IHI Expedition Patient and Family Advisors: Getting the Most Out of Your Partnership Session 3

Transcription

1 June 18, 2014 These presenters have nothing to disclose IHI Expedition Patient and Family Advisors: Getting the Most Out of Your Partnership Session 3 Martha Hayward Doug Bonacum Today s Host 2 Morgen Palfrey, Project Coordinator, Institute for Healthcare Improvement, is the current coordinator for web- based Expeditions. She also contributes to the IHI Leadership Alliance for Building Health Care s Future, the Always Project, and works with Strategic Partners in Singapore. Morgen is a member of Work- Life Wellness Team and Diversity and Inclusion Council at IHI, where she and fellow staff members develop strategies for improving the mind and body. Morgen graduated from the University of Florida in Gainesville, FL where she received her Bachelor of Arts degree in Political Science with a concentration in Public Administration. 1

2 Audio Broadcast 3 You will see a box in the top left hand corner labeled Audio broadcast. If you are able to listen to the program using the speakers on your computer, you have connected successfully. Phone Connection (Preferred) 4 To join by phone: 1) Click the button on the right hand side of the screen. 2) A pop-up box will appear with call in information. 3) Please dial the phone number, the event number and your attendee ID to connect correctly. 2

3 Audio Broadcast vs. Phone Connection If you using the audio broadcast (through your computer) you will not be able to speak during the WebEx to ask question. All questions will need to come through the chat. 5 If you are using the phone connection (through your telephone) you will be able to raise your hand, be unmuted, and ask questions during the session. Phone connection is preferred if you have access to a phone. WebEx Quick Reference Welcome to today s session! Please use chat to All Participants for questions For technology issues only, please chat to Host WebEx Technical Support: Dial-in Info: Communicate / Join Teleconference (in menu) Raise your hand Select Chat recipient Enter Text 6 3

4 When Chatting 7 Please send your message to All Participants Faculty 8 Martha Hayward, Lead for Public and Patient Engagement joined the Institute for Healthcare Improvement (IHI) in March 2011 as the Lead for Public and Patient Engagement. The focus of her work at IHI is to bring patients and families into the design of all work at IHI to accelerate improvement of health care delivery. A cancer survivor herself, she is a founding board member of the nonprofit Women s Health Exchange and served on the Patient and Family Advisory Council of Dana-Farber Cancer Institute in Boston. Prior to joining the health care world Martha enjoyed a 20 year career in communications, marketing, and fundraising in the areas of health, politics, and education. In her role at IHI, she speaks and teaches programs including Patient Safety Officer Training, Executive Development, Strategic Partners, and Patient Experience Seminars. Martha has offered keynote addresses on the subjects of Patient and Family Centered Care, Patient Engagement, and End of Life Care to local, regional, and national audiences. 4

5 Faculty 9 Libby Hoy is Founder of Patient and Family Centered Care Partners, a resource organization for patient- and familycentered care on the West Coast. She has 18 years of experience navigating the health care system as the mother of three sons living with mitochondrial disease. Ms. Hoy began volunteering as a Parent Mentor in 1995 and has been working to improve health systems and empower parents and kids with special health care needs since that time. In her role as the first Family Advocate at Miller Children's Hospital, she developed the Parent Advisory Board and created the structure for the long-term integration of the patient and family voice within the organization. She recently completed the LEND Fellowship at USC University Center for Excellence in Developmental Disabilities. Ms. Hoy has been consulting to organizations for many years to promote patient- and family-centered care, and has presented at several national conferences on this topic. Today s Agenda 10 Ground Rules & Introductions Debrief action period assignment Engaging Others, Hearts & Minds Action Period Assignment 5

