patient- and family-centered care for adults with chronic conditions
TRANSCRIPT
Patient- and Family-Centered Care for Adults with Chronic Conditions
Web Event
May 20, 2014
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Patient- and Family-Centered Care for Children and Older Adults
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Patient- and Family-Centered CareImplications for Adults with
Chronic Conditions
Beverley H. Johnson
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Patient- and Family-Centered Core Concepts
▼ People are treated with respect and dignity
▼ Health care providers communicate and share complete and unbiased information with patients and families in ways that are affirming and useful
▼ Patients and families are encouraged and supported for participation in care and decision-making at the level they choose
▼ Collaboration among patients, families, and providers occurs in policy and program development and professional education, as well as in the delivery of care
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Patient- and Family-Centered Core Concepts
Patient- and family-centered care is working with patients and families, rather than to or for them
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A Broad Definition of Family . . .
▼ In health care settings, patients are asked to define their families and how they will be involved in care and decision-making
▼ The American Academy of Family Physicians (2009) defines family as “a group of individuals with a continuing legal, genetic and/or emotional relationship”
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Why Patient- AND Family-Centered Care and not just Patient-Centered Care?
▼ Individuals who are most dependent on health care are most dependent on families
▼ Those with chronic conditions
▼ The very young
▼ The very old
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Why Patient- AND Family-Centered Care and not just Patient-Centered Care?
▼ Families can be allies for quality and safety
▼ Families often are the constant support across settings and assist with transitions of care
▼ Families can participate in the development of a care plan and support the patient in following the plan
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Triple AimPatient- and Family-Centered Care
"The most direct route to the Triple Aim is via patient- and family-centered care in its fullest form.”
- Don Berwick (June 5, 2012)
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Best Care at Lower Cost: The Path to Continuously Learning
Health Care in America
▼ Institute of Medicine Recommendation: “Involve patients and families in decisions regarding health and health care, tailored to fit their preferences” (S-23)
▼ “In a learning health care system, patient needs and perspectives are factored into the design of health care processes, the creation and use of technologies, and the training of clinicians” (5-5)
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Insights From an Institute of Medicine Working Group
“In high-functioning health care teams, patients are members of the team; not simply objects of the team’s attention…”
Wynia, Matthew K., Isabelle Von Kohorn, and Pamela H. Mitchell. "Challenges at the intersection of team-based and patient-centered health care: insights from an IOM working group." JAMA 308.13 (2012): 1327-1328.
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Redesign of Primary Care and the Management of Chronic Conditions
http://www.chcf.org/topics/patient-self-management
Self-Management Support
▼ Information Sharing
▼ Goal Setting
▼ Action Plans
▼ Follow-Up Support
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Anne Arundel Medical Center Annapolis, MD
Bedside Nurse Change of Shift Report WITH the Patient and Family
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H. Lee Moffitt Cancer Center & Research Institute in Tampa, FL
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Patient and Family Advisors for Change, Improvement, and Health Care
Redesign
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Patient- and Family-Centered Best Practices
▼ Senior leaders believe in the possibility and potential of patient and family partnerships
▼ There is an executive champion for patient- and family-centered care
▼ A designated staff liaison for collaborative endeavors facilitates the process
▼ Orientation and preparation for collaboration are provided to patients, families, staff, clinicians, and leaders
▼ Patient and family involvement from the beginning of a project makes a difference.
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Additional Resources
http://www.ipfcc.org/tools/downloads-tools.html
http://www.ipfcc.org/index.html
Partnering with Patients and Families As Advisors
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Bernard Roberson, MSM, BA, HSC
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Frontline Innovators on Providing Patient- and Family-Centered Care
Patients and Families As Advisors Begins With…
Recruitment
• Referred by faculty, administrators, staff, students and other patient and family members
• Must be utilizing health system services► Patients and families – satisfied or dissatisfied with
services and come with positive recommendations for change
► Highly recommended by faculty, staff, students and others
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Patients and Families As Advisors Begins With…
Qualities advisor should possess• Positive attitude
• Willingness to assist with positive change in patient care, education, research and Patient- and Family-Centered Care initiatives
• Ability to share their experience and insight in a balanced and objective way
• Ability to listen to and reflect on differing points of view
• Ability to keep information confidential
• Willingness to look beyond their own personal issues
• Willingness to work with others as an active member of the team
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When to Partner with Patients and Families as 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
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Partnering is a Factor in all Aspects of the Health System
• Strategic planning
• Management
• Operations
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Patients and Families are Involved in the Following:
• Patient Satisfaction
• Electronic Personal Health Record (EPHR)
• Family Faculty – Personal Healthcare Stories► University and Staff Educational Programs and Trainings► Conferences
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Patients and Families are Involved in the Following:
• Quality and Safety Committees► Ethics► Performance Improvement► Joint Commission Leadership► Safety and Security► Medication Error and Prevention► Discharge Education and Planning► Quality Unit Council Committees
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Patients and Families are Involved in the Following:
• Community Coalitions and
Outreach Initiatives
• Renovations and New Construction
Projects
• Research: Sub-Investigators
• Board Level Committee
• Human Resources► New Employee Orientation► Employee Interviews
• Administrative Committees► Billing
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Involving Patients and Families in EVERY Aspect of Operations
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Examples of Partnership
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Improving Patient and Family Centered Care Rounds Research
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Improving Patient and Family Centered Care Rounds Research
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Improving Patient- and Family-Centered Care Rounds Research
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Improving Patient and Family Centered Care Rounds Research
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Collaborating with Shock Trauma Unit and Medical Illustration
Breast Health Center Redesign
Renovation
Workflow
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• Improving Hand Washing throughout the Organization► Working on Campaign► Auditing the Faculty and Staff► Confronting the Faculty and Staff► Rewarding the Faculty and Staffo Buttons
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Hand Washing Initiative
Neurosciences Center of ExcellenceResults
• Patient Satisfaction► 10th → 95th percentile► 75th to 90th percentile
• Staff vacancy rate► 7.5% → 0%► Have waiting list
• Discharges increased 15.5%
• 62% decrease in medication errors
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Questions?
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Additional Resources
• Guide to Patient and Family Engagement in Hospital Quality and Safety
• Patient Centered Medical Home (PCMH) Resource Center► Engaging Patients and
Families in the Medical Home
► Strategies to Put Patients at the Center of Primary Care
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