quality care paradigm
TRANSCRIPT
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2007 University HealthSystem Consortium
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Goals of This Presentation
Participants will:
Understand the findings and conclusions ofthe Patientand FamilyCentered Care (PFCC)Benchmarking Project
Learn about effective methods for implementing thecore concepts of PFCC across the organization
Dignity and respect
Information sharing
Participation
Collaboration
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What Is PFCC?
The Institute for FamilyCentered Care (IFCC) defines*patientand familycentered care (PFCC) as:
An innovative approach to the planning, delivery, and
evaluation of health care that is grounded in mutuallybeneficial partnerships among health care patients, families,and providers.
Successfully implementing PFCC concepts requires a
major paradigm shift:
PFCC means developing collaborative partnerships withpatients and families to improve care and operationalefficiency and recognizing patients and families as equal,important members of the care team.
Source: *http://www.familycenteredcare.org/faq.html
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The IOM Supports
PatientCenteredness Health care should be based on continuous healing
relationships.
Care should be individualized.
It is important for patients to be involved in their own caredecisions.
Patients and families should have better access to information. Health care should become more transparent.
IOMs Six Aims for Healthcare Improvement are safety,patientcenteredness, efficiency, effectiveness, timeliness,and equity.
Source: Institute of MedicineCrossing the Quality
Chasm: A New Health System for the 21stCentury
Many health care professional, regulatory, and qualityimprovement organizations also support or require PFCC
concepts, e.g., AHA, Joint Commission, and ACGME
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PFCC Is a Business Decision 3 years ago MCG Health, Inc. began implementing PFCC
in neurosciences: The units Press Ganey satisfaction was at the 10th
percentile (the lowest across the medical center.) Staffmorale was poor and there were 7.5 FTE open
positions. MCG had poor market share in neuroscience.
Patient/family advisors worked with caregivers on fixingproblems, facility design, and interviewing staff, including
medical staff; every staff member signed a commitment toPFCC concepts.
Dramatic improvements were seen almost immediately
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PFCC Is a Business Decision
After implementing PFCC concepts in MCGs
Neurosciences unit:
Unit Press Ganey satisfaction = 95th percentile.
The unit has low turnover with a waiting list of quality
candidates. The unit has experienced a significant decrease in
medication errors.
MCGs neurosciences market share has increased
12% in 3 years.
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PFCCNot Just a Nice Thing to Do!
Communication problems may lead to legal action for
malpractice:*
Failing to understand patients or families perspectives
Delivering information poorly
Devaluing patient and/or family views Desertion
Source: *Beckman et al.,Archives of Internal Medicine, 1994
MCGs leaders feel that the organizations commitment to PFCC
is a significant factor in the dramatic decrease in malpracticesuits theyve experienced in recent years (see next slide).
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MCG: Favorable Trend in
Variances, Claims, and LitigationFiles, Claims, and Litigation
2001 2002 2003 2004 2005 2006 (YTD)
Years
N
umberofRecorded
Incidents
ClaimsLitigation
Files
0
10
20
30
40
50
60
70
80
90
Most UHC membersreport regular, annual
increase inmalpractice pay-outs
Source: MCG Health, Inc.
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Project Findings
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Goals of the PFCC Project
The projects steering committee focused the study on the
following key objectives:
To assist UHC members in determining their PFCCstrengths and improvement opportunities
To identify useful metrics for monitoring progress inachieving PFCC goals
To develop an aggregate database of PFCC practicesin academic health centers
To discover how organizations are successfullyimplementing PFCCs core concepts to address the
principles of quality care as outlined by the Institute ofMedicine
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Project Participation and Data Collection
26 organizations completed a PFCC survey/assessment.*
Part 1, Self-assessmenta rating of the organizationscurrent PFCC status across the entire enterprise (excludingbehavioral health and prisoner care)
Part 2, Drill-down on current practicesrespondents had the
option to respond for the entire organization or to select theunit or facility most successful in implementing PFCC
Organizations recommended by the steering committee wereinterviewed about their PFCC initiatives and practices (MCG,Vanderbilt, Washington, Colorado, Methodist, and Denver).
77 innovative strategy reports describing PFCC-relatedinitiatives were submitted.
The PFCC health care literaturewas researched.
