INCORPORATING PERSON & FAMILY ENGAGEMENT IN YOUR DIALYSIS FACILITY. March 23, 2017

Transcription

1 INCORPORATING PERSON & FAMILY ENGAGEMENT IN YOUR DIALYSIS FACILITY March 23, 2017 This resource was developed while under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. Contract #HHSM C. The contents presented do not necessarily reflect CMS policy.. This resource was developed while under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. Contract #HHSM C. The contents presented do not necessarily reflect CMS policy. Your Network Team Shane Perry, BS Executive Director Ellie Vail Brent, MPH Community Engagement Manager Sharlyn Bogner, MSN, RN, CNN, CCTC, CPHQ Quality Improvement Director DeeDee Velasquez-Peralta, LMSW Patient Services Director 1

2 WELCOME Objectives 1. Define patient engagement 2. Describe the three levels of patient engagement 3. Describe the Network resources to improve person and family engagement 4. Select at least one patient engagement strategy to implement 2

3 CMS Triple Aim to improve healthcare Patient engagement is one strategy to achieve the Triple Aim of improved health outcomes, better patient care, and lower costs. HEALTH AFFAIRS, February 14, "Health Policy Brief: Patient Engagement," AIM 1: Better for the Individual through Beneficiary and Family Centered CMS Clinics Person & Family Engagement Better care for the individual Network 3

4 Person Centeredness Health Home Future Spiritual life Family Hobbies Friends Work Interests Past Dialysis WHAT IS PATIENT ENGAGEMENT? 4

5 Patient Engagement involves patients taking an active part in their own health care. is a shared responsibility between patients (and their families), healthcare practitioners and healthcare administrators. is the patient being an active part of the decision making process to define their individualized treatment plan. is not about patients adhering to or complying with the treatment plan. What patients tell us about Patient Engagement When you, the patient, are involved with your care and care team and/or care partners Sean N. Shared decision making is important for patients to participate in care Patients and family to be fully informed of their disease, treatment options, and why their input in their healthcare is so vitally important to their care, mental well-being, and interaction with others. ArdyB. Friends and family are involved To make an obligation or promise to someone to do something or be committed to a certain task. Barbara B. Patient leads own care Patient engagement can t happen without being twosided. Professionals often present information as I know better than you Any patient that involves themselves in their care. By asking questions, making sure they understand as much as possible what s going on with their medical care. Judy R. 5

6 Patient Engagement Defined Patient activation refers to a patient s knowledge, skills, ability, and willingness to manage his or her own health and care. Patient engagement is a broader concept that combines patient activation with interventions designed to increase activation and promote positive patient behavior. "Health Policy Brief: Patient Engagement," HEALTH AFFAIRS, February 14, Key Engagement Behaviors communicate with health care professionals make good treatment decisions (gather information and ask questions about various treatment options) participate in treatment and seek health knowledge 6

7 LEVELS OF PATIENT ENGAGEMENT Three Levels of Patient Engagement Laws and Policy Organization Design and Governance Health Policy Brief: Patient Engagement, Health Affairs, February 14,

8 Patients get information and answer questions about their preferences to help inform their treatment decisions. Shared-Decision Making Shared decision making is a collaborative process that allows patients and their providers to make health care decisions together, taking into account the best scientific evidence available, as well as the patient s values and preferences. What is Shared Decision Making? Informed Medical Decisions Foundation, Web. 14 March

9 Shared Decision Making Honors both the provider s expert knowledge and the patient s right to be fully informed about all care options and the potential harms and benefits. Shared Decision Making is designed to increase: Patient knowledge Patient involvement in decision-making Consistency between decisions and patient values Communicating Information According to the North Carolina Project on Health Literacy: 40-80% of the medical information patients receive is forgotten immediately Nearly half of the information retained is incorrect Close the gap by using the teach-back method, also known as the show-me method or closing the loop. 9

10 Teach Back Teach-back is a way to confirm that you have explained to the patient what they need to know in a manner that the patient understands. Patient understanding is confirmed when they explain it back to you. It can also help the clinic staff members identify explanations and communication strategies that are most commonly understood by patients. Network Resources for Patient Engagement My Life, My Choices Knowledge is Power Project materials Network Patient Representative Program All About You Review Plan of Toolkit 10