6 Expedition Objectives At the end of this Expedition, participants will be able to: 11 Explain the role of Patient and Family Advisors within health care Utilize a communication technique to further improvement efforts Perform a test of change Schedule of Calls Session 1 Bedside to Boardroom Date: Wednesday, May 21, 2:00 3:00 PM ET 12 Session 2 The Roles & Competencies of Patient and Family Advisors Date: Wednesday, June 4, 2:00 3:00 PM ET Session 3 Engaging Others, Hearts & Minds Date: Wednesday, June 18, 2:00 3:00 PM ET Session 4 Telling Your Story Date: Wednesday, July 2, 2:00 3:00 PM ET Session 5 Examples of Excellence Date: Wednesday, July 16, 2:00 3:00 PM ET Session 6 Leaving in Action Date: Wednesday, July 30, 2:00 3:00 PM ET 6

7 Action Period Assignment Debrief 13 Write an aim statement to answer the question What are we trying to accomplish? A good aim addresses an issue that is important to those involved; it is specific, measurable, and addresses these points: How good? By when? For whom (or for what system)? Aim Statements To have at least one, or more Patient/Family Advisor on each of the Program Councils throughout the organization by June Heather Badder, Ontario My aim as a stroke survivor is to not only to promote Christiana Care mission of partnering with the patients on their care but also to tell the stroke survivors that there is life after the stroke. I listen to their story and then tell my story giving hope a little humor and helpful hints on living with the effects of a stroke. - Don Squires, Patient and Family Adviser Identify and incorporate the hospital patient advisors into my case assignments when warranted by the end of December Carolyn Hayes-Dozier, MSN, RN, Christiana Care Health System System-wide patient activation strategies to reform how we deliver care. Launch one advisory council for acute care by Dec. 31, Examples: CCO Community Advisory Council, St. Charles Medical Group Connectivity, Volunteer Network. - Brenda Finkle, St. Charles Health System 14 7

8 Why we tell stories 15 Connect to process Connect the heart Engage patients and staff Return to why Demonstrate meaning Call to Action Brené Brown 16 Maybe stories are just data with a soul 8

9 Marshall Ganz, Kennedy School 17 Storytelling is about translating our values into emotions that enable us to act. Kinds of stories 18 Personal narrative - every single story is the story of every patient Ethnography - discovering the truth Data - connecting your perspective to that of others 9

10 We must learn to listen Create the right atmosphere Prompt the audience to search for a meaning Develop an attitude of inquiry and discovery 19 Where Clinical interaction one on one deep listening Saves time Provides vital information Builds trust Team Interaction Provides focus and meaning to process Engages hearts and minds Enhances improvement Leadership Inspires Models meaning in work Offers a reference point 20 10

11 When 21 Opening board meetings Staff meetings New Hires Website You Tube Training/teaching All Staff parking lot to physical therapy Elevators and hallways Doug Bonacum, Kaiser Permanente 22 Doug Bonacum is Vice President, Quality, Safety, and Resource Management for Kaiser Permanente. In addition to his role with Kaiser Permanente, Doug serves on the Board of Directors for the National Patient Safety Foundation, as faculty for the Institute for Healthcare Improvement Patient Safety Executive Program, and as an advisor to ECRI s Patient Safety Organization Program. In 2013, Doug was named one of 50 Experts Leading the Field of Patient Safety by Becker s Hospital Review. He has been with the organization since July Doug was previously Environmental, Health and Safety Manager for two large manufacturing facilities of Tyco/North American Printed Circuits. Prior to that, his experience included eight years active duty in the US Submarine Force where he was responsible for weapons and ship's safety as well as nuclear power plant operations. Doug has a B.S. in Chemical Engineering from the University of New Hampshire, an M.B.A. from Rensselaer Polytechnic Institute, and a Certificate in Healthcare Management from the University of San Francisco. Doug is a Certified Safety Professional (CSP), and a Certified Professional in Patient Safety (CPPS). Outside of work, his Thrive activity is coaching high school freshman basketball. 11

