Carolyn Canfield’s life changed radically in 2008. Her husband of 35 years, Nick Francis, was diagnosed with a soft tissue sarcoma on his leg and underwent surgery. Sadly, eight days later, he was unexpectedly found nonresponsive. The axis of Carolyn’s world shifted. Nick’s healthcare team was taken by surprise and were devastated. She found herself comforting nurses who were overtaken by uncontrollably grief upon arriving for their shift and learning the sad news.
Carolyn was not prepared for what came next. She heard nothing again from the healthcare authorities after Nick’s death and felt abandoned. Nick’s healthcare team had also been abandoned. That didn’t meet Carolyn’s expected model for excellent healthcare. “I knew his care providers were highly trained, highly skilled, devoted and excellent. How could it be that the system wouldn’t provide accountability and support for them to learn what had happened when their patient died?”
This realisation was the catalyst for her activism. She became determined to improve the healthcare system for patients and their families, but also for healthcare workers. She started to study the system and to research about patient safety and healthcare improvement. “I learned how fragmented the system was; it seemed to be perfectly designed for professional burnout.”
Soon after, Carolyn found herself to be a pioneer as an independent citizen patient volunteer, determined to empower patients’ and families’ voices in the healthcare system. “I thought that we could do better. I wanted to help the system grow and benefit from the patient voice. There is so much insight and value that the system can gain from listening to a patient’s perspective and knowledge.”
As she started interviewing healthcare professionals, it became clear to her that the system worked in silos, and people within them were isolated without the benefit of true collaboration. Today much of her work aims at building deliberate relationships of trust in providing care, and connecting up team strength across the silos. Because of her international work, she often introduces people from different healthcare systems working with similar challenges in different countries.
Patient safety – “Patient safety is a system experience, but patient harm is a patient experience. So, if you want to know about harm, you have to talk to patients.” She developed five rules of how to optimally respond to adverse events from a system standpoint:
1 – INFORM the patient, family and clinicians that there has been a failure in care
2 – EXPLAIN what has happened as it is best understood from everyone’s input
3 – APOLOGIZE (a true apology) to allow all victims to express forgiveness and achieve closure
4 – Offer SUPPORT to everyone involved for full emotional and functional recovery
5 – REMEDY what failed patients and clinicians by strengthening relationships and processes
The object of these rules is to re-establish the patient’s trust with professionals in the healthcare system and also to help the professionals to understand what happened and heal from the event. “If the only thing I do is enable healthcare professionals to feel greater job satisfaction, I know I couldn’t have done more to help patients receive better care and safer quality care,” she says.
“The most satisfying aspect of my work is that even in the short eight years that I have been doing this, I’ve seen remarkable change. I’ve seen an embrace of the patient voice, enormous respect for the contribution that patients and families can make in every domain of healthcare and at every intensity of involvement,” says Carolyn.
Carolyn Canfield visited CM Health during Patient Safety Week. She delivered the presentation “Relationship-based Healthcare for Safer Care and greater Quality and Value” at Frontline Focus, where she met and talked with frontline staff. She also participated in a Leadership Safety Walk round.