Disclosure

I, Sarah Moody-Thomas, PhD, have no relationships with commercial interests to disclose.

A commercial interest is any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients.

LSU SCHOOL OF MEDICINE-NEW ORLEANS

Patient & Family Centered Care Initiative

Report of the CCC Sub-Committee on Patient Education January 24, 2012

Patient & Family-Centered Care

Institute of Medicine:Care that is respectful of and responsive to individual patient preferences, needs and values, and ensuring

that patient values guide all clinical decisions.

Planetree and the IPFCCAn approach to the planning, delivery and evaluation of

care grounded in mutually beneficial partnerships among providers, patients and families. It redefines

relationships in health care.

Patient & Family-Centered Care

• Transforms healthcare into a participatory process

• Requires teamwork and participation at all levels of the organization

CCC Patient Education Sub- Committee

• Lynn Besch• Jay Besse• John Couk• Jane Herwehe• Sarah Moody Thomas• Kathy Viator

Creating a Culture ofPatient & Family-Centered Care• Recap• Spring 2010 - Dr. Kaiser introduced• Winter 2011 - Presentation by Christine Bechtel,

Planetree Approach• Fall 2011 - Jane Herwehe presented at site visits

• Reviewed basic tenants of PFCC• Announced system-wide assessment• Encouraged sites to start discussions, pilots

Creating a Culture of Patient-Centered Care• Methods• Administered Planetree Assessment

• Resource for PCC improvement• Distributed – Fall 2011• Participants – groups at each facility completed the self-assessment

tool to rate performance in 11 categories

• Identify priorities

Self-Assessment ToolN=7 HCSD Facilities

1. Setting the Stage, Strengthening the Foundation

2. Communicating Effectively with Patients and Families

3. Personalization of Care

4. Continuity of Care

5. Access to Information

6. Family Involvement

7. Environment of Care

8. Spirituality

9. Integrative Medicine

10. Caring for the Community

11. Care for the Caregiver

Creating a Culture of Patient-Centered Care

• 7 facilities calculated their organization’s performance in 11 categories – 70 total questions

• Prioritized implementation of initiatives• Sites differed• Some overlap

Creating a Culture of Patient-Centered Care• Analyses

•Multi-method approach• Planetree scale - % sites responding• Context and Solutions Ranking

A patient and family advisory council meets regularly and actively provides input to hospital leadership on

hospital operations.

Patients and family members have been invited to share their experiences with your hospital in focus groups.

Expectations for what staff can expect in a patient-cen-tered environment are clearly stated and proactively

shared.

The organization's commitment to patient-centered care is formally and consistently communicated with patients, families, staff, leadership, and medical staff (e.g. mission,

care values.)

0 0.2 0.4 0.6 0.8 1

86%

57%

14%

43%

71%

57%

0.285714285714286

0.428571428571429

Setting the Stage, Strengthening the Foundation

Fully Implemented Throughout Organization Partially Implemented (in progress or in place in some areas, but not all) No Activity Not Applicable

Staff at all levels, clinical and non-clinical, have the opportunity to voice their ideas and suggestions for

improvement.

Patient-centered behavior expectations are included in all job descriptions and performance evaluation tools.

The input provided by patients and families is used to guide the organization's strategic direction.

Patients and family members participate as members on hospital committees.

0 0.2 0.4 0.6 0.8 1

29%

57%

43%

14%

71%

29%

43%

14%

14%

86%

Setting the Stage, Strengthening the Foundation

Fully Implemented Throughout OrganizationPartially Implemented (in progress or in place in some areas, but not all)No ActivityNot Applicable

Creating a Culture ofPatient-Centered Care• Methods• Context and Solutions Ranking• Survey items combined into a table to determine

16 – B – A; 2 – I – A; 1 – O -A

AreaAffected

Level of Sign Responsible Measure

I/O/B A B C D Who How

Survey Item AreaSignificance Responsible How?

Expectations for what staff can expect in a patient-centered environment are clearly stated and proactively shared.

B A

Medical Home & Hosp Adm Formalize Medical Home Iniative Standards

The organization's commitment to patient-centered care is formally and consistently communicated with patients, families, staff, leadership, and medical staff (e.g. mission, care values.) B A

Medical Home & Hosp Adm Formalize Medical Home Iniative Standards

Systems are in place to assist patients and families in knowing who is providing their care, and what the role is of each person on the care team.

