New St. Paul’s: Planning a Hospital With Patients at the Center

“Patient-centered care” is a relatively new standard in health care delivery, and one that is being actively pursued in B.C.’s health system. In fact, the B.C. Ministry of Health named patient-centered care its first priority in its 2014 strategic plan.

At SFU’s City Conversations lunch-hour discussion today (Sept. 16), participants heard that motto – “patient-centered” – many times. The dialogue was about plans to move St. Paul’s Hospital to a new facility to be built in the False Creek Flats.

A business plan for the proposed $1.2 billion facility will be developed over the next 12 to 18 months, and participants posed many wide-ranging questions about everything from transportation access for the new St. Paul’s to whether one central facility would be better than many small sites throughout Vancouver’s core.

With patient-centered care, the goal is to build and deliver health care services around the individual – not the providers or administration. Darlene MacKinnon, the redevelopment project’s Chief Clinical Planner, told participants this is the first time a new hospital in B.C. is being planned with a patient-focused approach, as opposed to planning by hospital department.

“It’s all about better care for patients,” she said.

But what does it mean to plan and build a hospital with patients at the centre? And how can that ideal be achieved?

Individuals have widely varying needs and priorities. A pregnant woman who wants to have a natural birth experience will have extremely different expectations for her hospital experience compared to an acutely ill person battling cancer, or someone in palliative care.

One of the key strategies for building patient-centered care models is patient engagement – connecting with patients and listening to their experiences, hopes and needs. And St. Paul’s is just starting a 3-phase engagement process to hear from patients, health care providers and other project stakeholders.

MacKinnon also said the project team has pledged to have at least three patient representatives on every committee that’s formed to help plan the new hospital.

That all sounds great and as engagement professionals with experience in patient engagement, we see some opportunities to go even further.

While three patient reps on each committee may sound like a lot, there are many different kinds of patients. Health status and history, age, ethnicity, income levels, education levels and many other demographic considerations will impact the kind of experience and input a patient will bring to the planning table. The question then goes the recruiting diverse patients.

Often, the people who need the health care system the most – those with chronic diseases, mental health challenges, substance abuse patterns, frail seniors, homeless – are unable to easily participate in such committees or other engagement activities. How can care be centered around these patients when they’re perhaps too sick to communicate what they want their health care to look like?

We see great opportunities for engagement beyond the committee structure. For example, webinars, in-clinic engagement, engaging families and caregivers through established support networks, and leveraging support groups and advocates for vulnerable populations, including Positive Living BC.

We look forward to following St. Paul’s process as they move towards a patient-centered facility and we think this is a major step in the right direction for all patients in B.C.