Health System Accountability & Public Participation: Greg Price’s Legacy After 10 Years

By Annamarie A. Fuchs, Creator. Partners in Health | Conversations.

“In healthcare we build legacy buildings and have ribbon cutting events in response to issues of volume, demand, and wait lists. We are working toward achieving the wrong goals. We first need to learn how to work together. And we need to learn how to enable the system to allow for information to be shared so that we can experience whole person care instead of treatment of disease.”

 Dave Price. March 2022

Introduction

On May 19, it will be 10 years since the Price family lost their beloved son Greg and the world began to learn about his story. It will be 5 years this summer since the movie of his story “Falling Through the Cracks” began filming and 4 years since the public launch of that film in Calgary on May 17, 2018.

In 2012, I was a member of the Board of Directors with the Health Quality Council of Alberta when we began working with Dave Price, a distraught father of 31-year-old Greg Price who had passed away suddenly in Dave and Isabelle’s home shortly after having surgery for testicular cancer. Dave knew that there was a great deal wrong with what had happened to Greg in the months before his death. And even in those raw and agonizing days of fresh loss, he knew instinctively that something had to be done. Someone had to investigate Greg’s journey through the health system, and make sure THIS story, wouldn’t be lost.

Over the coming year the investigation of Greg’s journey through the health system unfolded and the story of the Price family’s tragedy was ultimately released to the public by the Health Quality Council of Alberta on December 19, 2013 and entitled the “Continuity of Patient Care”[1] Study.

This article is the first in a series about Greg and his enduring influence on the health system. It is about the commitment of his remarkable family to raise issues of the lack of shared accountability across the entire health system that resulted in the system’s failure on multiple levels – to come to his aid to diagnose him and to save him.  But most importantly, this is Greg’s story. It is his family’s story. And it is our collective story. The tragedy of Greg Price’s death highlights the gaps, the incorrect assumptions, and the abdications of responsibility that occurred in what we know to be a complex and flawed system, all of which could have been avoided.

What follows are excerpts from a recent 2-hour conversation with Dave Price and his daughter Teri, Greg’s sister. Dave and Teri are the founders of Health Arrows, Greg’s Wings, and the Co-Pilot Collective.

Our Conversation

Dave and Teri, it’s been nearly 4 years since the public launch of the movie “Falling through the Cracks.” I remember that night so well. It was bittersweet in so many ways for me as a former member of the Board and a new friend (and fan) of yours but for you and your family it must have been so much more than that. Tell me a bit about what these past years have been like since you made the decision to shoot the film and to release it to the world.

Well, we’ve screened the film more than 470 times since that launch in Calgary in May of 2018. And since then, so much has changed. We didn’t really know what the response to the film would be, but I remember realizing after we wrapped on the first day of shooting the film that we were going to have something truly special that could have a lot of impact.  We are incredibly grateful to everyone who was involved in the production of the film.  It truly is a gift.  We know how powerful storytelling can be, but the film is effective in a way that I don’t think standing at the front of a room and telling our story ever could be and it continues to have an impact on audiences every time it is shown. With each screening, we have seen how Greg’s story resonates with almost everyone. And while that in itself is a tragedy, it has also been valuable to us to participate in each of the post-film conversations so we can also learn from the participants.

Over the last fours years, we have learned a lot.  The fundamentals of what we believe needs to change in the health system haven’t changed, but these conversations have enabled us to continuously deepen our understanding of the system and to refine our messaging. At the beginning we knew we wanted Greg’s story to spark change. We wanted to raise awareness to try to prevent tragedies like Greg’s death from happening again. Some screenings have been followed by very difficult conversations about other incidents of health system failure, but we have learned how to not only respect and guide those conversations but to learn from them.

We hope that by exposing some of the dangerous assumptions that are out there in the public realm, we can strengthen the public’s knowledge about the gaps that exist between an ideal system and the current system.  Ultimately, we hope that this knowledge will enable each of us to speak up, to ask better questions, and to advocate for ourselves and our loved ones when we are receiving care.

We host monthly online screenings that are open to the public. The film is also embedded in medical school education in some places, and in other health professional training programs as well.  We have also been invited to share the film with a range of organizations such as hospitals, primary care networks and clinics, private technology companies, patient advocacy groups, government agencies, front line workers, executives, and at board room tables. We have presented at 40 conferences, with 22 post-secondary institutions, and are confident that to date, more than 37,000 people have seen the film. We hope that the fact that we are still being invited to participate in such a wide range of conversations is a signal that this story, that Greg’s story, will foster real and lasting change.

Let’s talk a bit about some examples that demonstrate how the film has sparked positive change.

Chinook Primary Care Network in the southwest corner of Alberta is one example. They have been doing remarkable work in moving quality improvement opportunities out to all health care professionals, and they’ve since launched a campaign called “I Saved a Life” where they recognize and celebrate the actions that people in their network have taken to close gaps in the system to better support and protect patient safety.  The intent is to acknowledge and highlight that everyone has a role to play in a patient’s journey through the healthcare system.  This spring we reviewed the pool of “I Saved a Life” award applicants and chose two as recipients of a “Greg’s Wings Award” and “Greg’s Teamwork Award”.  The actions taken by both award recipients did save lives and through the programs and/or changes that were implemented as a result, they will continue to save lives.  Hopefully by sharing and highlighting stories like these and others, individuals and teams will contribute in new ways to provide safe and quality care to patients.  We know that it’s at the grassroots where health system transformation is really going to take hold.