*Many survey questions were adapted from Strategies
for PFCC: A Hospital Self-Assessment Inventory. IFCC
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Though Status Varies
All Respondents Are Engaged
In PFCC Implementation
Overall organizational PFCC status:
Have not yet begun to implement PFCC = 0% Early stages of PFCC implementation = 32%
Partial PFCC implementation in selected locations = 68%
Source: Survey Q 1 (one outlier response was trimmed)
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Disconnects Exist Between PFCC
Goals and the Efforts Made to
Achieve Those Goals 65% indicated that PFCC is part of the organizations mission
and values and 68% include PFCC goals in strategic planning,but
68% responded none or unknown for the annual budgetdevoted to supporting PFCC initiatives.
42% agreed that PFCC is part of the philosophy of care(POC), but none included patients/families in POCdevelopment.
36% reported that PFCC is included in job descriptions andperformance evaluations.
20% have created a paid patient and family leader position.
Source: Survey Qs 2, 3, 5, 12, 71, 73
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PFCC Leadership StrategiesCollaborate with patients and family advisors to:
Incorporate PFCC concepts into mission, vision, values, plans,safety initiatives, philosophy, and scope of care for each area
Create and describe a paid patient and family leader position(supported by appropriate budget and resources) and with primaryresponsibility for overseeing, coordinating, and implementing PFCC
initiatives across the enterprise
Select leaders and providers who practice PFCC concepts, e.g.,outsourced service/equipment vendors, administrative leaders, andcaregiversincluding medical staff
Leaders must believe in and practice PFCC concepts and act asrole models for the organization
Hold staff and vendors accountable by including PFCC goals in jobdescriptions, evaluations, credentialing procedures, and contracts
Source: UHC PFCC project
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PFCC Core Concept:
Dignity and Respect
Dignity and Respect:
Health care practitioners listen to and honor patient andfamily perspectives and choices
Patient and family knowledge, values, beliefs, andcultural backgrounds are incorporated into the planningand delivery of care*
Source: *The Institute for Family
Centered Care
Methodists International Department includes speakers of 12languages and represents 14 ethnicities to improvecommunication and assist in understanding cultural concerns and
enhancing the care experience for patients and families.
Digni ty and
Respect
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Dignity and Respect:
Improvement Opportunities
64% agreed that effective processes are in place to ensurepatients/families are greeted in a friendly manner.
52% agreed that the ethnic/cultural diversity of staff isconsistent with the patient populations served.
40% agreed that the facility offers a healing, supportive dcor.
40% agreed that conversations about patients are conductedaway from public areas.
52% agreed that confidential registration discussions areheld in private locations.
32% agreed that care settings provide privacy.
Source: Survey Qs 22, 24, 30, 31, 36, 46
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PFCC Dignity and
Respect Strategies
Partner with patients and family advisors to: Put effective processes in place to ensure all staff and
employees always introduce themselves to the patient andfamily and explain their roles in his/her care
Implement friendly policies and procedures that respect thecultural and lifestyle needs of patients and families
Implement practices to encourage family participation in thecare team and endure that other team members listen to andrespect their opinions
Put organization-wide practices in place that are designed toprovide patient/family privacy and respect confidentiality
Fairview Childrens Hospital has open visitation and
digital camera technology is used to create pictureID badges for parents, who are viewed as equal
members of the care team.
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PFCC Core Concept:
InformationSharing
Information Sharing:
Health care practitioners communicate and sharecomplete and unbiased information with patients and
families in ways that are affirming and useful
Patients and families receive timely, complete, andaccurate information to allow them to effectivelyparticipate in care and decision making
Source: The Institute for Family Centered Care
Information
Shar ing
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Paper Records Are Common and
May Hinder Patient, Family,
and Provider Communications
Medical Record Format Inpatient Outpatient ED
Primarily electronic 8% 12% 25%
Primarily paper 12% 28% 29%
Partially electronic/partially paper 80% 60% 46%
Source: Survey Qs 93, 94, 95, 96
31% of survey respondents offer few or no electronic systems for patients and
families but Duke, UAMS, MCG, Oregon, OSU, Vanderbilt, Colorado, andothers have invested in electronic systems that offer patients and families manycommunication options and resources, e.g., personal health information, testresults, education, scheduling and registration, billing, e-mail providers.
