Collaboration based on an integrated multiparty approach

to smooth the inter-establishment trajectory of patients

The primary objective of the Patient Trajectory project is to implement solutions that will make the inter-establishment trajectory clearer, smoother and more comprehensible for patients, so that they can be directed towards the appropriate care and services. To grasp the scope of this project, we need to look at the list of multiple stakeholders who have been included in the process of analyzing, brainstorming and co-creating these solutions, right from the start. The project involves :

  • A multi-disciplinary, multi-center working group (clinical professionals, managers, MUSCO inter-institutional trajectory coordinator and families), to reflect on the solutions to be implemented;
  • A research team in charge of conducting a study (the My Way study | Mon chemin study) to analyze needs and assess the impact of the solutions implemented;
  • Local research teams in each partner hospital to support the work carried out by the My Way | Mon chemin research team;
  • A Meilleur Monde social design cooperative to support the working group in facilitating the brainstorming workshops, as well as assisting the research team in gathering family-related data;
  • And finally, the MUSCO coordination team, who facilitated exchanges between all these stakeholders.

In all, nearly 50 people have contributed to the project’s progress, based on a truly integrated approach. Each of these contributors has made his or her own small contribution to the project. It was a lengthy process, but one whose methodology has proved its worth, resulting in a list of concrete solutions recently submitted to the establishments. According to Kelly Thorstad, Director of Nursing and Patient Services, Shriners Hospitals for Children – Canada, but also responsible for this project within MUSCO, it’s not possible to say that a best practice is proven if it’s not “evidence-based, which is facilitated by the research process.”

Working in this way has many advantages. As Marie Beauséjour, principal investigator in charge of the My Way | Mon chemin study, explains, in this context it has enabled the team “to learn from each other, in particular, about approaches to data collection adapted to the collective setting and objectives, but also to share theoretical knowledge and the partners’ experiential knowledge in order to deploy a relevant protocol for documenting families’ experiences of care.”

Indeed, both Kelly and Marie agree that the collaboration was fruitful, enriching analysis and reflection throughout the evolution of the project. For the patients who were involved in the project in particular, there were a number of other benefits, not least of all the opportunity to make their reality known. Many of those involved were surprised to learn that the situations experienced by the parents were very different from what they had imagined, or from what would usually happen.

It’s as if the difficulties encountered by patients weren’t known or reported to all the parties involved,

Mentions Caroline Marie Fidalgo, Patient-Resource on the project’s working group and Patient-Expert on MUSCO’s Advisory Pole.

Being a patient partner is a pleasure, because we know that people are trying to incorporate patients’ experiences into future initiatives,

Adds Matthew Bergamin, a patient who has been asked to contribute to the My Way | Mon chemin study component of the project.

Caroline Marie and Matthew’s contribution was instrumental in really understanding the care trajectory and what may be experienced by families struggling with long and frequent visits to facilities, as was the contribution of the professionals. “The presence of patients and partners was essential because we can discuss processes and improvements all we want, but if healthcare professionals don’t validate with patients and families what their real needs are, we’ll miss the mark every time. We really need to value the voice of patients, families and partners, because they’re the reason we’re here,” says Kelly.

Kelly also notes that the workshops organized to reflect on barriers and potential solutions had the advantage of bringing all these stakeholders together around the same table. According to her, this enabled “to have concise discussions on the real problems facing patients and families, and on plausible solutions that could be validated immediately with the stakeholders since they were all present”.

Thanks to this integrated process, several important milestones have been reached in recent months:

  1. Workshops were held to brainstorm and come up with potential solutions to the problems hampering inter-facility patient transfers;
  2. These solutions were presented to establishments management for subsequent implementation.

In addition to professionals and families, and researchers to feed discussions with evidence-based data, another type of partner played a central role in getting through these stages. With the help of ongoing facilitation by Meilleur Monde cooperative service designers Sophie Riendeau and Solen Roth, trained in field research methods, the workshops helped define the solutions to be implemented in the next phases of the project. Their skills in representing the project in “a more visual way, using quotes and schematizations, for example”, enabled the various collaborators to take ownership of the subject in the first instance. It’s a step that makes it easier to design solutions later on.

“Indeed, it’s one thing to know how things are done today, and quite another to imagine how things could be done differently. That’s what design is all about: moving from knowledge to concrete projects”, explains Solen. She and Sophie particularly appreciate the fact that they were able to work closely with the My Way | Mon chemin research team and the MUSCO resources team to have a “positive impact on the lives of the families concerned”, a model of integrated collaboration that they both hope to “apply in their future projects”.

All in all, a model of collaboration that has proved its worth so far, and which will hopefully inspire others.