Candid patient video testimonials help MGH researchers study patient experience

Robert Matte candidly shares his hospital experience with MGH's Patient Video Program 
– an initiative dedicated to providing patients with a platform to tell their stories.

East York resident Robert Matte sits patiently in the oncology clinic at Michael Garron Hospital (MGH).

Diagnosed with stage four colon cancer one year ago, he receives chemotherapy treatment at the East Toronto hospital every two weeks.

But today, Robert is not here for treatment. Today, he is waiting to participate in an on-camera interview to candidly share his hospital experience with MGH's Patient Video Program – an initiative dedicated to providing patients with a platform to share their stories and identify opportunities to improve safety, quality, and patient experience in the hospital.

Now for the first time, Researchers from the Medical Education Office have joined forces with the Quality and Safety team at Michael Garron Hospital to analyze the dataset of patient experiences from the Patient Video Program. Since 2011, more than 150 patient videos have been recorded and shared.

Sarah Wright, Research Scientist and lead on the Patient Video Program research project and Mari Iromoto, Director of Quality, Patient Safety & Risk, Privacy, Operational Excellence & Sustainability and Research & Innovation.

“Person-centred care is at the centre of everything we do, so we wanted to find a way to organize this information and catalogue videos to really appreciate and understand all of the different types of experiences shared by patients,” says Mari Iromoto, Director of Quality, Patient Safety & Risk, Privacy, Operational Excellence & Sustainability and Research & Innovation.

What may have started as a quality improvement project seven years ago, now offers a unique opportunity to explore untapped insights into the patient experience.

“The issues we hear from patient videos is not typically about clinical or medical errors, it's about how we made them feel or how we could have reduced their anxieties during their stay,” adds Mari.

This year, the goal is to publish findings from the videos to help inform medical education and training for future doctors and health professionals when it comes to improving patient experience at the bedside. Students enrolled in the University of Toronto's Institute of Health Policy, Management and Evaluation Master's Program have already begun to watch videos from the Patient Video Program.

Putting ‘human' back into medicine

“In medical school, the emphasis is on diagnosis and disease management – but when you talk to the patient, that is only one aspect of what they care about,” says Sarah Wright, Research Scientist at Michael Garron Hospital and lead on the Patient Video Program research project.

Sarah's analysis of a subset of the videos so far has identified a few emerging themes influencing patient experience when in hospital, ranging from the loss of control and sense of dehumanization that can occur during a hospital stay – to profoundly positive experiences with healthcare providers during what can often be a very stressful time.

The common theme among positive patient experiences was the personal connections with their healthcare providers, highlighted by comments such as: “they smiled at me”, “made time for me”, and “they remembered my name”. These serve as humbling reminders of how the human side of medicine can easily be overlooked; and how by simply treating patients as individuals can have a major impact on their experience.

These themes are echoed prominently in Robert's testimonial of his experience in the oncology clinic.

“The nurses are quite warm. They actually sit down and ask you how you are doing. They make an unpleasant situation that much more pleasant,” says Robert.

“I like the fact that the nurse that I'll see tomorrow will probably be a nurse that I know now. They get to know you, you get to know them, it makes it that much more comfortable.”

Sarah adds, “There is an assumption that healthcare providers have interpersonal skills that establish a patient-physician connection, but we should be looking at how we can improve teaching around this,” she says.

“Patients are a crucial part of the quality care we deliver – we need to listen and learn from them. When you watch the videos, you realize that the person sitting in the hospital bed could just as easily be you.”

Promoting a transparent dialogue between patient and provider

In 2017, the Patient Video Program began incorporating personal reflections and commentary from healthcare providers to represent both patient and staff perspectives.

With consent from those featured on-camera, the videos are shared with healthcare providers from the units to promote transparency and an open dialogue around opportunities for improvement. In addition, the videos are shared at weekly operations huddles attended by the hospital's executive team and program leadership, all staff open forums, medical quality and patient safety committee, quality committee of the board and the hospital's governance board.

In Robert's testimonial, he provides feedback on how the hospital might improve its services.

“Questions and concerns can build up during the few weeks you're out of hospital, and you don't see the doctor before every treatment like when you come in for blood work; even as thorough as my doctor is, and the nurses answer as many questions as they can, I'm not sure if it's feasible to have an oncologist to check in with.”

Robert's oncologist, Dr. Jing Li, had the opportunity to view the video and offer insight into Robert's suggestion.

“My first impression was how brave and sincere he was in sharing his personal story and experience,” says Dr. Li.

“I think the personal touch, the familiarity, the comfort – this is what we're trying to achieve in this clinic. I think every day we have the opportunity to try and take more time to listen to our patients, our team and our colleagues and then it's up to us to use that invaluable input to make us better at what we do.”

The hospital's Patient Video Toolkit has been shared with more than 30 organizations across Canada and the United States interested in transforming the way care is delivered through reflection and the direct voice of patients.

In 2016, the program was the recipient of the Patient Safety Organization Champion Award from the Canadian Patient Safety Institute and Cleveland Clinic's Innovation of the Year Award. The Program was also recognized as a leading practice with Accreditation Canada.