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Staff Competencies for Patient and Family Centered Care. Ann Buzaid & Kirk Hennig Co-leads of the Rehabilitation Services Patient and Family Advisory Council at University of Washington Medical Center. University of Washington Medical Center Department of Rehabilitation Medicine.

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Staff competencies for patient and family centered care l.jpg

Staff Competencies for Patient and Family Centered Care

Ann Buzaid & Kirk Hennig

Co-leads of the Rehabilitation Services Patient and Family Advisory Council at University of Washington Medical Center


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University of Washington Medical Center Department of Rehabilitation Medicine

  • Inpatient Acute Rehabilitation Unit:

    20 Bed, CARF Accredited Unit

    Team approach with patient & family including:

    Physiatrist

    Occupational Therapist

    Physical Therapist

    Speech Language Pathologist

    Recreational Therapist

    Nurse

    Psychologist

    Rehabilitation Counselor

    Prosthetics and Orthotics


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Department of Rehabilitation Medicine Rehabilitation Medicine

  • Outpatient Services

    Outpatient Rehabilitation Medicine and Therapy clinics

  • Inpatient services provided throughout the Medical Center


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Rehabilitation Services Patient & Family Advisory Council Rehabilitation Medicine

  • Founded in January 2003

  • Composed of 10 patient and family advisors, the medical director, occupational therapy manager, and 4 direct care staff. Ad hoc members include the inpatient nurse manager, outpatient medical clinic manager, and the patient care services administrator.


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Rehabilitation Patient & Family Advisory Council Rehabilitation Medicine

  • Meets monthly

  • Develops annual work plan

  • Participates in facility and departmental initiatives

  • Members of the Rehab Advisory Council serve on other hospital committees such as the ADA committee, the Aesthetics committee, and other special projects


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Development of staff competencies for patient and family centered care

  • Council has always been interested in developing ways of bringing patient and family centered principles into direct patient care by training staff in patient family centered principles and behaviors.

  • Competencies are reviewed with staff annually as part of the performance review process and training to these competencies is provided to staff.

  • Development of patient family centered competencies was specifically made part of the Sept 2006 work plan for the council.


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Preparation centered care

  • Reviewed outside literature

  • Reviewed behavioral dimensions developed by the Perinatal/NICU Advisory councils, patient satisfaction results, PFCC patient satisfaction questions, and the annual performance evaluation including the job description and competencies

  • Formed a sub-committee that consisted of 3 patient advisors, the Occupational Therapy Manager & council co-lead and a direct care staff person (PT)


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Review of literature centered care

  • “Templates – Philosophy of Care Statements, Definitions of Quality, and PositionDescriptions” from the Institute for Family-Centered Care developed through a subcontract with Axiom Resource Management, Inc. Sept 27, 2005-Sept 26, 2006


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Behavioral Dimensions for PFCC Perinatal & NICU Councils centered care

  • Demonstrates respectful caring.

  • Demonstrates collaborative orientation to working with patients and families.

  • Understands and describes patient perspective.

  • Recognizes and empathizes with multiple points of view.

  • Demonstrates knowledge and application of patient and family centered care.

  • General communication approaches.


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Patient Satisfaction centered care

  • Press Ganey survey

  • Patient Family Centered Care steering committee developed 5 custom questions to be included in the survey.


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Custom Questions centered care

  • How well staff member explained his/her role.

  • The degree to which staff supported your family.

  • The degree to which your choice to have family present is respected.

  • The degree to which staff respected your cultural and spiritual needs.

  • The degree to which staff supported your participation in decisions regarding your health care.


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Job Descriptions/Performance Evaluations/Competencies centered care

  • 12 page document that is reviewed with staff upon hire, 6 mos, and then annually

  • Occupational Therapist II job description was selected to represent Rehabilitation Services

  • Manager is on Rehabilitation Advisory Council

  • Majority of Occupational Therapists are Occupational Therapist II

  • Duties represented would be able to be generalized to other job descriptions


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Format centered care

  • Job Summary

  • Duties and Responsibilities

  • UWMC–Wide Competencies

  • Professional Requirements


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Human Resource considerations centered care

  • Meeting with human resource manager:

  • Not able to change the UWMC-wide as the competencies require an approval process that had already been completed.

  • Hospital is in process of standardizing total number of duties and responsibilities to 12.

  • Need to use the current rating scale.


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4 hour sub-committee retreat centered care

  • Changed language of the Job Summary – was important that the first sentence start with the inclusion of patients and their families (see handouts).

