Case studies

Social Movement Action Framework

Social Movement Action Framework, Key characteristics Making change happen Momentum

Building momentum for change for BPSO OHT champions at Humber River Hospital

Humber River Hospital is a designated Best Practice Spotlight Organization® (BPSO®) and is also a part of the North Western Toronto BPSO Ontario Health Team (BPSO OHT). During the pandemic, they faced challenges keeping their champions motivated and engaged in their change initiatives. To re-energize their champions, they integrated multiple strategies including building momentum. Read more in this case study.

Image
shutterstock hrh

Humber River Hospital (HRH) (Home - Humber River Hospital (hrh.ca)) (now Humber River Health) is a designated Best Practice Spotlight Organization® (BPSO®) and is also a part of the North Western Toronto BPSO Ontario Health Team (BPSO OHT). During the pandemic, they faced challenges keeping their champions motivated and engaged in their change initiatives. To re-energize their champions, they integrated two key characteristics from the Social Movement Action (SMA) Framework:” Momentum” and “Public Visibility.”

The HRH change team built momentum for change and raised awareness about the BPSO OHT and its work by:

  • Offering monthly workshops to re-energize and re-engage their champions. Workshop topics included simulation learning and reviewing updated assessments on BPG implementation.
  • Producing and sharing a regular newsletter which included BPG implementation tips and updates.
  • Giving a “BPSO champion t-shirt” to all champions after completing the workshop.
  • Including a QR code in each newsletter and on each BPSO champion t-shirt, linking anyone who scanned the code to a video promoting the BPSO program (see image of t-shirts below.)  

As a result of their individual and collective actions, HRH has been able to maintain its champion network. We’re pleased to report that 25 per cent of the nurses in their organization are now trained champions!

Image
T-Shirt

Turquoise and Yellow Illustrative Character Project Report Video (canva.com)

Image
hrh workshop

Shared with permission from Humber River Hospital as part of the North Western Toronto Best Practice Spotlight Organization® (BPSO®) Ontario Health Team (OHT)

Humber River Hospital
fall image

Knowledge-to-Action Framework

Knowledge-to-Action Framework, Sustain knowledge use Sustaining change

Sustaining the Assessment and Management of Pain Best Practice Guideline across a multi-site long-term care home

The Region of Peel, a Best Practice Spotlight Organization® (BPSO®), has sustained the implementation of the Assessment and Management of Pain best practice guideline (BPG) for almost a decade. 

The Region of Peel, an RNAO Best Practice Spotlight Organization® (BPSO®) started implementing the RNAO Assessment and Management of Pain best practice guideline (BPG) in 2014 and has sustained its use since then. For example, in their 2019 BPSO annual report, they cited a continuous downward trend in the number of clients who reported a worsening of their pain. Pain experienced by the residents was better controlled, and the staff was found to assess, identify, and manage pain better by using the BPG.

Their keys to success include:

  • building on what works (for example, existing practices and policies)
  • empowering champions and growing their champion network
  • involving residents and families
  • gaining support from leaders and partners including RNAO, Peel of Region Leadership, Health Quality Ontario).
  • collaborating with an interdisciplinary team
  • conducting a formal sustainability evaluation

To learn more about The Region of Peel’s journey in sustaining the use of the Assessing and Managing Pain BPG, along with other BPGs, check out this webinar.

Region of Peel
Region of Peel
Knowledge-to-Action Framework, Assess barriers/facilitators to knowledge use

Overcoming barriers to evidence-based practice – Lessons learned from DongZhiMen Hospital and Beijing University of Chinese Medicine (BUCM) School of Nursing

DongZhiMen Hospital and Beijing University of Chinese Medicine (BUCM) School of Nursing are international BPSOs in Beijing, China. Staff at the sites identified barriers to the use of evidence in practice including heavy workloads, cultural differences and reluctant attitudes about using evidence to inform practice.   

DongZhiMen Hospital and Beijing University of Chinese Medicine (BUCM) School of Nursing are international BPSOs in Beijing, China. They identified barriers to the use of evidence in practice including heavy workloads, cultural differences and reluctant attitudes about using evidence to inform practice. The assessment and identification of barriers allowed change teams to develop effective strategies for implementation with the input of stakeholders.

For example, for the implementation of the RNAO best practice guideline Assessment and management of foot ulcers for people with diabetes, barriers included

  • nursing shortages across China,
  • a lack of training to support the development of knowledge and skills in evidence-based nursing practice,
  • the costs of guideline implementation. and
  • practice recommendations that exceeded local nursing scope.

SOURCE: Transforming Nursing Through Knowledge, 2018.

Beijing, China
Beijing School of Nursing
Knowledge-to-Action Framework, Assess barriers/facilitators to knowledge use

Facilitating an evidence-based culture at Unity Health Toronto - St. Michael’s Hospital

Unity Health Toronto - St. Michael’s Hospital, a Best Practice Spotlight Organization® (BPSO®) has embedded evidence-based practices into its culture and daily work processes as part of its corporate strategy. 

Unity Health Toronto - St. Michael’s Hospital, a Best Practice Spotlight Organization® (BPSO®) in Toronto, Canada, has embedded evidence-based practices into its culture and daily work processes. Evidence-based practice is part of the hospital’s corporate strategy. It has invested resources to build a critical mass (over 30 per cent) of staff members who are best practice champions.

Image
Heather McConnell, former Director, IABPG Centre, at St. Mike's Hospital Gallery Walk

The hospital also provides multiple capacity-building opportunities, including a community of practice, boot camps, booster sessions and mentorship. The annual Nursing Week Gallery Walk, depicted in the image above, is just one way that St. Michael’s Hospital profiles the work of champions and others dedicated to using evidence to inform change initiatives.
SOURCE: Transforming Nursing Through Knowledge, 2018.

Unity Health Toronto - St. Michael's Hospital
Unity Health Toronto

Engaging Persons with Lived Experiences

Engaging persons with lived experience

Holland Bloorview Kids Rehabilitation Hospital: Co-designing change through the active engagement of persons with lived experience

A case study from Holland Bloorview Kids Rehabilitation Hospital focused on engaging persons with lived experience in a change process. 

Holland Bloorview Kids Rehabilitation Hospital (hereafter referred to as Holland Bloorview) is a designated Best Practice Spotlight Organization® (BPSO®) in Toronto, Ontario, Canada.  Holland Bloorview has an award-winning Family Leadership Program (FLP), through which family leaders partner with the organization and the Bloorview Research Institute to co-design, shape, and improve services, programs, and policies. Family leaders are families and caregivers who have received services at Holland Bloorview, and have lived experiences of paediatric disability. Family leaders’ roles include being a mentor to other families, an advisor to committees and working groups, and faculty who co-teach workshops to students and other families. 

Image
Family leader roles from Holland Bloorview

 Family Leader Roles at Holland Bloorview. Photo provided with permission by Holland Bloorview Kids Rehabilitation Hospital.

The ENFit Working Group is an example of a successful implementation co-design process within Holland Bloorview. The ENFit Working Group is an interprofessional team working on the adoption of a new type of connection on products used for enteral feeding  [feeding directly through the stomach or intestine via a tube]. By introducing the ENFit system, a best practice safety standard, the working group plans to reduce the risk of disconnecting the feeding tube from other medical tubes, and thus decrease harm to children and youth who require enteral feeding.

Image
Family partnering graphic

Family Partnering with the EnFit Working Group. Photo provided with permission by Holland Bloorview Kids Rehabilitation Hospital. 

The working group invited a family member and leader whose son had received services at Holland Bloorview. This family member had significant lived experience with enteral feeding management, enteral medication administration, and other complexities associated with enteral products. During the meetings, great attention was given to the potential impacts on persons and families. The group engaged the family member by:

  • co-creating the implementation plan
  • involving them in a failure mode affects analysis, which highlighted the impact of the feeding tube supplies on transitions to home, school, and other care settings
  • working with the family member to advocate for safe transitions within the provincial pediatric system, which led to the development of the Ontario Pediatric ENFit Group

To learn more about Holland Bloorview’s experience in partnering with families in a co-design process, watch their 38-minute webinar: The Power of Family Partnerships.

Toronto, Ontario
Image of two children running in a field