11 My Life, My Choices: Knowledge Is Power MY KIDNEY KIT MY KIDNEY CALENDAR MY KIDNEY KIT ONLINE MY CLINIC PLAN MY KIDNEY KIT Sections: My Life My Choices My Treatment My Plans My Network My Information 11

12 3/23/2017 Collaboration Tool MY KIDNEY CALENDAR _MY_KIDNEY_CALENDAR_topics.pdf 12

13 My Journey with Kidney Disease - Patient video Patient experts answer: My Life How do I play an active role in my care? My Choices Why did you choose home hemodialysis? My Treatment Tips What are some tips to improve my treatment experience? Words of Encouragement 13

14 MY CLINIC PLAN Review of Patient Engagement Review of Network Resources Ideas Planning questions Additional Tools Pre-Assessment & Post- Assessment My Education Sheet (Individual Teach-Back) My Clinic Education Sheet Crossword Puzzles Network Patient Representative Program Who they are? People on dialysis and/or have had a kidney transplant Good role models Engaged in their own care & want to help others Have a positive outlook Have good insight What they do? Help with patient education Bulletin boards Lobby days Newsletters Welcome new patients Organize patient socials Participate in QAPI 14

15 Network HIGHLIGHT DaVita- Atlantic Dialysis Mark Johnson & Tonja Downey, RN, CDN Network HIGHLIGHT Mercy Dialysis Mike Warner & Andria Fisher Mercy Newsletter Given to patients on a monthly basis Dialysis health information/education Information on nutrition/renal diet Information on psychosocial issues/concerns Dialysis themed crossword puzzles/games Birthday announcements 15

16 All About You Review Plan of Toolkit Goal = Patient participation in plan of care My Questions & Goals Checklist Brochures- New patients (blue) Existing patients (green) 16

17 Network HIGHLIGHT Danita Minor- DCI Carondelet, Network BOD Steps for Successful Plans Appointments Invitation Plan Meeting Encourage Facility Manager to attend. Open meeting with explanation of what the care plan is. Focus on improving their quality of life. Focus on most pressing issues Record items and goals Follow up with action items and goals. Network HIGHLIGHT Benefits of A Successful Plan + Patient directs the goals they would like to work on with the entire team everyone is on the same page. + Trust level between patient and team can dramatically improve because the patient s choices and value system are respected. + Dialysis Team becomes more aware of patient s priorities and can focus energy on achieving their individual goals. + Patient is more engaged which can encourage better adherence that leads to improved outcomes. + Easier to track progress and find solutions when everyone is involved. 17

18 Providers reach out for patient input to ensure they will be responsive to patients needs. Organization Design & Governance Patient involvement Network Projects Organization Design & Governance Subject Matter Experts Involved in the Quality Improvement Activities development (PAC) Involved at the clinic level Examples of activities: Completing surveys to give input and feedback Reviewing educational resources Doing audits Giving input or helping to develop/implement patient educational/engagement activities (bulletin boards/ lobby day) Involvement in clinic Quality Improvement team 18

19 Engaging Patients in Quality Assurance & Performance Improvement Join Us Select & Invite Network Patient Rep (NPR) or other patient Why Role Meeting Introduce Agenda Directed questions After Meeting Patient shares information with other patients Organization Design & Governance Part 1: Patient Selection Partner Constructive Ideas Network Patient Representative Look for individuals who have demonstrated interest in partnering with you in their care or the care of a family member. Consider those who have offered constructive ideas for change and who have a special ability to help staff and physicians better understand the patient or family perspective. Involved in NPR program Patient is involved as a peer mentor Source: Institute for Patient- and Family- Centered. Advancing the Practice of Patient- and Family-Centered In Primary and Other Ambulatory Settings: How to Get Started. (1/2011) 19

