Years before COVID-19 came along to test the resilience of health care workers across Canada, an earlier crisis forced Christine Donaldson to take pause and figure out how to come through the other side of it a stronger and better-prepared leader.
At the time, nearly a decade ago, Donaldson was Director of Pharmacy at Windsor Regional Hospital, which was under scrutiny when a serious medication error meant nearly 300 cancer patients were unintentionally given lower-than-prescribed doses of intravenous chemotherapy medication.
As pharmacy lead, Donaldson became the primary public face of the hospital as the crisis swirled and patients, government officials and investigators appointed by the Ministry of Health sought answers.
“I was the one standing in front of patients and families after we disclosed the error and had to try to explain to them what had happened. There were some really tough days when you saw the impact on patients who were already going through so much. That was the most humbling moment of my career so far,” recalled Donaldson. “Then you come to a realization that even though failure is not an option in health care, it’s going to happen. So how do you take that learning and then champion and advocate for change so this type of error never happens again?”
Today, Donaldson has a national role serving as Vice President, Pharmacy at HealthPRO Procurement Services, where she oversees the contracting of pharmaceutical supplies and medicines for more than 1,300 member hospitals and health care organizations across Canada, optimizes procurement, and ensures that critical drugs and essential products for hospitals are available when they’re needed.
We recently spoke with Donaldson about resilience in health care and the power of pushing for positive change to overcome gaps in the health system, such as those that have been amplified by the pandemic over the past couple of years.
She told us she continues to draw strength from lessons she learned through the career-changing experience of dealing with the chemotherapy crisis and its aftermath years ago.
The error that caused the crisis was determined by provincial investigators to be the responsibility of a pharmaceutical provider that mixed the chemotherapy medicine and another group purchasing organization (not HealthPRO) that provided it to hospitals. Ultimately, more than 1,200 cancer patients at five hospitals received diluted medication that was approximately 10% weaker than it should have been.
Even though her hospital was not to blame for the error, Donaldson said it was initially difficult not to feel responsible.
“You take it personally at first, but you have to quickly turn to what we can do to improve the system overall and how that will remove the risk to all patients,” she said. “Your advocacy actions afterwards are what people will also remember.”
Donaldson focused her energy on ways to improve the quality of the medication supply both at her own hospital and other hospitals across the province. She sat on hospital task teams, worked on improvements with the Ontario College of Pharmacists leading to new hospital pharmacy accreditation standards and became an advocate of change to increase patient safety.
She continues to focus on patient safety today in her role with HealthPRO, where she convenes advisory committees with hospital-based pharmacists across the country. She also assists the Institute for Safe Medication Practices Canada on various projects, including a campaign to improve labelling on chemicals to avert dispensing errors and help patients better understand the medicines they take.
“If I can make things better and strengthen our pharmaceutical supply and quality, that’s something I’m going to tell my grandchildren about someday,” she said. “That becomes part of your legacy.”
Donaldson said she sees many health care clinicians adopting a similar approach to navigate the ongoing pressures of the pandemic and related challenges, such as chronic shortages of health workers.
She pointed to pharmacists who stepped up immediately after COVID-19 vaccines became available to help run mass immunization clinics – around the clock or until supplies ran out, in some cases – to stem the spread of the virus.
“It was pretty high stakes in terms of the pressure and the stress they were under and they handled it exceptionally well.”
While health care and pharmacy professionals have proven their endurance and resilience repeatedly over the course of the pandemic, burnout has become more prevalent the longer the pandemic has dragged on.
One of the most important elements for people in the health care field, in times of crisis as much as not, is to practice self-care. Providing the same empathy and compassion for themselves that they do for their patients is a key step for healthcare and pharmaceutical professionals to be able to build personal capacity, resilience, and maintain focus.
Donaldson said she has found helpful strategies to strengthen resilience and support mental health through the University of Toronto’s Leslie Dan Faculty of Pharmacy, where researchers are studying the impact of occupational burnout and how to prevent it.
