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  • How Will You Stay Inspired in 2016?

    Jan 08, 2016
    Shari Hughes, Associate Registrar—Practice, College of Physiotherapists of Ontario

    Shari Hughes, Associate Registrar—Practice, College of Physiotherapists of Ontario

    Guest Blogger: Shari Hughes, PT

    I just read something inspiring—so inspiring in fact, that I want to share it with my fellow PTs. Here it is:

    “Our quest [as health care providers] is clear…It’s a search for meaning in the value of the person who has come to honour us with his or her quest for some help. And we think to ourselves, is this a [prime minister]? Is this a hero? Is this a mother? Is this a father? An artist? A craftsman? An honest labourer? A climber of hills? A singer of songs? Who is this person who honours me with their presence, and what can I do to help them?”

    I read this paragraph in an article describing the closing keynote speech delivered by Don Berwick at the Institute for Healthcare Improvement (IHI) 27th Annual National Forum on Quality Improvement in Health Care.

    I read the article because it was about Don Berwick—a powerful thought leader and an engaging speaker committed to sparking bold, inventive ways to improve the health and health care.

    This is not the first time Berwick and the IHI group have inspired me.

    The first time was in 2005 with the 100,000 lives campaign. I’ve also turned to IHI to learn about rapid response teams and care bundles and PDSA improvement cycles and the Triple Aim initiative—I could go on and on but you should check them out for yourself at www.ihi.org.

    Maybe it’s because I’ve heard and have been impacted by Don Berwick before. Maybe it’s because it’s a new year filled with new possibilities. Or maybe it’s because I can so easily apply his words to the profession I love so much.

    In this latest speech he also talks about a new era in health care and nine steps to take going forward.

    1. Stop excessive measurement: I don’t mean that we should stop measuring. Indeed, I celebrate transparency in every form. How else can you learn? But we need to tame measurement. It has gone crazy. Far from showing us our way, these searchlights training on us, they blind us. We can’t find Sean in that glare. I vote for a 50 percent reduction in all metrics currently being used.
    2. Abandon complex incentives: We need a moratorium, I think, on complex incentive programs for individual health care workers, especially for doctors, nurses and therapists. If a program is too complicated to understand, too complicated to act upon by getting better, then it isn’t an incentive program. It’s a confusion program. It’s a full-employment program for consultants.
    3. Decrease focus on finance: This could be impossible. I feel naïve, almost, suggesting it, but for just a while, wouldn’t it be great if we could step off the treadmill of revenue maximizing? …If leaders really did care about profit, they would concentrate unremittingly on meeting the needs of people who came to them for help, but they aren’t. We aren’t.
    4. Avoid professional prerogative at the expense of the whole: From Era 1, we clinicians, doctors, nurses, we inherited the privilege. It’s still there. We can still use it. It’s the trump card of prerogative over needs, over the interests of others. ‘It’s my operating room time.’ ‘I give the orders.’ ‘Only a doctor can.’ ‘Only a nurse can.’ These are habits and beliefs that die very hard, but they’re not needed. They’re in our way.
    5. Recommit to improvement science: For improvement methods to work, you have to use them, and most of us are not. I’m trying to be polite, but I am stunned by the number of organizations I visit today in which no one has studied [W. Edwards] Deming’s work, no one recognizes a process control chart, no one has mastered the power of testing PDSA (plan-do-study-act), Nathaniel’s Method or the route to the top. You can see the proof of concept. This is beyond theory now.
    6. Embrace transparency: The right rule is really clear to me. Anything we know about our work, anything, anything we know about our work, the people and communities we serve can know too, without delay, without cost or smoke screens. What we know, they know, period.
    7. Protect civility: With the self-satisfaction courted by Era 1, with the accusatory posture that’s at the heart of Era 2, civility and, therefore, possibility have been in much too short of supply. I don’t lack a sense of humor, although I may sound like it right now, but in my opinion, jokes about herding cats or green eyeshades or soulless bureaucrats or the surgical personality, or the demanding patient—these are not funny.
    8. Listen. Really listen: These terms—coproduction, patient-centered care, what matters to you — they’re encoding a new balance of power: the authentic transfer of control over people’s lives to the people themselves. That includes, and I have to say this, above all, it has to include the voices of the poor, the disadvantaged, the excluded. They need our mission most.
    9. Reject greed: For whatever reason, we have slipped into a tolerance of greed in our own backyard and it has got to stop … We cannot ask for trust if we tolerate greed. The public is too smart.

