Dr Simon Racine, in Prototype Role as Surveyor Section Head, Quebec

June 25, 2019

Dr Simon Racine
Dr Simon Racine

Accreditation Canada (AC) has created a prototype role to be tested in the Quebec market, as a result of its surveyor model redesign. AC has selected an experienced team leader and surveyor to step in as Surveyor Section Head, Quebec: Dr Simon Racine, former family physician and health care administrator. This prototype intermediary role will liaise with and provide additional support to the teams of surveyors on the ground.

AC deploys surveyors across the country and abroad to act as peer reviewers on accreditation surveys by assessing the performance of healthcare organizations against standards of excellence and identifying opportunities to achieve improved quality and safety.

AC’s open and transparent process in creating this prototype role, was one outcome of the surveyor model redesign. The objectives of this redesign are to review organizational structure, improve support to surveyors, grow and retain the AC client base, and improve the training and performance of surveyors, while creating a culture of recognition and engagement.

Having been a surveyor for AC since the 1990s, Dr Racine was an obvious choice to test this new role, which will include mentoring and supporting surveyors, as well as reporting their needs, questions and challenges back to AC. Seeing how the Quebec vertical is undergoing changes with the implementation of the adapted accreditation program for the Minister of Health and Social Services (Ministère de la Santé et des Services sociaux, MSSS), this prototype role will allow two-way communication between surveyors and AC.

The new Surveyor section head for Quebec says that AC needed to additionally guide and prepare surveyors for this new context. As an example, the adapted accreditation program uses the “patient trajectory” approach, which required additional training for surveyors. Dr Racine will play a role in supporting surveyors through this change and ensuring further learning needs are shared with AC.

“This role will help us grasp the needs of Quebec-based surveyors and better define areas where they need help and guidance. Our mentoring varies greatly whether we are training new surveyors or addressing experienced surveyors and even team leaders.”

Dr Racine notes that “this six-month position will enable the organization to assess how it’s doing with surveyor support in this market, if AC has a good overview of issues surveyors may be facing and is addressing them effectively, and ultimately, if there’s value in this role in the long term.”

He adds that some of the surveyor section head responsibilities such as training and mentoring new team leaders, will also be adapted and tested across Canada as well as abroad.

Dr Simon Racine is passionate about accreditation and sees it as a rich experience for the surveyor as much as for the surveyed organization.

“Throughout my career, I’ve tried to put best practices in my own work. Years ago, when I heard about AC, it wasn’t compulsory to be accredited (in Quebec), yet the organization was applying best practices to facilities, and I was interested. I decided to learn and to bring these best practices into my own professional practice. I also wanted to help other organizations improve their own processes, so I became a surveyor for AC. It was such a rich experience to meet other surveyors, because ultimately, they are colleagues with which to exchange. I’m always engaged by the survey process! I hope to share this enthusiasm with other surveyors.”

Beyond his extensive experience as a surveyor, Dr Racine believes he brings a few other key skills that will help this pilot succeed.

“I’m a planner, I’m pragmatic and I have a good sense of organization, as well as a keen ability for concision and analysis. I think I can help AC increase their knowledge and understanding of the needs of surveyors in terms of professional support and development.”

He adds “Of course, it will add to my surveyor experience and help me know more about the process, and how to support those teams who fulfill important responsibilities while surveying for AC.”

Ultimately, this prototype role is meant to improve both the surveyor and client experience by strengthening the survey process through targeted support and training of surveyors and greater responsiveness to feedback obtained in the field.

“I think we well know, especially with HSO, that the big picture is to develop Canadian and international standards that translate into best practices and assessment programs. The real strength of AC rests on the shoulders of the surveyors. Those people are on the field, and each day when they perform a survey, they are the representatives of Accreditation Canada. To make sure that they successfully fulfill this, we really need to support AC surveyors.”

Dr Simon Racine feels strongly that quality improvement is tied to close communications with surveyors, and to their relevant training and appropriate management.

“Through this role, and learning the current surveyor needs and questions, we can support them more closely in real time around real challenges they face. That’s how we improve the survey process.”

The experienced surveyor notes how important accreditation is to the overall quality improvement of health care.

“It’s essential. I look back to annual reports of AC, and it’s amazing to see the level of standardization from medication administration, infection prevention, and informing patients, to risk management quality improvement and patient-centered care. It’s improved significantly in 10 years!”

Dr Racine concedes that all organizations generally strive for quality, and accreditation supports this goal in an effective way.

“Naturally, established standards are necessary to accreditation, and all facilities attempt to implement best practices. But bringing in an outsider to help assess and improve through a targeted approach is most effective both in the short and long term. People like to improve, and it’s the same for organizations.”

There’s also great benefit to being assessed by external surveyors.

“Having people coming from similar fields means an opportunity to meet peers, and there’s a kind of mentorship that blossoms with the AC surveying process.”

Over the years, Dr Simon Racine has come to appreciate the willingness of certain organizations to go above and beyond accreditation.

“Sometimes people think that if you’re accredited, that you’ve ‘made it’ and have no more work to do. We have to remember that thanks to being surveyed, we reach a level where we have quite good patient safety and processes for quality. In other words, we’re in line with standards. But we have to continue to improve! One organization I surveyed brought innovation into their practices.”

He calls this “the second level of the accreditation process.”

“When organizations operate on that level, they have more to share with colleagues. What’s more, AC has the resources to foster continuing improvement. And through innovative practices, research goes further as well.”

Dr Racine believes there are also many benefits to the surveyor.

“The first advantage is to act as a peer; we usually work in a position like those of the people we meet in surveyed organizations. The second, is that accreditation brings us to support organizations in their assessment and quality improvement journey. It’s being in the field, and providing guidance or ‘coaching’. As I go abroad, I see other accreditation bodies and they don’t offer those two aspects to the surveying experience.”

He adds that being a partnered organization, where one creates standards and the other who implements through assessment programs and accreditation is an incredible asset.

“Partnered with HSO, we benefit from a large set of standards to rely on, and best practices are being reviewed regularly – it’s top notch work.”

What are factors motivating professionals to become new surveyors?

“I think we aim to work in line with high-level of standards. It becomes a form of professional development. It brings learning opportunities, helps us to integrate new information, implement best practices, all while helping others—real people in organizations—implement these practices and improve their services. From the human perspective of connection, it’s stimulating!”

Though he didn’t have direct experience with patient partnership, Dr Racine believes that this approach is key to improving health care for all.

“Patient-centered care, having teams in organizations, including patients and relatives, be part of their own care, and sometimes involved in the reorganization of services from a consultation’s perspective, is very important.”

The surveyor compares this to the client-centered approach of the business world.

“If you don’t have a satisfied client or meet their needs, your business won’t thrive. In public facilities, we tend to lose this client-centred service. As an industry, we’re a bit late to the game, but it’s good that we’ve been getting to that in recent years. The MSSS is supporting this objective. Increasingly, we see more patients being part of the discussion, and bringing in a patient partner is very important to get the full picture of care.”

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