INSTITUTE FOR PATIENT-AND FAMILY-CENTERED CARE.

Transcription

1 INSTITUTE FOR PATIENT-AND FAMILY-CENTERED CARE

2 Partnering with Patient and Family Advisors to Reduce Readmissions Strategies for Success Bev Johnson, IPFCC President and CEO

3 In Our Time Together... Discuss best practices for developing effective QI partnerships with patient and family advisors as part of the process for reducing readmissions. Describe key steps for creating a variety of ways to involve patient and family advisors in reducing readmissions.

4 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. People with and families are encouraged and supported in participating in care and decision-making at the level they choose. Collaboration among patients, families, and providers occurs in policy and program development, quality and safety improvement, professional education, and research and evaluation, as well as in the delivery of care.

5 An IDEAL discharge Include the patient and family as full partners in the discharge planning process Discuss with the patient and family key areas to prevent problems at home Educate the patient and family in plain language about the patient s condition, discharge process, and next steps Assess how well providers explained and patients understood via teach back Listen to patients and families AMERICAN INSTITUTES FOR RESEARCH 5

6 Do any of you currently have patient and family advisors collaborating with staff and clinicians in reducing unnecessary readmissions at your hospital? If yes, how have they been involved? What has facilitated the process? What have been the challenges and barriers?

7 Best practice is to have a variety of ways that patient and family advisors are involved in quality improvement and safety and to show the impact of this collaboration.

8 First Impressions... Anne Arundel Medical Center Annapolis, MD

9 Anne Arundel Medical Center Annapolis, MD

10 Patient and Family Advisors Serve on QI Team

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12 Key HCAHPS Transition Questions During this hospital stay, staff took my preferences and those of my family or caregiver into account in deciding what my healthcare needs would be when I left. When I left the hospital, I had a good understanding of the things I was responsible for in managing my health. When I left the hospital, I clearly understood the purpose for taking each of my medications.

13 Adapted with permission from BIDMC.

14 Partnering with a PFAC to Improve Patient Experience with Pain Management One year collaborative process among multidisciplinary nursing team, administrative leaders, and patient and family advisors. Redesign initial pain management nursing assessment. Create a menu of pain control and comfort measures. Create door hangers indicate patient s wish not to be disturbed. Create a comfort cart. Provide blanket warmers on all inpatient units. Bookout, M. L., Staffileno, B. A., Budzinsky, C. M. (2016). Partnering with a patient and family advisory council to improve patient care experiences with pain management. The Journal of Nursing Administration.

15 Partnering with a PFAC to Improve Patient Experience with Pain Management (cont d) Goal was to increase HCAHPS pain control score to 78.3 or greater. After only three months, result was 78.9 from the initial score of Goal was to increase HCAHPS rating to 84.6 After only three months, result was 90.3 from an initial score of 78.3.

16 What We Learn from Patients and Families Before 7 pages long Follow-up Appointment on page 5 No information on pending labs Unclear instructions on danger signs After Eliminated Noise - 3 pages only! Moved F/U appt. to first page Identified missing information Suggested visual ways to ensure understanding

17 Patient and Family Advisory Council NYSPFP asked the hospital s PFAC to review the checklist and provide recommendations for improvement.

18 Valley Health System, Ridgewood, NJ Patient and Family Advisors... Shadowed the home care staff doing medication review in initial home visits with patients and families and discovered inconsistencies in practice. Provided recommendations to support reliability in the process. The medication wallet card is now in hospital discharge materials and in the home care admissions packet.

19 Why involve patients and families as advisors to reduce readmissions? Bring important perspectives. Teach how systems really work. Keep staff honest and grounded in reality. Provide timely feedback and ideas. Inspire and energize staff. Lessen the burden on staff to fix the problems staff do not have to have all the answers. Bring connections with the community. Offer an opportunity to give back.

20 Recruiting Patient and Family Advisors Ask staff and physicians for suggestions. Contact support groups and community organizations such as emergency medical servies, fire stations, and religious organizations or place an ad in the local newspaper. Call or send a mailing to patients and families. Ask patients/families during a clinic visit or during a hospital stay when appropriate. Post signs/brochures on bulletin boards in waiting areas, corridors, and lobbies. Place notices in the publications, websites, and TV systems of clinics, hospitals, or nursing homes. Post information on Twitter and Facebook.

21 Peace Health Medical Group Eugene, OR A Recruiting Tool

22 Recruiting Advisors A physician conveys the importance of patient and family partnerships.

23 Pajama advisors...

24 One patient or family advisor on a committee is NOT sufficient... Now the round table symbolizes our equality, while my fancy chair and golden crown signify that perhaps I m just a smack more equal.

25 What are your key questions about creating and sustaining effective partnerships with patient and family advisors to reduce unnecessary readmissions?

26 Tools for Getting Started PFA Sample Application Form Suggestions for Screening Interview Questions in Selecting Patient and Family Advisors New Ideas and Next Steps for Partnering with Patient and Family Advisors Strategy 1: Working with Patient and Family Advisors amilies/strategy1/index.html... Comprehensive guidance: Essential Allies: Patient, Resident, and Family Advisors Guidance for Staff Liaisons available from: