"An enjoyable presentation, well-delivered with excellent insight into community and stakeholder engagement strategies. Terry Dyni - July 23, 2015" on the webinar version. This version is my complete slide deck from a live webinar presentation requested by the Conference Board of Canada. April, 2015. Thanks for your interest in Better Healthcare Through Community and Stakeholder Engagement. Compliments of Paul W. Gallant, CHE, GALLANT HEALTHWORKS & Associates (GHWA), Vancouver, BC, Canada. PS See the last slide for contact details or to arrange customized training/facilitation or advice on your organizational needs.

1. BETTER HEALTHCARE
THROUGH COMMUNITY &
STAKEHOLDER ENGAGEMENT
Complete slides from live webinar presented
April 30, 2015
with the Conference Board of Canada
Paul W. Gallant, CHE, PhD(c), MHK, BRec(TR)
www.GallantHealthWorks.com
© 2015 Gallant HealthWorks
All Rights Reserved

2. Overview
• Community engagement & stakeholder engagement
• Assessing needs of multi-stakeholder communities
• Prioritizing the needs of multi-stakeholder communities
• Tools that support engagement
• Mitigating risks
• Lessons learned
• Resources
• Questions
2

3. Speaking from experience with…
• Acute care
• Hospice
• Senior’s
• Mental health
• Community
• Education
• Research
• Governance
• As a patient
• Business development
3

4. Roles include:
Past
• Allied health clinician (multiple areas), Operations Leader Provincial Mental Health (acute)
• Founding Chair, Task Force on Understanding Community Diversity, urban hospital
Present
• Specialty consulting in Canada, China, USA & beyond
-project leadership, strategic planning/advising, needs assessments, B2B
• Partner in creating patient generated health data & applications (pain)
• Patient experience advocate & conduit
• Advisory Board, Canadian Association for People Centred Health
• Chair & 2014 Distinguished Service Award
CCHL, BC Lower Mainland Chapter
• Member:
4

5. Community Diversity Task Force
• Where: Large urban Canadian hospital
• Need: create more culturally sensitive approaches to care
-Response to concerns voiced by patients, local community, staff
• What/How: Comprehensive needs assessment & planning processes weaved
throughout hospital departments & services
-outreach focus groups, internal surveys/multiple languages
• Results: 80+ % response rate with ALL staff & patients (excluding ICU).
• Lessons Learned: omitted from this version and part of the complete presentation
5

6. Time: mid 1990s
• Issues discussed at multi-stakeholder task force reporting to VP
• Focus groups, neighbourhood advisory committee, First Nations communities, others
• Increased sensitivity and working together with community
• Establishing greater trust
• Greater openness to health & wellness practices of First Nations & non-Western medicine
• 80% response rate
• Increased mutual respect
• Incorporating needs and improving services for many patients: including gay, lesbian, non-
English speaking, people with disabilities, mental health
• Translation and interpretation services, visual communication boards
• Triage & Admission process improvements Training
• Teamwork & immense sense of accomplishment by staff, community
• Policies created
6

7. Setting the Context
The health of a community is a shared responsibility
of all its members.
Although the roles of many community members are
not within the traditional domain of “health activities”
each has an effect on and a stake in a community's health.
As communities try to address their health issues in a
comprehensive manner, all parties—including individual health care providers, public
health agencies, health care organizations, purchasers of health services, local governments,
employers, schools, faith communities, community-based organizations, the media, policymakers,
and the public—will need to sort out their roles and responsibilities, individually and collectively.Weinstein et al 2005 Primary Care Clinics in Office Practice.
7

8. 8

9. Triple Aim
9

10. 10

11. Engagement: What is it?
Community engagement Stakeholder engagement
the process by which organizations and
individuals build ongoing, permanent
relationships for the purpose of applying
a collective vision for the benefit of a
community.
the process by which an organisation
involves people who may be affected by
the decisions it makes or can influence
the implementation of its decisions.
11

12. Organizations’ motivations for
stakeholder engagement in health care
1. More relevant services
2. Ensure that issues that are identified and prioritized are important
3. Ensure that money and resources are not wasted
4. Ensure that outcome measures are important to the end-user
5. Help identify & access priority populations
6. Help disseminate information, products, or services
7. Building a culture of customer service
12

13. Engagement STEPS
• Determine the goals
• Plan who to engage
• Develop engagement strategies
• Prioritize those activities
• Create an implementation plan
• Monitor your progress
• Maintain those relationships
13

14. Guiding Principles
• Participate at a level that you feel most comfortable/remain present
• Ask questions about what is presented/discussed if you are uncertain
• Listen to others' contributions & any time constraints within the session
• Meet others: as many people as you can during our session
• Use common language: avoid using jargon, abbreviations or acronyms (ED)
• Create a safe place & respect confidentiality
• Create a bike rack/parking lot for other ideas, comments, questions
14

15. Summary of an Ideal Process
From Consult 101
15

16. Another
Overview of
Stakeholder
Engagement
16

17. Example: Your Voice Counts
Working with health authority leaders, patients and public to
plan for change together.
17

18. Your Voice Counts: Why we’re here
AIM: To provide patients and those who work in healthcare (providers) with the
support, information and skills they need to better work together as partners in their
health and healthcare.
Prototype workshop
18

19. Your Voice Counts
The session focused on three topics identified through interviews with
health leaders, surveys and community consultations:
1. How to talk about your health care
2. How the health care system works and the challenges it faces
3. How to use your experiences to improve the health care system.
http://ehealth.med.ubc.ca/2011/10/17/first-of-its-kind-workshop-brings-citizens-and-providers-together-to-talk-health-system-redesign/
19

20. Example of doctors & a community:
Assessing Needs
• 150 + family doctors in a diverse & large city
• Outreach into community
• Including 100 face to face surveys or interviews with people at risk of homelessness- compensated
• Youth at risk, seniors and new immigrants at health & community centres (gift cards $15)
• New immigrant health interviews with providers
• Card drop to ALL households in the community and businesses -draw for prizes 20 x $50 gift cards
• Media awareness
• Public survey created with public input
• Physician survey created with family doctor, emergency doctor input
• Medical office assistant (MOA) survey with MOA input
• 1:1 meetings with sample of the above
• Meaningful discussions and processes to discuss and work through results
• Compensation for doctors, MOAs, some honorariums to representatives, meals
20

21. “Meaningful engagement is needed.”
Meaningful change in the health system - that will ensure an affordable system
with the best patient experiences and best health outcomes, can only happen
when we all work together.
21

22. Who Was in the Room
• Health Authority Leaders
• Front-line workers: allied
• Patients, clients, family
• Non-profit & community organizations including
recreation, mental health, seniors, youth
• Doctors: family doctors and specialists
• Association members
• School Board
• Board/Staff/contractors
• Government, elected councilors
• RCMP
22

23. Example: Phased Plan
23

24. Discovery Phase
Nine Months
Planning Phase
Six months
Surveys: GP,
MOA, Public
Key
Informant
Interviews
Environmental
Scan
Advisory
Committee
Input
Data
Analysis
Data
Gathering
Implementation
16 months +
Members
Meetings
Evidence-
based
lnitiatives
Board
Input
Series of
stakeholder
engagement
sessions with
parallel Advisory
Committee
meetings
(more detail on
next slides)
24

25. Planning Phase
25
• Reviewed priority areas
• Generated and prioritize
ideas for each area
• Outcome: 3-4 broad-level
concepts per priority area

26. Visual Recordings
26

27. Planning Phase
27
• Reviewed proposed
concepts
• Identified key
questions
/recommendations
• Identified decision-
making criteria for
future prioritization

28. Planning Phase
28
• Input into concepts
• Develop each concept
in greater depth
• Outcome: Mid-level
plan for all concepts

29. Planning Phase
29
• Review mid-level
project plans
• Prioritizes N=
__projects for further
development
• Gives feedback on
prioritized projects

30. Planning Phase
30
• Report back on Advisory’s
decisions
• Input and feedback into
prioritized plans
• Outcome: strong plans,
clear understanding of
prioritized plans and
community commitment

31. Planning Phase
31
Further activities:
• Confirm implementing
partners
• Develop detailed
project plans
• Working groups with
key populations

