Abstract
During October 4-7, 2021, Toronto hosted the first North American Conference on Integrated Care (NACIC) fully co-designed with patients and caregivers; Elizabeth Tay, Philiz Goh, and Carole Ann Alloway. One of the sessions developed and organized by Tay, Goh, and Alloway, was titled, ""What are Barriers of Co-Design and What Does Truly Integrated Care Look Like?"" Speakers for this session included Karen McIntyre, Senior Director of Human Resources at Southcentral Foundation; Dr. Steve Tierney, Senior Medical Director of Quality Improvement at Southcentral Foundation; Diane Fierheller, Family and Child Health; Leslie Ashley, patient and lead in Engagement & Design at Trillium Health Partners, and; Francine Buchanan, Research Patient & Family Engagement Coordinator at SickKids Hospital. The session was hosted and moderated by Carole Ann Alloway, a caregiver, and co-founder of Family Caregivers Voice. It was an ambitious title to discuss and resulted in a lively conversation. A few of the main points that were raised included:
·Currently, those invited into hospitals for their perspectives are of the privileged who are similar in background, and there needs to be a way to go to all types of customers to get their perspective.
·What matters to the patient is fundamental to wellness.
·Healthcare is intrinsically connected to social care, housing, food, and financial security.
·Holding self and others accountable within the healthcare system is needed.
·Digital networks need to be built around the family's needs and not the system, recognizing that the patient owns the records but wants the necessary people to have access when needed.
·Integrated care means seeing and caring about the customer (patient) more than seeing and caring about the illness.
What was challenging was naming the one thing that could tip the first domino to make integrated healthcare happen. The root settled in behaviour. McIntyre and Tierney, two of the speakers, are part of NUKA, which has integrated healthcare. The result was a healthcare team that included doctors, nurses, and western medicine, and access to the native community healing traditions. Sounds great, but how did it happen?
Dr. Tierney and NUKA looked at the needs of their customers and himself and the staff at the healthcare center. The more they met with the community, the more they learned of their needs and about themselves. It was a significant shift within each healthcare worker to ask patients' ‘what is important to you' rather than 'what's the problem.' Trust is the primary building block of any relationship and is especially important for healthcare providers. So, when you're meeting with a patient (customer), are you treating the problem (physiology), or are you building a relationship with the whole person?