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Improvement: It’s About Relationships

No Comments   |   ksmith   |   Mar 12, 2013

Quality Forum 2013’s theme was Inspiring Improvement – a play on words that ended up as a fairly accurate description of the Forum’s content and outcome. As 630 participants traversed the Hyatt Regency Vancouver (we used 16 rooms stretched across 32 floors!), one theme stood out among all the great work being spread by 150+ presenters: quality improvement is all about relationships.

Improving health care quality requires change, and in a field where teamwork is paramount, change requires engagement from many people (especially for it to be sustained). Good relationships form the foundation of this commitment, and the Forum’s presentations were full of examples.

It started with plenary speaker Gerard van Grinsven. He worked for over 25 years in the luxury hospitality industry before being hired by Henry Ford as the president and CEO of Henry Ford West Bloomfield Hospital. With no experience working in health care, Gerard had his work cut out for him. Right away he began gaining the trust of his hospital’s board and clinical leaders.

Many of Gerard’s ideas (a hair salon, an atrium and a greenhouse) were pretty radical for the health system and gaining the support of his colleagues was critical for their implementation. These days, he establishes relationships with new employees before they work a day at his hospital. About a week before their start date, he phones them, and thanks them for choosing to work at his hospital. What a great way to build support from colleagues from the front lines to the administration. Check out Gerard’s presentation to learn more.

The Academic Health Education pre-Forum deep dive session featured a fantastic improv activity that had participants act as, and react to, some pretty exaggerated characters we might come across in the emergency department. How is a care team supposed to deliver the best care for a patient when its members don’t know each other, don’t trust each other, and are afraid to ask questions?

In the Twitter 101 breakout session, Ajay Puri, Robyn Sussel and Kemp Edmonds taught a curious group of participants why and how to use the social media tool. Twitter can help you establish relationships with colleagues from around the world. It’s a great way to share resources, best practices and event information. The BC Sepsis Network co-hosted a global Twitter chat on World Sepsis Day – a collaboration built on relationships established through Twitter.

And who knew reducing urinary tract infections would require team efforts? But the UR IN(e) Trouble! breakout may have set a record for the most presenters in one session. Teams throughout Fraser Health worked together to reduce UTIs, particularly for patients undergoing joint replacement surgeries. Three teams of presenters (one of which featured five people!) delivered rapid fire presentations about their improvement efforts; it was clear that open communication and fantastic levels of teamwork played a role in dramatically reducing UTIs at their sites.

Friday featured a couple of great examples of how technology can be used to build relationships. The Health in BC – Citizens @ the Centre breakout session heard how the provincial government is using websites like and to engage the public. And presenters in the Crowdsourcing & Collaboration to Drive Innovation breakout session provided vivid examples of how people (who are often strangers) are working with each other, and technology, to create pioneering games and health apps.

Finally, a patient’s story is more than what a physician sees in the emergency room. Vincent Lam told three impactful stories during his plenary presentation that shared a common theme: no matter how busy you are, how mean a patient is, or how simple a diagnosis may seem, it’s important to take the time to develop relationships with patients and their family members so that you can gain a complete understanding of their stories.

The stories and initiatives highlighted in these presentations are pretty diverse. They deal with different areas of care, were implemented at numerous levels – from the front line to the board room – and improve care in their own ways. But they all depend on relationships to succeed. They combine to drive home the point that great improvement plans can be ready to roll out, but great relationships between the people who will be implementing them are integral to success.

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