    As insightful and thought-provoking as the nine steps are, what resonates so much for me is the powerful reminder of my role as a physiotherapist in the simple question: “Who is this person who honors me with their presence, and what can I do to help them?”

    History is full of little sayings that inspire big outcomes.

    I’d love to hear more about what inspires you—what makes you get up every day and love doing what you do. Tell us, please!

    Guest Blogger: Shari Hughes, PT I just read something inspiring—so inspiring in fact, that I want to share it with my fellow PTs. Here it is: “Our quest [as health care providers] is clear…It’s a search for meaning in the value of the person who has come to honour us with his or her quest […]
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    • Patients
    • physical therapists
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    • quality care
  • Shout, Shout – Let it All Out!!!

    Dec 11, 2015
    You Talk. We Listen.  By now you know we’ve been working hard to consult about the potential for clinic regulation in Ontario. The one and only thing about the consultations that has disappointed me is the suspicion I’ve encountered about the consultation process itself. It appears that many people seem to think that our working […]
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  • Shhh! The Registrar’s TOP SECRET FORMULA for Avoiding Complaints!

    Oct 21, 2015
    Amanda is a young woman in pain. Mr. McBean is an experienced physiotherapist who achieves excellent clinical outcomes. So how come she’s complained about him? Because he reached his arm across her chest, coming into contact with her breast Because it really hurt when he moved her arm through the full range of motion Because […]
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  • Regulating Clinics – Your Turn to Talk!

    Oct 14, 2015
    We know physiotherapists are sometimes compelled by their employers to provide services in a way that does not meet the profession’s clinical or ethical expectations. And sometimes business operators engage in behaviour that physiotherapists aren’t even aware of, but can still get the PT in trouble: they use the physio’s name for bad advertising or billing practices, […]
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  • Friend not Foe: A PT Student Experience

    Aug 31, 2015
    When I learned that I would be completing my clinical placement at the College of Physiotherapists of Ontario, I was apprehensive. In the world of PT students, I have found that the College is often misunderstood and sometimes negatively perceived. From creating standards to performing practice assessments, aka “audits,” to discipline hearings, my impression was […]
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    • Shenda's Blog
  • Sitting in My Castle, Making Up the Rules…

    Aug 10, 2015
    Judging by some of the comments to some of my blogs, some of you must think I sit in my office, scheming to write rules that make the lives and jobs of physiotherapists harder than they need to be. When I wrote the blog “My support person hurt someone. Am I in trouble?” one person […]
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  • Patients or Friends—Does it Have to Be One or the Other?

    Jul 08, 2015
    Your patient asks you to play on her softball team. There’s nothing romantic and you have lots of common interests and a couple of common friends. Should you join the team? I’ve written in my blog about boundaries before—we are pretty clear that dating patients is a problem and that sexual relationships are forbidden. But […]
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  • Records, Consent and How to Stay out of Trouble

    Jun 08, 2015
    I’ve blogged about consent before (What do you call uninformed consent? Punchline: No consent at all). In that post, I reminded you that your job in getting consent is to make sure that the patient fully understands his or her options and makes his or her own decision about how to proceed. Too often, the […]
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  • Perspective is Everything

