into our decision making, who envisioned our PFAC, is committed to family presence in our hospital, had to be the person to cancel it all. I was heartbroken and so were the leaders involved in dealing with the consequences of that decision. I stand by that decision as the right one at that time though because in the early days of the pandemic not one of us knew what we were dealing with nor did we understand the risks nor the mitigations that were possible. However, even though I knew it was the right decision, I knew I had to find a way as quickly as possible to change that decision for the betterment of our patients and their families. iPad visits could only do so much – some of our patients truly needed their families to be with them for all the reasons listed above.",{"type":15,"attrs":941,"content":942},{"textAlign":53},[943],{"text":944,"type":299},"So I reached out to folks who know a lot more about what is possible than I did – I asked for help – I asked for advice – I asked for examples of where it was different and not surprisingly I got them all. I got help, advice and support from the caregiving community and as a result of that we made a different decision than CANCEL – we decided to INNOVATE – we decided to CREATE – we decided to TRY something new. As a result we introduced a new program into our hospital that, frankly, wouldn’t have come about without the pressure of this decision to not allow families in. We now have a Designated Care Partner program (DCP program) and it’s amazing!",{"type":15,"attrs":946,"content":947},{"textAlign":53},[948],{"text":949,"type":299},"Our patients have what they need from their families and our families are core to our high quality of care that we’ve been able to maintain through all the chaos of the pandemic. They are trained in the techniques needed to keep their loved ones safe and they understand their obligations and importance of staying true to the training. There have been a few bumps but those are to be expected and they are well worth it. We know so much now that it’s hard for me to imagine when we thought our only option was to CANCEL family presence in our hospital.",{"type":15,"attrs":951,"content":952},{"textAlign":53},[953],{"text":954,"type":299},"Our team will go over all the good stuff about the DCP program so I won’t do that but what I will say in closing is that I’ve taken away a few important lessons from this past year and one of them is this; When your heart and your soul tell you something isn’t right about what you’re doing – listen closely to that voice and find the helpers – they are always there and willing to help you find the way forward. I, along with our team, count ourselves among the helpers now and will happily help/support anyone who asks for it.",{"type":738,"attrs":956,"content":957},{"order":740},[958,971],{"type":672,"content":959},[960],{"type":15,"attrs":961,"content":962},{"textAlign":53},[963,965,970],{"text":964,"type":299},"Institute for Patient- and Family-Centered Care. “Patient-and Family-Centered Care.” (2010), ",{"text":966,"type":299,"marks":967},"https://www.ipfcc.org/about/pfcc.html",[968],{"type":760,"attrs":969},{"href":966,"uuid":53,"anchor":53,"custom":53,"target":764,"linktype":765},{"text":767,"type":299},{"type":672,"content":972},[973],{"type":15,"attrs":974,"content":975},{"textAlign":53},[976],{"text":977,"type":299},"Frampton, Susan B., Sara Guastello, Libby Hoy, Mary Naylor, Sue Sheridan, and Michelle Johnston-Fleece. “Harnessing evidence and experience to change culture: a guiding framework for patient and family engaged care.” NAM Perspectives (2017).",{"_uid":979,"title":980,"ctaLeft":981,"ctaRight":982,"component":550,"columnLeft":983,"columnRight":1009},"0973ae2d-6ffc-45fb-b886-0bc6b671bdf2","Everyone must have access",[],[],{"type":12,"content":984},[985,993,1004],{"type":15,"attrs":986,"content":987},{"textAlign":53},[988,991],{"text":557,"type":299,"marks":989},[990],{"type":560},{"text":992,"type":299},"- Presence of Essential Care Partners is nice to have, but doesn’t impact quality of care.",{"type":15,"attrs":994,"content":995},{"textAlign":53},[996,999,1001],{"text":571,"type":299,"marks":997},[998],{"type":560},{"text":1000,"type":299},"- Impact of restrictive family presence policies has demonstrated risks to patient care, safety, and outcomes, including increased medical errors and inconsistencies in care, especially for those who are medically complex or vulnerable.",{"text":891,"type":299,"marks":1002},[1003],{"type":527},{"type":15,"attrs":1005,"content":1006},{"textAlign":53},[1007],{"text":1008,"type":299},"Pamela is a mother and essential care partner to her son who has multiple complex disabilities. During the pandemic, Pamela has fought to be allowed to be with her son as an essential care partner.",{"type":12,"content":1010},[1011,1016,1021,1026,1031,1036],{"type":600,"attrs":1012,"content":1013},{"level":602,"textAlign":53},[1014],{"text":1015,"type":299},"Everyone Must Have Access",{"type":15,"attrs":1017,"content":1018},{"textAlign":53},[1019],{"text":1020,"type":299},"My son is 15, a sweet and joyful child who has multiple complex disabilities. Just before COVID-19 hit Canada, he experienced a seizure that caused an injury to his lip. His caring group home support staff took him to the hospital at our request, where we raced to meet them. Once we arrived, he had been seen by an Emergency Room physician, who advised the group home staff that “it would take too many resources to stitch his lip and we should just let it heal on its own,” despite the fact that it was painfully split open. Questioning the need for additional resources, I was told that because he wouldn’t stay still for the stitches they would have to sedate him, which would require staff from other areas of the hospital. As caring as the group home staff was, they accepted the doctor’s assessment at face value and were prepared for him to be discharged. As his mother and essential care partner, I challenged the advice and asked for a second opinion, knowing that all too often people with intellectual disabilities are treated differently from their neurotypical peers; in school, in access to services, and yes, in healthcare.",{"type":15,"attrs":1022,"content":1023},{"textAlign":53},[1024],{"text":1025,"type":299},"Our second opinion yielded what I already knew; OF COURSE he needed stitches, just as any other child who presented with the same injury would receive. The “additional resources” were gathered, and because we were present and advocated on his behalf in a situation where he was unable to advocate for himself, he received the stitches that his younger non-disabled brother would have received without question.",{"type":15,"attrs":1027,"content":1028},{"textAlign":53},[1029],{"text":1030,"type":299},"I wonder what the outcome would have been if this incident occurred in April 2020, when I was considered “non-essential” to my son.",{"type":15,"attrs":1032,"content":1033},{"textAlign":53},[1034],{"text":1035,"type":299},"There is an intersectionality in this story between essential care partners, congregate care staff and the healthcare system. Everyone in a congregate care setting, and everyone who enters an ER, must have access to their essential care partners to ensure they receive the treatment and care they require and rightfully deserve.",{"type":738,"attrs":1037,"content":1038},{"order":740},[1039,1046],{"type":672,"content":1040},[1041],{"type":15,"attrs":1042,"content":1043},{"textAlign":53},[1044],{"text":1045,"type":299},"National Collaborating Centre for Methods and Tools. “Rapid Review: What Risk Factors are Associated with COVID-19 Outbreaks and Morality in Long-term Care Facilities and What strategies Mitigate Risk?” (October 2020).",{"type":672,"content":1047},[1048],{"type":15,"attrs":1049,"content":1050},{"textAlign":53},[1051],{"text":1052,"type":299},"Cacioppo, John T., and Louise C. Hawkley. “Social isolation and health, with an emphasis on underlying mechanisms.” Perspectives in biology and medicine 46, no. 3 (2003): S39-S52.",{"_uid":1054,"title":1055,"ctaLeft":1056,"ctaRight":1057,"component":550,"columnLeft":1058,"columnRight":1090},"2efc0511-a838-4f67-a300-94e1b7b6409d","I am a Human Being",[],[],{"type":12,"content":1059},[1060,1067,1085],{"type":15,"attrs":1061,"content":1062},{"textAlign":53},[1063,1066],{"text":557,"type":299,"marks":1064},[1065],{"type":560},{"text":881,"type":299},{"type":15,"attrs":1068,"content":1069},{"textAlign":53},[1070,1073,1075,1079,1081],{"text":571,"type":299,"marks":1071},[1072],{"type":560},{"text":1074,"type":299},"- Evidence continues to grow that demonstrates that the presence of essential care partners improves the safety, quality, and experience of care, including reducing readmissions to hospital,",{"text":1076,"type":299,"marks":1077},"[1] ",[1078],{"type":527},{"text":1080,"type":299},"and decreasing anxiety and stress for patients, essential care partners, and staff.",{"text":1082,"type":299,"marks":1083},"[2-5]",[1084],{"type":527},{"type":15,"attrs":1086,"content":1087},{"textAlign":53},[1088],{"text":1089,"type":299},"Serena is a patient with a chronic condition that causes pain requiring emergency care. Read more about her experience visiting an emergency department alone.",{"type":12,"content":1091},[1092,1097,1102,1107,1112,1117,1122,1127,1132,1137,1142,1147,1152,1157,1162,1167,1172,1177,1182,1187,1192,1197,1202,1207,1212,1217,1222,1227,1232,1237,1242,1247,1252,1257,1262,1267,1272,1277,1282,1287,1292,1296],{"type":600,"attrs":1093,"content":1094},{"level":602,"textAlign":53},[1095],{"text":1096,"type":299},"I AM A HUMAN BEING",{"type":15,"attrs":1098,"content":1099},{"textAlign":53},[1100],{"text":1101,"type":299},"I am a Human being",{"type":15,"attrs":1103,"content":1104},{"textAlign":53},[1105],{"text":1106,"type":299},"I live with pain every single day of the year",{"type":15,"attrs":1108,"content":1109},{"textAlign":53},[1110],{"text":1111,"type":299},"Diagnosing me & my parents at the time of my birth devastated them",{"type":15,"attrs":1113,"content":1114},{"textAlign":53},[1115],{"text":1116,"type":299},"I would be spending the rest of my days in pain",{"type":15,"attrs":1118,"content":1119},{"textAlign":53},[1120],{"text":1121,"type":299},"Sick Kids Hospital became my second home as a child",{"type":15,"attrs":1123,"content":1124},{"textAlign":53},[1125],{"text":1126,"type":299},"and",{"type":15,"attrs":1128,"content":1129},{"textAlign":53},[1130],{"text":1131,"type":299},"Scarborough