12 SBAR 23 A structured communication format utilized for situational briefings and calls to action SBAR: Situation Background Assessment Recommendation Helps organize information / thinking Bridges differences in communication styles Can help flatten the hierarchy A Sea Story 24 We are in the North Atlantic Ocean, on the USS George Washington Carver, SSBN 656(B). It s at the heart of the Cold War, and we are hundreds of feet below the ocean s surface on a strategic deterrent patrol. Sonar has recently reported a new contact, designated S-17. S-17 is classified as a submerged contact and it appears to be closing in range. It s 2:00 a.m. And I m in charge, all 24 years old of me! Captain, I am sorry to wake you sir. This is Ensign Bonacum, Officer of the Deck. 12

13 The Origins of SBAR The Seed is Planted A Hospitalist told me a story about reviewing some charts outside a patient s room and being pulled into the following: RN calls Intern: Patient s family really wants you to come and see him. Appears that the Intern states that he ll come, but he can t come right now. 15 minutes later, family member comes out to get RN and as a result, RN calls Intern again I told you, I ll come, but can t come right now 10 Minutes later, family member comes out again, quite agitated, and demands to see a doctor. RN approaches me and I go into the room to find the patient in full code. Debrief Intern RN didn t tell me how sick patient really was RN RN sees it differently, I couldn t have been much clearer Family, of course, sees it quite differently 25 The Origins of SBAR The Framework is Created 26 Observing a Team of Perinatal Experts in 2002 Nurses expressing frustration around not being heard Doctors expressing frustration around not knowing what was wanted and why What are the pebbles in your shoes? MDs I want the headlines what s the issue and what needs to be done. RNs I ve been trained to describe narratively and not to diagnose. MDs If they re gonna wake me up, it better be good RNs The last time I woke him up, he yelled at me 13

14 Elements of SBAR 27 Situation (What s going on, 5-10 sec) Background (Brief history, relevant context) Assessment (What I think, conclusions) Recommendation (What I need and in what time frame) Clinical Example: Walking Through A Case year old male POD#3 hip repair Hx CHF, HTN, DM Was doing well, eating, working with PT Now SOB, respirations look labored RR 26, O2 sat 93% BP 130/65 Lungs with crackles 1/2 up, I/O ml past 24 hours No chest pain 14

15 Traditional Model of Communication 29 I m calling about Mr. Smith, he s Short of Breath Play 20 questions, then come up with a plan that may or may not be mutually acceptable but is always uncomfortable for both parties More Effective Model of Communication: SBAR Format 30 Situation: Dr. Shivago, this is Nurse Ratchet. I m calling about Mr. Smith; he says he s Short of Breath and his breathing looks labored to me. Background: He s POD#3 from hip replacement and has a history of HTN and CHF. He d been doing well until today---he was eating, working with PT. Now his RR is 26, O2 sat 93%. Lungs have crackles half way up, I/O s +1.5L 15

16 SBAR Format 31 Assessment: I think he might be fluid overloaded Recommendation: I d like to Hep Lock his IV and get you to evaluate him as soon as possible. When might I expect you? Bad and Good Examples of SBAR 32 See videos 16

17 33 How Might SBAR May Be Helpful To You? As a patient and family advisor, and for the staff working with advisors, you lead from where you stand. You are committed to getting results and have a sense of urgency around where change is needed. You may be faced with real or perceived hierarchies and, you will be faced with an organization that is doing its best to manage multiple competing priorities and objectives. Can you think of a situation you are currently dealing with, or have dealt with, where SBAR would be useful? Questions? 34 Raise your hand Use the Chat 17

18 Action Period Assignment Please create a one page SBAR using the template attached. The completed template should be the first page of the presentation following the title slide. Situation/Desired Outcome: What is the situation/problem/change/issue you are bringing forward? What outcome are you seeking from the council? Background: What factors led up to this? What is the relevant history? Assessment: How would you assess the situation? What are the implications? Recommendation: What action do you propose? What decision or action do you need from the Committee 35 Expedition Communications 36 Listserv for session communications: PatientFamilyPartnerships@ls.ihi.org To add colleagues, us at info@ihi.org Pose questions, share resources, discuss barriers or successes 18

19 Next Session 37 Wednesday, July 2 nd, 2:00 PM 3:00 PM ET Session 4 Telling your story Martha Hayward Libby Hoy 19