An Interview with Laura Williams, Director of Client and Family Integrated Care at Holland Bloorview Kids Rehabilitation Hospital

Laura Williams, Director Of Client And Family Integrated Care at Holland Bloorview Kids Rehabilitation Hospital, talks about its family leadership program and how rewarding it has proved to be to their clients, their families as well as staff. QHN.CA has reached out to Laura and the efforts at Holland Bloorview to showcase their commitment to hearing the voice of their customer, across the entire experience.

A Family-Centred Approach

Laura Williams admits that she’s not too good at relaxing and switching off from her day-job, because she loves it.

“I tell people I have the best job in the hospital.  Creating meaningful partnerships between clients, families and staff is by and far the most rewarding experience of my career to date.   I feel very lucky to come in and do the work I do every day,” she says.

Her role has brought patients, or clients, at Holland Bloorview Kids Rehabilitation Hospital, and their families, to the forefront of all the decisions being made in the organisation. Holland Bloorview assesses and treats children born with disabilities and special needs and those who acquire disabilities through serious illness or accidents.

Laura explains that the hospital had a long history of family-centred care practice due to the long-term relationships developed with kids and families, but four years ago, senior leadership instigated a program to include a more family-centred approach to treating those children.

“Once we sat down to look at the family leadership program and what it should look like, that’s when it took shape and we realised this could be much bigger than we probably even initially anticipated,” explains Laura. “Our family advisory committee co-chair, Heather Evans, was incredibly involved along with other very strong client and family leaders who helped us shape it at the beginning. They were a huge motivator in making this program happen,” says Laura.

A Shift in Culture

They were very excited by the prospects of the family leadership program, but knowing whatever program was started had to be sustainable and lasting, they set about creating something transparent, with a searingly honest approach. They resisted the urge to quick-fix things prior to the initial process of exchange between families and staff.

“We had to convince staff – ‘No, no, no, don’t fix anything until you have someone at the table who has experienced this journey.’ Early on, this was sometimes uncomfortable for staff,” says Laura.

That honesty has proved to be one of the solid foundations of the family leadership program and Laura is sure that being brave and open at the beginning has helped to develop a program that is unequivocal in its mission to embed the client and family voice in decision-making.  Her advice to any organization or family seeking to emulate Holland Bloorview’s achievements is to learn together.

“I would say, look for some quick wins – show some success early on so people can see that it works. Be open about making mistakes – you’re going to make them… There will be difficult conversations but be genuine in your pursuit and you will build up great relationships. The other piece of advice is put the process in place. It doesn’t have to be the perfect process – but put some resource behind it so you know it’s sustainable.”

Holland Bloorview is committed to having families on all of its quality and safety committees and tied that commitment to its provincial legislation. It is now measuring the authenticity of the family leader experience by evaluating if family leaders feel the partnership is meaningful and respectful.

“We put together a formalized program for client and family leadership. This program includes advisors, mentors, faculty and a family advisory committee. We sat down with families and clients to say, ‘We’re going to develop a formal program – can you help us develop it?’ because we wanted to make sure it was going to work and that it would be meaningful for them.”

Defining the Partnership

Holland Bloorview has built on its history of an active, volunteer resources program. Family leaders are either referred or self-identify. They interview, fill out a formal application form and then are matched to allow them to perform at their best.

“Everyone has strengths and interests. I think that is where our real success came – we were able to find some really great matching opportunities and recognized that our families and clients don’t come to the table without experience. They have the user experience but they also bring their personal and professional life experience.”

Laura feels that they have reached a tipping point where family engagement is clearly aligned with Holland Bloorview’s strategic plan, enabling them to enhance their programs and services, and promote a stellar healthcare system, with fully engaged partnerships between clients, families, front-line staff and management.

“The value of these partnerships is undeniable and, knowing that allows us to be innovative and creative while removing our assumptions of how health care is provided. Now we can tie our user experience and clinical expertise to the improvement of health outcomes.  This is not just the right thing to do but evidence shows us that more family-centred hospitals have statistically better health outcomes for their patients” she says, adding that culture change has come about more quickly than she could have imagined.

Laura credits health care providers’ skill and care and says that once they experienced the power of the client and family voice at the table there was no turning back.

“I hope and anticipate that in two or three years this program, as a seamless function of our organization, will become a model for others to adopt without concern or trepidation,” she says.

An Honest Approach

There have been no negatives so far, says Laura. “I feel like everyone has come to the table with understanding. Some is attributed to the training and preparation – you have to prepare people for what they’re going to do and what the expectations are on both sides. You can’t be afraid to have those really honest conversations about what the role is and what they can bring to the table. This has been very eye-opening.”

Staff is reminded that the hospital does not see client and family-centred care as a customer service model, but a partnership model. In the early days the families got involved as members of the family advisory committee. Now, the hospital has some 100 family leader-volunteers on around 40 committees, in mentorship roles and as teachers.

“People get confused, thinking that this means the family is always right – the client is always right. I disagree actually. I think it’s about the synergy which is created between the clinical team and the client and their family, who come together to build an amazing care plan and an amazing organization because there’s a mutual commitment there. You build on that with amazing ideas and thoughts and skills,” says Laura.

A children’s advisory of kids ranging in age from around three to thirteen make sure rooms are accessible to them, that space is enjoyable and provide input to ensure the environment is the best that it can be. There’s also a youth group that provides perspective on different committees.

Building Resilience

“We’re now at the point where the number of family leaders we have is not enough, because we have so many requests from the hospital staff to have families and clients at their table to make sure that we’re moving in the right direction. So it’s been a real evolution, for sure.”

Laura says the program is a clear benefit to the organization, the client and the families and the fact it is rewarding brings meaningfulness to everyone’s engagement. She adds: “You see the resilience and the strength and the joy of our families and I‘ve learnt that there’s no dollar value that this kind of program can build. My son is a client at Bloorview as well. I’ve found it rewarding myself – wow we can do something in an organization that really does impact lives and can make a big difference overall.”

Laura names Tommy Douglas, the founder of Medicare, as one of her inspirational leaders.

“We strive to have a great healthcare system so people can have fulfilled lives. They shouldn’t be bogged down by health problems if we can help build systems that really work for them. My family – my parents, they helped me have those values and my kids, my son, are my greatest inspiration.”