Grace Hospital became my second home as an adult that saved me...Why?",{"type":15,"attrs":1133,"content":1134},{"textAlign":53},[1135],{"text":1136,"type":299},"Because of a protocol",{"type":15,"attrs":1138,"content":1139},{"textAlign":53},[1140],{"text":1141,"type":299},"My pain is so real and the protocol helped advocate for me",{"type":15,"attrs":1143,"content":1144},{"textAlign":53},[1145],{"text":1146,"type":299},"IV, Oxygen and pain meds",{"type":15,"attrs":1148,"content":1149},{"textAlign":53},[1150],{"text":1151,"type":299},"IV, Oxygen and pain meds sounds simple but yet",{"type":15,"attrs":1153,"content":1154},{"textAlign":53},[1155],{"text":1156,"type":299},"So challenging to receive basic care",{"type":15,"attrs":1158,"content":1159},{"textAlign":53},[1160],{"text":1161,"type":299},"Oh wait, is it because I am not dressed up? Don’t I look approachable at 4am in the morning?",{"type":15,"attrs":1163,"content":1164},{"textAlign":53},[1165],{"text":1166,"type":299},"...sorry, let me brush my hair",{"type":15,"attrs":1168,"content":1169},{"textAlign":53},[1170],{"text":1171,"type":299},"I apologize for looking like I just rolled out of bed",{"type":15,"attrs":1173,"content":1174},{"textAlign":53},[1175],{"text":1176,"type":299},"...i don’t want to be here but the pain is too much",{"type":15,"attrs":1178,"content":1179},{"textAlign":53},[1180],{"text":1181,"type":299},"The stress, the anxiety...I’m here because I need help...please…",{"type":15,"attrs":1183,"content":1184},{"textAlign":53},[1185],{"text":1186,"type":299},"Will you help me? I’ve been here for hours",{"type":15,"attrs":1188,"content":1189},{"textAlign":53},[1190],{"text":1191,"type":299},"“It’s very unusual, you don’t look like you’re in pain”...that’s because I’m used to it",{"type":15,"attrs":1193,"content":1194},{"textAlign":53},[1195],{"text":1196,"type":299},"But not the intensity",{"type":15,"attrs":1198,"content":1199},{"textAlign":53},[1200],{"text":1201,"type":299},"...Please don’t think I'm a drug seeker, please don’t think I’m a drug seeker…",{"type":15,"attrs":1203,"content":1204},{"textAlign":53},[1205],{"text":1206,"type":299},"Do you have a protocol? Can you help? My list of meds is on there",{"type":15,"attrs":1208,"content":1209},{"textAlign":53},[1210],{"text":1211,"type":299},"It would be nice to see a change after 48 years or even after 111 years",{"type":15,"attrs":1213,"content":1214},{"textAlign":53},[1215],{"text":1216,"type":299},"Yes, that was my boyfriend who dropped me off",{"type":15,"attrs":1218,"content":1219},{"textAlign":53},[1220],{"text":1221,"type":299},"but the pain was too much for him to witness",{"type":15,"attrs":1223,"content":1224},{"textAlign":53},[1225],{"text":1226,"type":299},"So I am here alone",{"type":15,"attrs":1228,"content":1229},{"textAlign":53},[1230],{"text":1231,"type":299},"Fending for myself, hoping someone understands",{"type":15,"attrs":1233,"content":1234},{"textAlign":53},[1235],{"text":1236,"type":299},"What am I going to tell work again?",{"type":15,"attrs":1238,"content":1239},{"textAlign":53},[1240],{"text":1241,"type":299},"I hope they understand this time...I don’t want to be let go again",{"type":15,"attrs":1243,"content":1244},{"textAlign":53},[1245],{"text":1246,"type":299},"School is going to fail me because my paper was due",{"type":15,"attrs":1248,"content":1249},{"textAlign":53},[1250],{"text":1251,"type":299},"I don’t want to start the semester over again",{"type":15,"attrs":1253,"content":1254},{"textAlign":53},[1255],{"text":1256,"type":299},"Oh no! Rent is due next week and my finances are not enough",{"type":15,"attrs":1258,"content":1259},{"textAlign":53},[1260],{"text":1261,"type":299},"I can’t stay here, I must go back to work",{"type":15,"attrs":1263,"content":1264},{"textAlign":53},[1265],{"text":1266,"type":299},"Daycare will never understand so I will have to keep my daughter enrolled",{"type":15,"attrs":1268,"content":1269},{"textAlign":53},[1270],{"text":1271,"type":299},"Now I have to call my sister to help and she has work",{"type":15,"attrs":1273,"content":1274},{"textAlign":53},[1275],{"text":1276,"type":299},"I feel lonely...like I have no control",{"type":15,"attrs":1278,"content":1279},{"textAlign":53},[1280],{"text":1281,"type":299},"Maybe it’s best that I speak to a social worker",{"type":15,"attrs":1283,"content":1284},{"textAlign":53},[1285],{"text":1286,"type":299},"Empathy is all we ask from you",{"type":15,"attrs":1288,"content":1289},{"textAlign":53},[1290],{"text":1291,"type":299},"All conscience and unconscious biases are real but",{"type":15,"attrs":1293,"content":1294},{"textAlign":53},[1295],{"text":1101,"type":299},{"type":738,"attrs":1297,"content":1298},{"order":740},[1299,1313,1320,1327,1334],{"type":672,"content":1300},[1301],{"type":15,"attrs":1302,"content":1303},{"textAlign":53},[1304,1306,1312],{"text":1305,"type":299},"S. Department of Health and Human Services. “New HHS Data Shows Major Strides Made in Patient Safety, Leading to Improved Care and Savings.”, 2014, ",{"text":1307,"type":299,"marks":1308},"https://innovation.cms.gov/files/reports/patient-safety- results.pdf",[1309],{"type":760,"attrs":1310},{"href":1311,"uuid":53,"anchor":53,"custom":53,"target":764,"linktype":765},"https://innovation.cms.gov/files/reports/patient-safety-results.pdf",{"text":767,"type":299},{"type":672,"content":1314},[1315],{"type":15,"attrs":1316,"content":1317},{"textAlign":53},[1318],{"text":1319,"type":299},"Belanger, Mary Anne, and Sandra Reed. “A rural community hospital’s experience with family-witnessed resuscitation.” Journal of emergency nursing: JEN: official publication of the Emergency Department Nurses Association 23, no. 3 (1997): 238.",{"type":672,"content":1321},[1322],{"type":15,"attrs":1323,"content":1324},{"textAlign":53},[1325],{"text":1326,"type":299},"Helmer, Stephen D., R. Stephen Smith, Jonathan M. Dort, William M. Shapiro, and Brian S. Katan. “Family presence during trauma resuscitation: a survey of AAST and ENA members.” Journal of Trauma and Acute Care Surgery 48, no. 6 (2000): 1015-1024.",{"type":672,"content":1328},[1329],{"type":15,"attrs":1330,"content":1331},{"textAlign":53},[1332],{"text":1333,"type":299},"McClenathan, CPT Bruce M., COL Kenneth G. Torrington, and Catherine FT Uyehara. “Family member presence during cardiopulmonary resuscitation: a survey of US and international critical care professionals.” Chest 122, no. 6 (2002): 2204-2211.",{"type":672,"content":1335},[1336],{"type":15,"attrs":1337,"content":1338},{"textAlign":53},[1339],{"text":1340,"type":299},"Davidson, Judy E., Karen Powers, Kamyar M. Hedayat, Mark Tieszen, Alexander A. Kon, Eric Shepard, Vicki Spuhler et al. “Clinical practice guidelines for support of the family in the patient-centered intensive care unit: American College of Critical Care Medicine Task Force 2004–2005.” Critical care medicine 35, no. 2 (2007): 605-622.",{"_uid":1342,"title":1343,"ctaLeft":1344,"ctaRight":1352,"component":550,"columnLeft":1353,"columnRight":1386},"fea95108-75e2-4804-8e28-5e121455d8f7","Emi's Story",[1345],{"_uid":1346,"link":1347,"label":1350,"component":1351},"e51f8b1b-d48d-4be0-ac39-5bedd7757b5c",{"id":16,"url":1348,"target":764,"linktype":765,"fieldtype":1349,"cached_url":1348},"https://a-ca.storyblok.com/f/850807391887861/e399114e45/emilianos-story-comic-pdf.pdf","multilink","Download the comic","simple-link-only",[],{"type":12,"content":1354},[1355,1363,1381],{"type":15,"attrs":1356,"content":1357},{"textAlign":53},[1358,1361],{"text":557,"type":299,"marks":1359},[1360],{"type":560},{"text":1362,"type":299},"- Presence of Essential Care Partners is nice to have, but doesn’t impact quality or safety.",{"type":15,"attrs":1364,"content":1365},{"textAlign":53},[1366,1369,1371,1375,1377],{"text":571,"type":299,"marks":1367},[1368],{"type":560},{"text":1370,"type":299},"- Essential Care Partners are a constant part of a patient’s care journey and know them best. 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",{"type":12,"content":1387},[1388,1393,1402,1411,1420,1425,1434,1443,1448,1457],{"type":600,"attrs":1389,"content":1390},{"level":602,"textAlign":53},[1391],{"text":1392,"type":299},"Transcript of Comic",{"type":15,"attrs":1394,"content":1395},{"textAlign":53},[1396,1400],{"text":1397,"type":299,"marks":1398},"April 8, 2015: ",[1399],{"type":560},{"text":1401,"type":299},"Emiliano 6.5 pounds. Welcome baby boy.",{"type":15,"attrs":1403,"content":1404},{"textAlign":53},[1405,1409],{"text":1406,"type":299,"marks":1407},"April 11, 2015: ",[1408],{"type":560},{"text":1410,"type":299},"We brought our second baby boy home from the hospital. Meet your little brother. Baby Cute.",{"type":15,"attrs":1412,"content":1413},{"textAlign":53},[1414,1418],{"text":1415,"type":299,"marks":1416},"April 12, 2015: ",[1417],{"type":560},{"text":1419,"type":299},"At night Emi started having breathing difficulties. … We rushed him to the hospital. ",{"type":15,"attrs":1421,"content":1422},{"textAlign":53},[1423],{"text":1424,"type":299},"Our baby stopped breathing and had a devastating brain injury. He was intubated for 20 days. 30 days in NICU",{"type":15,"attrs":1426,"content":1427},{"textAlign":53},[1428,1432],{"text":1429,"type":299,"marks":1430},"Soon came the first diagnoses: ",[1431],{"type":560},{"text":1433,"type":299},"Cerebral palsy, seizures, dystonia, deafblindness. The brain injury was extensive. He might never be able to walk, see or hear.",{"type":15,"attrs":1435,"content":1436},{"textAlign":53},[1437,1441],{"text":1438,"type":299,"marks":1439},"Suddenly life became a roller coaster: ",[1440],{"type":560},{"text":1442,"type":299},"Therapies, treatments, surgeries. We soon discovered that caring for a medically complex child is more than a full-time job. I’m going to quit my job. We don’t have support and Emi needs full-time care. Emi had severe functional limitations and fragile health. He required extensive care and support. Not having adequate services and supports was very challenging.",{"type":15,"attrs":1444,"content":1445},{"textAlign":53},[1446],{"text":1447,"type":299},"When the pandemic started we were even more isolated and lonely. Nobody understands what my family is going through.",{"type":15,"attrs":1449,"content":1450},{"textAlign":53},[1451,1455],{"text":1452,"type":299,"marks":1453},"July 30, 2021: ",[1454],{"type":560},{"text":1456,"type":299},"Emi is now 6. He is deafblind. He can't hold his head up, sit, stand or walk by himself and requires full support for all daily living activities. He suffers from a sleep disorder and is frequently ill. His parents are his sole caregivers. We feel invisible.",{"type":738,"attrs":1458,"content":1459},{"order":740},[1460,1471,1493,1507],{"type":672,"content":1461},[1462],{"type":15,"attrs":1463,"content":1464},{"textAlign":53},[1465,1466],{"text":964,"type":299},{"text":1467,"type":299,"marks":1468},"https://www.Ipfcc.org/about/pfcc.html",[1469],{"type":760,"attrs":1470},{"href":1467,"uuid":53,"anchor":53,"custom":53,"target":764,"linktype":765},{"type":672,"content":1472},[1473],{"type":15,"attrs":1474,"content":1475},{"textAlign":53},[1476,1478],{"text":1477,"type":299},"Evidence Brief: Caregivers as Essential Care Partners. 