32. Planning Phase
32
Implementation
Plan Submitted
to funders
Evidence-based addressing the key
goals of the initiative
Pre-planning

33. Priority Setting Decision-making Criteria
33
• Goals
• Impact & effort rankings
• Low-high impact x low to high-effort
• Priority areas & specific problem statements with
evidence supporting need
• Buy-in:
• Members (doctors)
• Health Authority
• Board & Advisory

34. Decision-making Criteria Include:
34
• Sustainability
• Breadth
• Depth
• Realistic
• Organizational capacity
• Use of existing resources
• Risk

35. Four Priority Areas
Mental Health with a
family doctor
35
Mental
Health without
a family doctor
GP Education Frail Seniors

36. AGM of Members: Level of Support
for each initiative
36

37. Engagement Examples
Community Engagement: radio talk show brief audio clip
https://www.youtube.com/watch?v=wyF16_SWQ7M
IAP2: Collaborate
Stakeholder Engagement (Males with Eating Disorders):
https://www.youtube.com/watch?v=ctlGqM0ekOY
IAP2: Involve & Empowerment
37

38. Mitigating
• Have a risk management plan
• Have clear & articulated roles for staff, working group & governance
• Create an emotionally safe setting for dialogue, discussion
• guiding principles, trained facilitators, resources, evaluation feedback, privacy compliant
• Set realistic goals: to be reached & successful in the next ___months or __years
• Monitor & modify with stakeholders
• Clearly communicate expectations, limitations, unforeseen findings or
processes & debrief
• Remain transparent and true to the process
38

39. Lessons Learned – Across Multiple
Experiences
Meaningfully engage
People ARE committed including those not working in community
engagement/stakeholder engagement….eventually
Help those typically in power (health executives, managers, physicians,
politicians, etc) to listen non-judgementally & encourage others to do the
same
 Be realistic and do not set up false expectations
Past experiences do not necessarily equal present & future outlook
"I assumed as I didn’t get a reply 3 years ago- they weren’t interested.“
39

40. Lessons Learned – Across Multiple
Experiences (continued)
Agendas, be aware everyone has one or more
Plan for flexibility (added time, added stakeholders, delays, detours, scope)
Go to the community & to stakeholders, wherever possible
Support participation fairly: honorarium, gift card, transportation, meals, parking
Enable Others to Act towards achieving goals (vs micro-managing)
Grow champions
What is Your priority may not be Others‘ priority
Walk in the other person’s shoes
Celebrate accomplishments as they occur
40

41. RESOURCES
Joanna Siegel (2012). Innovative Methods in Stakeholder Engagement: An Environmental Scan. Agency for Healthcare
Research and Quality. http://www.effectivehealthcare.ahrq.gov/tasks/sites/ehc/assets/File/CF_Innovation-in-Stakeholder-
Engagement_LiteratureReview.pdf
IAP2 Canada. International Association for Public Participation (Canada). http://iap2canada.ca
Katharine Partridge et al (2005). From Words to Action. The Stakeholder Engagement Manual. Volume 1: The Guide to
Practitioners’ Perspectives on Stakeholder Engagement. By Stakeholder Research Associates Canada Inc. & contributions
from United Nations Environment Programme http://www.accountability.org/images/content/2/0/207.pdf
Thomas Krick et al. (2005). VOLUME 2: THE PRACTITIONER'S HANDBOOK ON STAKEHOLDER ENGAGEMENT
Wallerstein (2006). What is the evidence on effectiveness of empowerment to improve health? Copenhagen, WHO, Health
Evidence Network report; http://www.euro.who.int/Document/E88086.pdf
Weinstein, Plumb, & Brawer (2006). Community engagement of men. Primary Care Clinics in Office Practice. 33: 247-259.
Abstract http://www.primarycare.theclinics.com/article/S0095-4543%2805%2900107-7/abstract
www.GallantHealthWorks.com
41

42. Thanks for participating!
Have a question after this webinar?
Contact or connect with me…
https://www.linkedin.com/in/paulwgallant
https://twitter.com/HealthWorksBC
Paul@GallantHealthWorks.com
Direct: 604.999.9164
www.GALLANTHEALTHWORKS.com
https://www.facebook.com/GallantHealthWorks
42