Planetree International Designation Criteria

Transcription

1 APPLICATION FOR PLANETREE MERIT AWARD for Achievement in Person-Centered Care Date of Application: Name of Organization: Planetree All Rights Reserved. SECTION I: REQUESTING ORGANIZATION INFORMATION Designation Site Visit Coordinator (Name & Title): Phone: Fax: Organization Type: Acute Care Hospital Behavioral Health Hospital Continuing Care Community Integrated Site/Healthcare System Other. Please describe: Date of Last Planetree Progress Assessment or Gap Analysis: If applicable, date of last Planetree Merit Award conferred: Level Awarded: Bronze Silver Gold (Planetree Designation) Award Tier Being Sought*: Bronze Silver Gold (Planetree Designation) *Sites must identify what award tier is being sought. Only that tier will be awarded, e.g. sites applying for one level will not have the option of being awarded the preceding level nor the subsequent level based on the documentation provided. SECTION II: SELF-ASSESSMENT To initiate the Planetree Merit Award assessment process, this Application must be accompanied by a completed Self-Assessment Tool with all supporting documentation required for the award level sought provided in an electronic format and one hard copy. Please complete if applying for Gold-level Planetree Designation: Designated sites are leaders in the field of patient- and resident-centered care. In an effort to continually share best practices, designated sites agree that all implementation materials submitted with the organization s Self-Assessment Tool to Planetree, Inc. ( Planetree ) will be added to Planetree s Resource Library and may be made available to individual Planetree affiliate organizations and/or published in a Planetree-published manual(s) as examples of best practices in patient- and resident-centered care. At the discretion of the designated site, these documents may be provided with identifying information intact or removed. Please indicate the organization s preference: Please remove any and all identifying information from these documents prior to sharing. Please preserve all identifying information within these documents when sharing. Continued next page

2 Planetree International Designation Criteria By signing below (name of applicant organization) formally initiates its application for recognition through the Planetree Merit Award Program with the goal of achieving recognition by Planetree at one of three levels: Bronze, Silver or Gold (which equates to Planetree Designation as a Patient-Centered Hospital or a Resident-Centered Community). The organization agrees to pay the cost of all applicable fees, including the application review fee and, if applicable, the reasonable, associated travel expenses and the site evaluation fee (Planetree affiliates may apply prepaid consultation funds toward the evaluation fee). By signing this Application, the organization waives and releases Planetree, its officers, directors, agents, servants and employees from any and all claims, demands, actions, lawsuits, and damages that may arise from or relate to, directly or indirectly, the survey and recognition process. Moreover, the organization recognizes and confirms that the award of Bronze, Silver and Goldlevel recognition requires compliance with established criteria published by Planetree and that it waives any attempt at recourse in the event such recognition is denied, suspended, or terminated for failure to meet the conditions established by such criteria. Duly authorized signatory Date Planetree All Rights Reserved. 2

3 PLANETREE INTERNATIONAL MERIT AWARD SELF- ASSESSMENT TOOL For Organizations Applying for Bronze, Silver, or Gold Level Recognition from Planetree Revisions in red take effect January 1, 2016 Organizations interested in pursuing Tiered Recognition or Designation should complete the following questionnaire (with the appropriate number and type of baseline and elective criteria based on the recognition tier being sought) to assess their organization s status as it relates to the standards for each level. Upon the determination to move ahead with the application process, the questionnaire and supporting documentation should be submitted electronically and in hard copy to Planetree along with the Merit Award Application. Setting Bronze (75%) Silver (88%) Designation (Gold) (100%) Continuing Care 40 (20 baseline; 20 elective) 47 (24 baseline; 23 elective) 53 (all required) Behavioral Health 38 (19 baseline; 19 elective) 45 (23 baseline; 22 elective) 51 (all required) Acute Care 38 (19 baseline; 19 elective) 44 (22 baseline; 22 elective) 50 (all required) A NOTE ABOUT THE INTEGRATED CRITERIA The Planetree International Designation criteria are designed to be applicable to all healthcare providers. In some cases, however, specific criteria may apply differently in various healthcare settings (acute care, continuing care, behavioral health, etc.), and not all criteria apply to all settings. If not otherwise noted, the criteria are applied consistently across settings and the questions and documentation requests in this self-assessment should be completed by all applicants. Questions and documentation requests indicated as applying only to behavioral health settings or continuing care settings need only be satisfied by applicants serving those specified populations. If a site is inclusive of a number of settings, all the applicable criteria will be applied as appropriate, e.g. behavioral health criteria will be applied to a behavioral health unit within an acute care hospital. Planetree All Rights Reserved.