2020. ",{"text":1479,"type":299,"marks":1480},"Evidence Brief: Caregivers as Essential Care Partners",[1481],{"type":760,"attrs":1482},{"href":1483,"uuid":1484,"anchor":53,"custom":1485,"target":1486,"linktype":1487,"story":1488},"/programs/essential-together","5121c67b-655c-4fe2-b0d7-d8d6193f6aaf",{},"_self","story",{"name":1489,"id":1490,"uuid":1484,"slug":1491,"url":1492,"full_slug":1492,"_stopResolving":461},"Essential Together",123451112281264,"essential-together","programs/essential-together",{"type":672,"content":1494},[1495],{"type":15,"attrs":1496,"content":1497},{"textAlign":53},[1498,1500],{"text":1499,"type":299},"Hegelius et al. 2021. Consequences of visiting restrictions during the COVID‐19 pandemic: An integrative review. ",{"text":1501,"type":299,"marks":1502},"Consequences of visiting restrictions during the COVID‐19 pandemic: An integrative review - ScienceDirect",[1503],{"type":760,"attrs":1504},{"href":1505,"uuid":53,"anchor":53,"custom":1506,"target":764,"linktype":765},"https://www.sciencedirect.com/science/article/pii/S0020748921001474",{},{"type":672,"content":1508},[1509],{"type":15,"attrs":1510,"content":1511},{"textAlign":53},[1512],{"text":1513,"type":299},"Raphael et al. 2021. Unintended consequences of restrictive visitation policies during the COVID-19 pandemic: implications for hospitalized children. 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More recent data reported by the Canadian Institute for Health Information found ",{"text":2063,"type":299,"marks":2064},"one in 17 hospital stays in Canada",[2065],{"type":760,"attrs":2066},{"href":2067,"uuid":357,"anchor":53,"custom":2068,"target":1486,"linktype":1487,"story":2069},"/resources/hospital-harm-is-everyones-concern",{},{"name":2070,"id":2071,"uuid":357,"slug":2072,"url":2073,"full_slug":2073,"_stopResolving":461},"Hospital harm is everyone’s concern",116783774126329,"hospital-harm-is-everyones-concern","resources/hospital-harm-is-everyones-concern",{"text":2075,"type":299}," involved at least one harmful event in 2022-23. The data highlight the urgency of improving patient safety as rates in recent years have been higher compared to pre-pandemic numbers. The majority of the data available focuses on physical harm rather than all forms which also includes psychological, social and spiritual harm.",{"type":15,"attrs":2077,"content":2078},{"textAlign":53},[2079],{"text":2080,"type":299},"Healthcare Excellence Canada plays an important role in shaping the way patient safety is defined and understood. Initially through the work of the Canadian Patient Safety Institute (CPSI) and now as HEC, we are supporting a transformative shift from seeing safety as the absence of harm to a more holistic approach to fostering safe, inclusive care. One of the primary ways we are doing this is by working to apply the leading framework for measuring and monitoring safety, to see what lessons can be learned about its application in Canada.",{"type":600,"attrs":2082,"content":2083},{"level":1568,"textAlign":53},[2084],{"text":2085,"type":299},"A framework for expanding the definition of safety",{"type":15,"attrs":2087,"content":2088},{"textAlign":53},[2089,2091,2097,2099,2105],{"text":2090,"type":299},"The release of the ",{"text":2092,"type":299,"marks":2093},"Measurement and Monitoring Safety Framework (MMSF)",[2094],{"type":760,"attrs":2095},{"href":2096,"uuid":53,"anchor":53,"custom":53,"target":764,"linktype":765},"https://www.health.org.uk/publications/the-measurement-and-monitoring-of-safety",{"text":2098,"type":299}," catalyzed a major change in the way safety is defined and practised and has informed and influenced Healthcare Excellence Canada’s approach. Created by Professor Charles Vincent and colleagues at ",{"text":2100,"type":299,"marks":2101},"The Health Foundation",[2102],{"type":760,"attrs":2103},{"href":2104,"uuid":53,"anchor":53,"custom":53,"target":764,"linktype":765},"https://www.health.org.uk/",{"text":2106,"type":299}," in 2013, the MMSF proposed shifting away from focusing on the absence of harm towards adopting a broader view of safety. This new view examined the sources of resilience and capabilities that enable safe care and endorsed a less reactive approach to improving safety.",{"type":600,"attrs":2108,"content":2109},{"level":1622,"textAlign":53},[2110],{"text":2111,"type":299},"Shifting from rethinking towards acting on patient safety",{"type":15,"attrs":2113,"content":2114},{"textAlign":53},[2115],{"text":2116,"type":299},"How we act to create safer care is just as important as how we conceptualize it. That’s why Healthcare Excellence Canada has developed the following resources to help you rethink and act to improve patient safety in healthcare settings.",{"type":600,"attrs":2118,"content":2119},{"level":1568,"textAlign":53},[2120],{"text":2121,"type":299},"Rethinking Patient Safety Discussion Guide",{"type":15,"attrs":2123,"content":2124},{"textAlign":53},[2125,2127,2131],{"text":2126,"type":299},"Healthcare Excellence Canada published ",{"text":2128,"type":299,"marks":2129},"Rethinking Patient Safety, a Discussion Guide for Patients, Healthcare Providers and Leaders",[2130],{"type":560},{"text":2132,"type":299}," during Canadian Patient Safety Week 2023 to encourage everyone across the continuum of care to enable safer care. The guide explains Healthcare Excellence Canada’s approach to patient safety that fosters a curious mindset and shifts away from seeing safety as simply the absence of harm. This resource also aims to spur discussions around patient safety and what is means for you.",{"_uid":2134,"file":2135,"link":2137,"label":2121,"linkType":760,"component":1667,"linkLabel":1554},"163f74cd-8ed4-47bd-be65-745efb6a722d",{"id":53,"alt":53,"name":16,"focus":53,"title":53,"source":53,"filename":16,"copyright":53,"fieldtype":288,"meta_data":2136},{},{"id":415,"url":16,"linktype":1487,"fieldtype":1349,"cached_url":2138,"story":2139},"resources/rethinking-patient-safety-discussion-guide",{"name":2121,"id":2140,"uuid":415,"slug":2141,"url":2138,"full_slug":2138,"_stopResolving":461},113880292322786,"rethinking-patient-safety-discussion-guide",{"_uid":2143,"content":2144,"component":540},"9860c1c5-eafc-4943-bcc5-0c94b4e127a3",{"type":12,"content":2145},[2146,2151],{"type":600,"attrs":2147,"content":2148},{"level":1568,"textAlign":53},[2149],{"text":2150,"type":299},"How Safe is Your Care?",{"type":15,"attrs":2152,"content":2153},{"textAlign":53},[2154],{"text":2155,"type":299},"The release of \"How Safe is Your Care? Measurement and monitoring of safety through the eyes of patients and their care partners\" provides important insights into how patients and their care partners see safety. The report offers guidance on how to effectively engage patients and care partners in all aspects of measurement and monitoring of safety and provides recommendations outlining how to strengthen provider and patient partnerships in support of safer care.",{"_uid":2157,"file":2158,"link":2163,"label":2164,"linkType":1873,"component":1667,"linkLabel":16},"d4595014-4524-4d17-9f41-36a05c1fd4a6",{"id":2159,"alt":2160,"name":16,"focus":16,"title":2160,"source":16,"filename":2161,"copyright":16,"fieldtype":288,"meta_data":2162,"is_external_url":290},114293584038291,"20220525 Howsafeisyourcare FINAL EN","https://a-ca.storyblok.com/f/850807391887861/bc9df4166f/20220525-howsafeisyourcare-final-en.pdf",{},{"id":16,"url":16,"linktype":1487,"fieldtype":1349,"cached_url":16},"How Safe is Your Care? Measurement and monitoring of safety through the eyes of patients and their care partners",{"_uid":2166,"content":2167,"component":540},"fb2cf783-9aa4-45d8-abc8-ac894bb6160c",{"type":12,"content":2168},[2169,2174,2194,2212,2230,2245,2260,2276,2293,2302,2322,2336,2367,2376,2499,2507],{"type":600,"attrs":2170,"content":2171},{"level":1622,"textAlign":53},[2172],{"text":2173,"type":299},"A timeline of patient safety",{"type":15,"attrs":2175,"content":2176},{"textAlign":53},[2177,2179,2192],{"text":2178,"type":299},"Important work has taken place to evolve our understanding of patient safety, what it means to different stakeholders, and how to foster it. While there has been tremendous progress, more work is needed to refine this understanding and address harm. As early adopters and leaders on the MMSF in Canada, Healthcare Excellence Canada and partners have a role to play in this effort—one that we hope you will join—so that we can truly ",{"text":2180,"type":299,"marks":2181},"transform to the presence of safety",[2182],{"type":760,"attrs":2183},{"href":2184,"uuid":2185,"anchor":53,"custom":2186,"target":1486,"linktype":1487,"story":2187},"/updates/are-we-safe-or-just-lucky","19a25cf2-515c-4f1a-8e4a-cca4111ca274",{},{"name":2188,"id":2189,"uuid":2185,"slug":2190,"url":2191,"full_slug":2191,"_stopResolving":461},"Are we safe or just lucky?",123415441417262,"are-we-safe-or-just-lucky","updates/are-we-safe-or-just-lucky",{"text":2193,"type":299},". Together.",{"type":15,"attrs":2195,"content":2196},{"textAlign":53},[2197,2201,2203,2210],{"text":2198,"type":299,"marks":2199},"1999: ",[2200],{"type":560},{"text":2202,"type":299},"A report titled ",{"text":2204,"type":299,"marks":2205},"To Err is Human: Building a Safer Health System",[2206,2209],{"type":760,"attrs":2207},{"href":2208,"uuid":53,"anchor":53,"custom":53,"target":764,"linktype":765},"https://pubmed.ncbi.nlm.nih.gov/25077248/",{"type":617},{"text":2211,"type":299}," was published by the Institute of Medicine. The report explores patient deaths due to medical error and concludes that the problem is not necessarily people, but the system in which people work.",{"type":15,"attrs":2213,"content":2214},{"textAlign":53},[2215,2219,2221,2228],{"text":2216,"type":299,"marks":2217},"2001: ",[2218],{"type":560},{"text":2220,"type":299},"The