Patient Experience

Patient & Family Centred Care

Our Journey Continues……

1

TBRHSC new Vision, Mission and Value

Patient and Family Centred Care Why it is our Philosophy of Care

What it is and what it is not

Role of our Patient Family Advisors

Visitors vs. Partners, what is the difference

Partnership Outcomes and Initiatives

Communicating and Literacy– why it is important

Patient Family Centred Care Video

Quiz

Course Overview

2

3

Please click the link below to watch

a video on PFCC

https://www.youtube.com/watch?v=-pauyow4r3Y

Vision, Mission, Values & Philosophy

Vision: Healthy Together

Mission: We will deliver a quality patient experience in an academic health care environment that is responsive to the needs of the population of Northwestern Ontario.

Philosophy: Patient & Family Centred Care is the philosophy that guides us. Patients and Families are at the centre of everything we do.

The new Mission, Vision and Values recognizes that PFCC is fundamental to our organization and has become our Philosophy of Care.

Values: Patients ARE First

Patients First, Accountability, Respect, Excellence

4

Patient and Family Centred Care

(PFCC) is defined as…

the provision of care

that is respectful of, and responsive to,

individual patient / family preferences,

needs, and values,

and ensures that those values guide

all clinical decisions

Adapted from IOM, 2004

5

Patient Focused

- Recognizes the patient as an

individual, but not as a whole

person.

- Each healthcare provider sees

the patient as a sum of their

parts…looking at each

individual part separately

without the full picture of the

entire patient for who they are.

PFCC is NOT……

System Centred

Patient Focused

System Centred

- the system is designed to work

for the convenience of the

people in the system.

- You may be an individual with

unique considerations but are

treated the same as everyone

else with your condition – like an

assembly line product.

or

Why PFCC….

7

The Goal of Patient and Family Centred Care is to :

Create partnerships among patients families, and the

Interprofessional team, which supports;

Improved patient experience, outcomes and patient

satisfaction

Enhanced quality, safety and experience of care

Higher staff satisfaction

Improved staff, physician and learner satisfaction

Decreased medical errors

Reduced length of stay for patients,

reduced complications

Enhanced teamwork and shared

responsibility

Patient and Family Centred Care Is A

Philosophy of Care Which: Places the patient and family at the centre of care.

Involves patients and families in all aspects of planning,

implementation and evaluation of health services.

Ensures patients and families inform policies, programs,

facility design, and staff day-to-day interactions.

Facilitates collaborative partnerships between and among

patients, families, staff, professionals, physicians and

volunteers.

8

Core Concepts of PFCC

Dignity & Respect Healthcare practitioners listen

to and honour patient and

family perspectives and

choices. Patient and family

knowledge, values, beliefs

and cultural backgrounds are

incorporated into the planning

and delivery of care.

Communication & Information

Sharing Healthcare providers communicate

and share complete and unbiased

information with patients and

families in ways that support them

and are useful. Patients and

families share all necessary and

relevant information with their care

team.

Collaboration

Collaboration among patients,

family members and providers,

that occurs in policy and

program development,

professional education and

delivery of care.

Participation

Patients and families are

encouraged and supported to

participate in experiences that

build on their strengths and

enhance control and

independence.

9 9

To be partners in their care

To be treated with dignity and respect

To receive coordinated and integrated care

To be given the information and education they need

To be as comfortable as possible

To be supported emotionally

To have family and friends involved in their care

To move through the system in a coordinated way

To be able to access care when needed

Patients and Families tell us that quality

care means:

10

Patient and Family Centred

Dimensions of Care

11

The yellow

circles

represent

The eight

categories

(dimensions)

of care. The

patient

satisfaction

survey

questions are

based on these

eight

dimensions.

The 4 Core

Concepts (in

blue) that we

have adopted

reflect the

values of the

eight

dimensions of

care.

Patient Experience - Creating a Quality Framework

Safe

Effective

Patient and

Family Centred

Appropriate and timely

access

Equitable

Efficient

12

Patient & Family Centred Care offers the strategies and framework

for enhancing quality, safety, satisfaction, efficiency and creating an

effective learning environment for future health care professionals.

Patient Experience is the sum of all interactions that influence

patient perceptions, across the continuum of care that is:

Foundational Building Blocks:

PFCC and Quality Quality care cannot be delivered without PFCC as the

foundation

Our patients, families and our diverse communities are at the centre of everything we do

Priorities and choices of the patients and families drive the delivery of healthcare

Patient and Family Centred Care is the umbrella for all our care initiatives, integrating best practices related to patient care, flow, quality & safety

Culturally competent care

13

Welcoming Patients and Families Advisors of the Patient Experience

Patient Family Advisors (PFAs) are experts who advise the organization about

the patient experience

Active partners in “everything we do”

Share their experience of what went well and why, as well as what could be

done differently to improve the patients experience –

Partners in policy and program development e.g. bariatric & angioplasty

program

Partners in education – PFA provides education to staff, residents & physicians

14

Patient Family Advisors (PFA’s) are volunteers that

partner with us to help meet the needs and priorities of

our patients, families and our community

Anyone who has had care experiences at TBRHSC

within the past 2 years can apply to become a PFA

PFAs are selected through the interview process and

provided with education, orientation and support for

their role

There are no age limits – our youngest PFA started at the age of 9

Patient Family Advisors

15

Patient and Family Centred Care

helps us clearly understand that….

