How to Create Safe Spaces for Patients: Zoom Meeting Version

Here are tips + hints about making video-conference meetings welcoming, friendly and safe for all participants.

BEFORE THE MEETING

1. Make sure patient’s schedules are included when the meetings are set up. This might mean being open to evening/weekend times for work/childcare/medical reasons.
2. For national or global groups, watch out for time-zone differences. In Canada, it is assumed everybody is on Eastern time! But that can mean late meetings for those in the Maritimes or early meetings for those on the west coast.
3. Don’t assume everybody uses the same video technology as you do, especially if you use a platform other than Zoom. Be flexible and use the most accessible system.
4. Be clear beforehand if people are expected to be on video so they can prepare for that – and consider why you are asking people to be on video (or not). Not everybody has a professional Zoom set-up. Offer up advice about lighting and sound so people don't feel at a disadvantage if they don't have a formal office space set-up.
5. If some members are being paid through their jobs to be there and others are not, consider how this immediately sets up a power imbalance. For more about patient engagement and compensation, read this article that was published in the Patient Experience Journal, written by Dawn P. Richards, Isabel Jordan, Kimberly Strain, and Zal Press.

DURING THE MEETING

1. Consider reframing groups from running a business meeting to building a community. A great way to begin is to have a conversation about why each member is there – what is their passion? What brings them there?
2. The white elephant in the room is that everybody on the call has different levels of power. Consider how you are going to mitigate this – will you acknowledge this verbally? Talk about it? Ask those with more power to purposely create space and listen to those who do not have power? IT IS YOUR JOB as a chair/lead is to figure out a way to overtly address power imbalances.
3. It is a good use of time to get to know each other as people instead of titles. Ice-breakers can help with that, as can a rotating lead for the meeting, or asking people to present about their area of expertise.
4. Think creatively about introductions – beyond the ‘name and role’ intro. The power imbalance begins when people are introduced using their graduate degrees and position titles.
5. If you are asking patients to make themselves vulnerable to share their stories, even through introductions, they should have advance notice and support to prepare. Consider how unfair it is for some people to share intimate stories, while others (usually the professionals) do not. Perhaps storytelling can be centred around a subject that all the members can contribute to (what brings them to health care, what is their passion, etc).
6. It is important that everybody has space to speak without being interrupted. If there is a quiet member, it is the chair’s responsibility to make space for that person to contribute – whether it is speaking, typing through the chat, or having a way to contribute ideas afterwards.
7. If you are concerned about time, ask people to speak for a specific amount of time (say, two minutes) without interruption, use a stopwatch and make sure the time is equitable for all members.
8. If you are taking notes or minutes, ensure that everybody’s words are documented (including patients) and shared back with the group. If patients have ideas and you don’t use them, indicate why, don’t just ignore their contributions. Don't take patients' words and ideas and take credit for them! (I speak from recent and painful experience).
9. Be aware of the signs of power imbalances that happen in meetings: male members interrupting female members, those with senior positions dismiss ideas from people with more junior positions, people being cut off or shut down. It is the chair/lead’s role to step in if/when that happens.
10. Consider your endings: clicking off ‘End Meeting’ on Zoom after sharing one’s story or a contentious meeting can leave members feeling exhausted or used. Do not just rush to your next meeting – have a plan for how you will follow up and let your members know. Perhaps you stay on the call to do a quick check in?

AFTER THE MEETING

1. Privately ask for feedback from the meeting – ‘how was it for you? – and do something with the feedback to make the next meeting better!
2. Consider unsolicited feedback from a patient a gift. Try your best not to take it personally and be defensive. Take some time to think about how you can utilize the feedback to make your group better.

Finally, here is an essay I wrote about meaningful patient engagement based on an in-person strategy meeting I attended in 2015. It includes lessons like this:

LESSON: It can be tricky to find your voice in a strange group. You have to figure out when to speak up and when to shut up. It is a bit of a dance while you first encounter the group dynamics. I knew I was there to bring value, and that I wasn’t supposed to sit there silently.

I'd love to add more tips and hints from you! Please add your own wisdom in the comments and I'll add to this list - with credit to you of course.

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