One-page profiles in hospitals – Something to shout about!

By Julie Malette, HSA Canada

Julie Malette

Julie Malette

Our work in health care settings is fairly new in Canada.  In November, I worked with the North Bay General Hospital’s Mental Health team and I am quite excited about the direction they are taking in terms of listening to the patient voice and focusing on being more person-centred.  We spent two days focusing on person-centred thinking and one day on person-centred reviews.

The hospital’s mental health department is currently transitioning from traditional multi-disciplinary team meetings where the focus is often on clinical goals and meetings are lengthy, to what they call the ‘One Patient One Plan’ approach where mini-team meetings occur weekly with a core team of supports and focus on the patient’s priority goals.  We will be working together to look at how person-centred thinking skills/tools can be helpful with this approach.

Soon, I will also be spending time with key leaders from both the mental health and the medicine departments of the hospital to support them to develop their one-page profiles.  The hospital would like to start with its leaders who will then support their staff in developing their own one-page profiles.  This is a very important step. One-page profiles in hospitals could totally revolutionize the way patients and staff are supported. It means that healthcare workers will be supported to understand the person, not just the condition and that patients will be able to communicate what is important to them and how best to support them. Starting from within means we can really embed the concept of using one-page profiles deep within the culture of the hospital and this will give it the commitment it needs to grow and be used well by both staff and patients.

Our colleagues in the UK have already introduced one-page profiles into two hospitals and their recent pledge for NHSChangeDay (to support patients and colleagues working and using health services throughout England to create one-page profiles) has significantly raised the profile of what this could achieve in health. Nurses, Hospital Chaplains, Patients, Therapists, GPs and Hospital CEOs are mobilizing to have their own one-page profiles in support of the pledge. I’d love to see something like this happen in Canada.

I’ll keep you updated on how our own health one-page profiles are progressing and leave you with these thoughts: Imagine you were in hospital and your healthcare team really got and understood you as a person. Now imagine you are a health professional and because of a simple, easy to read sheet of paper you had all the information at your finger tips to make someone feel understood, well cared for and well supported when treating them. This is what one-page profiles in health could help us to achieve. To my UK colleagues – I wish you every success in your pledge. To my Canadian friends – what about doing something similar here?!

 

Not just someone lying in bed 2B

An inspirational example of how one-page profiles can help people in hospital connect with others during confusing and difficult times. Kris had no idea of the impact her mum’s one-page profile would have, not just for them, but for the medical staff, other patients and their loved ones.

A photo of Laurine's one-page profile on the wall in  the hospital

A photo of Laurine’s one-page profile on the wall in the hospital

Written by Kris, a person-centred thinking trainer

Meet my mother, Laurine Kaiser. She has been married to my father for soon to be 63 years. They have three children, myself (Kris) being the middle child in addition to my older brother Stephen and my younger sister Kimberly. Mom was born in 1927 and will be celebrating her 86th birthday in November this year. She has always enjoyed an active life as a Mom, wife, travel companion, pharmacist, bridge player, friend and sister to a younger sister and brother who live in Kitchener.

My Mom and Dad moved in to my home in 2010 shortly after my husband passed away. We spent a few months together before my Mom fell ill for the first time in her life. She ended up at St. Joseph’s hospital in Hamilton where she remained a patient for five months. The doctors had quite a challenge for some time trying to figure out exactly what was wrong with her. She eventually ended up in the Intensive Care Unit (ICU) and spent almost two weeks there before she graduated to the Progressive Care Unit.

At that time my Mom was not able to use words and was extremely tired from the long journey she’d been on in the ICU. On several occasions nurses, doctors, therapists etc. would enter the room and ask me questions about my Mom…did she ever work, what line of work, is she married, how many grandchildren etc. That was when I decided to create a one-page profile for my Mom. Looking at this frail yet dignified and elegant woman lying there so peacefully yet so helpless I knew that I needed to do something so that people could connect with my Mom by looking and reading her profile. It was a way to humanize my Mom and value her as a person with a story to tell and not just someone lying in bed 2B.

I was excited to complete this one-page profile for her, knowing that this would make a positive difference in her life. I created the profile in one night with a dollar store bristle board, a black magic marker and a few photos of her along with the joys in her life.

When I returned to the hospital the next day I couldn’t wait to put it up! My Mom was thrilled with it and stared at it for hours. She would smile and point to people making kind gestures. The nurse came in the room that afternoon and read the board and quickly pointed out that my Mom’s favourite TV show was Big Bang Theory which was also hers. She remarked, “I’ll put it on the TV for her tonight at 7:30. Mom gave her the biggest smile.

Word seemed to get around the floor and the hospital about my Mom’s one-page profile and soon other patients’ families and friends on the floor were asking to see it, vowing to create one for their loved one. It just seemed to snowball with positive remarks from all. Close to the end of my Mom’s extended stay at St. Joseph’s the administration team came to have a look at the profile and said that they should introduce this in their hospital. That was a great day!!

Doing the one-page profile for my Mom made such a difference in her mental and physical recovery. Having this tool created a way for others to have a conversation with Mom and it also provided information about her interests and hobbies which often was a source of some great chats with people she met at St. Joe’s.

I’ve always known that the one-page profile works however I didn’t know the impact it would have on so many people and their loved ones.

 

Decisions are Jennie led, not service, organisation or support worker led!

An example of how one-page profiles can change perceptions and attitudes as well as supporting a person with autism and learning disabilities to make positive changes, growing and adapting with them through life.

