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CARe and PFAC: How patient input helped BIDMC’s Communication, Apology, and Resolution program to succeed. Health Care For All Webinar March 12, 2014. BIDMC’s PFAC. Started in 2010 Composition: 17 patient/family advisors, 6 staff

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slide1

CARe and PFAC:

How patient input helped BIDMC’s Communication, Apology, and Resolution program to succeed

Health Care For All Webinar

March 12, 2014

bidmc s pfac
BIDMC’s PFAC
  • Started in 2010
  • Composition: 17 patient/family advisors, 6 staff
  • Invite staff to present and welcome staff to request the opportunity to present
  • Strategic “in-reach” to staff working on quality and safety issues
  • Goal: Align work of PFAC and work of hospital
what is communication apology and resolution
What is Communication, Apology, and Resolution?

A transparent and honest approach to adverse events.

Components of CARe:

  • Culture of Safety, including encouraging reporting
  • Communication with patients when things go wrong
  • Empathy and apology
    • An apology of responsibility will be given if there was an error.
  • Timely and fair injury compensation outside of the court system
    • Attorney representation is encouraged
  • Improvement of systems and practices through learning from adverse events, and reporting the improvements to harmed patients
what is macrmi
What is MACRMI?
  • MACRMI: The Massachusetts Alliance for Communication and Resolution following Medical Injury
    • An alliance of patient advocacy groups, hospitals, their insurers, and statewide provider organizations committed to transparent communication, sincere apologies and fair compensation in cases of avoidable medical harm. BIDMC is a member of this organization.

www.macrmi.info

pfac s work for care 2013 2014
PFAC’s Work for CARe, 2013 - 2014
  • Assist in developing our CARe Patient Brochure
    • help clarify CARe’spurpose
    • find an appropriate tone
    • determine ways that it could be more helpful to patients
  • Review our Patient Best Practices Document
    • ensure that the Best Practices describe how patients would want to be treated after an adverse event
    • create consistent clarity and tone in the document
  • Assist in redesigning the required Massachusetts DPH SRE letter templates
    • help us understand possible patient reactions to these required letters
    • improve the letters to better serve their purpose
care patient brochure
CARe Patient Brochure
  • Purpose of brochure: To help patients better understand what CARe is, and how it works.
  • Audience: Patients in general, but mainly those who have experienced an adverse event.
  • PFAC’s Contributions:
    • Greater emphasis on communication
    • Clarify the “decider” in each step of the process
    • Clarify how to initiate the process if you’re a patient
    • Clarify legal rights
    • Elimination of the word “money”
    • Addition of clearer “bulleted” formatting throughout
slide8

The CARe Patient Brochure

Front Cover

Inside Flap

Back Cover

care best practices for patient interaction
CARe Best Practices for Patient Interaction
  • Purpose of the document: to make it clear that patients are an essential part of the CARe process, and to guide CARe sites in how to best work with patients who have been harmed.
  • Audience: Staff at CARe sites (and potential sites)
  • PFAC’s Contributions:
    • Simplify the language, and bold important points of practices so that staff can read quickly and easily.
    • Add a separate practice that focused on Listening.
revised best practices
Revised Best Practices

Soon to be on our website: www.macrmi.info

state required dph letters for sres
State-Required DPH letters for SREs
  • Massachusetts health care facilities are required to send letters to patients at 7 and 30 days after an event, if they experience what the state calls a Serious Reportable Event (adverse events that are seriously harmful to patients such as hospital acquired infections, wrong site surgeries, falls, etc.)
    • Audience: Patients who have been harmed
    • Purpose of the document: to ensure that patients are fully informed about adverse events they experienced
pfac s contribution to the dph letters
PFAC’s Contribution to the DPH Letters
  • Reframe each letter entirely!
    • Human First – we are telling you because we are committed to being transparent and to treating you like a human being, not because we’re required to by law.
  • Bigger concerns
    • Discussion first
    • Reopening the wound
    • Transfer of personal information
new dph 7 and 30 day letters
New DPH 7 and 30 Day letters
  • Rewrote both letter templates entirely, based on feedback
  • Now in use at BIDMC, with future expansion to our affiliates
  • Associate Commissioner of the DPH reviewed and really liked them, and appreciated our joint effort
pfac member perspective
PFAC Member Perspective
  • Appreciate the concept of apology without blame.
  • Able to give insight regarding how a patient might view the situation.
  • Thrilled there is a forum for patients who feel something has been done that deserves attention but may not want a suit.
  • Makes the institution more human and the patients feel more respected.
questions
Questions?
  • Contact information
    • Pat Folcarelli, Director of Patient Safety
      • pfolcare@bidmc.harvard.edu
    • Melinda Van Niel, Project Manager, CARe/MACRMI
      • mvanniel@bidmc.harvard.edu
    • Elana Premack Sandler, Project Leader, Patient and Family Engagement
      • epremack@bidmc.harvard.edu
    • Holly Thomas, PFAC Member
      • zubsha@gmail.com
how can pfac s get involved
How Can PFAC’s Get Involved?
  • Ask your organization how it’s currently handling communication following medical harm.
  • Ask to see the letters that they are mandated to send out to patients. Maybe you can provide improvement
  • Find out how they are providing emotional support to patients and families following harm. Let them know about MITSS
  • Ask if they are doing early compensation on cases meet criteria.
  • Ask if they have any PFAC members who are assisting in the Root Cause Analysis (RCA).