“We want to feel heard and feel valued.”Collaborative Goal Setting with Families

Alda Antunes Silvestre, RN, MSN Program Manager Acute Rehabilitation ProgramRita Janke, RN, MSNQuality, Patient Safety LeaderSunny Hill Health Centre for Children

Family-centered care is neither a destination nor

something that one instantly becomes.

It is a continual pursuit of being responsive to the priorities and choices of

families.- Bissell

Hearing from Families

“Listen to parents, they know their child.”

“We want to be heard and feel valued.”

“Care is not always tailored to us”.

Provide parents with control and choice whenever possible.”

Engage child and parents in decision making.”

Hearing from Families:Family voice in the literature

Families Want:

Why Goal Setting?Effective means of understanding and changing human behavior. Clear and functional goals enhance motivation, leading to improved outcomes (Oien et al., 2010; Eccles & Wigfield, 2002; Locke & Latham, 2002; Mastos et al., 2007).

Implementing a family centered approach within a goal setting framework emphasizes parental involvement in decision-making, collaboration, and partnership, acceptance of the family’s choices, and empowerment (Law et al. 2003, 2005) Oien et al., 2010); Wiart et al., 2010).

Key Principles for Collaborative Goal Setting

Family identified needsShared responsibility Family empowermentInterprofessional PracticeSpecific tools and processes are needed

to facilitate family collaboration in goal setting.

Value Stream MapFamily Integrated Care

Unified and Integrated Team

Optimizing child participation, motivation, and function

Holding families and each other as capable, resourceful, and whole

Child-centered care

Inspiration from Mike (our family representative)

“The concept of rehab is not just for the child but is a family process…

Emphasizing to the family that they have a key role on the rehab team [because] they will be the teams eyes and ears for

the extended parts of the day”

Current State: Problem and Aim Statements

There is no documented, consistent collaborative goal setting process for children and families

receiving Acute Rehabilitation services.

100% of children will have goals set using a validated goal setting tool.

100% of families will be satisfied with their participation in their child’s rehabilitation

journey.

Intro to TeamThe Winning Team: With Family!

Alda Antunes Silvestre, Tanya St. John, Sandy Tatla, Kim Magnus, Patricia Bastante, Daniel Budgell, Sarah Small, Tamara Zagustin, Michael McCormick, Rita Janke, Kristen Barnes

The Task! By the end of the week….

Choose/develop a goal setting tool

Establish outcome &

process measures

Develop a “scale up”

and sustainment

plan

Develop a goal setting

process which involves families

Begin testing.

Our Process

Sustainment Plan

I feel the team plans with me so that we are working in the same direction.

1 2 3 4 5 6 7 8 9 100%

10%

20%

30%

40%

50%

60%

70%

0% 0% 0% 0% 0%4% 4%

12%16%

64%n= 25

I have been treated as an equal member of the team.

1 2 3 4 5 6 7 8 9 100%

10%

20%

30%

40%

50%

60%

70%

0% 0% 0%4%

0% 0% 0% 0%

28%

68%

n= 25

The information that the team gave me was consistent from

person to person.

1 2 3 4 5 6 7 8 9 100%

10%

20%

30%

40%

50%

60%

0% 0% 0% 0% 0% 0%

12%

20%

12%

56%n= 25

I know how I can support my child's rehabilitation goals.

1 2 3 4 5 6 7 8 9 100%

5%

10%

15%

20%

25%

30%

35%

40%

0%4%

0% 0% 0%4%

12%

20%24%

36%

Chart Title n= 25

What families are saying…“As my child has changed so quickly the information provided has given me the information we will require to integrate back into our home.”

“Team supported us in our top priorities around feeding and toileting”

“Again, I was included and able to assist in providing my child's care.”

“Consistency prevailed throughout our experience with therapists and nursing.”

“Staff is respectful of me and asking to have my input.”

“Everyone seems to be on the same page.”

Lessons Learned: Our Ongoing Journey

Culture Change

Lessons Learned: Our Ongoing Journey

Sustainment

Team Involvement Family

Daily Managem

ent

Coaching

Discussion

PDSAs

Domino Effect

Visual Cues

We are making a difference!

“You guys make me feel so special."