Saskatchewan Health Authority (SHA) Transforms Accreditation with Indigenous-Inspired Co-Design

November 25, 2019

As part of their accreditation journey, the Saskatchewan Health Authority (SHA) has pioneered an integrated model of accreditation, designed to meet their unique needs. Through a consultation process that included their Visioning Day, the SHA understood that to improve quality and safety, they needed to consult key stakeholders across the continuum of care.

In care settings across the province, the SHA strove to create an atmosphere of accreditation readiness that would be sustainable and inclusive of all voices from First Nations and Métis, to patients and families, and health care providers.

The Circles of Change Accreditation Model, by the Saskatchewan Health Authority

The SHA’s unique approach was to adopt indigenous-inspired co-design to create their integrated accreditation model that embraces ongoing improvement and people-centred care. In fact, their Visioning Day led to the ‘Circles of Change’ accreditation model.

This model is inspired by the Medicine Wheel, which has four quarters representing four directions, seasons, life stages and various peoples. The Circles of Change model refers to these quarters as cycles in a system. In other words, it represents holistic health, which is reflected in a 4-year provincial plan to improve care for all.

SHA Cultural Advisor, Andre Letendre (Métis) shares that “in our way, health begins at conception, and that is what the Circles of Change model is based on.” The model’s first order of business is to review maternal and child health care. In line with this value, SHA CEO Scott Livingstone shared that the new Jim Pattison Children’s Hospital opened on September 29, 2019 in Saskatoon.

The SHA aims to apply the First Nations and Métis lens to all policy making. The Circles of Change has outlined actionable goals in three other areas of care over the next three years, including primary health care, mental health and addictions, community care, inpatient care, as well as continuing care.

The CEO notes that “having conversations that build trust is crucial to a collaborative model and to repairing relationships.” Livingstone adds that time, consistency and shared accountability are important factors of success in co-design.

The SHA is embracing co-design to actively listen and learn how to partner with all players. “We always start any event or meeting with a ceremony and have Elders at the table,” he says. “We ask communities what they are looking for, and we open the door to discussions about ‘how’ we can partner together.”

As SHA Patient Advisor Heather Thiessen puts it, the model helps develop a ‘bedside to boardroom’ approach to care. Their accreditation process opened the communication lines, and policies are shifting to reflect what patients and families truly need and want.

Thiessen shares that the First Nations and Métis voices help ground the co-design process in their shared values, while the patients and family voices guide the co-design in their best practices, as the SHA becomes an egalitarian partner in the health care journey.

SHA Patient Advisor Brenda Andreas adds that when one feels culturally safe and is being included, one brings the visibility, voice and passion to the conversation of those who would otherwise be forgotten, creating a more comprehensive view of health care. This aspect of accreditation builds community trust.

Referring to accreditation readiness, Andreas states “we don’t want to take out the fancy china every four years. We want to take it out every day and use the cracked cups.”

The Circles of Change accreditation model is now used in hospitals, clinics and all forms of care centres in Saskatchewan, as a reminder to embrace ongoing quality and patient safety improvement and people-centred care.