Institute of Medicine in the US releases ",{"text":2222,"type":299,"marks":2223},"Closing the Quality Chasm: A New Health System for the 21st Century",[2224,2227],{"type":760,"attrs":2225},{"href":2226,"uuid":53,"anchor":53,"custom":53,"target":764,"linktype":765},"https://pubmed.ncbi.nlm.nih.gov/25057539/",{"type":617},{"text":2229,"type":299},". This report outlined the Six Aims for Improvement (Safety, Timeliness, Effectiveness, Efficiency, Equity, Patient-Centredness).",{"type":15,"attrs":2231,"content":2232},{"textAlign":53},[2233,2237,2243],{"text":2234,"type":299,"marks":2235},"2004: ",[2236],{"type":560},{"text":2238,"type":299,"marks":2239},"The Canadian Adverse Events Study: the incidence of adverse events among hospital patients in Canada",[2240,2242],{"type":760,"attrs":2241},{"href":2059,"uuid":53,"anchor":53,"custom":53,"target":764,"linktype":765},{"type":617},{"text":2244,"type":299}," by Baker, Norton et al., is the first Canadian study to provide a national estimate of the incidence of adverse events. The study found that 7.5% of 100 admissions resulted in an adverse event, of which 36.9% were preventable.",{"type":15,"attrs":2246,"content":2247},{"textAlign":53},[2248,2252,2253,2258],{"text":2249,"type":299,"marks":2250},"2013: ",[2251],{"type":560},{"text":2090,"type":299},{"text":2254,"type":299,"marks":2255},"Measurement and Monitoring of Safety Framework (MMSF)",[2256],{"type":760,"attrs":2257},{"href":2096,"uuid":53,"anchor":53,"custom":53,"target":764,"linktype":765},{"text":2259,"type":299}," catalyzed a major change in the way safety is defined and practiced. Created by Charles Vincent and colleagues at The Health Foundation, the MMSF presented an approach for shifting away from focusing on the absence of harm towards adopting a broader view of safety.",{"type":15,"attrs":2261,"content":2262},{"textAlign":53},[2263,2267,2274],{"text":2264,"type":299,"marks":2265},"2015: ",[2266],{"type":560},{"text":2268,"type":299,"marks":2269},"Beyond the Quick Fix: Strategies for Improving Patient Safety",[2270,2273],{"type":760,"attrs":2271},{"href":2272,"uuid":53,"anchor":53,"custom":53,"target":764,"linktype":765},"https://tspace.library.utoronto.ca/handle/1807/80119?mode=full",{"type":617},{"text":2275,"type":299}," published by the Institute of Health Policy, Management and Evaluation at the University of Toronto concluded that despite the growing understanding of the safety threats and efforts made to identify safety practices, there is still effort needed to broaden and link efforts to improve care and care environments.",{"type":15,"attrs":2277,"content":2278},{"textAlign":53},[2279,2283,2285,2291],{"text":2280,"type":299,"marks":2281},"2016: ",[2282],{"type":560},{"text":2284,"type":299},"The Canadian Institute for Health Information (CIHI) releases the ",{"text":2286,"type":299,"marks":2287},"Hospital Harm Indicator",[2288],{"type":760,"attrs":2289},{"href":2290,"uuid":53,"anchor":53,"custom":53,"target":764,"linktype":765},"https://www.cihi.ca/en/indicators/hospital-harm",{"text":2292,"type":299},". This indicator measures the rate of acute care hospitalizations with at least one occurrence of unintended harm during a hospital stay that could potentially have been prevented.",{"type":15,"attrs":2294,"content":2295},{"textAlign":53},[2296,2300],{"text":2297,"type":299,"marks":2298},"2017: ",[2299],{"type":560},{"text":2301,"type":299},"The Canadian Patient Safety Institute (CPSI), now Healthcare Excellence Canada, began working with healthcare teams from across the country to advance our knowledge and experience of the MMSF in Canada.",{"type":15,"attrs":2303,"content":2304},{"textAlign":53},[2305,2309,2311,2320],{"text":2306,"type":299,"marks":2307},"2023: ",[2308],{"type":560},{"text":2310,"type":299},"Healthcare Excellence Canada and Patients for Patient Safety Canada released ",{"text":2312,"type":299,"marks":2313},"Rethinking Patient Safety: A Discussion Guide for Patients, Healthcare Providers and Leaders",[2314,2319],{"type":760,"attrs":2315},{"href":2316,"uuid":415,"anchor":53,"custom":2317,"target":1486,"linktype":1487,"story":2318},"/resources/rethinking-patient-safety-discussion-guide",{},{"name":2121,"id":2140,"uuid":415,"slug":2141,"url":2138,"full_slug":2138,"_stopResolving":461},{"type":617},{"text":2321,"type":299}," which summarizes learnings and ideas suggesting a new way of approaching patient safety.",{"type":600,"attrs":2323,"content":2325},{"level":1622,"textAlign":2324},"left",[2326,2332],{"text":2327,"type":299,"marks":2328},"Measurement and Monitoring of Safety Framework",[2329],{"type":2330,"attrs":2331},"textStyle",{"color":16},{"text":2333,"type":299,"marks":2334}," ",[2335],{"type":560},{"type":15,"attrs":2337,"content":2338},{"textAlign":2324},[2339,2343,2350,2355,2361,2366],{"text":2090,"type":299,"marks":2340},[2341],{"type":2330,"attrs":2342},{"color":16},{"text":2344,"type":299,"marks":2345},"Measurement and Monitoring Safety Framework (MMSF) in 2013",[2346,2348],{"type":760,"attrs":2347},{"href":2096,"uuid":53,"anchor":53,"custom":53,"target":764,"linktype":765},{"type":2330,"attrs":2349},{"color":16},{"text":2351,"type":299,"marks":2352}," catalyzed a major change in the way safety is defined and practiced and has informed and influenced Heathcare Excellence Canada’s approach. Created by Professor Charles Vincent and colleagues at ",[2353],{"type":2330,"attrs":2354},{"color":16},{"text":2100,"type":299,"marks":2356},[2357,2359],{"type":760,"attrs":2358},{"href":2104,"uuid":53,"anchor":53,"custom":53,"target":764,"linktype":765},{"type":2330,"attrs":2360},{"color":16},{"text":2362,"type":299,"marks":2363},", the MMSF proposed shifting away from focusing on the absence of harm towards adopting a broader view of safety. This new view examined the sources of resilience and capabilities that enable safe care and endorsed a less reactive approach to improving safety. ",[2364],{"type":2330,"attrs":2365},{"color":16},{"text":2333,"type":299},{"type":15,"attrs":2368,"content":2369},{"textAlign":2324},[2370,2375],{"text":2371,"type":299,"marks":2372},"The MMSF offers many advantages when it comes to how we think about safety. It:   ",[2373],{"type":2330,"attrs":2374},{"color":16},{"text":2333,"type":299},{"type":669,"content":2377},[2378,2389,2400,2411,2422,2433,2444,2455,2466,2477,2488],{"type":672,"content":2379},[2380],{"type":15,"attrs":2381,"content":2382},{"textAlign":53},[2383,2388],{"text":2384,"type":299,"marks":2385},"creates a more holistic view of safety. ",[2386],{"type":2330,"attrs":2387},{"color":16},{"text":2333,"type":299},{"type":672,"content":2390},[2391],{"type":15,"attrs":2392,"content":2393},{"textAlign":53},[2394,2399],{"text":2395,"type":299,"marks":2396},"changes our safety focus – moving away from a focus on past harm. ",[2397],{"type":2330,"attrs":2398},{"color":16},{"text":2333,"type":299},{"type":672,"content":2401},[2402],{"type":15,"attrs":2403,"content":2404},{"textAlign":53},[2405,2410],{"text":2406,"type":299,"marks":2407},"provides a shared and consistent understanding of safety. ",[2408],{"type":2330,"attrs":2409},{"color":16},{"text":2333,"type":299},{"type":672,"content":2412},[2413],{"type":15,"attrs":2414,"content":2415},{"textAlign":53},[2416,2421],{"text":2417,"type":299,"marks":2418},"changes the way we think about safety. ",[2419],{"type":2330,"attrs":2420},{"color":16},{"text":2333,"type":299},{"type":672,"content":2423},[2424],{"type":15,"attrs":2425,"content":2426},{"textAlign":53},[2427,2432],{"text":2428,"type":299,"marks":2429},"helps us move away from managing risk to managing safety. ",[2430],{"type":2330,"attrs":2431},{"color":16},{"text":2333,"type":299},{"type":672,"content":2434},[2435],{"type":15,"attrs":2436,"content":2437},{"textAlign":53},[2438,2443],{"text":2439,"type":299,"marks":2440},"moves us from assurance and accountability reporting to a \"practice of inquiry.\" ",[2441],{"type":2330,"attrs":2442},{"color":16},{"text":2333,"type":299},{"type":672,"content":2445},[2446],{"type":15,"attrs":2447,"content":2448},{"textAlign":53},[2449,2454],{"text":2450,"type":299,"marks":2451},"empowers everyone to take a proactive role in safety. ",[2452],{"type":2330,"attrs":2453},{"color":16},{"text":2333,"type":299},{"type":672,"content":2456},[2457],{"type":15,"attrs":2458,"content":2459},{"textAlign":53},[2460,2465],{"text":2461,"type":299,"marks":2462},"promotes a culture of collective responsibility for safety. ",[2463],{"type":2330,"attrs":2464},{"color":16},{"text":2333,"type":299},{"type":672,"content":2467},[2468],{"type":15,"attrs":2469,"content":2470},{"textAlign":53},[2471,2476],{"text":2472,"type":299,"marks":2473},"promotes an understanding that staff and patient safety go hand in hand. ",[2474],{"type":2330,"attrs":2475},{"color":16},{"text":2333,"type":299},{"type":672,"content":2478},[2479],{"type":15,"attrs":2480,"content":2481},{"textAlign":53},[2482,2487],{"text":2483,"type":299,"marks":2484},"places value on soft intelligence (e.g. listening, observing and perceiving).   ",[2485],{"type":2330,"attrs":2486},{"color":16},{"text":2333,"type":299},{"type":672,"content":2489},[2490],{"type":15,"attrs":2491,"content":2492},{"textAlign":53},[2493,2498],{"text":2494,"type":299,"marks":2495},"recognizes the value that patients and caregivers have in creating safety. ",[2496],{"type":2330,"attrs":2497},{"color":16},{"text":2333,"type":299},{"type":600,"attrs":2500,"content":2501},{"level":1568,"textAlign":2324},[2502],{"text":2503,"type":299,"marks":2504},"How it works ",[2505],{"type":2330,"attrs":2506},{"color":16},{"type":15,"attrs":2508,"content":2509},{"textAlign":2324},[2510],{"text":2511,"type":299,"marks":2512},"MMSF is made up of five dimensions that healthcare leaders, providers, patients and families can use to understand and improve patient safety. The framework assesses and evaluates safety from \"ward to board\" by providing a comprehensive and accurate real-time view of patient safety. It helps users move from \"assurance\" to \"inquiry\" by shifting away from a focus on past cases of harm towards current performance, future risks and organizational resiliency.   ",[2513],{"type":2330,"attrs":2514},{"color":16},{"_uid":2516,"items":2517,"component":2532},"87523179-6e6d-461e-8d4c-92d66373e0c8",[2518],{"_uid":2519,"image":2520,"quote":2522,"author":2529,"component":2530,"author_title":2531},"6520e012-4669-4bad-8caf-73e926b50727",{"id":53,"alt":53,"name":16,"focus":53,"title":53,"source":53,"filename":16,"copyright":53,"fieldtype":288,"meta_data":2521},{},{"type":12,"content":2523},[2524],{"type":15,"attrs":2525,"content":2526},{"textAlign":53},[2527],{"text":2528,"type":299},"\"The framework for the Measurement and Monitoring of Safety helps people rethink their understanding of safety in their own clinical environment,\" says Dr. Baker. \"What we saw during the demonstration project is that staff were really engaged by this idea that they can have an active role in promoting and maintaining safety.\"","Dr. G. Ross Baker","quote-item","PhD, Professor, Institute of Health Policy Management and Evaluation, University of Toronto  ","quote",{"id":16,"_uid":2534,"content":2535,"component":541},"42e298e1-7e88-40aa-91c6-245a3ed1ca70",[2536,2545],{"_uid":2537,"content":2538,"component":540},"d168f704-36b1-4cd9-8443-6345f345c66d",{"type":12,"content":2539},[2540],{"type":15,"attrs":2541,"content":2542},{"textAlign":53},[2543],{"text":2544,"type":299},"Armed with a series of valuable questions, you can make better decisions about the safety of the care you provide. The primary questions are:",{"_uid":2546,"image":2547,"component":2552},"18e48b18-8da1-4d06-b18d-c7af91deabf7",{"id":2548,"alt":2549,"name":16,"focus":16,"title":16,"source":16,"filename":2550,"copyright":16,"fieldtype":288,"meta_data":2551,"is_external_url":290},114300191903786,"A diagram consisting of one dark grey circle in the centre with the text, “Safety measurement and monitoring,” surrounding by five petal-shape objects in various colours connected by a larger circle outline, containing the text “Past harm: Has patient care been safe in the past?” “Reliability: Are our clinical systems and processes reliable?” “Sensitivity to operations: Is care safe today?” “Anticipation and preparedness: Will care be safe in the future?” and “Integration and learning: Are we responding and improving?”","https://a-ca.storyblok.com/f/850807391887861/0a134b9440/2022-safetymeasurementandmonitoring-en.png",{"alt":2549,"title":16,"source":16,"copyright":16},"simple-image",{"_uid":2554,"content":2555,"component":541},"3c630d12-c036-408c-9b4d-93e05a5c5afc",[2556],{"_uid":2557,"content":2558,"component":540},"91fa781f-844d-4361-add1-e2d1cf1aea6b",{"type":12,"content":2559},[2560,2565,2570,2575,2580,2585,2590,2616,2621,2626,2638,2642],{"type":600,"attrs":2561,"content":2562},{"level":1568,"textAlign":53},[2563],{"text":2564,"type":299},"Applying the framework in Canada",{"type":15,"attrs":2566,"content":2567},{"textAlign":53},[2568],{"text":2569,"type":299},"In 2017, the Canadian Patient Safety Institute (which amalgamated with the Canadian Foundation for Healthcare Improvement to form Healthcare Excellence Canada in 2021), began working with healthcare teams from across the country to advance our knowledge and experience of the MMSF in Canada. Following a successful demonstration project led by Dr. G. Ross Baker at the University of Toronto, a subsequent learning collaborative was launched in 2018 with 11 teams from seven provinces. With expert faculty and mentoring over 18 months, each team used the MMSF to develop a more comprehensive approach to delivering safer care.",{"type":15,"attrs":2571,"content":2572},{"textAlign":53},[2573],{"text":2574,"type":299},"An evaluation in 2020 concluded that the collaborative successfully built the capacity of teams to understand and implement the MMSF in their local settings. Participants reported positive impacts on stakeholder groups' knowledge and behaviours, healthcare processes and patient outcomes.",{"type":15,"attrs":2576,"content":2577},{"textAlign":53},[2578],{"text":2579,"type":299},"\"We started out in the safety world really worrying about past harm and I think that was really important because it raised peoples' understanding about the magnitude of the safety issues. But it is insufficient because people don't go to work thinking about past incidents; they go to work thinking about the patients they are going to see today. So that is part of the shift now is that we are putting safety into a much more relevant context for the staff on their units doing their daily jobs. I think we can still build on that. We can build a broader sense of how units function, and how units interact with other units.\"",{"type":15,"attrs":2581,"content":2582},{"textAlign":53},[2583],{"text":2584,"type":299},"- Dr. G. Ross Baker, PhD, Professor, Institute of Health Policy Management and Evaluation, University of Toronto",{"type":600,"attrs":2586,"content":2587},{"level":602,"textAlign":53},[2588],{"text":2589,"type":299},"Learn more:",{"type":669,"content":2591},[2592,2604],{"type":672,"content":2593},[2594],{"type":15,"attrs":2595,"content":2596},{"textAlign":53},[2597],{"text":2598,"type":299,"marks":2599},"Measurement and Monitoring of Safety Framework: a qualitative study of implementation through a Canadian learning collaborative | BMJ Quality & Safety",[2600],{"type":760,"attrs":2601},{"href":2602,"uuid":53,"anchor":53,"custom":2603,"target":764,"linktype":765},"https://qualitysafety.bmj.com/content/32/8/470",{},{"type":672,"content":2605},[2606],{"type":15,"attrs":2607,"content":2608},{"textAlign":53},[2609],{"text":2610,"type":299,"marks":2611},"Measurement and Monitoring of Safety Framework (MMSF): learning from its implementation in Canada | BMJ Quality & Safety",[2612],{"type":760,"attrs":2613},{"href":2614,"uuid":53,"anchor":53,"custom":2615,"target":764,"linktype":765},"https://qualitysafety.bmj.com/content/32/8/441",{},{"type":600,"attrs":2617,"content":2618},{"level":1568,"textAlign":53},[2619],{"text":2620,"type":299},"Measuring and monitoring safety: A patient and care partner perspective",{"type":15,"attrs":2622,"content":2623},{"textAlign":53},[2624],{"text":2625,"type":299},"The evaluation showed that the MMSF improved safety practices and was well-received by frontline teams, senior leaders and board members. Limited attention, however, had been paid to how patients engage with this wider view of safety.",{"type":15,"attrs":2627,"content":2628},{"textAlign":53},[2629,2631,2636],{"text":2630,"type":299},"The release of ",{"text":2164,"type":299,"marks":2632},[2633,2635],{"type":760,"attrs":2634},{"href":2161,"uuid":53,"anchor":53,"custom":53,"target":764,"linktype":765},{"type":617},{"text":2637,"type":299}," provides important insights into how patients and their care partners see safety. The report offers guidance on how to effectively engage patients and care partners in all aspects of measurement and monitoring of safety and provides recommendations outlining how to strengthen provider and patient partnerships in support of safer care.",{"type":600,"attrs":2639,"content":2640},{"level":602,"textAlign":53},[2641],{"text":2589,"type":299},{"type":669,"content":2643},[2644,2655],{"type":672,"content":2645},[2646],{"type":15,"attrs":2647,"content":2648},{"textAlign":53},[2649],{"text":2650,"type":299,"marks":2651},"‘Safety is about partnership’: Safety through the lens of patients and caregivers",[2652],{"type":760,"attrs":2653},{"href":2654,"uuid":53,"anchor":53,"custom":53,"target":764,"linktype":765},"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hex.13939",{"type":672,"content":2656},[2657],{"type":15,"attrs":2658,"content":2659},{"textAlign":53},[2660],{"text":2661,"type":299,"marks":2662},"Reconceptualizing Patient Safety Beyond Harm: Insights From a Mixed-Methods Qualitative Inquiry",[2663],{"type":760,"attrs":2664},{"href":2665,"uuid":53,"anchor":53,"custom":53,"target":764,"linktype":765},"https://journals.lww.com/jncqjournal/abstract/9900/reconceptualizing_patient_safety_beyond_harm_.122.aspx",{"id":16,"_uid":2667,"items":2668,"title":2794,"component":1515,"description":2795},"f9756087-feb3-444a-979e-dd64fde0e851",[2669,2689,2704,2779],{"_uid":2670,"title":2671,"ctaLeft":2672,"ctaRight":2673,"component":550,"columnLeft":2674,"columnRight":2677},"29dbd715-39cd-4bf0-a9d8-53b7b6777bf5","Executive summary",[],[],{"type":12,"content":2675},[2676],{"type":15},{"type":12,"content":2678},[2679,2684],{"type":15,"attrs":2680,"content":2681},{"textAlign":53},[2682],{"text":2683,"type":299},"The Measurement and Monitoring of Safety Framework (MMSF) consists of five dimensions, and a series of prompting key questions, that guide users to comprehensively and conceptually view safety. These five dimensions and related questions address: past harm, reliability, sensitivity to operations, anticipation and preparedness, and integration and learning. ",{"type":15,"attrs":2685,"content":2686},{"textAlign":2324},[2687],{"text":2688,"type":299},"In October 2018, the Canadian Patient Safety Institute (CPSI), now Healthcare Excellence Canada, launched a patient safety improvement project under the leadership of Maryanne D'Arpino of CPSI (Executive Lead) and Dr. G. Ross Baker at the University of Toronto (Academic Lead). This program, a learning collaborative with expert faculty and mentorship, aimed to enable the implementation of the MMSF amongst 11 teams from seven provinces across Canada over an 18-month period with the aim of each team developing a more comprehensive approach to safety and the delivery of safer care. This report presents findings from an evaluation study funded by CPSI that aimed to examine the effectiveness of this Collaborative.",{"_uid":2690,"title":2691,"ctaLeft":2692,"ctaRight":2693,"component":550,"columnLeft":2694,"columnRight":2697},"d9f19cdb-2f20-42bf-bb33-a6da9cd5aecf","Methods",[],[],{"type":12,"content":2695},[2696],{"type":15},{"type":12,"content":2698},[2699],{"type":15,"attrs":2700,"content":2701},{"textAlign":53},[2702],{"text":2703,"type":299},"This study used a qualitative approach based on interview, observation and documentary data collection methods. In-depth semi-structured interviews were conducted with team members. One-day site visit observations were conducted at five sites; observations of learning sessions were conducted and relevant documents were collected. Thirty-six team members participated in the interviews. A total of 29 hours was spent at site visits; in addition to approximately 33 hours in learning session 3, the closing congress and all-team virtual meetings. ",{"_uid":2705,"title":2706,"ctaLeft":2707,"ctaRight":2708,"component":550,"columnLeft":2709,"columnRight":2712},"ed56d671-ca2b-4a1c-b2e9-6fa064be6608","Key findings",[],[],{"type":12,"content":2710},[2711],{"type":15},{"type":12,"content":2713},[2714],{"type":669,"content":2715},[2716,2723,2730,2737,2744,2751,2758,2765,2772],{"type":672,"content":2717},[2718],{"type":15,"attrs":2719,"content":2720},{"textAlign":53},[2721],{"text":2722,"type":299},"Overall participants provided positive feedback about the in-person learning sessions. They particularly valued the expert presenters, multifaceted approaches used to teach the MMSF, and the structure created for learning within and between participating teams. ",{"type":672,"content":2724},[2725],{"type":15,"attrs":2726,"content":2727},{"textAlign":53},[2728],{"text":2729,"type":299},"While some participants felt 'overwhelmed' at the amount of information in the first learning session, the majority felt positive about the framework from the outset. The first learning session set in place the need for a shift in thinking about safety from an absence of harm to presence of safety, to thinking about changing culture, and that it would take time to understand and implement the MMSF. ",{"type":672,"content":2731},[2732],{"type":15,"attrs":2733,"content":2734},{"textAlign":53},[2735],{"text":2736,"type":299},"The coaching by CPSI senior program managers played key roles in participants' understanding and implementation of the MMSF. The coaches were responsive and accessible between site visits. They provided ongoing education and support; and were instrumental in providing the feedback necessary for ongoing implementation of the MMSF. Some participants would have wanted more coaching and more clarity about coaching and team accountability expectations. ",{"type":672,"content":2738},[2739],{"type":15,"attrs":2740,"content":2741},{"textAlign":53},[2742],{"text":2743,"type":299},"Team members used a range of teaching strategies and methods to support the implementation of MMSF into practice. These included teaching about the framework to groups of stakeholders (e.g. healthcare providers and senior leadership). ",{"type":672,"content":2745},[2746],{"type":15,"attrs":2747,"content":2748},{"textAlign":53},[2749],{"text":2750,"type":299},"Quality improvement (QI) consultants, physicians and boards began teaching about the framework by integrating its language into day- to- day communication and using it to discuss specific safety or patient care issues. Team members made decisions about how to teach the framework to stakeholder groups, taking into consideration issues such as availability, number of people involved, professional roles and interest. There were different perceptions about the effectiveness of teaching the MMSF and whether it’s necessary to teach the framework itself or if it’s sufficient to teach and implement tools and processes informed by the framework. ",{"type":672,"content":2752},[2753],{"type":15,"attrs":2754,"content":2755},{"textAlign":53},[2756],{"text":2757,"type":299},"Teams were encouraged to focus on MMSF implementation strategies that were context specific and allowed for the integration of the framework into the daily clinical and administrative work of the units or targeted areas. Teams consequently used a variety of strategies. These included the use of the MMSF to inform the following processes and activities: safety huddles, health care processes, safety incidents and reports; meetings; communication; patient and family focused initiatives; and board and senior leadership level activities. Each strategy had success in targeting different stakeholders and effecting change in different ways. ",{"type":672,"content":2759},[2760],{"type":15,"attrs":2761,"content":2762},{"textAlign":53},[2763],{"text":2764,"type":299},"The MMSF teams consisted of individuals with varied professional backgrounds and roles at local, regional and provincial levels. This variability allowed for sharing of diverse perspectives and multiple avenues to teach, implement and spread the MMSF. However, variability in engagement with the collaborative and movement out and into the teams over the 18 months were challenges. A small number of teams had patient, family and board representation who were seen to bring valuable perspectives to the team and its work. Physicians were a more difficult group to engage. ",{"type":672,"content":2766},[2767],{"type":15,"attrs":2768,"content":2769},{"textAlign":53},[2770],{"text":2771,"type":299},"The majority of participants were supportive of wider spread of the MMSF yet there was variability in their opportunities for spread beyond their implementation site(s). While a small number remained focused at the original site of implementation, the other teams demonstrated varying levels of spread: unplanned spread; planned individual or team efforts which led to pockets of uptake in the organization or region; planned and coordinated widespread efforts to spread the MMSF across an organization and region. Challenges to spread included limited dedicated resources, uncertain authority to influence spread, the need for alignment with wider-level processes and frameworks and healthcare organizational and regional restructuring. ",{"type":672,"content":2773},[2774],{"type":15,"attrs":2775,"content":2776},{"textAlign":53},[2777],{"text":2778,"type":299},"The majority of participants reported positive impacts from MMSF implementation. 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In it you will find tools, resources and templates from organizations across the globe who have successfully implemented their own models.",[84,76],[3019,3212],{"_uid":3020,"content":3021,"component":541},"72be8b08-b1ff-432e-b3ea-ceaa7abdb67c",[3022,3186,3194],{"_uid":3023,"content":3024,"component":540},"c607c08d-a1a4-40a2-86c5-af1ef1b54eb0",{"type":12,"content":3025},[3026,3052,3057,3069,3074],{"type":15,"attrs":3027,"content":3028},{"textAlign":53},[3029,3031,3037,3039,3051],{"text":3030,"type":299},"We developed, and updated in 2020, this toolkit in partnership with the ",{"text":3032,"type":299,"marks":3033},"Mental Health Commission of Canada",[3034],{"type":760,"attrs":3035},{"href":3036,"uuid":53,"anchor":53,"custom":53,"target":764,"linktype":765},"https://mentalhealthcommission.ca/",{"text":3038,"type":299},". It is a part of a comprehensive guide, ",{"text":3040,"type":299,"marks":3041},"Creating a Safe Space: Strategies to Address the Psychological Safety of Healthcare Workers",[3042],{"type":760,"attrs":3043},{"href":3044,"uuid":332,"anchor":53,"custom":3045,"target":1486,"linktype":1487,"story":3046},"/resources/creating-a-safe-space-psychological-safety-of-healthcare-workers-peer-to-peer-support",{},{"name":3047,"id":3048,"uuid":332,"slug":3049,"url":3050,"full_slug":3050,"_stopResolving":461},"Creating a Safe Space: Psychological Safety of Healthcare Workers (Peer to Peer Support)",113880502320667,"creating-a-safe-space-psychological-safety-of-healthcare-workers-peer-to-peer-support","resources/creating-a-safe-space-psychological-safety-of-healthcare-workers-peer-to-peer-support",{"text":767,"type":299},{"type":600,"attrs":3053,"content":3054},{"level":1622,"textAlign":53},[3055],{"text":3056,"type":299},"Toolkit focus and categories",{"type":15,"attrs":3058,"content":3059},{"textAlign":53},[3060,3062,3067],{"text":3061,"type":299},"We built the ",{"text":3000,"type":299,"marks":3063},[3064],{"type":760,"attrs":3065},{"href":3066,"uuid":53,"anchor":53,"custom":53,"target":764,"linktype":765},"https://a-ca.storyblok.com/f/850807391887861/e225399e41/5-creating-a-safe-space-toolkit-en-final-ua.pdf",{"text":3068,"type":299}," by selecting useful documents and examples from existing peer support programs for healthcare providers, with input from experts and contributing organizations. We sorted these practical resources into three tables – peer support, psychological self-care and moral distress – and listed the source organization, title and a short description for each.",{"type":15,"attrs":3070,"content":3071},{"textAlign":53},[3072],{"text":3073,"type":299},"The resource categories are:",{"type":669,"content":3075},[3076,3087,3098,3109,3120,3131,3142,3153,3164,3175],{"type":672,"content":3077},[3078],{"type":15,"attrs":3079,"content":3080},{"textAlign":53},[3081,3085],{"text":3082,"type":299,"marks":3083},"Background",[3084],{"type":560},{"text":3086,"type":299}," – background context on the importance of psychological health and safety in healthcare, and the value of peer support.",{"type":672,"content":3088},[3089],{"type":15,"attrs":3090,"content":3091},{"textAlign":53},[3092,3096],{"text":3093,"type":299,"marks":3094},"Program description ",[3095],{"type":560},{"text":3097,"type":299},"– overviews of existing peer support programs.",{"type":672,"content":3099},[3100],{"type":15,"attrs":3101,"content":3102},{"textAlign":53},[3103,3107],{"text":3104,"type":299,"marks":3105},"Program development tool ",[3106],{"type":560},{"text":3108,"type":299},"– useful when developing a peer support program; these tools include checklists and templates to help you get started.",{"type":672,"content":3110},[3111],{"type":15,"attrs":3112,"content":3113},{"textAlign":53},[3114,3118],{"text":3115,"type":299,"marks":3116},"Policy document ",[3117],{"type":560},{"text":3119,"type":299},"– examples from various peer support programs.",{"type":672,"content":3121},[3122],{"type":15,"attrs":3123,"content":3124},{"textAlign":53},[3125,3129],{"text":3126,"type":299,"marks":3127},"Recruitment ",[3128],{"type":560},{"text":3130,"type":299},"– role descriptions, documents and templates that can help you recruit peer supporters for a program.",{"type":672,"content":3132},[3133],{"type":15,"attrs":3134,"content":3135},{"textAlign":53},[3136,3140],{"text":3137,"type":299,"marks":3138},"Training resources ",[3139],{"type":560},{"text":3141,"type":299},"– documentation from training programs and links to established external training on mental health and peer support for healthcare providers.",{"type":672,"content":3143},[3144],{"type":15,"attrs":3145,"content":3146},{"textAlign":53},[3147,3151],{"text":3148,"type":299,"marks":3149},"Documentation template ",[3150],{"type":560},{"text":3152,"type":299},"– for documenting interactions between peer supporters and their peer.",{"type":672,"content":3154},[3155],{"type":15,"attrs":3156,"content":3157},{"textAlign":53},[3158,3162],{"text":3159,"type":299,"marks":3160},"Promotional material ",[3161],{"type":560},{"text":3163,"type":299},"– examples of brochures and flyers used to promote peer support programs.",{"type":672,"content":3165},[3166],{"type":15,"attrs":3167,"content":3168},{"textAlign":53},[3169,3173],{"text":3170,"type":299,"marks":3171},"Evaluation tool ",[3172],{"type":560},{"text":3174,"type":299},"– to evaluate satisfaction and impact of a peer support