Listening to our Patients and Families

At Headwaters, we understand that an excellent patient experience involves the delivery of safe, high-quality care, delivered with compassion.   

Our definition of Patient Experience is informed by the work done through the Beryl Institute:
 
The sum of all interactions, shaped by an organization's culture, that influence patient perceptions across the continuum of care. 
 
Patient Experience at Headwaters is guided by our Vision, Mission, Values and the strategic priorities outlined in our 2017-18 Strategic Priorities.
 
Help Us Serve the Community Even Better:
Become a Headwaters Patient and Family Advisor

What is a patient and family advisor? A patient experience advisor is someone who:

 

  • Has had a recent experience (usually within 3 years) of being a patient, or the family member of a patient, and is partnering with staff and physicians to provide direct input into policies, programs and practices which affect patient care and services.   
  • Wants to help improve the quality of our hospital’s care for all patients and family members by ensuring the voice of the patient is heard and influences planning and decision making on issues that affect patient care
  • Volunteers his or her time
  • Provides a voice that represents all patients and families of those receiving care at Headwaters Health Care Centre

Being a patient and family advisory may be a good match with your skills and experiences if you are: 

  •         Respectful of others and their perspectives
  •        Comfortable speaking in a group and interacting with others
  •         A good listener
  •         Able to use your personal experience constructively
  •         Able to see beyond your own experience to the ‘big picture’
  •         Non-judgmental
  •         Positive
  •         Collaborative
  •         Desiring to participate in bringing about meaningful change
  •         Desiring to expand your knowledge and skills
  •         Able to maintain confidentiality of patient and organizational information

What do patient and family advisors do?

Headwaters Health Care Centre uses patient and family advisors in the following ways:

  •        Participate in committee work to influence decision making
  •         Review or help create educational or informational materials
  •         Work on short term projects

If you are interested in volunteering as a Patient Family Advisor please complete the Expression of Interest Form below. You will be contacted within 15 business days by the Quality Coordinator. Alternatively if you wish to ask any questions about the PFA role please contact: Sharon Hendry, Quality Coordinator 519-941-2410 ext. 2576 or email shendry@headwatershealth.ca.

Expression of Interest Form
 
First Name: 
Last Name: 
Preferred Name:
Address: 
City: 
Postal Code: 
Phone (best number to reach you on during the day):   ext.
Alternative phone number:   ext.
Email:  
Preferred method of contact
Telephone:
Email:
Are you a: 
Can you speak English?: 
What other languages you speak:
Your lived experience at Headwaters in the past 3 years was in:

What services have you experienced in the past 3 years:
Adult Surgical Services:
Adult Medical Services:
Pediatric Services:
Ambulatory Care Clinic:
Dialysis:
Palliative Care:
Intensive Care Unit:
Maternal/Child Services:
Cancer and Supportive Care:
Mental Health:
Diagnostic Imaging:
Other (please state):
Are you comfortable sharing your lived experience with the Patient & Family Advisory Partnership and/or other project/program groups in order to learn from that experience and make improvements?: 
Are you currently a volunteer at Headwaters: 
Do you have access to a computer and email?: 
Have you participated in any patient and family engagement activities in the past?: 
Are you currently or have you ever been involved in a legal challenge between you/your family and a hospital?: 
If yes, please provide details:
Why would you like to become a Patient & Family Advisor? : 
Are there any specific health or hospital care areas that interests you? (e.g. Emergency Care, Pediatrics): 
Please tell us how your lived experience/interest could be helpful to improve our services and the experience of others?: 
Please specify the time when you are most available to attend group meetings, be involved in projects/committees
Available During
Daytime (7am-5pm):
Evening (5-9pm):
Weekends:
Methods
In person:
Teleconference:
How did you hear about the Patient & Family Advisory role/opportunity?: 
Please confirm that you understand and agree with the following.
I understand that submitting this application and/or being interviewed does not guarantee a position as a Headwaters Patient & Family Advisor: 
I understand that, prior to starting in my role as a Patient & Family Advisor, I would be required to submit the results of a vulnerable sector search (18+years old), sign a Headwaters Confidentiality Agreement and pledge to support the Headwaters Values: 
I understand that, as a Patient & Family Advisor, I would be accountable to the Quality Committee of the Board: 
I declare the above information to be true and complete to the best of my knowledge. I understand that a false statement may disqualify me or lead to my exit as a Patient & Family Advisor: 
By completing and submitting this form you are providing a digital signature.
Date: