When Jannica Hoskins gave birth to her daughter three years ago, she had been experiencing both physical complications and personal stress. But it was her voice and opinions being overruled that left her feeling truly frustrated with her experience.
“I gave birth that day in an emergency vaginal delivery, it happened so fast. The room was filled with a student doctor and a number of other student doctors taking notes,” says Hoskins. “I wasn’t able to have skin to skin right away. There were just so many things in terms of communication and processes that could have been better.”
Today, Hoskins is a patient advisor on Saskatoon Health Region’s Maternal Services Patient Family Advisory Council, as well as an advocate for indigenous women. She keeps in mind the family experience and the need for clear communication at the forefront of all she does.
“We, as patients, want to see communication happening that is not just considerate of the patient, but truly a mindful reflection of what the patient is asking for,” says Hoskins.
“We know health care professionals are doing what they know is best, but having the inclusion of patients through the process makes for a more transparent health care experience and goes a long way in building trust and removing predispositions.”
(Jannica Hoskins, patient advisor)
When she was asked to participate in an improvement event where for the first time, a team would live trial the single room maternal care concept, she jumped at the chance.
“The concept makes so much sense to me,” says Hoskins. “The challenges of today with limited space combined with the reality of big families and inability to support social dynamics both can often work against the care experience. Visitation and proper education are so important in helping a patient heal. This concept really supports that.”
Single room maternal care in the new maternal and children’s hospital will see the majority of pregnant women, with their supports, stay in one private patient room for labour, delivery, recovery and for post-delivery care right until they leave hospital. The concept is not new for Canada as other areas are using this this for low-risk pregnancies. But this is a first in Canada for a hospital that cares for the highest risk pregnancies in the province.
At the end of April, Jannica joined a team of labour and delivery nurses, postpartum nurses along with other unit staff and physicians to see how this concept would work in a real labour and delivery.
“We wanted the team to design and test the model of care for Single Room Maternity Care (SRMC),” explains Maternal Services operational manager Lisa Clatney. “The work out of this trial and improvement event would build on other events over the past year which has started to define our workflow processes, supplies, medications, equipment, and information flow for our single room maternal care.”
There are a few rooms within Royal University Hospital’s current labour and delivery unit which are of comparable size of the new rooms within the maternal floor. These rooms were equipped and set up to simulate the new rooms for the hospital.
“Each step and decision was documented during our set up. Care teams prepared and trained. And then, we took that critical step and did a live trial,” says Clatney.
This meant bringing in a real family in the throes of labour, who agreed to be part of this trial, delivering and caring for them in one room at RUH. After a week, the team reflected on how this worked.
“This was a very positive experience for the patient, her family, and me. As a nurse I feel that stability as well as continuity of care is very important,” explains Jannah Roufosse, RN. “One factor that really stuck out to me in this experience was how early I was able to start the education process with this family. Neither of us felt rushed or pressured. Teaching was offered through intrapartum (labour and delivery) and the postpartum period. The patient appreciated the amount of teaching and felt as though she wasn’t as rushed as her friends had stated they felt from their deliveries.”
“One factor that really stuck out to me in this experience was how early I was able to start the education process with this family” (Jannah Roufosse, RN)
As a patient advisor, and talking with patients after the experience and others who were in the current model, Hoskins noted as well how much faster the transition was between care providers.
“But it was the ability to have a private experience that really stuck out for me,” says Hopkins. “One woman had her baby transferred to NICU and was rooming with another woman who had her baby in the room. The NICU parent was so uncomfortable and spent time pacing the halls rather than healing. We ended up getting her a different room. But, you can imagine what the new hospital’s privacy and design will do to support care teams in teaching and helping patients in asking questions and transition home more successfully.”
An improved patient and family experience is at the heart of process changes being made today and for tomorrow within CHS.
“Last year, we had a group of staff, managers and patients within input from their colleagues, articulate the philosophy, vision and purpose for Maternal Services Maternal Services philosophy, purpose and visionand how we can live the values of Saskatoon Health Region,” explains Leanne Smith, director for Maternal Services. “We needed to do this first because over the course of the next several years there will be many changes coming to our area as we prepare for the new hospital.”
“Having a philosophy, vision, purpose and values can help us envision the future and make principled decisions. It defines for staff, physicians, patients and families what should be expected of us.”
(Leanne Smith, director, Maternal Services)
April’s improvement team embedded this philosophy, vision and purpose into that first live trial of single maternal care room. Now, this week, another important next step is underway with the training of all maternal care staff and physician in family centered maternity care by one of the foremost international experts on family-centred maternal care.
Dr. Celeste Phillips is conducting training for Maternal Services at RUH and has led the way transforming maternal units as they move to single room maternal care. Her research and work forms the foundation of best practises in maternity and newborn care across both Canada and the United States.
“Family Centered Maternity Care is a way of providing care for women and their families that integrates pregnancy, childbirth, postpartum and infant care into the continuum of the family life cycle, “ explains Dr. Phillips.
“The care provided is individualized and recognizes the importance of family support, participation, and choice.”
(Dr. Celeste Phillips)
Maternal Services received a professional development grant to bring in Dr.Phillips into Saskatoon for the training seminars. While she is here, she will also be reviewing and providing advice to leaders on how to prepare Maternal Services operationally and ensure national best practises are truly being considered in preparing for the new hospital.
It’s all this that has patient advisors like Hoskins excited when she imagines the future.
“It certainly makes me hopeful for those who might be in my scenario,” says Hoskins. “I am really noticing how health care providers are working together more and listening and talking with their patients. And I think women and their families will feel more comfortable and open as that evolves. I certainly saw that during the live trial. And as the teams do this continued education and build their own awareness of family-centred care, we will really build a system that can meet the changing needs in health care and our province.”
For more information on the new hospital, visit www.saskchildrenshospital.ca or check out Children’s Hospital of Saskatchewan on Facebook or Twitter.
Image: Drawing of single room maternal care patient room in Children’s Hospital of Saskatchewan