By Christine S.
Chief Medical Officer Dr. Susan Shaw sits across from me with her legs bent at the knee, feet resting comfortably on the chair in front of her.
She’s talking about the things and people she loves, and as she does, her face lights up.
“I really enjoy hip hop music,” she says with a playful grin. “Kendrick Lamar is my favourite.”
She also loves baseball but is quick to add that she’s not a baseball nut.
What she loves most of all is her family: a husband of 24 years, an 18-year-old daughter and a 15-year-old son. She describes her teenagers as silly and fun, her inner child shining through as she talks about their shared love of amusement park rides. Her children may not be quite as geeky as she describes herself, but she admits that one of their shared passions is to track how many rides they can go on in a single day.
Dr. Shaw enjoying an amusement park with her teenagers.
“Our record is 28,” she enthuses in a rare moment of self-satisfied delight. “We’re pretty hard core!”
Value of interdisciplinary teams learned early
In her day-to-day life, Dr. Shaw is a humble and unassuming physician, who expresses gratitude often and is quick to recognize the team effort that goes into providing health care to the people of Saskatchewan. Very early on as a resident anesthesiologist, she loved working on an interdisciplinary team of health-care providers.
“It was overwhelming, but it was also fascinating, interesting and exciting,” she says of the month she spent in the Intensive Care Unit (ICU) at Royal University Hospital. “I really liked how the physicians worked so closely with nurses, pharmacists, respiratory therapists, social workers, speech language pathologists, and the list goes on. We’re all interconnected, and it’s that interconnectedness that I really like.”
Unexpected patient criticism leads to change in thinking
Dr. Shaw would go on to spend more than two decades in the ICU and operating room as a critical care physician and anesthesiologist, helping patients and their families recover from illness and injury.
“I’m very lucky to be part of a patient’s care team,” she says. “It’s a privilege to be able to have an impact on patients and their families. Saskatoon is small enough that it’s not unusual for me to go grocery shopping and for someone to come up and say, ‘You might not remember me, but you looked after my dad, and I’m really grateful.’ That’s pretty amazing.”
But the feedback from patients and families hasn’t always been positive.
As head of former Saskatoon Health Region’s Department of Adult Critical Care, one of Dr. Shaw’s mentors challenged her to seek additional feedback from patients and families.
“I took my mentor’s advice and I picked who I thought was a pretty safe person to ask. She was the mother of a young man who had been in the ICU for about six weeks. He’d been severely injured and was now in the recovery phase getting ready for rehab. I had a good relationship with his mother, so I thought it would be pretty safe to ask her what it was like to receive care as part of my team.
“When I asked, she looked at me and said, ‘I’m going to be honest. You suck.’
“I was almost speechless,” continues Dr. Shaw, the shock of the woman’s response still evident in her expression 10 years later.
“I took a deep breath and asked her, ‘Tell me what you mean by that.’
“‘I’m asked to leave whenever you make big decisions about my son’s care,’” the woman responded, “‘but these are the times when my son needs me there as his mother the most.’”
Dr. Shaw immediately asked her to join the care team on rounds the next day.
“It’s not that he didn’t want his mom there. ICU teams just didn’t round with patients or their families back then,” Dr. Shaw says of why her patient’s mother had not been asked to join the team.
From then on, with patient consent, Dr. Shaw and her team began inviting families to sit in on patient rounds.
“That young man and his mother changed my practice,” she says. “I learned a lot. I learned how to round with families at the bedside and not use medical language. I learned how to tackle difficult conversations in a more open setting. I learned how to make families feel supported, and that our staff also required support through this change because it was very unusual at the time.”
The willingness of Dr. Shaw and her critical care team to embrace change and to share their success is one example of a patient- and family-centred approach to care that led to Saskatchewan’s Open Family Presence policy. As of March 2016, every health-care facility in the province has adopted this policy, which ensures that families and loved ones are treated as part of a patient, client or resident’s care team.
“What I’m proud of is that the culture changed,” says Dr. Shaw. “It wasn’t me, it was the mother – she was brave, and it was the whole unit working together through what was at times pretty strong resistance, but we got there. Having family at the bedside doesn’t happen every day for every single patient, but it’s our new normal.”
Making quality improvement inroads
Quality improvement work has always been a passion of Dr. Shaw’s. The seed was planted by one of her teachers, Dr. David Johnson, during her anesthesiology residency.
“He told me, ‘The way we care for patients individually and collectively is not mutually exclusive. We can be good at taking care of patients one-on-one and good at caring for many at once by improving how the system works through the science and skills of quality improvement.’”
For the past two decades, Dr. Shaw has worked hard to make clinical and system improvements at the local, regional and provincial level in Saskatchewan. She has been a successful department head, a physician leader with the Saskatchewan Surgical Initiative and co-lead of the former Saskatoon Health Region's Safer Every Day initiative. She is currently a member of the Saskatchewan Health Authority’s Executive Leadership Team and board chair for the Saskatchewan Health Quality Council, and prior to her appointment as chief medical officer, was a director of physician advocacy and leadership with the Saskatchewan Medical Association.
“As a leader, one of the lessons I’ve learned is that we can have a greater impact as physicians if we’re willing and able to lead with our administrative colleagues,” Dr. Shaw says. “I don’t think physicians always have had the opportunity to see that our non-clinical, system leaders want the same things we do. They want patients to receive excellent care, and they want staff and physicians to be happy and feel supported in a sustainable health-care system.”
CMO role to support physicians, build leadership
Working with administrative and physician leaders to improve Saskatchewan’s health-care system is one of Dr. Shaw’s priorities in her new role as chief medical officer, which began in December 2017 when the province’s 12 former regions amalgamated into one provincial authority.
“I want physicians to have the skills, ability, time and resources to do their work and to improve their work, because if we do that patients will receive better care and better outcomes, and physicians will be healthier and happier,” says Dr. Shaw, who recently wrote about
physician wellness and the high rate of physicians who are at risk of burnout.
“Saskatchewan has strong physician leaders,” she adds. “The next step is to make it easier for physicians to have more influence, because we know that high-performing health-care organizations consistently have physicians as leaders who have the data and analytics to help drive change.”
Although physicians comprise most of the practitioners in Saskatchewan, this group also includes dentists, chiropractors, nurse practitioners and mid-wives. As chief medical officer, it is Dr. Shaw’s responsibility to liaise between practitioners and health-care executives, as well as to ensure that patients receive the highest quality of care from these practitioners. It is also her job to provide leadership and direction on matters related to clinical organization, advances in medical technology and practitioner staff compensation, recruitment, orientation and retention.
What does Dr. Shaw like most about her new job?
“The potential,” she says without hesitation. “There’s so much more potential than ever before and a real sense of optimism that we’re in a position to help re-design the system. Health care is always changing, but I don’t think we’ve ever been in a position to re-design the system in a way that takes the best of what we have locally and make it work across the whole province.
“That’s a lot of work!” she says of the enormity and significance of the task at hand, her feet falling to the ground from where they had been resting on the chair.
“It’s going to take years, but it’s amazing to have this chance,” she adds. “Every day I’m learning new things and that’s exciting. I’m very lucky.”