    May 20, 2015
              Shenda’s Peter’s Blog If the saying “perspective is everything“ holds true, then I got my fair share of ‘everything’ earlier this month at World Confederation for Physical Therapy (WCPT) in Singapore. It was an excellent conference with more than 3,500 PTs from around the world coming together for three days […]
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  • The Best Thing About Being A Professional…

    Apr 20, 2015
    Might be the worst thing too—you are accountable for all elements of your professional life. When things go right you should feel great—you helped a patient through a tricky problem, you contributed your time to a charity event, you had a successful business year. Well done! But you are also responsible for anything to do […]
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  • Let’s talk about S*X

    Mar 02, 2015
    Sharon’s young. Ali’s great looking. She’s treating the rotator cuff he tore playing ultimate Frisbee. They both like House of Cards. The next thing you know, Ali is offering to meet Sharon at a local pub and teach her how to play pool. She finds him attractive, can she say yes? Joan is recovering from […]
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  • Is It Health Care Or Is It A Business?

    Feb 04, 2015
    Does it have to be this way? I think that the difference between a health care profession and a business is simple: it’s in your motive. If you do this for a living to take care of patients, you are a professional. If your top priority is profit, you are a business person. Before you […]
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  • My support person hurt someone. Am I in trouble?

    Jan 05, 2015
    Scene 1: You assessed your patient and made a plan that included having her walk with a walker. But one day, in your absence, your support person independently decides that the patient is ready to use a cane instead. This was really bad judgement. Now the patient has fallen and broken her hip. Are you […]
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    • Policy
  • Bad Start to a New Career

    Nov 13, 2014
    I’m not kidding you, this was a conversation that one of my colleagues overheard recently on a train. Student 1 (let’s call him Jason): I’m going to start my own business. Student 2 (let’s call him Mateo): Me too—I’m never going to work for someone else. Jason: I know, right? And here’s what I’m going […]
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  • Physiotherapy Ethical Issues: Transparency to Patients and the Public

    Oct 16, 2014
    How much information about their health care providers should patients and other members of the public be able to see? Where’s the line between the public’s right to know and the professional’s right to privacy? All of the health care professions in Ontario have Public Registers on their websites. These Registers all have some information […]
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  • Joke: What Do You Call Uninformed Consent? Punchline: No Consent at All!

    Sep 11, 2014
    OK. I know, that was a lame joke. I hope you aren’t coming to this blog for humour. Let me tell you about something that happened to me a few years ago, before I was Registrar of the College of Physiotherapists of Ontario. I called a sports rehab clinic where I’d been before, to see […]
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  • What if Your Colleague Made a Mistake But You Got Punished?

    Jul 09, 2014
    A few years ago the British Parliament was considering how they could improve patient safety after a series of crushing hospital incidents. And here is what the members of parliament said, “Doctors could risk losing their licence if they fail to report fitness to practise concerns about their colleagues.”[1] Do you think about that for […]
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  • Why is the College such a lousy advocate for PTs?

    Jun 10, 2014
    Hi Everyone—the headline is a trick question. We aren’t advocates for physiotherapy or physiotherapists at all. We aren’t even allowed to be. The legislation that creates the College of Physiotherapists (and all the other health colleges in Ontario) gives us our power but also limits our power. It creates the College for the purpose of […]
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    • Shenda Tanchak
    • Shenda's Blog
  • Clinic Regulation: Now What?

    May 20, 2014
    Two posts ago, I asked you whether you thought that the College ought to regulate clinics in addition to the physiotherapists who work in them. The overwhelming majority of comments favoured this idea. You told us that College regulation would mean higher quality care in the clinics and that it would make them safer places […]
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  • Should the College Regulate Physiotherapy Clinics? Thanks for the Feedback!

    Apr 03, 2014
    Thank you for all your input on the issue of whether the College ought to regulate clinics. We left the blog post up for longer than usual because new comments kept coming in. The College will be exploring the potential for clinic regulation over the next few years. Watch Perspectives or the website for updates […]
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