4 By submitting this completed Self-Assessment and the accompanying required documentation to Planetree, Inc., a site formally initiates the process of applying for recognition from Planetree for Meaningful Progress, Significant Advancement, or Excellence in Person-Centered Care. The Self-Assessment Tool includes questions to answer and additional documentation requirements to demonstrate implementation of specific criteria. Sites are required to submit one hard copy of the completed self -assessment with documentation, as well as an electronic version (via , disc or flash drive). The self-assessment must be submitted in English to Planetree s Designation staff. Mail Signed Application and Self-Assessment to: Christy Davies, Designation Coordinator Planetree 130 Division Street Derby, CT USA Self-Assessment to: Cdavies@planetree.org Upon receipt of the completed Self-Assessment and the required documentation, Planetree will schedule a conference call with the applicant site to review next steps. Planetree All Rights Reserved. 4

5 SECTION I: STRUCTURES AND FUNCTIONS NECESSARY FOR IMPLEMENTATION, DEVELOPMENT, AND MAINTENANCE OF PERSON-CENTERED CONCEPTS AND PRACTICES Bronze I.A: A multi-disciplinary, site-based task force or committee structure is established to oversee and assist with implementation and maintenance of personcentered practices. Active participants on the task force include: Patients/residents and/or family members; A mix of nonsupervisory and management staff; A combination of clinical and nonclinical staff 1. When was this task force initiated? 2. How often does it meet? 3. How are ideas and input from patients/residents incorporated into the work plans of this task force? 4. Do members of the medical staff participate on this task force? If no, describe efforts to expand medical staff representation on this task force. 5. How are committee members prepared and oriented to the role they will play? A. Copies of minutes from the task force s last three meetings. B. A current task force membership list, which includes each member s name, title, and department/role. Identify which staff are nonsupervisory and which are supervisory, and which members are patients/residents/family members. Bronze (Note: For home care providers, this task force is based out of the administrative office / staff headquarters.) I.B: A person-centered care coordinator or point 6. What is the coordinator s name and job title? 7. Approximately how many hours per week does this person spend C. Coordinator s job description Planetree All Rights Reserved. 5

6 Silver of contact person is appointed who is able to commit the time required to coordinate related activities on an ongoing basis. This individual will have direct access to, and support from, senior level decision makers to remove barriers as needed, properly resource and align this strategic priority within the organization. I.C: Goals and objectives related to personcentered care are developed at least annually, supported by the patient/resident partnership council and key organizational stakeholders, and progress on objectives is shared with the governing body with a frequency commensurate with the reporting schedules for comparable strategic priorities. I.D: Community needs and patient/resident perceptions are incorporated in the planning and implementation of on person-centered tasks and responsibilities? 8. Summarize the person-centered activities coordinated by the contact person within the last twelve months. 9. How is information on person-centered care efforts shared with your governing body (e.g. highest authority that has governance responsibility) on an ongoing basis? 10. How do you communicate information about person-centered care with patients/residents and their family members? 11. As changes occur in the organization (e.g., board, senior leaders, coordinator), what are your plans for maintaining and transferring knowledge about your person-centered philosophy of care? 12. What clinical, operational and financial metrics do you monitor to gauge progress in person-centered care implementation? With whom do you share this information? With the leadership team? With employees? With the governing body? With the patient/resident advisory council or equivalent? Others? 13. How have you aligned person-centered care initiatives with your organization s current strategic and/or operational plan? 14. Do you have a patient/resident or community advisory council in place? If yes, when was it established? How often does it meet? How are the participants recruited and selected? Who serves as the consistent link between the council and the D. A copy of your personcentered care dashboard, or other reporting mechanism regularly updated to monitor implementation progress and related outcomes E. A copy of your organization s current strategic and/or operational plan (or the executive summary) F. Agendas and minutes from the last two meetings of the patient/resident/ community advisory council (or equivalent). Planetree All Rights Reserved. 6

7 person-centered programmatic elements. Patients/residents/family members are meaningfully engaged in these efforts, and structures are in place that promote partnership between patients/residents/family members and the organization s leadership and governing body. There is evidence that this partnership has resulted in a visible difference in the operations of the organization. I.E: Leadership exemplifies approaches that motivate and inspire others, promote positive morale, enhance performance of others, and model organizational values. governing body (i.e. regularly participates in meetings of both groups)? Is this person a staff or external community member? Provide at least 2 specific examples of ways the council s input helped to drive ongoing improvement efforts. If no, what other formalized mechanism is in place to obtain regular input from patients/residents and community members? Provide at least 2 specific examples of ways the input obtained through this system has helped to drive ongoing improvement efforts. 15. What linkages exist between the patient/resident/community advisory council (or equivalent) and the multi-disciplinary task force that oversees implementation of person-centered care? 16. Do current and/or former patients/residents currently serve as active members on teams in place to address specific patient- /resident-centered initiatives? If yes, summarize patients /residents involvement on these teams. If no, describe efforts to expand patient/resident representation on these teams. 17. How are leaders new to the organization ingrained in its culture of person-centered care? 18. How are leaders within the organization held accountable for exhibiting behaviors that reflect the values of person-centered culture change, specifically their effectiveness in communicating a vision, inspiring others, promoting positive morale and engaging others in organizational culture change? 19. What opportunities, formal and/or informal, exist for leaders to interact with frontline staff, including staff working at night and on weekends? 20. What opportunities, formal and/or informal, exist for leaders to interact with patients/residents and families? G. A list of any supervisory or leadership training conducted over the past two years. Planetree All Rights Reserved. 7