  • Identified 8 out of 18 duties and responsibilities that contain patient and family competencies.


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Sub-committee retreat centered care

  • Introduced 1 new competency to professional requirements.

  • Revised the Service Orientation and Relationships and Teamwork competencies under UWMC-Wide as a recommendation to Human Resources.

  • All changes made by the sub-committee were reviewed by the full Rehab Patient Family Advisory Council.


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Original Job Summary centered care

  • Job Summary: Responsible for evaluation, planning, directing and administering occupational therapy evaluation and intervention to patients referred by a licensed provider. Administers treatments, training and physical agents as determined by the evaluation in an effort to restore function and prevent disability following injury, disease or physical disability. Evaluates and administers treatment for functional living skills such as self care, homemaking, range of motion, muscle testing, cognitive, visual perception, vocational and avocational skills, splinting, assistive technology and community integration. Reports data in both written and oral form following the policy and procedures of the OT department and the Medical Center. Provides supervision to less experienced therapists, students, COTAs, aides, and volunteers. Participates in the operational aspects of the department, maintains performance improvement activities within the department and participates in Quality Improvement activities. Follows procedures and standards for cost effectiveness. Ensures that patient charges are accurate and entered in a timely basis. Participates in all infection control, departmental equipment training, organizational safety and fire safety programs.


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Patient/Family Centered Changes to the Job Summary centered care

  • Job Summary: In collaboration with patients, families (asdefined by thepatient), and staff across disciplines and departments is responsible for evaluation, planning, directing and administering occupational therapy evaluation and intervention to patients referred by a licensed provider. Administers treatments, training and physical agents as determined by the evaluation in an effort to restore function and prevent further disability following injury, disease or physical disability. Partners with the patient and family and,considering the patient’s environment, evaluates and administers treatment for functional living skills such as self care, homemaking, range of motion, muscle testing, cognitive, visual perception, vocational and avocational skills, splinting, assistive technology and community integration. Reports data in both written and oral form following the policy and procedures of the OT department and the Medical Center. Provides supervision to COTAs, aides, and volunteers. Participates in operational aspects of the department, maintains performance improvement activities within the department and participates in Quality Improvement activities. Follows procedures and standards for cost effectiveness . Ensures that patient charges are accurate and entered in a timely basis. Participates in all infection control, departmental equipment training, organizational safety and fire safety programs.


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Original Duties and Responsibilities centered care

2. Ability to observe and evaluate treatment effect. Communicates with physician and other team members as needed.

3. Ability to perform an appropriate evaluation on all patients as related to the therapy requested and provided and reassessments as per protocol. This includes adolescent, geriatric patients and the general patient population.


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Patient/Family Centered Changes centered care

1. Using feedback from the patient and family,

performs an appropriate evaluation as

related to the therapy requested, observes

and evaluates the effect of treatment, and

progresses the plan accordingly.


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Original Duty and Responsibility centered care

10. Interacts professionally with patient/family

and involves patient/family in the

formulation of the plan of care.


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Patient/Family Centered Changes centered care

2. Involves the patient/family in the formulation

of the plan of care by interacting

professionally and compassionately with the

patient/family.


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Original Duty and Responsibility centered care

4. Able to assess patient pain interfering with

optimal level of function or participation in

rehabilitation – makes appropriate physician

contact for intervention.


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Patient/Family Centered Changes centered care

3. In discussion with the patient and/or family,

assesses patient pain interfering with optimal

level of function or participation in

rehabilitation, makes appropriate provider

contact for intervention.


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Original Duty and Responsibility centered care

6. Formulates a teaching plan based upon

identified learning needs and evaluates

effectiveness of learning, family is included

teaching as appropriate.


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Patient/Family Centered Changes centered care

4. Formulates a teaching plan, with the patient

and family members, based upon identified

learning needs and evaluates effectiveness

of learning.


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Original Duty and Responsibility centered care

11. Communicates appropriately and clearly to

physicians, staff and administrative team.


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Patient/Family Centered changes centered care

5. Communicates, orally and in writing,

appropriately and clearly to physicians, staff,

patients and their families, the administrative

team, and outside entities. Maintains records

pertinent to personnel and operation of the

department.


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Original Duty and Responsibility centered care

8. Treats patients and their families with

respect and dignity. Identifies and

addresses psychosocial, cultural, ethnic and

religious/spiritual needs of patients and their

families.