20 Part 1: Patient Selection Organization Design & Governance Shares insights with openness See beyond their personal experiences Shows concern for more than one issue Positive outlook on life & sense of humor Listens well Shows respect for perspective of others Interacts with different people Speak comfortably in a group with candor Source: Institute for Patient- and Family- Centered. Advancing the Practice of Patient- and Family-Centered In Primary and Other Ambulatory Settings: How to Get Started. (1/2011) Part 1: Patient Invitation Organization Design & Governance Make It personal Invite NPR or other patient in-person Explain the purpose of QAPI Share reasons why the patient is being invited Review their role during and after meetings Accommodate patient s schedule to attend meeting If patient says yes, educate patient on topic(s) covered & ask if they have any questions 20

21 Part 2 Meeting Remove any PHI info from reports IDT members all prepare directed questions Before During Introduce all with name & role Confidentiality Observe all HIPPA rules No names/or specific cases Agenda 1 st minutes for patient feedback topics Use patient friendly language (avoid acronyms) Graphs and Charts Review for all group members Organization Design & Governance Include in minutes Follow up with patient directly before next meeting Patient shares with other patients Update on topics discussed Get feedback for next meeting After Additional Resources: Organization Design & Governance Institute for Patient- and Family-Centered. Partnering with Patients and Families to Enhance Safety and Quality: A Mini Toolkit. Bethesda, MD: Author. Available from Tips for How to Be an Effective Patient or Family Advisor: A Beginning List Tips for Group Leaders and Facilitators on Involving Patients & Families on Committees and Task Forces Checklist for Attitudes about Patients and Families As Advisors Thank you to Network 14 for sharing their PPT- Nothing About Me Without Me. This resource was originally created by The End Stage Renal Disease Network of Texas and adapted for use by Heartland Kidney Network. 21

22 Network Highlight FMC- Des Moines Ardy Boucher & Ryan Mchugh, LMSW Network QIA Highlights Hand Hygiene Audits 22

23 Laws & Policy Consumers are involved in the decisions that communities make about policies, law and regulations in public health and health care. Network Level Person & Family Engagement Patient Advisory Committees 25 representatives Board of Directors Two patient representatives Medical Review Board One representative for each state NW Quality Improvement Activities Two patient representatives on each (minimum) Attend CMS calls & NW Evaluation National Learning & Action Network Five patient representatives 23

24 WHAT ARE YOU CURRENTLY DOING? Participation Expectations Project Specific Identification of a patient representative Seek input from patients about the project Hand hygiene auditing (begins April 10 th ) BSI QIA General Every Network facility should incorporate the My Life, My Choices: Knowledge is Power resources into your PE activities Use at least two MY KIDNEY KIT pages/section with at least 10% of your patient population Ideas available in MY CLINIC PLAN and monthly in the Heartland Happenings e-newsletter and at rticle/share_how_you_care_

25 Share How You Who: All dialysis facilities in the Network What: Share at least one patient engagement activity Where: Go to Share How You in 2017 *If you are in a Network QIA project you are already doing this just make sure to report here as well Benefits Patients People actively involved in their health and health care tend to have better outcomes and, some evidence suggests, lower costs. CMS ESRD Conditions for Coverage CORE Survey expectations "Health Policy Brief: Patient Engagement, HEALTH AFFAIRS, February 14,

26 Call to Action By June 30 th I will 26

27 Questions Thank YOU! Patient Advisory Committee Members Ardy Boucher Ryan Mchugh, LMSW, FMC-Des Moines Mark Johnson Tonja Downey, RN, CDN, Davita- Atlantic Dialysis Danita Minor, RD, LD, DCI Carondelet 27

28 Please complete the evaluation. NANT CEU s will be provided within 4 weeks DeeDee Velasquez-Peralta, LMSW, Patient Services Director dvelasquez-peralta@nw12.esrd.net Sharlyn Bogner, MSN, RN, CNN, CCTC, CPHQ, Quality Improvement Director sbogner@nw12.esrd.net Ellie Vail Brent, MPH, Community Engagement Manager ebrent@nw12.esrd.net Links Share How You in eb9bcae0daad070f952 review_plan_of_care_toolkit and_goals LAN_FINAL_v3.pdf t_representative_program u_care_