program.",{"type":672,"content":3176},[3177],{"type":15,"attrs":3178,"content":3179},{"textAlign":53},[3180,3184],{"text":3181,"type":299,"marks":3182},"Testimonial ",[3183],{"type":560},{"text":3185,"type":299},"– videos and podcasts from healthcare providers and patients about the importance of psychological health and safety and of peer support.",{"_uid":3187,"file":3188,"link":3192,"label":3193,"linkType":1873,"component":1667,"linkLabel":16},"eabf1281-5c8c-4476-83f9-beb7ae89567d",{"id":3189,"alt":3190,"name":16,"focus":16,"title":3190,"source":16,"filename":3066,"copyright":16,"fieldtype":288,"meta_data":3191,"is_external_url":290},114291522131894,"5 Creating A Safe Space Toolkit EN FINAL Ua",{},{"id":16,"url":16,"linktype":1487,"fieldtype":1349,"cached_url":16},"Creating a Safe Space Healthcare Worker Support Toolkit ",{"_uid":3195,"content":3196,"component":540},"4af2bf33-9b01-47eb-8dcb-73e392d5e4c4",{"type":12,"content":3197},[3198],{"type":15,"attrs":3199,"content":3200},{"textAlign":53},[3201,3203,3211],{"text":3202,"type":299},"We have not made a complete inventory of every healthcare worker support model/resource available; we will update the toolkit regularly to ensure it remains relevant. Please use your discretion in selecting which tools are most appropriate for your context. We welcome feedback on what is helpful, what can be improved and content enhancements at ",{"text":3204,"type":299,"marks":3205},"info@hec-esc.ca",[3206,3210],{"type":760,"attrs":3207},{"href":3208,"uuid":3209,"anchor":53,"custom":53,"target":764,"linktype":765},"mailto:info@hec-esc.ca","null",{"type":560},{"text":767,"type":299},{"_uid":3213,"content":3214,"component":541},"b8d9aba0-11b1-46c6-ae11-d226954d64ae",[3215,3244],{"_uid":3216,"content":3217,"component":540},"a33f4fdf-630e-4df0-824c-bc0872ae31da",{"type":12,"content":3218},[3219,3224,3229,3234,3239],{"type":600,"attrs":3220,"content":3221},{"level":1622,"textAlign":53},[3222],{"text":3223,"type":299},"Creating a Safe Space – Strategies to Address the Psychological Safety of Healthcare Workers ",{"type":15,"attrs":3225,"content":3226},{"textAlign":53},[3227],{"text":3228,"type":299},"Cumulative stress, compassion fatigue and trauma due to experiences with patient safety incidents impact the mental wellness of healthcare providers. These factors contribute to preventable patient safety incidents, mental health issues and attrition, which compromise patient safety. Peer support programs (and other support models) help healthcare workers recover, restore and build resilience after patient safety incidents. They also improve the system and help make care safer.",{"type":600,"attrs":3230,"content":3231},{"level":1568,"textAlign":53},[3232],{"text":3233,"type":299},"Guideline focus and categories",{"type":15,"attrs":3235,"content":3236},{"textAlign":53},[3237],{"text":3238,"type":299},"The Creating a Safe Space – Strategies to Address the Psychological Safety of Healthcare Workers guideline is intended to assist healthcare organizations to support their healthcare workers by creating peer support programs (PSPs) or other models of support.",{"type":15,"attrs":3240,"content":3241},{"textAlign":53},[3242],{"text":3243,"type":299},"The guideline provides a comprehensive overview of what healthcare worker support models are available in Canada and internationally. It outlines best practice, and tools and resources that policy-makers, accreditation bodies, regulators and healthcare leaders can use to assess the support needs of healthcare workers.",{"_uid":3245,"file":3246,"link":3251,"label":3252,"linkType":1873,"component":1667,"linkLabel":16},"a351aec5-2b85-4b60-b5fc-8867c1135c81",{"id":3247,"alt":3248,"name":16,"focus":16,"title":3248,"source":16,"filename":3249,"copyright":16,"fieldtype":288,"meta_data":3250,"is_external_url":290},114291539191741,"Creating A Safe Space Manuscript FINAL Ua","https://a-ca.storyblok.com/f/850807391887861/88b9da509b/creating-a-safe-space-manuscript-final-ua.pdf",{},{"id":16,"url":16,"linktype":1487,"fieldtype":1349,"cached_url":16},"The Creating a Safe Space – Strategies to Address the Psychological Safety of Healthcare Workers",[],[],"creating-a-safe-space-healthcare-worker-support-toolkit","resources/creating-a-safe-space-healthcare-worker-support-toolkit",-15170,[],{"parent_slug":457,"umbraco_path":3260,"umbraco_uuid":3261},"/HealthcareExcellenceCanada/Resources/CreatingASafeSpacePsychologicalSafetyOfHealthcareWorkersPeerToPeerSupport/CreatingASafeSpaceHealthcareWorkerSupportToolkit","8085bc13-4747-4f11-93a5-0ee6289221d4","deb43c9b-43c4-4e4b-9782-f0b29922e483","2025-11-18T19:01:03.752Z",[],[3266],{"path":3267,"name":3268,"lang":469,"published":461},"ressources/creation-dun-espace-sur-boite-a-outils-de-soutien-aux-travailleurs-de-la-sante","Création d'un espace sûr - 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","7c04f156-63fe-49f0-99fd-fa0b58c4ce61",[3340],{"_uid":3341,"file":3342,"image":3343,"title":3330,"format":16,"component":501,"description":3345,"key_learning":16,"prerequisite":16},"6ecc6dd1-97ad-44d9-9eb0-5c8448fc8557",[],{"id":1608,"alt":16,"name":16,"focus":16,"title":16,"source":16,"filename":1609,"copyright":16,"fieldtype":288,"meta_data":3344,"is_external_url":290},{"alt":16,"title":16,"source":16,"copyright":16},{"type":12,"content":3346},[3347],{"type":15,"attrs":3348,"content":3349},{"textAlign":53},[3350],{"text":3351,"type":299},"Embedding Palliative Approaches to Care (EPAC) is a proven innovation that helps staff in long-term care homes identify residents who could benefit from a palliative approach to care.",[69,46],[3354,3419,3474,3485,3568,3584,3619],{"_uid":3355,"content":3356,"component":541},"3f108f55-1d7f-498e-a196-36d51ff2b970",[3357,3410],{"_uid":3358,"content":3359,"component":540},"7f363450-ff9e-405d-aec5-03cba7637384",{"type":12,"content":3360},[3361,3369,3374,3379,3390,3395,3400,3405],{"type":15,"attrs":3362,"content":3363},{"textAlign":53},[3364,3366],{"text":3365,"type":299},"Only 15 percent of people in Canada have early access to palliative care at home, including residents living in long-term care homes. Sixty-two percent of people in Canada who receive palliative care receive it in an acute care hospital – most likely in the last month of their life.",{"text":524,"type":299,"marks":3367},[3368],{"type":527},{"type":15,"attrs":3370,"content":3371},{"textAlign":53},[3372],{"text":3373,"type":299},"Through EPAC, team members have conversations with residents, their families and care partners about their preferences for palliative care. Together they create comprehensive, resident-centred care plans that honour the resident’s wishes, values and choices.",{"type":15,"attrs":3375,"content":3376},{"textAlign":53},[3377],{"text":3378,"type":299},"Early identification of care requirements plays a critical role in triggering other components of high-quality palliative care. Offering a common, consistent approach to supporting residents who are near the end-of-life creates opportunities – and provides permission – for death and dying to be openly discussed, normalized and supported.",{"type":15,"attrs":3380,"content":3381},{"textAlign":53},[3382,3384,3388],{"text":3383,"type":299},"EPAC originated from Vancouver Coastal Health’s ",{"text":3385,"type":299,"marks":3386},"The Daisy Project: embedding a palliative approach in residential settings",[3387],{"type":617},{"text":3389,"type":299},", part of the open call for innovations in 2017 by the Canadian Foundation for Healthcare Improvement (CFHI – now Healthcare Excellence Canada). The following year, CFHI worked closely with Jane Webley from Vancouver Coastal Health to launch a collaborative to spread EPAC. Seven teams from five provinces and one territory participated in the collaborative until November 2019, implementing EPAC through a train-the-trainer approach in 22 long-term care homes.",{"type":600,"attrs":3391,"content":3392},{"level":1568,"textAlign":53},[3393],{"text":3394,"type":299},"How EPAC contributes to better healthcare in Canada",{"type":15,"attrs":3396,"content":3397},{"textAlign":53},[3398],{"text":3399,"type":299},"EPAC was part of our ongoing effort to spread and scale proven innovations that deliver high quality care closer to home and the community.",{"type":15,"attrs":3401,"content":3402},{"textAlign":53},[3403],{"text":3404,"type":299},"Seventy-five percent of people in Canada who have a preference would prefer to die in their home2– including long-term care homes. By spreading EPAC, we aimed to help increase healthcare providers’ capacity and capability in delivering end-of-life care at home, as well as avoid unnecessary emergency department visits and hospital admissions.",{"type":15,"attrs":3406,"content":3407},{"textAlign":53},[3408],{"text":3409,"type":299},"EPAC has been instrumental in successfully shifting the culture and normalizing conversations about end-of-life and living goals. It improves end-of-life care experiences for dying residents, their families and loved ones, as well as for their healthcare providers.",{"_uid":3411,"file":3412,"link":3417,"label":3418,"linkType":1873,"component":1667,"linkLabel":16},"cda90c0e-8bd9-4db8-bbc4-4aff62536d4c",{"id":3413,"alt":3414,"name":16,"focus":16,"title":3414,"source":16,"filename":3415,"copyright":16,"fieldtype":288,"meta_data":3416,"is_external_url":290},114291761407989,"2022 EPAC Evalsummary EN UA","https://a-ca.storyblok.com/f/850807391887861/d7cf99cdc3/2022-epac-evalsummary-en-ua.pdf",{},{"id":16,"url":16,"linktype":1487,"fieldtype":1349,"cached_url":16},"Evaluation Results Summary",{"id":16,"_uid":3420,"content":3421,"component":541},"34204fa0-a19c-48bd-bae1-ab301b995939",[3422],{"_uid":3423,"content":3424,"component":540},"10d0a693-6ef3-4d18-9ce4-5314b8b06181",{"type":12,"content":3425},[3426,3431,3436],{"type":15,"attrs":3427,"content":3428},{"textAlign":53},[3429],{"text":3430,"type":299},"The Model",{"type":15,"attrs":3432,"content":3433},{"textAlign":53},[3434],{"text":3435,"type":299},"The EPAC model is a house with four pillars (shown in the diagram below) that are flexible, enabling individual long-term care homes to adopt and adapt them to their unique local needs and strengths. The overarching starting point is to identify, discuss, plan (IDP) at least six weeks prior to end-of-life. The four pillars that stand underneath this are:",{"type":738,"attrs":3437,"content":3438},{"order":740},[3439,3446,3453,3460],{"type":672,"content":3440},[3441],{"type":15,"attrs":3442,"content":3443},{"textAlign":53},[3444],{"text":3445,"type":299},"Increase