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Not All Are Compliant With Joint
Commission Safety Requirements for
Error Communication and Reporting 88% have a standard procedure in place to communicate errors,
near misses, and adverse events to patients/families.
84% have a process in place for patients and families to reportsafety concerns consistent with National Patient Safety Goal 13(Patient Involvement)
Source: Survey Qs 98, 99
Vanderbilts patient safety initiatives are strongly aligned with PFCC goals;separate communications and educational programs were designed (with
advisor input) for both staff and patients/families e.g., patient identificationDenver Health discovered that 80% of errors were due tomiscommunication; theyve incorporated PFCC goals into improvement
initiatives to increase safety
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Confidentiality Is Not New!
HIPAA regulations do not prevent sharing personal healthinformation with patients and families (in accordance withpatient preferences).
Organizations that have made a strong commitment to
PFCC are also bound by HIPAA regulations and havelearned how to respect confidentiality and promoteinformation sharing.
Put processes in place to provide privacy and protect
confidentiality and train staff and patient/family advisors torespect these conceptsthen monitor compliance and holdthem accountable.
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PFCC Information Sharing StrategiesPartner with patients and family advisors to:
Encourage patients and families to dialogue, share information,and embrace their roles as members of the care team, includingparticipation in rounds, goal-setting, safety, and care decisions.Provide patients and families with easy access to educational andpersonal health information and the medical record.
Implement electronic systems to facilitate communication,information sharing, and education.
Routinely follow-up with patients/families to ensure that careinstructions were understood and if additional support is needed.
Colorados Diabetes Star Web system offers access to personal healthinformation and guides patients in goal setting.At OSUs Ross Hospital, patient relations staff and nurse managers conductproactive rounds to meet patients and families, encourage communicationand participation, and identify and address concerns and complaints quickly.
Source: UHC PFCC project
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PFCC Core Concept:
Participation
Participation:
Patients and families are encouraged and supported inparticipating in care and decision-making at the level theychoose
The caveat at the level they choose above indicatesthat flexible care systems must be in place that can beadjusted as needed according to patient and familypreferences (e.g., family preference for remaining withthe patient during a code).
Only 35% of survey respondents agreed that flexiblecare delivery systems are in place to accommodatepatient and family preferences.
Sources: The Institute for Family Centered Care
and Survey Q 6
Participation
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Patients and Families Have Limited
Opportunities for Presence or
Participation in RoundsIn accordance with patient preferences:
Families remain with inpatients: Inpatients/Families participate in:
General care rounds = 85% General care rounds = 50%
Critical care rounds = 62% Critical care rounds = 35%
End-of-life care rounds = 62% End-of-life care rounds = 54%
ED rounds = 31% ED rounds = 15%
Not allowed to remain = 8% Not allowed to participate = 23%
58% of respondents have no process in place to accommodate familyschedules but at UH Cases Rainbow Babies and Childrens Hospital, if families
cannot be present during rounds then the attending, fellow, bedside nurse, andcharge nurse round with families when they arrive.
Source: Survey Qs 83, 83a, 84, 85, 85a
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Room Design and Visitation Policies
Often Dont Provide Privacy, Family
Sleep Space, or Access to Inpatients Total staffed inpatient
acute care rooms that
are private rooms:
Median = 50%
Mean = 52%
Minimum = 5%
Maximum = 100%
Inpatient rooms with family
sleep space:
Median = 10%
Mean = 35%
Minimum = 0%
Maximum = 100%
31% dont provide family sleepspace in critical care units
Source: Survey Qs 14, 107, 109, 110
Only 12% of respondents strongly agreed that families have
24/7 access to inpatients
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PFCC Core Concept:
Collaboration
Collaboration:
Patients, families, health care practitioners and hospitalleaders collaborate in:
Policy and program development
Implementation and evaluation
Health care facility design
Professional educationThe delivery of care
Source: The Institute for FamilyCentered Care
Collaborat ion
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Only Half of Respondents Have
Patient/Family Advisory Councils
It is essential for caregivers to collaborate with patients andfamilies at all levels of the organization. Each group contributesunique perspectives and experiences important to shapingorganizational policies, programs, practices, and facility design.