8 SECTION II: HUMAN INTERACTIONS/INDEPENDENCE, DIGNITY AND CHOICE Bronze at 50% Silver 70% H. Retreat agenda/curriculum II.A: All staff, including off-shift and support staff, as well as employed medical staff, are given an opportunity to participate in a personcentered retreat experience, or a comparable experiential PCC immersion program, with a minimum completion rate of 85%. Site-based volunteers, independent contract employees, and nonemployed medical staff members are invited to participate in this experience. 1. Describe your staff retreat process (length, agenda, location, facilitators, frequency, and participation rates), and if you do not hold 8-hour retreats, describe how you engage employees and educate them about person-centered care perspectives, sensitize them to the patient/resident experience and support changes in attitude and culture that move the organization toward a more holistic approach to care. 2. What percentage of staff has completed retreats or the equivalent to-date? (If it is 85% or less, please describe your plan to provide retreats for the remaining staff.) 3. Are you continuing to offer staff retreats to all new employees? 4. Are volunteers invited to participate in retreats or an alternative program specific to person-centered care? 5. Do non-employed members of your medical staff participate in staff retreats or other person-centered initiatives? Planetree All Rights Reserved. 8

9 Bronze II.B: All staff members, including employed physicians, nurses, other health care providers, and others who provide support and care are oriented, regularly educated about, and encouraged to participate in personcentered initiatives. 6. Beyond retreats, describe educational opportunities offered to employees to routinely reinforce person-centered care concepts, practices and behaviors. 7. Do you offer second-level or ongoing staff retreats? If yes, please describe. 8. Please describe any additional educational opportunities offered to your employees that reinforce person-centered concepts, practices, and behaviors and build competence among staff to address the evolving needs of the community. 9. What teams are currently in place to address person-centered initiatives and what is the function of each? 10. How is frontline, non-supervisory staff supported in participating in these teams? 11. How are ideas and input from patients/residents incorporated into the work plans for these teams? 12. Do members of the medical staff participate as active members on these teams? If yes, summarize their involvement on these teams. If no, describe efforts to expand medical staff representation on these teams. 13. How is the work of these teams communicated organizationwide? I. A list of each of your initiative teams, along with member names and job titles and/or role (e.g. patient/resident, family member). Please indicate how long each team has been active and how often they meet. Planetree All Rights Reserved. 9

10 Silver II.C: Person-centered care concepts, practices, and initiatives are provided for all new staff and volunteers as a part of orientation. In continuing care environments, residents and family members are included in a meaningful way in the new employee orientation program. In addition, the new resident/family orientation includes an introduction of residentcentered care concepts and how those concepts are realized within the community. II.D: Staff has the autonomy to personalize the patient/resident and family experience to meet the expressed needs and preferences of those receiving care. II.E: A mechanism is in place to provide staff support services that include elements identified by staff as priority areas. 14. How are new employees oriented to the organization s culture of person-centered care upon hire and how are they sensitized to the perspective of patients/residents as part of their orientation to the organization? 15. How are members of the medical staff oriented to the organization s culture of person-centered care? 16. Continuing Care Applicant Question: How are residents and family members involved in the new employee orientation program? 17. Describe your care delivery or work design model. 18. How does this approach ensure that staff who works most closely with patients/residents is given a voice in how care is delivered? 19. Provide at least one specific example of how staff has personalized the care experience for one patient/resident. 20. Describe the support services available to staff. 21. How did you ensure that staff priorities informed the development of these support services? 22. Describe the spaces available for staff to decompress between patients/cases. J. A copy of your new employee and new volunteer orientation agenda(s), indicating where and how person-centered concepts, initiatives and expectations are shared with staff and volunteers K. Continuing Care Applicant Requirement: A copy of your new resident/family orientation agenda, indicating where and how resident-centered concepts, initiatives and expectations are shared with new residents and their families Planetree All Rights Reserved. 10

