Patient and Family Centered Care

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1 Patient and Family Centered Care Lessons Learned from Changing Organizational Culture A Leader s Perspective: Maryland Patient Safety Conference March 2015 Chuck Hofius has indicated no conflict of interest to disclose

2 The Perham Journey Fargo Moorhead Duluth Perham Minneapolis St. Paul

3 Chuck Hofius Not an expert in the field, just someone who s lived it No secrets, no amazing techniques, reminders of fundamental leadership Sharing our story

6 Undertaking Culture Change

7 Patient- and family-centered care is working with patients and families, rather than just doing to or for them.

8 Patient- and Family Centered Principles Dignity and Respect. Health care practitioners listen to and honor patient and family perspectives and choices. Patient and family knowledge, values, beliefs, and cultural backgrounds are incorporated into the planning and delivery of care. Information Sharing. Health care practitioners communicate and share complete and unbiased information with patients and families in ways that are affirming and useful. Patients and families receive timely, complete, and accurate information in order to effectively participate in care and decision-making. Participation. Patients and families are encouraged and supported in participating in care and decision-making at the level they choose. Collaboration. Patients, families, health care practitioners, and hospital leaders collaborate in policy and program development, implementation, and evaluation; in health care facility design; and in professional education, as well as in the delivery of care.

9 The Leader s Role Create an environment where risks can be taken Story: Thunder Down Under Are you truly honest with yourself in this regard? Similarly, decision makers need to be at the bedside, we need to support Model the way (rounding, way finding)

11 The Leader s Role Create an environment where risks can be taken Story: Thunder Down Under Are you truly honest with yourself in this regard? Similarly, decision makers need to be at the bedside, we need to support Model the way (rounding, way finding)

12 Setting the stage Finding the champions Articulate the vision Show your commitment The Leader s Role Is it in your strategic plan? Board meetings? Annual goals? Mission?

The Leader s Role Create a culture where fun and laughter are appreciated We need to hold people accountable (i.e. rounding, peer interviews, bedside report, including patients and families on committees) Be firm that things will change.

13 The Leader s Role Create a culture where fun and laughter are appreciated We need to hold people accountable (i.e. rounding, peer interviews, bedside report, including patients and families on committees) Be firm that things will change. You need everyone s help with how. Example: lab draws at 5:00 a.m.

14 We re starting from Strength - acknowledge all the good things we are already doing We re building upon our strengths Listen to the Experts! Those closest to the patient patients, families, staff Story: selecting staff for trial Lessons Learned Story: dealing with death in the nursing home Put Patients and Families First - For Real!! De-escalates physician, staff, and others

15 Walk of Honor

16 We re starting from Strength - acknowledge all the good things we are already doing We re building upon our strengths Listen to the Experts! Those closest to the patient patients, families, staff Story: selecting staff for trial Lessons Learned Story: dealing with death in the nursing home Put Patients and Families First - For Real!! De-escalates physician, staff, and others

17 Leadership doesn t need to have all the answers (Move in) Admit our mistakes, openly, publicly Bonfire Story Use Rituals Lessons Learned Burning the nurse s station Don t let regulators be your excuse, how can you meet the intent Be willing to take a ding for doing the right thing

18 Those who truly get it will surprise you Example - yesterday s shining stars Not everyone will make it. Lessons Learned Focusing on quality of life, greatly increases quality of care!

19 Nursing Home Quality of Care 66% of residents in the first 6 months gained weight Reduction in number of Psychotropic medications Decrease in residents with little or no activity Reduction in injury from falls Reduction in nutritional supplements Reduction in number of residents requiring total assistance with eating Lights answered more quickly Outcomes

20 Measuring - Hospital Likelihood to Recommend 33 rd to 83 rd Percentile on Press Ganey Overall Satisfaction 18 th to 63 rd Percentile on Press Ganey Top of Mind and General Perception Stability Increased OP and Stable IP

24 Biggest Lesson Learned: PATIENCE! Deep culture change takes years - not days, not weeks, not months.

26 It s the Little Things that Matter It s the Little Things that Matter

27 It s the Little Things that Matter It s the Little Things that Matter

28 What if we try this and we accidentally improve?

31 QUESTIONS? Chuck Hofius, CEO Perham Health and Perham Living Phone:

CME Disclosure. Accreditation Statement. Designation of Credit. Disclosure Policy

CME Disclosure. Accreditation Statement. Designation of Credit. Disclosure Policy CME Disclosure Accreditation Statement Studer Group is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Designation