B A Nursing White boards and table tent cards

A patient and advisory council meets regularly and actively provides input to hospital leadership on hospital operations

B APatient Adv & Nursing Advisory Board Creation and Feed-back Loop

Patients and family members have been invited to share their experiences with your hospital in focus groups

B APatient Adv & Nursing Advisory Board Creation and Feed-back Loop

The input provided by patients and families is used to guide the organization’s strategic direction

B APatient Adv & Nursing Advisory Board Creation and Feed-back Loop

Patients and family members participate as members on hospital committees

B APatient Adv & Nursing Advisory Board Creation and Feed-back Loop

Opportunities exist for leadership to interact directly with patients and families

B B AdminNon-scheduled visit to floor and one on one random pt visits

Patients and families are able to participate in change of shift report

I B NursingDetermining appropriate scripting and method. Std Report?

Creating a Culture ofPatient-Centered Care

• PICK Chart• Developed by Lockheed Martin• Organizing and categorizing process improvement ideas• When faced with multiple ideas• Determine most useful

Creating a Culture ofPatient-Centered Care

• PICK Chart• 4 categories; 2x2 matrix• Horizontal: scale of payoff• Vertical: ease of implementation

Creating a Culture ofPatient-Centered Care• PICK Chart

PayoffLow

PayoffHigh

Easy to Do Possible Implement

Hard to Do Kill Challenge

Michael L. George (2006). Learn Six Sigma for Services. Seoul: McGraw Hill Korea.

Creating a Culture ofPatient-Centered Care

• Priority project emerged • Re-examine Self-Assessment Data

A patient and family advisory council meets regularly and actively provides input to hospital leadership on

hospital operations.

Patients and family members have been invited to share their experiences with your hospital in focus groups.

Expectations for what staff can expect in a patient-cen-tered environment are clearly stated and proactively

shared.

The organization's commitment to patient-centered care is formally and consistently communicated with patients, families, staff, leadership, and medical staff (e.g. mission,

care values.)

0 0.2 0.4 0.6 0.8 1

86%

57%

14%

43%

71%

57%

0.285714285714286

0.428571428571429

Setting the Stage, Strengthening the Foundation

Fully Implemented Throughout Organization Partially Implemented (in progress or in place in some areas, but not all) No Activity Not Applicable

Staff at all levels, clinical and non-clinical, have the opportunity to voice their ideas and suggestions for

improvement.

Patient-centered behavior expectations are included in all job descriptions and performance evaluation tools.

The input provided by patients and families is used to guide the organization's strategic direction.

Patients and family members participate as members on hospital committees.

0 0.2 0.4 0.6 0.8 1

29%

57%

43%

14%

71%

29%

43%

14%

14%

86%

Setting the Stage, Strengthening the Foundation

Fully Implemented Throughout OrganizationPartially Implemented (in progress or in place in some areas, but not all)No ActivityNot Applicable

Creating a Culture ofPatient Centered Care

• Recommendation

Hospital-Family Advising Board (H-FAB)• To address multiple areas requiring patient

input and feedback• Standardized purpose and format

Hospital-Family Advising Boards (H-FABs)• Mission: “Creating a patient-centered care environment that

promotes healthy lives through health care delivery.”

• Patient and family participation• Input in strategic directions of organization• Share experiences

… more to come

Thank you!

References• Thille, P.H. and Russell G.M. (2010). Giving patients responsibility or

fostering mutual response-ability: Family physicians’ constructions of effective chronic illness management. Qualitative Health Research, 20(10), 1343-1352.

• The Joint Commission (2010). Advancing effective communication, cultural competence, and patient- and family-centered care: A roadmap for hospitals. Oakbrook Terrace: The Joint Commission.

• Laird-Fick, H., Solomon, D., Jodoin, C., Dwamena, F.C., Alexander, K., Rawsthorne, L., Banker, T…Smith, R.C. (2011). Training residents and nurses to work as a patient-centered care team on a medical ward. Patient Education and Counseling, 84, 90-97.

• Bann, C.M., Sirois, F.M., Walsh, E.G. (2010). Provider support in complementary and alternative medicine: Exploring the role of patient empowerment. Journal of Alternative and Complementary Medicine, 16(7), 1-8.

References• Jacob, J. (2010). Voice of the patient: The essence of patient-

centered care. Critical Care Nursing, 22, 227-232.• Evardsson, D. & Innes, A. (2010). Measuring person-centered care: A

critical comparative review of published tools. The Gerontologist. Retrieved from http://gerontologist.oxfordjournals.org/content/early/2010/06/21/geront.gnq047.full.pdf+html

• Reynolds, A. (2009). Patient-centered care. Radiologic Technology, 81(2), 133-147.

• Institute for Family-Centered Care. (2008). Partnering with patients and families to design a patient- and family-centered health care system. Cambridge: Author.