Speaker
Description
In 2021, William Osler Health System (Osler) received Accreditation Canada exemplary status, being recognized for achievements in people-centred care, including implementation of the RNAO Patient and Family Centred Care (PFCC) Best Practice Guideline (BPG).
A PFCC BPG initiative resulted in adding a question to the inpatient nursing admission assessment (NAA) “We want to involve you in your care. What is most important to you today?” This resulted in patients feeling more involved in their care, evidenced by a 2.5 % improvement with a FYE 23/24 result of 80% “Yes, Definitely.” These positive outcomes prompted further discussions to embed cultural safety within the NAA process.
The NAA is informed by social determinants of health (SDoH) data gathered at Osler’s patient registration, validated by the nurse and patient, albeit limited to age, sex at birth, preferred language and religion. In this context, Osler’s transgender and non-binary patients shared several complaints, where they felt dismissed regarding their gender expression. In addition, staff felt a lack of confidence in asking about gender identity and partnering with patients to include this awareness in care and discharge planning.
An action plan included building foundational capacity, addressing immediate patient needs and planning for the future. Creating a culture of safety was initiated, ensuring Osler staff were supported through their own experiences of gender transition, education in the use of pronouns, change in public washroom signage, and consultation with persons with ‘lived experience’ and community experts. Immediate patient needs were addressed by revising Osler’s NAA to include gender expression and pronouns, with ongoing coaching at iHuddles. Future directions include adopting the RNAO ‘Promoting 2SLGBTQI+ Health Equity BGP, planning for advanced SDoH registration requirements and refreshing Osler’s commitment to AIDET (Acknowledge, Introduce, Duration, Explanation and Thank you) communication framework to include offering staff name, role, and pronouns in introductions.
Keywords
gender identity
people centred care
What RNAO BPG or tool/toolkit is this work related to:
Patient and Family Centred Care
2SLGBTQI+ Health Equity
Author(s) Credentials and Title
Mary Jane McNally, BScN, MN
Chief Patient Experience Officer
| Organization Name | William Osler Health System |
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