staff capacity and confidence: education, tools, resources.",{"type":672,"content":3447},[3448],{"type":15,"attrs":3449,"content":3450},{"textAlign":53},[3451],{"text":3452,"type":299},"Increase knowledge of residents and families: palliative care, disease trajectory, goals of care/serious illness conversation.",{"type":672,"content":3454},[3455],{"type":15,"attrs":3456,"content":3457},{"textAlign":53},[3458],{"text":3459,"type":299},"Psychosocial care for residents and families: impact of loss on survivors, tools, resources.",{"type":672,"content":3461},[3462,3467,3469],{"type":15,"attrs":3463,"content":3464},{"textAlign":53},[3465],{"text":3466,"type":299},"Psychosocial care for healthcare team: tools, resources.",{"type":15,"attrs":3468},{"textAlign":53},{"type":15,"attrs":3470,"content":3471},{"textAlign":53},[3472],{"text":3473,"type":299},"Underneath the pillars sits the foundation layer of metrics and reporting.",{"id":16,"_uid":3475,"image":3476,"component":3484},"0ee8cb4a-d03e-47e7-97c5-c2198334ae19",{"id":3477,"alt":3478,"name":3479,"focus":3480,"title":3481,"source":16,"filename":3482,"copyright":16,"fieldtype":288,"meta_data":3483,"is_external_url":290},114299146628894,"The EPAC model is a house with four pillars (shown in the diagram below) that are flexible, enabling individual long-term care homes to adopt and adapt them to their unique local needs and strengths. The overarching starting point is to identify, discuss, plan (IDP) at least six weeks prior to end-of-life. The four pillars that stand underneath this are:      Increase staff capacity and confidence: education, tools, resources.    Increase knowledge of residents and families: palliative care, disease trajectory, goals of care/serious illness conversation.    Psychosocial care for residents and families: impact of loss on survivors, tools, resources.    Psychosocial care for healthcare team: tools, resources.  Underneath the pillars sits the foundation layer of metrics and reporting.","The EPAC model is a house with four pillars (shown in the diagram below) that are flexible, enabling individual long-term care homes to adopt and adapt them to their unique local needs and strengths. The overarching starting point is to identify, discuss, plan (IDP) at least six weeks prior to end-of-life. The four pillars that stand underneath this are:\n\n\n\n\n\nIncrease staff capacity and confidence: education, tools, resources.\n\n\n\nIncrease knowledge of residents and families: palliative care, disease trajectory, goals of care/serious illness conversation.\n\n\n\nPsychosocial care for residents and families: impact of loss on survivors, tools, resources.\n\n\n\nPsychosocial care for healthcare team: tools, resources.\n\nUnderneath the pillars sits the foundation layer of metrics and reporting.","1505x1673:1506x1674","2022 EPAC Pillarsdiagram EN","https://a-ca.storyblok.com/f/850807391887861/46aecd0da4/2022-epac-pillarsdiagram-en.png",{"alt":3478,"title":3481,"source":16,"copyright":16},"single-media",{"id":16,"_uid":3486,"content":3487,"component":541},"c17bfa9c-133d-4bc6-8771-7331d9d6f5e8",[3488],{"_uid":3489,"content":3490,"component":540},"853a82c8-62a0-4e69-ab3a-bac23c15c2f8",{"type":12,"content":3491},[3492,3497,3502,3507,3512,3517],{"type":600,"attrs":3493,"content":3494},{"level":1568,"textAlign":53},[3495],{"text":3496,"type":299},"The Approach",{"type":15,"attrs":3498,"content":3499},{"textAlign":53},[3500],{"text":3501,"type":299},"Through the EPAC Collaborative, we provided teams with support and access to a range of resources to help spread and embed EPAC in their long-term care homes through a train-the-trainer approach.",{"type":15,"attrs":3503,"content":3504},{"textAlign":53},[3505],{"text":3506,"type":299},"Long-term care providers can use our four short modules to get started in delivering palliative and end-of-life care through EPAC.",{"type":15,"attrs":3508,"content":3509},{"textAlign":53},[3510],{"text":3511,"type":299},"Our interactive four-part module, Giving the Gift of Time: Embedding Palliative Approaches to Care , walks long-term care teams through the journey of a real resident, offering ways to improve end-of-life care.",{"type":15,"attrs":3513,"content":3514},{"textAlign":53},[3515],{"text":3516,"type":299},"EPAC Teams",{"type":669,"content":3518},[3519,3526,3533,3540,3547,3554,3561],{"type":672,"content":3520},[3521],{"type":15,"attrs":3522,"content":3523},{"textAlign":53},[3524],{"text":3525,"type":299},"Centre intégré universitaire de santé et de services sociaux (CIUSSS) de la Mauricie-et-du-Centre-du-Québec, Québec",{"type":672,"content":3527},[3528],{"type":15,"attrs":3529,"content":3530},{"textAlign":53},[3531],{"text":3532,"type":299},"Haliburton Highlands Health Services, Haliburton, Ontario",{"type":672,"content":3534},[3535],{"type":15,"attrs":3536,"content":3537},{"textAlign":53},[3538],{"text":3539,"type":299},"Institute for Continuing Care Education and Research (ICCER), Alberta",{"type":672,"content":3541},[3542],{"type":15,"attrs":3543,"content":3544},{"textAlign":53},[3545],{"text":3546,"type":299},"New Brunswick Association of Nursing Homes",{"type":672,"content":3548},[3549],{"type":15,"attrs":3550,"content":3551},{"textAlign":53},[3552],{"text":3553,"type":299},"Parkwood Seniors Community, Waterloo, Ontario",{"type":672,"content":3555},[3556],{"type":15,"attrs":3557,"content":3558},{"textAlign":53},[3559],{"text":3560,"type":299},"Western Health, Newfoundland and Labrador",{"type":672,"content":3562},[3563],{"type":15,"attrs":3564,"content":3565},{"textAlign":53},[3566],{"text":3567,"type":299},"Yukon Health and Social Services",{"id":16,"_uid":3569,"items":3570,"component":2532},"f4c3d386-c9ff-4227-82c2-3c88cea4e45b",[3571],{"_uid":3572,"image":3573,"quote":3575,"author":3582,"component":2530,"author_title":3583},"4c6c09d9-471d-4cef-8256-6ffd02e87e51",{"id":53,"alt":53,"name":16,"focus":53,"title":53,"source":53,"filename":16,"copyright":53,"fieldtype":288,"meta_data":3574},{},{"type":12,"content":3576},[3577],{"type":15,"attrs":3578,"content":3579},{"textAlign":53},[3580],{"text":3581,"type":299},"“Earlier conversations about things that matter provide permission for collaborative planning and saying goodbye in a meaningful way, creating lasting memories. I call this the ‘Gift of Time’ that we, as healthcare providers, can offer residents and the people that are important to them.”","Jane Webley","Regional Leader, End of Life, Vancouver Coastal Health (2018)",{"_uid":3585,"content":3586,"component":541},"aab35dd8-21a6-4b9d-bba7-f30ef2653580",[3587,3611],{"_uid":3588,"content":3589,"component":540},"1f58f3d2-331c-49ba-a95d-c5b052e368e3",{"type":12,"content":3590},[3591,3596,3601,3606],{"type":600,"attrs":3592,"content":3593},{"level":1568,"textAlign":53},[3594],{"text":3595,"type":299},"Embedding Palliative Approaches to Care (EPAC) Learning Modules",{"type":15,"attrs":3597,"content":3598},{"textAlign":53},[3599],{"text":3600,"type":299},"Palliative approaches to care improve the quality of life of residents, families and caregivers facing life-limiting illness.",{"type":15,"attrs":3602,"content":3603},{"textAlign":53},[3604],{"text":3605,"type":299},"We’ve developed these four short modules to help long-term care teams get started in delivering improved palliative and end-of life care. Through this learning, teams will be better equipped to have meaningful end-of-life conversations with residents, families and caregivers – giving them the gift of time to honour the resident’s wishes, values and choices.",{"type":15,"attrs":3607,"content":3608},{"textAlign":53},[3609],{"text":3610,"type":299},"Each module has a short video and accompanying resources to help learners reflect on and use what they see and hear in the videos. We’ve based the modules on materials from our Embedding Palliative Approaches to Care (EPAC) Collaborative.",{"_uid":3612,"file":3613,"link":3618,"label":3595,"linkType":1873,"component":1667,"linkLabel":16},"7f6fbe1a-eff3-48e2-b9ea-f9b2f64510d0",{"id":3614,"alt":3615,"name":16,"focus":16,"title":3615,"source":16,"filename":3616,"copyright":16,"fieldtype":288,"meta_data":3617,"is_external_url":290},114291756984307,"20220215 Epaclearningmodules EN","https://a-ca.storyblok.com/f/850807391887861/3a2853bb50/20220215-epaclearningmodules-en.pdf",{},{"id":16,"url":16,"linktype":1487,"fieldtype":1349,"cached_url":16},{"_uid":3620,"content":3621,"component":541},"3e6dac40-349b-46e7-88d1-afa86fd0cbff",[3622],{"_uid":3623,"content":3624,"component":540},"67b16e10-1bee-45ac-b127-a16404099615",{"type":12,"content":3625},[3626,3631,3636,3641],{"type":600,"attrs":3627,"content":3628},{"level":1568,"textAlign":53},[3629],{"text":3630,"type":299},"Giving the Gift of Time: Embedding Palliative Approaches to Care",{"type":15,"attrs":3632,"content":3633},{"textAlign":53},[3634],{"text":3635,"type":299},"Death and dying is hard to talk about. For residents, families and care partners in long-term care homes, it’s important. It gives them the gift of time. Time to say and experience the things they want to in the time they have. To live for today. And to make informed choices about their care.",{"type":15,"attrs":3637,"content":3638},{"textAlign":53},[3639],{"text":3640,"type":299},"We’ve developed an easy to use, interactive module to help long-term care teams have better conversations about end-of-life with residents, families and care partners. Long-term care homes and caregivers participated in creating this evidence-based module, which is broken into four parts.",{"type":15,"attrs":3642,"content":3643},{"textAlign":53},[3644],{"text":3645,"type":299},"As we walk through the journey of a real resident, 85-year-old François (a pseudonym), we offer guiding questions – giving the learner a chance to reflect on what they are doing now, and what they can do differently. We also share tips on how team members can take care of themselves and support colleagues too.",[129],[192,200],"embedding-palliative-approaches-to-care-epac","resources/embedding-palliative-approaches-to-care-epac",-14990,[],{"parent_slug":457,"umbraco_path":3653,"umbraco_uuid":3654},"/HealthcareExcellenceCanada/Resources/EmbeddingPalliativeApproachesToCareEPAC","995ad68b-1ffc-4970-bbed-bf0d78ada25f","492f572f-d46a-4b4e-92c8-476d5d04ca07","2025-11-18T19:00:56.206Z",[],[3659],{"path":3660,"name":3661,"lang":469,"published":461},"ressources/integration-des-approches-palliatives-aux-soins-epac","Intégration des approches palliatives aux soins (EPAC)",156,1776087583486]