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Georgia Hospital Association Bernard Roberson, MSM, BA, HSC Administrative Director Patient- and Family- Centered Care Georgia Regents Medical Center
Build a Collaborative Partnership with Patient- and Family- Centered Care and Patient Engagement Patient- and family-centered care is defined as an approach to the planning, delivery and evaluation of health care that is grounded in mutually beneficial partnerships among patients, families, and healthcare providers. It is founded on the understanding that the family plays a vital role in ensuring the health and well being of patients of all ages.
Patient Engagement Definitions • Patient engagement means fostering a fruitful collaboration in which patients and clinicians work together to help the patient progress towards mutually agreed-upon health goals. (Patient Engagement: On Metrics and Meaning, Leslie Kernisan) • Patient engagement is the process by which patients become invested in their own health. Health systems with effective patient engagement programs provide patients with the information and tools needed to take control of their care. (Patient Engagement Index Methodolog/Axial Exchange,axialexchange.com)
Patient Engagement A full patient engagement definition refers to: • The knowledge, skills, ability and willingness of patients to manage their own health and care. • The culture of the health care delivery organization that prioritizes and supports patient engagement. • The active collaboration between patients and providers to design, manage and achieve health outcomes. • Patient engagement is transitioning from “nice to have” status to becoming an essential component in government, academia and medical practice arenas. It is embedded in major health reform initiatives including Stage 2 Meaningful Use, the Patient-Centered Medical Home (PCMH) model of care, and Accountable Care Organizations (ACOs). (http://www.athenahealth.com/knowledge-hub/patient-engagement/what-is-patient-engagement.php)
Principles of Patient- and Family- Centered Care • Dignity and Respect- To listen to and honor all patient and family ideas and choices and to use patient and family knowledge, values, beliefs and cultural backgrounds to improve care planning and delivery. • Information Sharing- To communicate and share complete and unbiased information with patients and families in useful ways and empowering so they can take part in the care giving and decision making. • Participation- To encourage and support patients and families to participate in ways that enhance their control and independence. • Collaboration- To invite patients and families members to work together with health care staff to ensure the development and evaluation our policies, programs, education and delivery of care.
“For health care to truly improve health, the patient must become part of the system, not merely have input into the system.”--Julianne M. Morath, RN, MS
Key Success Factors for PFCC • Believe that patient input is truly valuable • Involve patients from the beginning of all aspects of care and facility improvements • Role model what partnering looks like • We are all accountable for the results; patients, families, providers, and health systems
What are Key Features of a PFCC Organization? • A shared vision for the care that reflects partnership • Warm and welcoming signage / attitudes • Open visitation / removal of barriers to communication • A resource center for patients / families • Open access to information • Supportive environment • An identifiable group of patient advisors
Patient- and family-centered care is not be confused with customer service or service excellence. • Patient- and family-centered care is not just “being nice” or addressing needs promptly. • Patient- and family-centered care emphasizes communication and relationships. • Patient- and family-centered care is about partnerships and the participatory involvement of patients and families in care and decision-making.
How to Engage with Patients and Families Patients and Families as Advisors An advisor is a patient or family member that has used the services of the organization; whom has been asked to become a partner to provide direct input and influence on policies, programs, and practices affecting care and services for patients and families.
What is Important to Patient and Family Advisors? • A welcomed member of the team. • Preferences honored. • Role as patient/family member respected. • Coordination and quality of care. • Family and support persons welcomed and supported. • Access to information to help make decisions. • Participate in planning for discharge and self care at home. • Lodging complaints and concerns and their resolution. • Being your Partner and part of Healthcare Team
Types of Patient- and Family- Centered Care Partnerships for Engagement • Formal / Informal • Spontaneous / Planned • Short-term / Long-term • Stipend / Volunteer
Engagement at all Levels: • Organizational • Program • Care
When to Engage Patient and Family Advisors • Brainstorming sessions • Planning new services • Developing new policies, procedures • Implementing new policies and procedures • Interviewing leadership candidates • Educating staff, students, other personnel • Changing clinically relevant processes
Examples: • Administration • Policies • Finance • Billing • Facilities • New Construction and Renovations • Human Resources • Interviews for New Hires • Information Technology • Electronic Personal Health Record • Quality and Safety Committees • Joint Commission Leadership Committee
Successof working with patient and family advisors include… • Encouraging participation and validate role as committee member • Recognizing advisor’s strengths - is there another opportunity for participation? • Building a relationship • Reinforcing HIPAA confidentiality regulations • Recruiting patient advisors for areas that aren’t represented….
Engaging the Family Caregiver at the Point of Care • Developing a caregiver identification process is vital and there are different ways to do this, including: • Ask patients who takes them to the doctor, does most of the cooking in the house, or who they call when they are feeling ill • Utilize family-centered rounds, family-friendly Medication Administration Records (MAR), and interpretation services • Meet the patient and caregiver “where they are” • Encourage collaboration between home care agencies and hospitals • Ask questions to identify multiple caregivers and determine roles • Caregivers may be parents, spouses, children, neighbors or others – they’re not always who one might think and many face barriers when identifying them • There are 90 million family caregivers in the US, and the demand for caregivers continues to grow Resources Shared by Speakers: www.NextStepInCare.org www.HelpforCancerCaregivers.org www.CaregiverAction.org www.RareCaregivers.org Communities of Practice Resources: General Master Class Resources: http://www.healthcarecommunities.org/ResourceCenter.aspx?CategoryId=40870 Resource Guide: http://www.healthcarecommunities.org/DesktopModules/Bring2mind/DMX/Download.aspx?portalid=3&EntryId=77215
"Culture does not change because we desire to change it. Culture changes when the organization is transformed; the culture reflects the realities of people working together every day.“ — Frances HesselbeinThe Key to Cultural Transformation, Leader to Leader (Spring 1999)
Neurosciences Center of ExcellencePFCC Results • Patient Satisfaction – 10th→ 95th percentile • Staff vacancy rate – 7.5% → 0%; have waiting list 5 RN’s • Length of stay decreased – 50% in Neurosurgery • Discharges increased 15.5% • Perceptions of the unit by doctors, staff, and house- staff • Capacity for continuous improvement • Organ donor program • Moved to staff self scheduling • Staff owns the culture – deviations addressed • Medication errors dropped 62%
Patient Engagement Has a Positive Impact On: • Patient Safety • Quality and Outcomes • Cost Effectiveness • Patient/Family Satisfaction • Staff Retention/Satisfaction • Reducing Risk/Malpractice
When looking at programs and services, all of us should ask the questions: • Is this patient- and family-centered? • Is this the only way we can do it? • Is this the best way we can do it? • Are we doing it this way only because it has always been done this way? • Are patients and family members involved
What can patients and their family members do for healthcare as integral members of the healthcare team?
The Answer: Help us to meet the new challenges facing medicine from external forces that are driving changes in the practice of medicine.
Partnerships between Health Care Providers, Patients, and Families It is “The Right Thing To Do” and everyone benefits with Improved Quality and Safety