Understanding the patient experience in the ICU

When Dr. Susan Shaw learned about NHS Change Day in 2013, she was inspired. She wanted to bring the concept to her home province of Saskatchewan, Canada – and she did just that.

“I had watched the energy and excitement that the first NHS Change Day was able to build in England. I thought that Saskatchewan would also embrace such a positive and fun idea,” said Shaw, who is the board chair of the Saskatchewan Health Quality Council.

“I work with people with lots of great ideas of how to improve their work and care for patients, so I wanted to bring in the idea of ‘just do it!’ I wanted to encourage people to just try something and see what happens. See how this makes you feel better about your work, yourself and your ability to make a difference.”

The first Saskatchewan Change Day was held on Nov. 6, 2014. The campaign, which was launched by the Health Quality Council, was the first of its kind in Canada.

Saskatchewan Change Day organisers hoped to receive 1,000 pledges on the Change Day website however, they surpassed that goal and received nearly 1,400 pledges from health care providers, patients and others in the province of about 1.1 million people.

Shaw, who practices critical care and anesthesiology in Saskatoon, Saskatchewan, seized Change Day as an opportunity to better understand the patient experience. Her pledge was to spend some time in an intensive care unit (ICU) bed, paying close attention to what it might feel like to be a patient there.

“I was able to spend 45 minutes in an ICU bed before I was discovered by my co-workers, so I think I was able to experience the ICU without my presence changing the environment or the behaviour of the ICU team,” she said.

While acting on her pledge, Shaw quickly made some observations.

“The first thing I noticed was that even though it wasn’t very loud, the noise was continuous in the ICU. I could hear beeps, alarms, voices, foot traffic and conversations about the care being planned or provided. My mind went to thinking about how much I don’t like noise when I’m stressed or feeling unwell and that this must be amplified for patients or families in our ICUs,” she said.

“I also noticed how much collaboration and support the doctors, nurses, pharmacists, dieticians, housekeepers and special care aides provided to our families, patients and each other on a continuous basis. That made me very proud. “

As a result of her time in the ICU bed, Shaw was also reminded how “overwhelmingly odd” medical care settings can seem.

“I think heightened sensitivity to this would help us, as care providers, to be more empathetic and sensitive to how overwhelmed and scared our patients and families must be,” she said.

“We can help shape their emotional experiences by being more aware and thoughtful. Our physical layout determines a lot of the noise and bustle of the ICU, but we can look to better manage what we can control.”

Shaw learned a lot as a result of her Change Day pledge. She said the experience has impacted the way she interacts with patients and families.

“I’ve noticed that I’m now spending more time sitting with families at their patient’s bedside to go through and try to better explain what is happening to their loved one. I thought I was doing a pretty good job of this before my Change Day pledge, but now I think I can do better based on what I noticed and felt.”

Shaw was also inspired by the Saskatchewan Change Day pledges made by other health care providers. For example, one physician pledged to double the number of house calls he makes to those who are unwell and who find it difficult to visit his office. Another physician pledged to arrange his office on Change Day so that no patient would have to wait to see him. He also pledged to greet each patient as they arrived.

“While health system transformation requires large improvement initiatives, the small actions we take and the things we say every day also matter. Combined, those small actions can make a big difference,” said Shaw.

You can read about other pledges made for Saskatchewan Change Day: in Story 81, Laboratory Manager Lenore Howey shares why she made changes to her teams' name tags; and in story 74, Registered Nurse, Sue-Ellen White shares how she is promoting team work and encouraging everyone to treat each other equally and with respect.

  • 100 Days of Change
  • Campaigns > Change Day 2015
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