11 Bronze II.F: Human resource systems, including job descriptions and evaluations, reflect the organization s personcentered care philosophy and values. There is evidence that patient/resident/family feedback is considered as part of hiring, coaching, and evaluation of staff. II.G: Organizational stakeholders involved in creating a personcentered environment are recognized and acknowledged for their work. 23. Provide examples of how the organization s commitment to person-centered care is reflected in job descriptions and performance evaluation tools and processes. 24. Describe processes in place for holding members of the medical staff accountable for behaviors consistent with the organization s culture of person-centered care. 25. Describe how staff is recognized and rewarded. 26. What opportunities are there for patients/residents and family members to recognize staff? 27. In continuing care settings, describe how residents and family members are recognized for their contributions to the continuing care community. Planetree All Rights Reserved. 11

12 II.H: Open, direct, and compassionate communication is demonstrated among all members of the organization. This includes having a documented process or system in place to fully and empathetically disclose when an adverse event, sentinel event, or unanticipated outcome occurs to patients/residents (and family members as appropriate.) II.I: Administrative processes, including billing processes, as applicable, are transparent, respectful and responsive to the needs of patients/residents and families. II.J: The organization balances safety considerations with being supportive of patient/resident empowerment, independence, and dignity. 28. Describe the approaches employed by the organization to keep all staff informed of organizational priorities. 29. What mechanisms are in place for staff, patients/residents and family members to voice their ideas and suggestions for improvement? 30. Describe the processes in place to provide support to staff affected by an adverse event. 31. Describe the organization s approach for disclosing unanticipated outcomes to patients/residents (and family members as appropriate). 32. Is this approach to disclosure formalized in a policy? 33. How is staff educated about this approach to disclosure? 34. Describe processes in place for encouraging patients/residents and families to communicate with staff about concerns related to their safety and/or care. 35. How are these processes for communicating concerns communicated to patients/residents and family members? 36. Describe changes that have been made to administrative processes (including billing, as applicable) to better meet the needs of patients/residents and families. 37. How were these changes informed by the perspectives of patients/residents and family members? 38. Provide at least two specific examples of how the organization s focus on safety is balanced with being supportive of patient/resident empowerment, independence and dignity. 39. What processes are in place for staff to provide education to patients/residents on the implications of choices that may pose a safety or health risk? L. If available, a copy of the organization s disclosure policy. Planetree All Rights Reserved. 12

13 II.K: Continuity of care and accountability for patients/residents is maximized and maintained for the duration of one s care, including during transitions between levels of care and across discrete episodes of care. Patients/residents and families are involved in shift-to-shift communication in a manner that meets their individual preferences and needs. II.L: Staff engages patients/residents, family, and/or their advocates in the care planning process, and ensures that treatment goals are aligned with the patient s/resident s documented personal goals and preferences. II.M: The professional development/ advancement of staff is supported. 40. Describe mechanisms integrated into hand-off processes that facilitate caregivers having the information they need to enhance continuity of care shift-to-shift, setting-to-setting, and episodeto-episode. 41. Describe opportunities for patient/resident and family involvement in shift-to-shift communications. (Examples include conducting change of shift report at the bedside and reviewing a patient s/resident s bio as part of the hand-off process.) 42. Describe how your organization works with other healthcare providers in your area to enhance continuity of care during transitions of care. 43. What changes have been introduced to the organization s approach to care planning and care plan documentation to more actively engage patients/residents and family in the care planning process? 44. Describe how the professional development and advancement of staff is supported. Planetree All Rights Reserved. 13

14 Bronze (only for continuing care applicants) II.N. In continuing care environments, systems and practices are in place to foster among residents and families a sense of belonging, individuality, ownership and pride. 45. Describe any retreat or community-building experiences for residents that assist with internalizing resident-centered care concepts and enhance residents sensitivity to the needs of the entire community. How often are such retreats (or an equivalent) held? 46. How are residents and family members involved in the new employee hiring and orientation? 47. Describe opportunities for celebrating residents life milestones and personal achievements. How often do such celebrations occur? How are they personalized? 48. Describe any programs, rituals or ceremonies that have been established to promote a sense of inclusion and connectedness with the community. Indicate how often each is held. 49. Describe the move-in process for new residents, with specific emphasis on ways the process is managed to maximize connections within the community. M. Agenda/curriculum for resident retreats (or an equivalent). SECTION III: PROMOTING PATIENT/RESIDENT EDUCATION, CHOICE AND RESPONSIBILITY Bronze III.A: During their care, patients/residents and families (with patient/resident consent) are provided education and access to a wide range of information in a manner that they understand, to support them in making informed choices. A policy and documented process is in place to offer and provide to 1. Describe the different ways (mechanisms and processes) that a patient s/resident s up-to-date personal health information (including information on the diagnosis and plan of care) may be shared with him or her. 2. Describe the process for sharing the active medical record and plan of care (or an equivalent) with patients/residents while they are being treated. 3. How are patients/residents informed that they may see their active medical record or plan of care (or an equivalent) while they are being treated? 4. How is staff educated about the organization s policy related to sharing clinical information with patients/residents? 5. Are there any laws or regulations in your country that limit patients/residents from seeing their current medical records N. A copy of the organization s policy related to sharing timely clinical information with patients/residents Planetree All Rights Reserved. 14

