Patient Relations

Here's the background on the Patient Relations offices you may have noticed in hospitals in Canada:

“A well‐established patient relations structure and process, supported by the right personnel, is key to identifying gaps between patient expectations and experiences of care, and managing perceptions of patient expectations and quality of care.” From Excellent Care For All Act

To strengthen patient relations processes in Ontario’s hospitals... they are required to have patient relations processes in place and make information on these processes available to the public. Regulation 188/15 adds to these requirements; specifying minimum standards regarding the retention of data, providing standards for keeping patients or complainants informed, and ensuring that hospitals have a specific patient relations process.1

I was lucky enough to attend a conference where many patient relations professionals were sharing information about their work.

Some had inspiring examples of meaningful engagement with patients and family caregivers, where they were regularly collaborating with them on projects and acting on patient ideas and input. 

Many talked about plans to start involving patients in their hospitals but had not yet started to work on it. In some cases they were very busy just keeping up with their everyday work. In other cases senior management (or other staff) was not behind their efforts.

They presented lovely charts and graphs to their peers showing the types of patient issues they had to deal with, and how quickly they were able to resolve problems were presented. But... after hearing my friend's story about a patient issue that she wanted to have looked into, I wondered how they define resolution. When she asked her hospital contact for a progress report on her complaint she was told her case was closed, though she had no word of any results or consequences.

Patient Relations can't help this 'patient'

Despite sincere talk of being patient centered, there were a few comments I heard that sounded tone deaf like these two:

We'll "give" you (ie patients) decision making authority as long as it's a consensus.

And the idea of staff deciding "What is it that you want these people to say?" in the area of changing the conversation in making films for internal staff training makes sense in one way, but can also be interpreted just the way it sounds.

On one occasion I tried to compliment the hospital on a positive change but my call was not returned. The only time I made a complaint, about an issue that cost me an extra year on a waiting list, I was unhappy with the result. 

Patient experience is recognized as a method people use to determine the quality of their care, and the feedback that patient relations offices get reflects the experience. The insight it gives can help to drive change and quality improvement. 

I learned just last month that Accreditation Canada has made Patient and Family Centered Care a key standard starting in 2016. The presentation I heard at their workshop was impressive and their resolve was unmistakable.

The big difference, and you may have seen signs of this already, is that instead of doing things 'for' and 'to' patients, they will now focus on doing things 'with' patients. That means we'll see more information sharing, partnership, participation and collaboration.

If you're a patient who thinks things could be better in health care there's no better time to try get involved personally. The door is opening up for us as patients, or as family caregivers to make a difference.


1. From Health Quality Ontario Striving For Excellence in Patient Relations Processes in Ontario's Hospitals

Patient Safety in Hospitals. Could Patients Help?

When I returned from the Medicine X Conference at Stanford I felt empowered as a patient. Meeting so many people with healthcare ideals that were similar to mine made me feel as though anything was possible. Once I got back I saw an invitation for patients to attend this year's Patient Experience Conference. That was one in the "win" column - last year in social media there were complaints about the same conference for having no patients in the room. This year the policy changed, in part due to sponsors I'm told.

Yet in hospitals as a patient I often don't feel like the advocate I am. I don't feel empowered - I do what I'm told to do. I would like to see a forum or some route for input into the Safety and Infection Control practices, but though I read the newsletter, newspapers, emails and even the signs posted looking for volunteers for mental health, depression, bone health, migraines etc, I see no way to join any discussion of safety and infection control in a particular institution.


As an example of an issue, the idea of walking barefoot on a hospital floor would not seem healthy to many people and yet I am asked to do that regularly. It's an ingrained habit not to rock the boat. Friends in my online group relate similar experiences, like Julie's at her hospital, when the CT tech wanted her to lie down on a sheet that did not look clean. She felt like taking a dirty sheet in to them with a footprint on it and then a clean sheet to show. the difference.

I would argue that no one is perfect, and that try as they do, the infection control committees could use input from patients who sit there sometimes for hours on end observing what is going on around them and worrying.

There are many more examples now of hospitals listening to patients and those are steps in the right direction but I would like to see them all on similar paths.