Tag Archives: OHA HealthAchieve

OHA HealthAchieve: Wrestling with the role of patients in the system

Photograph of Harvard professor Michael Porter speaking at this year's Ontario Hospital Association HealthAchieve.

Harvard professor Michael Porter speaking at this year’s OHA HealthAchieve.

There was an epiphany moment at this year’s Ontario Hospital Association HealthAchieve when a hospital administrator responsible for patient surveys admitted that she had been doing it all wrong. The surveys were all about the hospital’s performance, not about the patient, she said.

We are in the age of continual measurement as administrators try to reduce the business of providing health care to a series of performance data tables. One could argue that surveying patients about their care is about improving the patient experience, so one has to wonder where the sophistry ends and where practical management begins?

At this year’s conference there was plenty of angst about the role of the patient in determining how health care is delivered.

Paul Corrigan, a former health advisor to UK Prime Minister Tony Blair, made a less than convincing case that health care providers should be basing their decisions around outcomes defined by the patient instead of the health professionals. Instead of a surgeon deciding a procedure has been a success, for example, that success should be defined around whether the patient achieves his or her goal to “walk to the shops,” for example. It’s perhaps a good thing that Corrigan didn’t encounter a patient whose goal was to play piano at Carnegie Hall.

“Hearing what patients are saying would be transformative,” says Corrigan, the implication being that we don’t.

Sir Nigel Crisp, a former senior manager in the UK’s National Health Service, ramped up the rhetoric by going as far as saying “professionals need to get down from their pedestals and patients up from their knees.” Seriously?

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Few anti-stigma campaigns based on evidence — Stuart

“Mental health is set aside as that other kind of health care we don’t want to talk about.” – Asante Haughton, one of three youth featured in the Ontario Shores produced film “Talk To Someone: You’re Not Alone.”

Queen’s University researcher Dr. Heather Stuart says the majority of anti-stigma campaigns are not evidence based and few are evaluated. In fact, her research suggests that we may even have to retrench and undo the damage some of these past campaigns have created.

That includes discussion of mental disorders as a brain disease. Her research shows that such descriptors actually increase social distance, not close it.

Speaking at the Ontario Hospital Association HealthAchieve on Monday, Stuart says protests over stigma can “backfire,” resulting in greater polarization of the issue. Stigma should be regarded as a “transgenerational problem.”

“You can’t sell social inclusion like you sell soap,” she told the packed conference room.

We’re all part of it, she says, including families and the mentally ill themselves who create a “self-stigma.” That includes self-blame.

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