15 patients/residents access to their record and plan of care while they are being treated, and they are supported in understanding and amending the information contained within. There is evidence that this offer/process to access is communicated to every patient upon admission or when appropriate. Note: In certain settings, such as behavioral health, when sharing such information may be detrimental to the health and well-being of the patient/resident, organizations are obliged to find other ways of sharing up-to-date information with them on their diagnosis, care and other clinical information. III.B: Patients/residents and families (with patient/ resident consent) are provided with information and support needed to be as involved as they choose while they are being treated? If yes, provide a comprehensive overview of the law or regulations and the specific restrictions that limit patient/resident access to their current personal health information. How has the organization maximized patient/resident access to their timely personal health information within the constraints of this law? 6. Besides the medical record and care plan (or an equivalent), describe other health information and educational resources available to patients/residents, families and/or staff. 7. What efforts have been made to ensure that these health information and educational resources meet users needs, including varying literacy levels and diverse languages and cultures? 8. Describe the processes for providing patients/residents instructions to prepare them for their next level of care. What processes are in place for assessing their comprehension of these instructions? 9. What tools are provided to patients/residents and families to support them in managing their medical information and coordinating their medical care among multiple physicians? 10. What other processes are in place to support patients/residents and families in managing their medical information and coordinating their medical care among multiple physicians? 11. How does the organization support families participation in preparing the patient/resident for their next level of care? Planetree All Rights Reserved. 15

16 in coordinating their care across settings, among multiple providers, and across discrete episodes of care. III.C: Patients/residents are provided with discharge/transition instructions in a manner that accommodates their level of understanding, in a language that they understand, and includes family members in the discharge process as patient/resident desires. 12. Describe the process for providing patients/residents with discharge/ transition instructions. 13. What processes are in place for assessing patients /residents comprehension of these instructions? (E.g. Teach Back, Ask Me 3, etc.) 14. How does the organization support families participation in the discharge/transition process? SECTION IV: FAMILY INVOLVEMENT O. Samples of documents integrated into care processes to support the discharge/transition process. P. Acute Care Applicant Requirement: Please provide your hospital-wide 30-day readmission rate for the last 12 months Bronze IV.A: A flexible, 24-hour plan for family presence is mutually developed between patient/ resident and the care team. Exceptions may include psychiatric facilities, NICU, and in cases of communicable disease. Restrictions to visitation are determined by the treatment plan, 1. How long has 24-hour person-directed family presence been in place at your organization? 2. How is this policy communicated to patients/residents and families? 3. Other than the exceptions noted in the criterion, are there any areas/units and/or occasions (for example, change of shift) in which person-directed family presence is not in place? If yes, describe. 4. What education and support is provided to staff to support them in managing person-directed family presence? 5. Describe the protocols for informing family about any restrictions to their presence and/or involvement in their loved one s care. Q. A copy of the visitation/family presence policy. Planetree All Rights Reserved. 16

17 Silver SECTION V: DINING, FOOD, AND NUTRITION PLANETREE INTERNATIONAL DESIGNATION/TIERED RECOGNITION Bronze agreements with roommates, patient/resident preferences, and the rationale for any restrictions is clearly communicated to patients/residents and families. IV.B: When mutually agreed upon and clinically appropriate, staff encourages families to participate in the emotional, spiritual and physical care and support of the patient/resident. IV.C: A process is in place to encourage patients/residents and families to communicate with staff about any concerns related to their care and safety, and includes a specific commitment/path to resolution of concerns. V.A: A system is in place to provide 6. Describe the organization s approach to family involvement in patient/resident care. Provide specific examples of ways family is encouraged to participate in the emotional, spiritual and physical care and support of the patient/resident. 7. How is this approach to family involvement actively promoted to patients/residents and family members? 8. Is this approach formalized in a policy? 9. Besides lifting restrictions on visiting hours, describe other ways the organization actively supports the presence of family. 10. Describe the availability of kitchens, pantries, and lounges for families and visitors. 11. Describe processes in place for encouraging patients/residents and families to communicate with staff about concerns related to their safety and/or care. 12. How are these processes for communicating concerns communicated to patients/residents and family members? 1. Provide examples of ways that the organization s approach to meals and dining has become less institutionalized and more R. A copy of the family involvement policy, if available. Planetree All Rights Reserved. 17