52% of survey respondents have functional patient/familyadvisory councils in place.
Of these, 77% include the regular participation of seniorleaders.
Source: Survey Qs 74, 75
But
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Some Organizations Have
Developed Collaborative Partnerships
with Patients and Families At Duke, patient/family advisors participate on more than 15
organizational committees and other initiatives.
At Vanderbilt patient/family advisors accompany senior
executives on rounds and they also act as secret shoppersreporting on their service experiences.
MCG wont bid out construction jobs until patient/familyadvisors have signed off on the blueprints.
At Washington patient and family advisors on the aestheticscommittee regularly provide feedback on facility environmentand design.
36% of respondents agreed that patient andfamily advisors participate in facility design.
Source: UHC PFCC
project and survey Q 101
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Effective Patient/Family Advisors Ask doctors, nurses, and other staff for recommendations and
put notices hospital and newspapers to find potential advisors.
Look for individuals who have a genuine interest in improvingcare but without a strong personal agenda or an axe to grind.
Candidates must be carefully interviewed and trained asvolunteers (including safety, HIPAA, and confidentiality training).
Most project participants dont pay advisors but they may offer ateaching stipend and other perks, e.g., free parking, meals, ortickets to university sporting events.
Some organizations set a time limit/term for advisor participation
while others find that there is a natural attrition process. It is essential to also train staff to successfully work with advisors
to achieve mutual improvement goals.
Washington pairs advisors with committee membersfor follow-up, advice, and to answer questions.
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PFCC Is Not Often Included in
Health Care Education and Patients/
Families Rarely Serve as PFCCTeachers PFCC principles are included in
curriculum:
Nursing = 50%
School of medicine = 27% Allied health = 23% Dental = 8%
Patients/families participate asfaculty in orientation/education:
15% of employees 12% of volunteers 8% of temporary staff and
students/trainees 8% of medical staff 4% of trustees
Source: Survey Qs 9, 78, 79
Only 19% of surveyrespondents agreed that
patient and familyadvisors helped to
develop patient, family,and staff PFCC
educational materials
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Patients and Families
Rarely Collaborate in
Provider Selection Practices 8% invite patient/family advisors to interview clinical and
administrative leaders.
4% ask patient/family advisors to help in the selection ofresidents.
4% include patient/family advisors in selecting outsourcedservice and equipment vendors.
16% indicated that processes are in place to ensurethat outsourced service and equipment vendorspractice PFCC principles.
Source: Survey Qs 7, 80, 81, 82
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PFCC Collaboration Strategies
Partner with patients and family advisors to:
Develop a functional patient/family advisory council(s) thatmeets at least quarterly, includes senior leaders, and makesrecommendations to the leadership
Design a healing, supportive environment that encourages
family presence/involvement-including family resource centers,sleeping spaces, training labs, and easily understood signage
Develop understandable educational materials and includepatients and families in training programs designed for patients,families, and staff
Select leaders and providers who practice PFCC concepts, e.g.,outsourced service/equipment vendors, administrative leaders,and caregiversincluding medical staff
Source: UHC PFCC project
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PFCC in Ambulatory Care and
Business Office Practices
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PFCC and Ambulatory Care
Most PFCC-initiatives are focused on inpatient care units
- Primarily in maternal and child care and end-of-life care
In ambulatory care, PFCC care concepts are most likely to beimplemented in selected settings such as pediatric oroncology clinics
A study* evaluating the affects of PFCC on outpatient visitsconcluded that when patients and doctors find commonground:
Physical health status improved
Emotional health improved Fewer referrals and diagnostic tests were needed two
months after the visit
* Source: Stewart, et al. The Impact of Patient-Centered
Care on Outcomes, Journal of Family Medicine, 2000
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PFCC and the Business Office
Self-assessment and survey data revealed many
opportunities to implement PFCC concepts in non-clinicalareas:
Registration, scheduling, and access to services, e.g., theneed for simple, consistent, and confidential registration
and scheduling procedures; convenient access toservices; coordinated support during scheduling and caretransition, etc.
Finance, charge, billing, and payment procedures, e.g., the
need for consistent, easy and convenient practices (simplelanguage, combined copay, flexible, online paymentoptions, etc.)
See appendix for survey data
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PFCC Performance Measures:
Self-Assessment Scores,Satisfaction Surveys, and Other
Outcomes Measures
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Much PFCC Improvement Is Needed
in Every Area Evaluated
Self-Assessment Topics Mean
Leadership -0.1
Patient and family involvement 0.2
Communications 0.2
Environment/facility and patient/family support 0.0
Scheduling and registration -0.1
Finance, charge, and payment practices 0.1
Billing practices -0.1
*Scoring:Strongly agree = 1.0Agree = 0.5
Neutral = 0.0Disagree = -0.5Strongly disagree = -1.0Average score: sum ofscores divided by thenumber of responses
Average PFCC Self-Assessment Scores
(Maximum Possible Score = 1.0*)
Source: Survey Qs 2 through 67
Many felt that the self-assessment process wasbeneficial; getting keystakeholders to discuss theissues is eye-opening.None of the respondents
achieved the maximumscore in any PFCC topic.
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Measures Most Commonly Used
by Respondents
to Monitor PFCC Performance Vendor surveys (national
benchmarks):
92% Inpatient
58% Outpatient Internal surveys (internal
benchmarks) :
54% Inpatient
38% Outpatient 4% Patient satisfaction not
measured
Complaint Process:
73% Inpatient
65% Emergency department
54% Outpatient
Other outcomes measures:
65% Employee turnover
65% Length of stay
62% Fall rates
54% Errors
42% Financial measures
Source: Survey Q 113
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PFCC Satisfaction Scores Show
Improvement Opportunities
18 organizations that participate in Press Ganey Adult InpatientSatisfaction Surveys submitted their most recent scores for keyPFCC questions:
Explanation of tests and treatments
Information given to family about condition and treatment
Instructions given for care at home
Inclusion in treatment decisions
Nurses kept you informed
Physicians concern for questions and worries
Average PFCC scores were calculated: 4 organizations (22%): > 85.0 (range 85.2 to 88.5)
10 organizations (56%): > 80.0 and < 85.0 (range 81.0 to 84.6)
4 organizations (22%): < 80.0 (range 76.5 to 79.4)
Source: Survey Q 115
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New Press Ganey PFCC MeasuresUHC members using PG surveys are encouraged to use these
new questions to evaluate and benchmark PFCC practices Effective March 2006 Press Ganey added PFCC custom
questions to all 13 PG survey instruments:
How well staff explained their roles in your care
Degree to which the staff supported your family throughoutyour health care experience
Degree to which your choices were respected to havefamily members/friends with you during your care
Degree to which you and your family were able to
participate in decisions about your care
Degree to which staff respected your family's cultural andspiritual needs
Source: Press Ganey PFCC Metrics Task Force
(including a Univ. of Washington representative)
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HCAHPS Measures HCAHPS measures that may be used as indicators of patient-
centeredness for UHCs key organizational reports: How often did nurses treat you with courtesy and respect?
How often did nurses listen carefully to you?
How often did nurses explain things in a way you could
understand? How often did doctors treat you with courtesy and respect?
How often did doctors listen carefully to you?
How often did doctors explain things in a way you couldunderstand?
Using any number from 0 to 10, where 0 is the worst hospitalpossible and 10 is the best hospital possible, what numberwould you use to rate this hospital?
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PFCC Measurement Strategies Establish, evaluate, and routinely monitor PFCC performance
measures
Regularly collect complaint and customer satisfactioninformation in all care settings, including comparativeexternal satisfaction benchmarks versus other providers
Work with patients and families to review data, identify
opportunities, and design, implement, and monitor performanceimprovements
It may be difficult to discuss satisfaction data with patientsand families but this is essential to better understand the
information and create solutions that will successfullyaddress patient and family needs
The Institute of Medicine endorses transparency in healthcare organizations to improve quality and safety
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Project Conclusions Many PFCC improvement opportunities exist in the areas of:
Leadership Patient and family involvement in strategic planning,
operations, and care delivery
Communications and information sharing
Facility design Support and resources for patients and families
Education of patients/families and staff
Scheduling, registration, access, care transitions, and
charge, billing, and payment practices
Many other aspects of service and care delivery
All project participants have improvement opportunities
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The Most Important Take-Aways
From This Study
Patients and families are important, equal members of thecare team and have the right to participate in decisionsaffecting the planning, delivery, and evaluation of care.