16

This is Family… WE are the Visitors!

Patients and families are the EXPERTS about themselves and are

essential healthcare partners.

Visitors vs. Partners in Care Visitors

Visitors are guests of the

patient and are

encouraged to visit during

visiting hours.

Visitors may or may not be

a relative

Partners In Care

Are encouraged to be involved

and supportive of the patient

Are integral to the overall well

being of the patient

May or may not be a relative;

who the partner of care is; the

partner is defined by the patient

Are encouraged to be involved

and supportive of the patient

Will generally have more access

to the patient than visitors

17

18

Our partnership with patient’s has

supported several initiatives already

18

Patient Bedside Communication

Whiteboards

Strategic Planning & Development

New Way-finding signage

Bariatric and Angioplasty services

Visiting Policy

Televisitation

Website Re-design

Smoke free grounds policy/revision

New discharge form and process

Paediatric Operating Room tours

Patient education materials

ED/ICU care transitions

Outpatient Paeds Lab Redesign

Paediatric OR transport

Patient Bedside Communication Whiteboard

A tool that improves

communication through

collaboration between the patient,

family & healthcare team

Completed through active

engagement with the patient &

their family

A reflection of the patients needs,

priorities and goals

Involves everyone especially the

patient & their family

At the beginning of each shift

change, when the RN introduces

herself to the patient and their

family

When the patient is initially

admitted

Upon transfer from another unit

or room

Throughout the day as needed

19

What it is: When it is updated:

Bedside Communication Whiteboard

A tool to improve teamwork, communication and patient care

20

Name, Occupation, Do (NOD) Name Introducing yourself when you interact with a patient and family shows

respect

Occupation Telling your patients and families your occupation is

important. Patients and families need to know who they are

speaking with to have q quality conversation

Do It is important to tell your patients and families what you are

there to do

“Hi, my is Jan, I am your nurse, I am here to

change your dressing”

21

Name, Occupation, Do

NOD

A patient sees many different staff and learners

during the day

– nurses, physicians, dietary, housekeeping, lab/x-ray

techs, maintenance etc, making it difficult to know what

type of conversation to have unless staff identify

themselves

Please remember to

NOD

22

Listen Patient and Family Centred Care asked us to hear the stories

of the patient and understand the experience of care from the

eyes of the patient.

It asks that we listen and understand anxieties and fears in

order to be able to support the emotional, psychosocial and

physical needs of the patient.

From this understanding, we will be able to identify

opportunities for improvement.

Intentional focused integration of voice of our patients and

families – in everything we do!!

Patient stories have the power to change

your life, their care and our culture….

23

Listening with Patient Family Advisors

Patient Family Advisors provide us with an expert pool of

experience to learn from and improve our practice,

focusing on what we do well and where we can improve.

“No Policy, No Process, No Practice without PFA

involvement”

“nothing about me…without me!”

24

How Can I demonstrate that I am

actively listening?

Create a physical environment to support respectful listening – sit down and speak at eye level when able

Avoid speaking in jargon or using acronyms – speak at the listeners level of understanding

Ensure posture is open and inviting

Use full eye contact where culturally appropriate

Give full attention – resist looking elsewhere (e.g. at others, the clock)

Use non–verbal “I’m listening” cues such as nodding

Use silence to allow speaker to fully explore and state their message

Repeat back what you heard to ensure you understand the information provided

25

Leadership Rounding

Rounding is a proven strategy which achieves staff and patient care excellence by proactively building relationships between the patient, family members, employees, physicians, and other departments

“It is proactively engaging, listening to, communicating with, building relationships with and supporting your most important asset.” – What is right in Health Care™ Evidence to Outcomes, Studer Group 2008

Manager/Leader Rounding has been identified as one of the most important tools that contribute to employee and patient

satisfaction. - ”ref Studer, Nurse Manager July, 2004”

26

Rounding is another way we hear the voice of our patients.

Health Literacy Levels Impact Understanding of Health Information

Profile of Readmissions

• 4/10 adult Canadians age 16-65 represent 9M Canadians who struggle with low literacy.

• 15% of Canadians have serious problems with any printed materials; an additional 27% can only deal with simple reading tasks

• The majority of adult Canadians (60%) do not have the skills to manage their health

• Canadians with the lowest health-literacy skill are 2.5xs more likely to report being in fair or poor heath than those with higher skill levels.

• Improved health literacy has potential to reduce illness and enhance the quality of life for many people ultimately reducing cost to the HC System

Essential Skills ON, Canadian Literacy and Learning Network, Adult Literacy and Life Skills Survey, 2005

27

Even if what you are saying is clear to

you……if it isn’t understood by the

person receiving the

information…….it doesn’t matter

28

“I asked my husband to

help prepare supper. Told

him to peel half the

potatoes in the bag and

put them in the pot of

water!

Where was I not clear?”

Please click below to watch the

LISTEN video

29

https://youtu.be/LCd5IlD2y1U

30

Thank you.