18 patients/residents, families and staff with access to a variety of fresh, healthy foods. Patients /residents personal preferences and routines around dining are considered and accommodated to the extent possible, including but not limited to meal times, dietary restrictions, religious beliefs and cultural norms. V.B: The dining experience maintains patients /residents dignity, enhances socialization and supports independence while supporting individual preferences. personalized. 2. Describe ways that you are able to accommodate patients /residents personal preferences and routines as it relates to their meals. Address, at a minimum, meal choices and meal times. 3. What efforts have been made to ensure that patients/residents, visitors and staff have access to healthy, nourishing foods 24- hours a day? Be sure to address the food available to staff who work overnight and on weekends. 4. Describe the mechanisms in place that allow for personalization of the dining experience for patients/residents with dietary restrictions. 5. How are patients /residents cultural norms around food and mealtimes accommodated? 6. Describe ways that patients/residents participate in meal planning, on an individual basis (for example, selecting their meal and meal time) and at an organizational level (for example, patient/resident input into menu development). 7. In continuing care and behavioral health settings, describe the dining environment. How does the dining environment support independence and socialization during meal times? SECTION VI: HEALING ENVIRONMENT, ARCHITECTURE AND DESIGN Bronze VI.A: The built environment incorporates evidencebased principles of healing healthcare design, and is updated as appropriate based on feasibility. As updates 1. How have the evidence-based principles of healing health care design been integrated into the design of your space? Provide specific examples. 2. What processes or resources do you use when planning a design or renovation project to ensure that healing health care design principles are applied? 3. During your most recent design or renovation project, how did you involve users of the space (patients/residents, staff) in the Planetree All Rights Reserved. 18

19 and renovations occur, they incorporate evidence-based principles to enhance safety and security of patients/residents, visitors, and staff. design process? 4. Have you conducted a post-occupancy assessment as part of your evidence-based design process? If yes, please share any results. Bronze VI.B: Users of the space are actively involved in a design process. VI.C: Patients/residents have choices or control over their personal environment, including: personalization of their space electrical lighting, access to daylight, noise and sounds, visual privacy, temperature/thermal comfort. VI.D: As plans for future renovations and remodeling are developed, symbolic and real barriers are minimized and open communication and human interactions are prioritized. Specific changes demonstrate how environment of care 5. During your most recent design or renovation project, how did you involve users of the space (patients/residents, staff) in the design process? 6. Describe opportunities for patients/residents to make choices or maintain control over their physical environment. Address at a minimum: o Lighting o Access to daylight o Sounds o Temperature o Privacy 7. What efforts have been made to maintain a pleasant smelling environment? 8. Describe the organization s approach to overhead paging. 9. For continuing care settings, describe opportunities for residents to personalize their living environment. 10. Provide specific examples of how symbolic and real barriers have been removed from patient/resident care settings. 11. Describe the characteristics of your nurses stations that promote open communication and human interactions. 12. Describe your quiet, healing spaces, gardens, staff respite areas, family lounges, unit-based kitchens/pantries, and/or libraries. 13. How is the availability of these spaces communicated to patients/residents and families? 14. If applicable, how is the organization integrating new technologies to support a person-centered culture? Examples Planetree All Rights Reserved. 19

20 design supports the include technology that promotes effective communication, healing environment. partnership with caregivers, continuity of care, family VI.E: A patient/resident and visitor navigation plan provides a clear and understandable pathway for patients/residents and visitors to their destinations. Patient/resident input informs the navigation plan. In continuing care settings, signage in resident rooms is kept to a minimum. VI.F: Physical access to the building is barrierfree and convenient for those served. VI.G: The environment is designed to accommodate privacy needs in a culturally appropriate way and provides for patient/resident dignity and modesty, particularly in common areas, checkin/registration, checkout/billing, patient/resident rooms and bathrooms. involvement and quality of life. 15. Do patients/residents and visitors become lost easily in your building or on your campus? If yes, how do you address this? 16. Describe ways that patients/residents have been involved in the development and/or evaluation of your navigation plan. 17. Describe accommodations to promote barrier-free and convenient access to and within your building. 18. Describe the availability of parking, including valet parking and/or shuttle services, if available. 19. Describe environmental features that facilitate private conversations. Examples include arrangement of chairs in waiting areas, availability of private consultation rooms, bedside registration in Emergency Departments, and design of registration areas that promote privacy. 20. Describe any cultural norms around privacy that have influenced patient/resident care in your organization. 21. Describe environmental features that provide for patient/resident dignity and modesty. Address, at a minimum, common areas, patient/resident rooms and bathrooms. Planetree All Rights Reserved. 20