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Patient/Family Centered Changes centered care

6. Interacts respectfully with patients and their

families.In collaboration with patients and

their families, identifies and addresses

psychosocial, cultural, ethnic and

religious/spiritual needs.


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Original Duty and Responsibility centered care

12. Coordinates and directs patient care to

ensure patients’ needs are met and hospital

policy is followed.


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Patient/Family Centered Changes centered care

7. Is attentive to ensure that the needs of

patients and their families are met and

hospital policy is followed. (For example:

offering a glass of water, ensuring that the

call light is accessible, etc).


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Original Duty and Responsibility centered care

14. Consults with other departments as

appropriate to collaborate in patient care

and performance improvement activities.


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Patient/Family Centered Changes centered care

10. Collaborates with patient and/or family

members, and other departments, in the

development of performance improvement

activities.


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UWMC-Wide Competency centered care

24. Service Orientation – Supports the organizational and service

area’s mission and vision.Demonstrates knowledge of and

applies the UWMC Standards for Service Excellence:

Introduces themselves; Escorts as needed; Responds and

follows through with complaints; Asks what name the person

wishes to be called; Refers people to those who can give

assistance; Apologizes and provides additional services for

patients who have been inconvenienced or who need special

assistance; Assists if someone looks lost; Privacy is maintained

and care-related discussions are conducted in private settings;

Anything else is always the manner in which conversations are

ended. Demonstrates the ARISE (Accountability Respect

Innovation Service Excellence) values.


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Patient/Family Recommendations centered care

24. Service Orientation – Supports the organizational and service area’s mission and vision.Demonstrates knowledge of and applies the UWMC Standards for Service Excellence:

  • Introduces themselves.

  • Escorts as needed.

  • Responds and follows through with complaints.

  • Asks what name the person wishes to be called and ends conversations

    by asking if anything else is needed.

  • Refers people to those who can give assistance.

  • Apologizes and provides additional services for patients who have been

    inconvenienced.

  • Assists if someone looks lost or needs special assistance.

  • Privacy is maintained and care-related discussions are conducted in

    private settings.

  • Demonstrates the ARISE (Accountability Respect Innovation Service Excellence) values.


  • Uwmc wide competency37 l.jpg
    UWMC-Wide Competency centered care

    25. Relationships and Teamwork – Communicates

    effectively and respectfully with individuals and

    groups. Contributes to positive working

    relationships and collaborative teamwork with all

    disciplines and departments. Recognizes own stress and the

    impact on others. Identifies and manages stressors utilizing the

    guidance of others. Remains flexible with changes that are

    occurring in the department and/or medical center.

    Concerns/issues regarding departmental/organizational

    operations are communicated to the employee’s

    supervisor/manager.


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    Patient/Family Recommendations centered care

    25. Relationships and Teamwork – Communicates

    effectively and respectfully with individuals and

    groups. Contributes to positive working

    relationships and collaborative teamwork with all

    disciplines, departments, patients and their families.

    Recognizes own stress and the impact on others. Identifies and

    manages stressors utilizing the guidance of others. Remains

    flexible with changes that are occurring in the department and/or

    medical center. Concerns/issues regarding

    departmental/organizational operations are communicated to

    the employee’s supervisor/manager.


    New professional requirement l.jpg
    New Professional Requirement centered care

    31.Introduces self and explains his or her role

    to patients and their families.


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    Rollout of New Competencies centered care

    • Reviewed and enthusiastically embraced by the Occupational Therapy staff.

    • Reviewed by the Rehabilitation leadership of Rehab Nursing, Physical Therapy, Speech Pathology, Rehab Psychology, Therapeutic Recreation, and Rehab Counseling. Commitment that all job descriptions and competencies would include the patient/family centered language by October, 2007.

    • Reviewed with Human Resources. UWMC-wide recommendations to be discussed in the coming year.


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    Staff development/training centered care

    Training program is being developed by the Rehab

    Patient/Family Advisory council to include:

    1) Introduces self and explaining his/her role.

    2) Communicate with patients/families: allow time for

    explanations and questions.

    3) Involves the patient/family in the formulation of the

    plan of care by interacting professionally and compassionately

    with the patient and family.

    4) Staff will work with patient/families to clarify needs and ensure

    access in the environment.

    5) Self examination of ones own biases towards other cultures and

    professional background.


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    Resource contact information centered care

    Ann Buzaid

    [email protected]

    For templates:

    e-mail Sarah Kaufman at IFCC

    For powerpoint:

    Tools for Change

    www.familycenteredcare.org


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