Jennie's one-page profile

Jennie’s one-page profile

Written by Suzie Franklin

My daughter Jennie is twenty-two years old.  She has a great sense of humour, is affectionate, creative, honest, determined and fun to be with. She has a lovely home, close family and friends and enjoys art classes, horse riding and trampolining.  Jennie used to be described as ‘challenging’ until she started using one-page profiles and positively changed her life and the way people perceive her.

Jennie has autism and learning disabilities and has worked hard to achieve her independent lifestyle. The one-page profiles she has used over the years have helped her to do this by communicating what is important to her and how people can support her to do what makes her happy and healthy. She is a very impressive young woman.

Jennie’s first one-page profile was used as a ‘top tips’ for everyone in her life to get to know her better, provide consistency in support and communicate with Jennie in the way that was best for her. At the time, Jennie wasn’t able to dictate much verbally but her voice ran throughout and we produced the one-page profile using our in-depth knowledge of what was important to her and how best to support her by closely watching her behaviour and what it was telling us.  It was shared with the rest of her family and everyone who supported her as well as teachers, social workers, doctors, coaches, instructors and even her hairdresser! People who saw it commented on how useful it was and some even helped add to it by saying what they liked and admired about Jennie.

One of the things we realised when we started using person-centred thinking tools with Jennie was that despite having a fun seeking personality she had few friends of her own. Most people outside of her family were paid to be in her life. Having a one-page profile and identifying what was important to her has empowered Jennie to try new activities and develop new friendships. It has put her in the driving seat to make more choices in her life. Jennie even used her one-page profile to show to prospective support staff when she was picking her team for her new flat. It gave them an easy to understand picture about Jennie and meant that she was able to communicate very early on how best they could support her.

As Jennie’s independence has grown living in her own home, the one-page profiles have changed with her. What is important to Jennie and how she needs supporting has changed significantly but this has all been led by Jennie and the people around her keeping her profiles accurate, up to date and always reflecting Jennie’s voice.

Having one-page profiles has enabled Jennie to truly be in control of her own life. Decisions are Jennie led, not service, organisation or support worker led! Importantly, they have also changed the way Jennie is introduced and perceived. Jennie is no longer referred to as ‘challenging’. Now she is described as happy, active and independent. Thanks to Jennie’s one-page profile her positive reputation precedes her and the things that are important to Jennie are kept at the centre of everything that she does.

Suzie Franklin and Helen Sanderson have written a book about Jennie’s  journey, her transition to independent living and her Circle of Support. You can find out more about the book from HSA Press.

Finding dad’s voice after his stroke

A powerful example of how a one-page profile can help someone who has suffered an acute stroke to communicate how best to support him as well as helping his daughter advocate on his behalf.

Written by John’s daughter, Lisa Orme

chipMy dad, always known as ‘Chip’ was 65 when he suffered an acute stroke. It was in April 2012 and he experienced a massive bleed on the right side of his brain. He was admitted to the Derby Royal Hospital. It was one of the most fearful days of my whole life. I knew then that things were going to change forever. What I didn’t know, was that we were about to embark on a person-centred journey and that I was no longer just going to be his daughter, I was going to need to be his advocate too.

Dad lost his voice, his normal bodily functions and his pride that day. The first 24 hours were the hardest. Dad could only nod or shake his head and it was down to me to interpret this and advise the nursing team on his behalf. It was heart breaking and frustrating but I had a coping mechanism. I knew about person-centred thinking and used my understanding of him and the tools I’d learnt to advise the nursing team how best to support him. This was particularly important because I couldn’t be there all the time and it was essential that they were still acting on his wishes without me there to advocate them.

Every day in hospital highlighted another challenge for us. I sat with dad talking through his communication and decision making approaches identifying with him what he understood and what he wanted to share. He was able to nod or shake his head enabling me to capture his thoughts into his one-page profile. Once it was completed I shared this with the immediate nursing team. Every day I reviewed the one-page profile with Dad and my Sister to ensure we added new information gathered from his rehabilitation handovers.

I placed Dad’s profile laminated by the side of his bed as well as giving it to sit alongside his care plan. Nursing staff began asking me about our approaches and quickly recognised what was important to dad. Importantly they recognised when he chose not to engage with them as this remained in his control.

Helping dad to remain in control of his situation was my priority. His profile enabled this to happen. Chips connection to his family and the nursing team was so important in the seven weeks he was on the ward. Relationships were developed as the nursing team read and understood more about him from his profile. They learnt to engage with him using the information to promote conversations, laugh, joke, make him smile when he was having a bad day.

Despite his stroke dad was making choices and had capacity. Staff understood what made him more settled and more importantly they understood how he wanted to be supported. The one-page profile quickly progressed and became more detailed ensuring the right decisions were made when agreeing his continuing health care funding for his future nursing care.

Dad was going into a home in the centre of Derby. It was near to his friends and the places he grew up. I felt satisfied that dad would be happy there and made sure I shared pictures and information about the home with him to help him prepare. Sharing dad’s one-page profile with the nursing manager really helped me to engage with the assessment and referral process. It meant that I could clearly say what his needs were and ensure that they had the capacity to support him in the way he wanted to be supported.

Dad’s stroke had been incredibly sad for the whole family but throughout the journey I have been able to support him and help him to communicate by using the person-centred thinking tools. The nursing team briefly knew Chip. To me he will always be dad.