21 Silver (only for VI.H: The organization is able to demonstrate its commitment to the promotion of holistic community health through environmental stewardship. VI.I: Patients/residents and staff have access to nature. VI.J: Lighting is provided that is appropriate for the required task or function, promotes a safe environment for staff and patients/ residents and is supportive of patient/resident, comfort, control and security. VI.K: Protocols are in place for reducing coercive intervention. VI.L In continuing care and behavioral health sites: Common spaces are 22. During your most recent construction and/or renovation project(s), were any sustainable or green approaches adopted? If yes, describe. 23. Describe any environmentally-friendly practices that have been incorporated into facility maintenance and upkeep. Examples may include use of green cleaning products, equipment and lighting choices that decrease mercury, copper, etc. content and specification of products or materials free of contaminant ingredients like formaldehyde or polyvinyl chloride. 24. Is the organization LEED or Energy Star certified? 25. Are there active recycling and waste reduction programs in place? 26. Describe healing spaces in your building(s) or on your campus that provide patients/residents/staff with access to nature. 27. What type of lighting is provided in the corridors? Overhead fluorescent? Indirect? 28. Does staff have task lighting at their work areas to perform their duties appropriately? Are there low-level lights in patient/resident rooms for staff to check on them at night? 29. Can patients/residents control the lighting in their room for reading, visiting with family, etc.? 30. Can the corridor lights be dimmed or controlled for lower levels during quiet time and at night? 31. Describe your protocols for reducing coercive intervention and supporting healing interventions that promote quality of life. 32. Describe design features in common spaces that satisfy patients /residents needs for both privacy and social interaction. Planetree All Rights Reserved. 21

22 continuing care and behavioral health applicants) available and feature a sense of spaciousness and light. In addition, they satisfy patients /residents needs for both private spaces and spaces that support social interaction and decisionmaking. SECTION VII: ARTS PROGRAMS/MEANINGFUL ACTIVITIES AND ENTERTAINMENT Bronze VII.A: Arts, entertainment, and life enrichment activities are designed with and in response to the interests and input of patients/residents, families, and staff. The programming is meaningful and evidence-based (as appropriate) to enhance wellness, health, enjoyment, and to support a holistic approach to treatment goals. Active participation by staff, patients/residents, and families is encouraged, as appropriate. 1. Describe ways that this concept of sustaining a meaningful life for patients/residents that is consistent with their physical and mental state and length of stay has been brought to life within your organization. 2. Describe ways in which the organization supports patients / residents personal, intellectual and professional growth. 3. Describe the arts and entertainment programming in place for patients/residents and visitors. Include how long each has been in active practice. 4. Describe how the organization has investigated patients / residents interests related to arts and entertainment programming and how those perspectives have guided the development of the activities or arts and entertainment program. 5. Describe how staff is engaged in carrying out the menu of arts and entertainment programming. 6. Describe opportunities for family involvement in the activities offered. 7. For continuing care settings, describe opportunities for intergenerational interaction. 8. For continuing care settings, describe the transportation options available to residents.. Planetree All Rights Reserved. 22

23 SECTION VIII: SPIRITUALITY AND DIVERSITY Bronze VIII.A: Accommodations are made to support the cultural norms, spiritual needs, and other beliefs of patients/residents with documentation in the treatment plans. Human resource policies/protocols address the cultural and spiritual needs of staff. 1. Describe how the spiritual needs of patients/residents, family and staff are ascertained and addressed in your organization. 2. Describe the sacred spaces on-site for patient/resident, family and staff use. 3. Describe how you have investigated and documented the special needs of your diverse community members, including staff. 4. What resources and/or training opportunities are available to support staff in understanding and accommodating patients /residents and families different cultural norms and traditions related to health and healing? 5. Provide examples of specific accommodations that have been made to integrate patients /residents cultural beliefs/norms into their care and treatment. SECTION IX: INTEGRATIVE THERAPIES/PATHS TO WELL-BEING IX.A: Patients are supported in understanding and accessing a range of treatment options, including those considered complementary or alternative to local standards. Patients receive support from the care team to integrate such options into their treatment regimen, as appropriate. 1. Describe how complementary/integrative therapies have been integrated into the way care is provided within your organization. Describe the healing modalities available to patients/residents and include how long each has been in active practice. 2. Describe how you have determined the needs and interests of your patients/residents who wish to have access to complementary/integrative healing modalities. Include how this is done at an organizational level as well as at an individual level. IX.B: Clinicians assess the 3. Describe the organization s approach to supporting Planetree All Rights Reserved. 23

