It might have been just another change management fad. The room contained all the usual suspects: white boards, sharpies, post it notes, and a collection of chairs around a long table.
They had no idea what they were getting themselves into.
There were 12 people altogether – staff, leadership, physicians, and two family members. The group had come together to solve a wicked problem identified by obstetrical nursing staff about the visiting policy at the antepartum unit.
This unit is for women who require admission into hospital due to medical complications that could lead to premature birth of their baby or babies. These patients can be in hospital for long periods of time - 8 to 12 weeks - leading to lengthy separations from their families and support systems.
The visiting policy was a restrictive remnant of a previous time and was not at all in line with AHS’s Patient First policy. Something had to change.
These moms and their babies are essential participants for an effective Women's Health SPRINT
Enter Julie Schellenberg, healthcare rebel, and her Active Learning Project team. They were working with the AHS Executive Program to trial run a new problem-solving method called a SPRINT. The team modified the typical SPRINT 5 day process to 2 days, and then Julie facilitated the activities at the Foothills Medical Centre in Calgary in early April.
Two weeks later, they pulled together another maternal health group at the Royal Alexandra Hospital in Edmonton.
“It was a phenomenal experience,” recalls Julie. “It was kind of an unknown for us how the SPRINT would work being whittled down to two days, and it was such a different approach to have moms and babies in the room with staff and leaders. All the participants were equal partners in the process and the issue that we were working on had been previously talked about for several years. Years!” she laughs. “And we solved it with a SPRINT after only two days!”
Julie and her team adapted the five-day SPRINT into two days.
Penny Holmes is a unit manager at the Royal Alex. “I expected it to be similar to other change models, but I was surprised by how quickly we were able to put proposed solutions into action,” she comments.
Her colleague, also a unit manager, agreed. “I thought there would be a lot of information downloading; slides, etc.,” remembers Nomagugu Moyo, “but was pleasantly surprised that we went straight to the issues. The team is granted freedom to review issues and swiftly implement change.”
Bryan Peffers is an executive director for Women’s Health at FMC and a participant of the Executive Program. “If you’re doing design changes, you want to have the buy-in from the front line, because that’s the people that will have to use the solution every day. The neatest thing was watching the nurses come together because there were five nurses that had various backgrounds, had various relationships with each other, and they came up with a solid product and they were quite excited about it. They actually saw it from a concept to a reality within a very short period of time.”
After two days of ideating, prototyping and testing with real patients in the maternity ward, the Foothills SPRINT team knew they had a winning idea. The team was able to design a new process for visitors, develop patient and staff education and remove all the signs that showed any type of visiting restrictions, replacing the signs with more inclusive and engaging messaging.
Bryan took the time to talk to patients about the new visiting policy, and found that they and their families were incredulous the ward hadn’t always been so welcoming.
One patient wondered what women did to cope during the old policy, and points out,
“I am going to be here for a least eight weeks, and it is so hard to be away from my partner and children. I don’t want to be here, but I understand the importance of why I am here.
“It is so lonely and no one really understands what my partner and I are going through. We are so scared that we may have a premature baby and what that is going to do to our family or worse yet - we may lose this baby.
The worst time for me is late at night, so it is so comforting to have someone from my family stay with me. I cannot comprehend that the hospital would kick someone out when I needed them the most."
The new signs are more welcoming and inclusive to families. No more visiting hours!
Julie and Bryan are both keen to try SPRINTS with more groups in the future. “Sprints are incredibly valuable when trying to solve wicked problems, especially when things haven’t worked in the past or haven’t been sustainable,” Julie points out.
“They allow you to look at things through a different lens, to see things from the point of view of the end user – in this case, the patient. And then you can try out an idea and get some real feedback before you’ve launching into hours of steering committee meetings and pilot phases”.
In fact, Bryan would like to see a dedicated group of facilitators to run SPRINTS for AHS. “I can think of twenty problems that we could use a SPRINT for, definitely. It’s going to be resource dependent, and of course training - and getting people up to speed as to what a SPRINT is,” he says, then thinks for a moment. “Because it’s a different way of thinking, right? It’s not just solving a problem, it’s designing a new reality.”