Falling through the cracks

Longwoods’ screening sparks an informed debate around system alignment and team communication in healthcare

Monday, October 22, 2018 – Michelle Holden

When Dave Price’s son died suddenly in 2012, he was post-surgery and – after more than a year of appointments and phone calls – just at the beginning of his cancer treatment. Despite this, the Price family decided very early on they did not want to take an adversarial approach in dealing with the system issues their son faced. “We knew it would close the door to any larger discussions we could have,” said Dave.

At the time of his death Greg Price was undergoing treatment for testicular cancer – one of the most treatable forms of cancer. Greg’s fatal heart attack was the result of a blood clot that went unnoticed by his physicians. The tragic, yet avoidable factors that had a role in Greg’s death all play out in the short film, Falling Through the Cracks: Greg’s Story.

Today, the film and its teachings are the Price family’s way of keeping the discussion of teamwork and communication issues in healthcare alive.

On October 15, a special screening of Falling Through the Cracks was held at Longwoods’ Breakfast with the Chiefs in Toronto. For Longwoods, the screening and the panel discussion that followed acted as an opportunity to engage in an important dialogue with healthcare leaders – a mission that is of equal importance to HIROC. 

“One of the greatest blessings of this film is that it allows us to step back from the literature,” said Kevin Smith, President and CEO of UHN. Smith, along with Susan Fitzpatrick, CEO of the Toronto Central LHIN, Teri Price (Greg’s sister) and Dave Price (Greg’s dad) made up a panel of speakers following the screening.

For Fitzpatrick, many of the issues Greg faced on his journey can be summed up with several key themes:
  • A need for plain language communication
  • Increased health literacy and patient empowerment
  • More accountability through team-based care
  • A focus on empathy for the patient
  • A more robust emergency treatment system to act as a safety net
“There are a lot of different worlds in our healthcare system, and those worlds don’t always touch one another,” said Jennifer Zelmer, President and CEO of the Canadian Foundation for Healthcare Improvement who moderated the session.

For Dave Price, people are the primary driver for connecting those worlds. “People are at two ends of the spectrum,” said Price. “All of the providers and players in the film could have thought more about the safety of the patient.”

Alignment across the system

With panel members from both the LHIN and hospital setting, it’s no surprise that alignment was a hot topic of the morning. Throughout the film we see Greg interacting with his family physician, a physician at a walk-in-clinic, and a number of specialists. “It was a complete lack of connectedness, all by well-intentioned people in the system,” said Smith.

“I think there is a big redesign piece on how referrals get made to specialists…how they are tracked and how they are reported,” said Fitzpatrick. But this also extends to hospital linkages with primary care and across the system.

No news is good news

In the film one of Greg’s physicians uses the overused phrase, no news is good news. But in 2018 – as audience members reflected – that’s just not good enough. What happens when there is an error in a fax referral, or if a physician is on vacation for an extended length of time? In these cases the patient should feel empowered to tell their provider that saying ‘no news is good news’ is not good enough.

“Patients tend to be accepting and they shouldn’t be,” said Dave Price. In Greg’s case, he asked questions and did the research to be as informed as possible. Greg’s quality assurance was something that Smith found most striking.

Engrained in healthcare education

What’s unique about the Greg’s Wings Program and Falling Through the Cracks is that the Price family wants as many organizations as possible to see the film and talk about Greg’s story. They have been travelling the country spreading the word and also permitting the film and its additional 14 minutes of teaching scenes to become a part of the curriculum at the University of Calgary, and now the University of Toronto.

Teri and Dave Price credit a lot of the success they’ve had with the support they received from the Health Quality Council of Alberta.

For more information on the film and the Greg’s Wings Project, check out gregswings.ca

Michelle Holden, Communications and Marketing Specialist, HIROC