24 Bronze skills and ability of each patient/resident and family member to selfmanage their health care needs, and resources are available, as needed, to enhance selfmanagement skills and abilities, particularly for those with chronic conditions. patients/residents in chronic disease management. 4. Describe patients /residents access to wellness and health management opportunities and services. 5. When appropriate, how does the organization facilitate and encourage physical activity within and around its building(s) and campus? 6. Describe how caregivers assess patient/resident/family member abilities to self-manage their care needs. 7. Continuing Care Applicant Question: Describe residents access to wellness and health management opportunities and services. IX.C: Patients /residents daily care is provided with gentleness and in recognition of the importance and health benefits of physical contact and human touch, as appropriate based on the person s preference. IX.D: A plan is developed and implemented for providing holistic and dignified end-of-life care, as appropriate. 8. How is caring touch provided to patients/residents, family and staff? (Examples of caring touch include massage, healing touch, therapeutic touch and Reiki.) 9. Describe any additional efforts undertaken to promote gentleness in the daily care provided to patients/residents. 10. What practices around death and dying are in place to support holistic and dignified end-of-life care? Include practices to support the patient/resident at end-of-life, as well as practices and rituals that support both families and staff (and in continuing care settings, other residents) through grief and loss. SECTION X: HEALTHY COMMUNITIES/ENHANCEMENT OF LIFE S JOURNEY Bronze X.A: Based on the interests and needs of the community, a plan is developed to improve community health. 1. Provide specific examples of how the organization is contributing to the health of its external community. 2. Describe how you have assessed, determined, and are meeting the public health needs and interests of your community. Planetree All Rights Reserved. 24

25 X.B: The organization works with other local healthcare providers across the continuum of care to improve care coordination, communication and information exchanges around the needs of each patient/resident and family, especially during transitions of care. X.C Applies only to continuing care sites: The move-in process is managed to maximize connections within the community and to minimize the stress associated with the transition. 3. Describe how your organization works with other healthcare providers in your service area to enhance person-centered approaches to care across the continuum of care. 4. Describe the move-in process for new residents, with specific emphasis on innovations to emphasize relationship-building. SECTION XI: MEASUREMENT Bronze XI.A: Data is gathered to measure quality of care, patient/resident safety, the patient/resident experience and the staff experience, and the organization can demonstrate how the data is being used to enhance quality and 1. Indicate the instrument used to measure each of the following, and how often the data for each is collected: o Quality of Care o Patient/Resident Safety o Patient/Resident Experience o Staff Experience 2. Provide examples of how quality of care data and patient/resident safety data has been used to enhance quality and safety practices within the organization. 3. Provide examples of how patient/resident experience survey S. If available, summary results of your most recent 12 months of performance on appropriate quality and patient/resident safety measures, with comparisons to available benchmarks. (Use national benchmarks wherever available.) T. If available, annualized Planetree All Rights Reserved. 25

26 safety and to improve the patient/resident and staff experience. data has been used to improve the patient/resident experience. 4. Provide examples of how employee opinion survey data has been used to improve the employee experience. summary results of the most recent 2 years of patient/resident experience data, with comparisons to available benchmarks. (Use national benchmarks wherever available.) U. If available, annualized summary results of the most recent 3 years of employee experience data, with comparisons to available benchmarks. V. If available, summary results of the most recent physician experience survey data, with comparisons to available benchmarks. (Use national benchmarks wherever available.) W. Data on organizational vacancy and turnover rates Bronze Bronze XI.B: Performance data on organizational indicators related to efficiency and clinical and service excellence are made available to the public to support consumers in making informed health care choices. XI.C: The organization conducts regular (at 5. What venues are used to publicly report performance data related to clinical quality? 6. What venues are used to publicly report performance data related to service excellence? for the past 3 years. 7. What orchestrated methodology does your organization X. A summary report on the Planetree All Rights Reserved. 26

27 least every 18 months) currently use to regularly gather meaningful information from findings of your most recent focus groups or other patients/residents, family members and employees about their focus groups with organized methods to experiences with your organization? (An example is focus patients/residents, family gather meaningful groups.) members, staff and information from 8. If focus groups are regularly conducted with patients/residents, patients/residents, physicians, or an equivalent. family and staff family members and employees: members. The results o Are they facilitated by an independent vendor? are shared at a minimum o When were they last completed? (Provide dates and number with senior management, of patient/resident/family and the dates and number of the governing body, staff, employee focus groups held.) and patients/residents o How were the findings shared and with whom? and family members. o Provide at least one example of how findings from the most recent patient/resident/family focus group(s) were used to drive changes in the organization. o Provide at least one example of how findings from the most recent employee focus group(s) have been used to drive improvements in the workplace culture. 9. What orchestrated methodology does your organization currently use to regularly gather meaningful information from physicians? (An example is focus groups.) 10. How have these findings been used to drive ongoing improvement efforts? Bronze XI.D: The organization regularly solicits information from staff about safety concerns and uses the information generated to improve safety practices in the organization. The organization assesses its 11. What processes are implemented to solicit information from staff about your culture of safety? 12. When was your most recent safety culture survey and how was it conducted? When do you next anticipate administering a safety culture survey? 13. How do you use the information obtained from staff to enhance safety? 14. Provide current available data on Hospital Acquired Conditions, Healthcare Associated Infections and Surgical Complications. Planetree All Rights Reserved. 27