Dont assume that you understand and can effectively address
patient and family needs and concerns without sharing thedata, asking their opinions, and involving them in designingsolutions to create a friendlier, more effective, efficient, andsafer health care organization.
The doctors and nurses focus on my physical health and on treatingmy condition and thats very important, but quality of life is also very
important to me and they dont always think about that.
Terry H, MCGs Neurosciences Patient/Family Advisory Council
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PFCCNot Just a Nice Thing to Do! Blue Shield of California conducted an 18-month study of 756 HMO
members (all with late-stage illness and access to the same
benefits and provider network). Half were blindly assigned toreceive usual case management (UCM) and half received patientcentered management (PCM) including working with a caremanager to develop goals based on disease state, treatmentoptions, pain management, and end-of-life decisions. Survival rates
were the same for both groups; the study concluded that PCMeffectively reduced overall costs by 26%:
$18,000 cost reduction per patient
Hospital admissions reduced by 38%
Hospital days reduced by 36%
Emergency room visits reduced by 30% Home care use increased by 22%
Hospice use increased by 62%
Higher satisfaction rates for 92% of the PCM members
Source: LSweeney, et al,The American Journal of
Managed Care, Feb 2007
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Implement PFCC Concepts Through
Partnerships With Patients and Families
Dignity and Respect:Health care practitioners listen to and honorpatient and family perspectives and choices. Patient and familyknowledge, values, beliefs, and cultural backgrounds are incorporatedinto the planning and delivery of care.
Information Sharing: Health care practitioners communicate and
share complete and unbiased information with patients and families inways that are affirming and useful. Patients and families receive timely,complete, and accurate information to allow them to effectivelyparticipate in care and decision making.
Participation:Patients and families are encouraged and supported inparticipating in care and decision making at the level they choose.
Collaboration: Patients, families, health care practitioners, andhospital leaders collaborate in policy and program development,implementation and evaluation; health care facility design; professionaleducation; as well and in the delivery of care.
Source: The Institute for Family Centered Care
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Where To Start? Begin partnering with patients/families to implement PFCC
concepts in locations that make sense for your organization:
Maternal/child services because family participation is expectedand natural
Units with the greatest opportunity to improve customersatisfaction
Locations with the greatest opportunity to improve safety Units with a PFCC champion who is receptive to change
Construction projects that bring key stakeholders together
Share PFCC success stories and work with others to foster andimplement a PFCC culture across the organization
PFCC applies to every facet of health careinpatient, outpatient,ED, ancillary, home care, hospice, behavioral, subacute/long-term care, scheduling, registration, billing, support services,outsourced vendors, etc.
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PFCC Advice for Beginners
Stories change culture; ask patients, families, and staff to
share their (positive and negative) health care experiences.
Senior leadership buy-in is essential to provide role modelsand resources, and to hold staff accountable for practicingPFCC concepts.
Select PFCC performance measures (including safetymeasures), collect baseline data, monitor performance,and then share the results.
Look for early adopters and work with them to successfullyimplement PFCC concepts and help others to learn fromtheir example.
Continued...
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PFCC Advice For Beginners
Help staff confront their fears about patient and family
presence, participation, and collaboration by starting smalland working with one unit. Show staff the data and provideexamples of other AMCs that have implemented PFCCconcepts. Prepare staff to deal with a variety of issues andscenarios through training and scripting.
Recruit a physician champion(s) to convince other doctorsthat PFCC doesnt deter medical education, it enhances
learning. Incorporate PFCC concepts into educationthrough the use of patient/family advisors as faculty intraining doctors, caregivers, and other providers.
Constantly ask have we gotten patient/family input on this
plan? before moving forward to implement changes.
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2007 University HealthSystem Consortium
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Next Steps
Review project materials* to identify 1 or more best practices that yourorganization will implement:
1. Network with colleagues who are successful in this area tounderstand their practices and processes.
2. Identify/organize a team that includes all key stakeholders includingphysician champions, senior leaders, and patient and family advisors.
3. Formulate an improvement plan based on relevant data, withresources focused on your priorities.
4. Implement the plan.
5. Monitor changes and report results throughout the organization.6. Share your success stories with others in your organization and with
your UHC colleagues to help them to improve.
*All project materials will be available on the UHC Web site atwww.uhc.edu; select Improvement & Effectiveness,
Benchmarking, and Patient-and Family-Centered Care.
Implementat ion
PFCC I l t ti C ll b ti
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PFCC Implementation Collaborative UHC is currently enrolling members in a PFCC implementation
collaborative (due June 1st). Participant will work in any/all of 3
work groups to implement improvement strategies related to: Patient and family participation in care
Patient and family advisors and councils
Special PFCC initiatives (ambulatory/non-acute care, business office,PFCC measures, etc.)
Members can take part in any/all workgroups at no charge;participation in the original project is not required.
Implementation Support Project process:
Members enroll and identify executive sponsor, team leader,team members, and select performance goals and measures
Monthly networking conference calls for 6 months with teamleaders of all organizations enrolled in the work group
Web conference to present strategies and learnings
Field Brief document summarizing work done by workgroups
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PFCC Project Deliverables*
Survey results
Project results and findings Knowledge transfer presentations/Web conferences
Compendium of Innovative Strategy reports
Performance Opportunity Summary/Scorecard
Field Book, Executive Summary, and Action Plan
UHCs PFCC listserver, providing a networking forum for members
UHC PFCC Implementation Support Collaborative (enroll by 6/1)
Also see the many PFCC resources, assessments, and training
materials available from the Institute for Family-Centered Care athttp://www.familycenteredcare.org/index.html.
*All project materials will be available on the UHC Web siteat www.uhc.edu; select Improvement & Effectiveness,Benchmarking, and Patient-and Family-Centered Care.
Th S f B h ki
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The Success of Benchmarking
Comes From Implementation,
Not the Data
Digni ty and
Respect InformationShar ing
Part ic ipat ion Collaborat ion
Implementat ion
For more information about the UHC Patient-and Family-Centered Care Project contact Kathy Vermoch [email protected] or 630/954-1030
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Appendix
There Are Many Opportunities to
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There Are Many Opportunities to
Improve Scheduling, Registration,
and Access to Services 36% agreed that scheduling and registration procedures areconsistent across the organization.
28% agreed that patients complete the full registration processwhen appointments are scheduled.
24% indicated that online registration is available. 20% reported that business hours for scheduling appointments
include off-hours, e.g., weekends and evenings.
8% agreed that commonly requested appointments are availableduring off-hours, e.g., weekends and evenings (12% agreed that
commonly requested ambulatory and ancillary appointments areavailable within 2 weeks).
4% included patient/family advisors in the design of scheduling andregistration procedures and materials.
Source: Survey Qs 37, 39, 41, 42, 44, 47, 51
Ch Billi d P t PFCC
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Charge, Billing, and Payment PFCC
Improvement Opportunities Exist
28% agreed that easy-to-understand, patient-friendlydescriptions are used on billing statements.
24% indicated that patients are able to pay a single copay forservices provided by multiple departments.
16% reported that patients receive a combined billingstatement for services provided by multiple departments.
16% stated that billing statements are available in the primarylanguages of the communities served.
12% agreed that patient/family input is used to design andenhance billing statements and other communications.
8% reported that patients/families are able to check accountsand pay bills online.
Source: Survey Qs 55, 60, 64, 65, 66, 67
PFCC S h d li R i t ti
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PFCC Scheduling, Registration,
and Billing Strategies
Partner with patients and family advisors to: Design and implement simple, consistent, and confidential
registration and scheduling procedures with convenient accessto services and coordinated support during scheduling andcare transition
Implement consistent finance, charge, billing, and paymentpractices that are easy and convenient for patients andfamilies, e.g., simple language, combined copay, flexible,online payment options
Regularly obtain feedback on billing statements to make surethey make sense and are easy-to-read
I t ti l C f PFCC
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International Conference on PFCC
Partnerships for Enhancing
Quality and Safety
Jul 30 - Aug 1, 2007
Seattle, WA
With leadership support
from Children's Hospital &Regional Medical Center,University of WashingtonMedical Center, and SeattleCancer Care Alliance
http://www.familycenteredcare.org/index.html