Because of your own personal tragedy, the two of you have become respected experts and influencers regarding so many aspects of the health system in Alberta and beyond. You talk about gaps and barriers, about missed opportunities on the part of decision makers, and the influence of political cycles, policy makers, and government. You’ve shared innovations that are beginning to unfold and sadly, you also continue to hear about more tragedies. When you look back at the ten years since you lost Greg, if you could say anything to the public about your wish for the health system in Canada, what would that be?

In an ideal health system, the public should be given the opportunity to contribute to a shared vision and the future. They would have the power to recognize when decisions interfere with progress toward achieving that ideal system and to hold decision makers appropriately accountable.

Over time we’ve learned that the public makes a lot of assumptions about how the health system works but in the past few years, there seems to be a growing appetite to gain even greater understanding. We were in exactly that place before we lost Greg. We didn’t understand what drives and influences decisions in the healthcare system in those early days like we do now. And we are still learning. But by helping to educate the public, we hope that our collective efforts will enable greater understanding about how to apply pressure in the right ways and in the right places.

Tell me more about that.

The public assumes that patient and provider safety is the uppermost priority for everyone.  It should be but frankly, it isn’t.  At the top of the health system management pyramid, leaders measure risk in political terms and that is not the same thing as measuring risk in terms of patient safety. The public hears from various parties involved in the health system attempting to defend their positions or to maintain the status quo while reinforcing the image to the public that we have one of the world’s leading health systems.  That also is simply not true, at least not yet.  In a system that truly puts patient safety first, there would be openness and transparency about the flaws in the system and their plans to fix them alongside those aspects of the system that are performing well.

Any good system continually recognizes and responds appropriately to errors, learns, improves, and innovates.  What is needed now more than ever, is a level of maturity and courage among all leaders to be transparent about what needs to improve in the current system.  Effective public engagement is a challenge but could be a powerful lever for change that will eventually advance patient and provider safety as the political priority it should be, and everyone will be much better for it.

So with that in mind, what do you want to see happen in Greg’s memory? What’s next for Greg’s Wings?

Well, we believe there are three priorities. We need a system with a strong foundation of teamwork, where access to information is critical, and with a culture that embraces, learning, continuous improvement, and innovation. Our goal is to facilitate deeper, collective conversations in safe spaces where people can share ideas, raise questions about gaps and other issues, learn how to ask the right questions and understand where and how to advocate for change.  One initiative we have established is our online community known as The Co-Pilot Collective.  It is a space where we hope people will feel comfortable continuing the conversations that have been sparked by the film. 

In the early days after we lost Greg, we were desperate to learn what had happened. We had experienced a terrible loss. Early discussions we had were, for the most part, unwelcome, and responses from leaders to our questions were defensive instead of seeing those questions as an opportunity to learn and improve. Our experience with the Health Quality Council of Alberta and their investigation that lead to the release of the Continuity of Patient Care Study in December of 2013 was entirely different.  We recognized that together we could work as a team to acquire a deeper understanding about what had happened while intentionally focusing on what could be done to close the gaps that occurred in Greg’s journey to make things better in the future.

All these years later, it’s becoming not about if we can reach that destination; it’s about how and when we will reach it together. We are willing to work with leaders, providers, and the public, and over time the list of people and groups who are willing to work with us has been growing. That in itself is a transformation. And eventually we know there will be less focus on questioning the ‘what if’s’ when a tragedy happens like Greg’s story and a move toward a shared understanding about how we are working together to enable better healthcare for everyone.

Next Steps

At Greg’s Wings, The Co-Pilot Collective, and Health Arrows, the conversation continues. Over the coming months the teams at Partners in Health | Conversations and Greg’s Wings will be co-writing three articles that will capture insights associated with:

• Barriers to accessing patient information
• Effective teamwork
• Challenges and opportunities in governance (how to establish a learning health system)

 

And we also want to hear from you!

• Help us understand what’s changed for you over the last 10 years by joining the Co-Pilot Collective and sharing in those conversations. The Co-Pilot Collective
• If you’ve seen the film “Falling through the Cracks” we’d appreciate you taking a few minutes to complete a survey: https://collector.sensemaker-suite.com/collector?projectID=47ef6b9c-04ac-499b-b69a-f6d0629a1633
• If you’d like to see the film, here’s where you can go to register for a screening. https://www.eventbrite.com/cc/public-film-screenings-254169

Our final thoughts are for Greg.

What follows is tribute to Greg Price, some of which is paraphrased from an obituary printed in the Three Hills Capital on May 30, 2012.[2]

Greg Price was born to Dave and Isabelle Price on August 5, 1981. He was a mechanical engineer and a pilot. He was a son and a brother, an uncle, a grandson, a nephew, and a beloved community member.

Greg would be 41 years today. He was supportive and compassionate, putting everyone ahead of himself. Everyone who knew Greg knows that he would not want this tragedy to hold us back or negatively affect our futures. He would want us to be stronger for it, while respecting our memories of him and what he stood for. This will be our challenge and our goal for the rest of our days on this earth.

Greg accumulated and shared inspiration throughout his life. His journals were filled with quotes, and we’d like to share one that was paraphrased from a poem written by Mother Teresa.

 Yesterday is gone.
Tomorrow is uncertain.
Today is here,
So, use it!

If Greg was alive today, there is no doubt he would be using his time to contribute in remarkable ways to his family, his community, and the world. And yet, despite his absence he continues to do just that.

[1] Health Quality Council of Alberta. Continuity of Patient Care Study. December 19, 2013. https://hqca.ca/wp-content/uploads/2021/12/Dec19_ContinuityofPatientCareStudy-2013.pdf

[2]  http://www.threehillscapital.com/index.php?option=com_content&view=article&id=2257:price-greg-michael&catid=99:obituaries&Itemid=319