Photo of Walter Sermeus

Leading health workforce scholar appointed Frances Bloomberg International Distinguished Visiting Professor for 2015-16

23 February 2016

Professor Walter Sermeus is a professor healthcare management at the Leuven Institute for Healthcare Policy, University of Leuven – KU Leuven in Belgium, where he is also the programme director of the Master in Health Care Policy and Management. As member of the European Academy of Nursing Science, Sermeus coordinated the EU-FP7 RN4CAST project, investigating nurse forecasting in Europe from 2009-2011. A respected researcher, Sermeus has authored more than 120 scientific papers, and is a member of the Strategic Advisory Committee of the European Health Management Association.

Sermeus made his first visit to Bloomberg Nursing for the Quality and Safety Summit in November 2015, and will visit us again throughout 2016, meeting with graduate students, faculty and researchers.

What drew you to nursing?

I started my nursing studies in 1976. I had completed a traditional pathway into the sciences, but at the time, health care was moving into a patient-centred care model in primary nursing. Belgium was experimenting with the concept, and during a month spent as a hospital assistant, I saw many challenges. In medicine, the main responsibility of patient care tends to remain on the disease and how to treat or cure it. In nursing, the focus is really on the patient, in solving their health problems to the maximum extent possible.

Much of your work centres on health care management in Europe. What sorts of challenges exist in health care management in North America? Are they similar/dissimilar to those found in Europe, or are the challenges global?

The main challenges in health care management are controlling rising costs, and improving quality of care. We see in both European and North American systems that health care is shifting to population health, making prevention much more important. We see tasks shifting between doctors and nurses, nurses and health care assistants, professionals and patients because of standardization and the implementation of eHealth. One aim of my time at Bloomberg Nursing is to familiarize myself with the Canadian health care system to help identify similarities and differences.

You’ve done a great deal of research in workforce planning and forecasting. What is the important of workforce planning in improving patient care?

I am becoming more and more convinced that health workforce is the critical factor in quality improvement. It has been 15 years since the publication of To Err is Human, a report from the Institute of Medicine in America, and yet we still see that the number of avoidable deaths, complications, and adverse events is still unacceptably high. Policy makers continue to think that anyone can become a nurse, and operate without the understanding that it is among the most complex and challenging professions in the world.

There are many other initiatives for quality improvement in patient care, such as safe surgical checklists, blame-free workplace cultures, etc, but the bottom line is that the knowledge of nurses and the time spent with the patient are two important ingredients for creating a safe patient environment. In Belgium, one nurse is caring for eleven patients on average, which is much higher than we see in comparable health systems. The number might increase to 25 for night nurses. As a former night nurse, I know how difficult it can be to decide a course of action under those conditions. The stress lies not in the workload, but in dealing with uncertainties. Workforce planning is key to addressing this, and improving quality of care.

What do you hope to accomplish during your time as the Frances Bloomberg International Distinguished Visiting Professor?

One of the aims of my visit is to determine if there is interest in continuing the work we started with the RN4CAST project. That study benchmarked nurse qualifications, nurse staffing, and working environments in one country and compared it to others. The study ran initially in 12 European countries in close collaboration with Dr. Linda Aiken at the University of Pennsylvania. The study also worked to unveil the blackbox of nurse staffing and its relationship to patient outcomes. I know this a major focus for researchers at Bloomberg Nursing, and I look forward to opening pathways for collaboration in this area.

You’ve already completed one visit to Bloomberg Nursing – what is your most memorable Toronto moment so far?

My visit for the Quality and Safety Summit in November was my first visit to Canada. I was struck by how welcoming everyone was, starting right at the airport with customs and immigration personnel. The faculty and staff at U of T were similarly welcoming, and I enjoyed speaking at the summit, meeting new colleagues and expanding my understanding of quality care in Canada. Finally, on the weekend following the summit I was able to visit the Art Gallery of Ontario, where they had an exhibit on William Turner, one of my favourite English painters. This was a fantastic addition to my trip, and I’m looking forward to seeing more Ontario and Toronto during the rest of my term.