The Power of Storytelling

Thursday, May 30, 2019 – Michelle Holden

"What unites people?” asked Tyrion Lannister in the Game of Thrones series finale. “Stories. There’s nothing in the world more powerful than a good story.” Tyrion was on to something. When told well, stories are sticky, they are memorable, and most of all… a good story can drive change.   
 
Earlier this month, at the Emergency Preparedness for the Health Care Industry event organized by Spark Conferences, delegates came together for a day of storytelling. 
 
On the agenda were codes Orange (mass casualty), Silver (person with a weapon), and Black (suspicious object), as well as cyber threats and Incident Command Systems. Despite this heavy and, at times, emotional selection of topics, each organization’s story offered invaluable lessons and best practices. 
 
“Listening to lived experiences from some of the emergency healthcare events we’ve seen in recent years makes it very real for the audience,” said Arlene Kraft, Director of Healthcare, Safety, & Risk Management at HIROC. 
 
As an educational supporter of this event, having the opportunity to experience these powerful subscriber stories and help spread best practices is critical to HIROC’s mission. This philosophy of storytelling drives the creation of our resources and events which focus on closed claims and risk management best practices. 

Processes are meant to be practiced

At Sunnybrook, the Code Orange called during the 2018 van attack reinforced the procedures in place and the importance of drills. Read more about Sunnybrook’s Code Orange journey
 
During last month’s Code Orange panel, Claudia Cocco, Emergency Preparedness Coordinator at Sunnybrook Health Sciences Centre and Emergency Preparedness Hospital Lead at the Toronto Central LHIN, stressed the importance of reviewing each code. 
 
“I urge all of you to look at your processes,” she said. “If you think you have a good system, let me know or look again.” Cocco stressed that there is always something that can be improved.

Delegates also learned how critical it is to ensure a solid process is in place and is understood, especially in the case of hospital amalgamations and regional integrations. 
 
For Jessica Harris, Manager of Emergency Preparedness at Unity Health Toronto, being a part of a new hospital network around the time of the Danforth shooting drove the team to review admission and discharge processes during codes. “We’d have to discharge and then admit a patient if moving them within the system,” she said.
 
Linda Brothwell, Facility Administrator at Nipawin Hospital in Saskatchewan, shared her organization’s story of the Code Orange called after the Humboldt bus crash. Brothwell reflected on the fact that a Health Emergency Operations Centre (HEOC) was not yet established in the region. Having the HEOC could have resulted in better information flow between dispatch, EMS, the three community hospitals triaging patients, families, and senior leaders. 
 
Being a part of the recently-formed Saskatchewan Health Authority did have its advantages. For example, all media requests were funneled through SHA’s communication department, taking the pressure off of the staff who are on the ground and reducing media presence at community hospitals.
 
Implementing processes and practicing them extends beyond the four walls of each healthcare organization to community organizations and partners. 
 
Simon Bridgland, Manager of Enterprise Risk Management at Trillium Health Partners walked delegates through the successes and challenges of a recent Code Black at Credit Valley Hospital. While Peel Regional Police responded and cleared the event within four hours, there were some learnings on both sides as to how the two organizations can better work together during a code. 
 
One key takeaway is ensuring your security and safety partners know the entrances and exits, and understand the flow for your organization. During the code police vehicles blocked access to exits and the parking garage, meaning patients, visitors and staff were initially unable to leave. The need to develop a stronger partnership with the Peel Police Tactical Unit was highlighted by this event. 

Know your partners

Like Bridgland, many speakers that day stressed was the importance of working with partners. “You can’t provide the care that you need to… if you don’t know how to speak to your partners,” said Cocco. At Sunnybrook shedding a light on partnership meant taking a closer look at partner policies around Personal Health Information, as well as resources available through the Toronto Police Service. 
 
At Kingston Health Sciences Centre (KHSC), a unique partnership exists with Correctional Service Canada. Delegates heard from Rocky Prosser, KHSC’s Director of Protection Services about a recent Code Silver involving an inmate, with shots being fired in the Emergency Department (ED). While having inmates visit the hospital is a fairly regular occurrence at KHSC, Prosser says that this event illuminated the fact that hospital staff weren’t always sure which procedures were dictated by law for CSC staff. Prosser and his team now meet monthly with a CSC joint steering committee to go over policies. 
 
In healthcare, we also partner with a number of other providers, and these organizations should be considered and communicated with during codes. One example brought forward by speakers was rehabilitation services – after the dust has settled patients may need these services, so they need to be kept in the loop. 

Communication is critical

Communication internally as well as externally played a large role in all of the speakers’ stories. Internally, one takeaway is to ensure all staff understand the codes. 
 
At a recent event Halton Healthcare event, staff didn’t realize who had the authority to call a Code Green. And when one was officially called, not everyone understood they couldn’t be in the area. “These codes are for you, not just for patients and visitors,” said Kossondra Stockman, Emergency Preparedness Advisor at Halton.  
 
Around external communication, the subject of social media use in codes came up during the question period with delegates questioning how organizations can get ahead of unofficial tweets and posts. 
 
“I would like to see it [social media] addressed more in our policies,” said Jessica Harris from Unity Health. She referenced the Federal Emergency Management Agency and other organizations in the United States who are using social channels to send out a source of truth. 

At Nipawin, Brothwell says social media and word of mouth played a big part in the notification of staff – which was largely a positive. However, so many staff and volunteers came to offer help that Brothwell says they did experience some congestion – something they’ve addressed in recently-updated procedures.
 
As you can see, conferences like Spark’s which centre on lived experiences and storytelling contain so many important lessons. While Brandon Stark may be the keeper of stories on Game of Thrones, in the real world we all have the power to tell our story. In sharing stories and acting on their lessons, we are building the safest healthcare system, together.
 
Michelle Holden is Communications & Marketing Specialist, HIROC