Session Three Foundational Element: Engagement

Transcription

1 Session Three Foundational Element: Engagement Kelly McCutcheon Adams, MSW, LICSW, IHI Director Barbara Balik, RN, EdD, IHI Faculty February 8, :00 3:00pm EST David Kim David Kim, Institute for Healthcare Improvement (IHI), is responsible for managing and coordinating a variety of programs based on Key Processes on the IHI Improvement Map. Mr. Kim is a graduate of Boston University. He has been with the IHI for 2 years. He enjoys sports, food, and travel. 2 1

2 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 3 When Chatting Please send your message to All Participants 4 2

3 Kelly McCutcheon Adams, MSW, LICSW Kelly McCutcheon Adams, MSW, LICSW, Director, Institute for Healthcare Improvement (IHI), has served in this capacity for eight years for a variety of IHI Collaboratives and programs, particularly those focused on critical care. She is a medical social worker with experience in hospice, nursing home, sub-acute rehabilitation, emergency department, and ICU settings. She has also served as faculty for the US Department of Health and Human Services Organ Donation Collaborative and for the Gift of Life Institute. 5 Barbara Balik, RN, EdD Barbara Balik, RN, EdD, Principal, Common Fire Healthcare Consulting, is also Senior Faculty at the Institute of Healthcare Improvement. Her areas of expertise include leadership and systems for a culture of quality and safety, including patient- and familycentered care, patient experience, systems to improve transitions in care, and transforming care prior to or with optimization of an electronic health record implementation. She works with leaders to develop adaptive systems to excel and innovate in complex organizations, and to ensure sustained improvement and innovation every day. Ms. Balik's publications include the book, The Heart of Leadership, and the IHI white paper on Achieving an Exceptional Patient and Family Experience of Inpatient Hospital Care, among others. Previously, she served in senior leadership roles at Allina Hospitals and Clinics, United Hospital, and Minneapolis Children's Medical Center. 6 3

4 Martha Donovan Hayward Martha Hayward joined the Institute for Healthcare Improvement (IHI) in March 2011 as the Lead for Public and Patient Engagement. 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. Her career experience includes over 20 years in marketing and fundraising in the areas of health, politics, and education. As a partner at Donovan & Vicenti, a branding and web design firm on Boston s North Shore, Ms. Hayward works with a variety of small businesses and nonprofits. Most recently, as Executive Director at The Partnership for Healthcare Excellence, she brought a particular focus on, and considerable experience in, the area of patient advocacy. 7 Overall Objectives At the end of this program, participants would be able to: Articulate key foundational elements in support of all domains of patient experience improvement Share specific testable ideas for improving nurse communication, pain management, and cleanliness Plan small tests of change to try during the Expedition 8 4

5 Session Agenda Homework What did you learn? Patient Experience Change Package o Our focus today Engagement learning from the Patient Experience Collaborative o Martha Donovan Hayward, IHI Lead/Public and Patient Engagement Hear from successful hospitals o Sandee Moore, Eastern Idaho Regional Medical Center o Cathy Denesia and Rob McEver, Overland Park Regional Medical Center Time for Q&A 8 Homework for this call Test one of the Leadership Key Change Share what you learned from the test Complete an additional patient shadowing activity 10 5

6 Patient Experience Change Package Overview o Original work: Patient Experience White Paper and Driver Diagram o Focused content 48 hospital collaborative Nurse Communication Pain Management Cleanliness 11 IHI Patient Experience Driver Diagram Exceptional patient and family inpatient hospital experience (safe, effective, patient centered, timely, efficient, equitable) as measured by HCAHPS willingness to recommend Governance and executive leaders demonstrate that EVERYTHING in the culture is focused on patient and family centered care, practiced everywhere in the hospital (individual, microsystem, organization) The hearts and minds of staff and providers are fully engaged Every care interaction is anchored in a respectful partnership anticipating and responding to patient and family needs (physical comfort, emotional, informational, cultural, spiritual, and learning) Hospital systems deliver reliable quality care 24/7 In words and actions leaders communicate that the patient s safety and well being is the critical decision guiding all decision making Patients and families are treated as partners in care at every level: on decision making bodies to team members with individual care PFCC is publicly verifiable, rewarded, and celebrated with relentless focus on measurement, learning, and improvement with transparent patient feedback Sufficient staff are available with the tools and skills to deliver the care the patient needs when they need it Staff and providers are recruited for values and talent, supported for success, and accountable individually and collectively for results Compassionate communication and teamwork are essential competencies Patients and families are part of care team and participate at the level the patient chooses Care for each patient is based on a customized interdisciplinary shared care plan with patients educated, enabled and confident to carry out their care plans Communication uses words and phrases that the patient understands and meets their emotional needs The physical environment supports care and healing Patients are able to access care and say that there were not long and unreasonable waits and delays Patients say there were staff available to give the care I needed The Patient always means patient and those they choose to call family The care team instills confidence by providing collaborative, evidenced based care Care is safe, concerns are addressed and if things go wrong, there is open communication and apology Care is coordinated and integrated through use of a shared can plan and everyone on the patient s care team, including the patient, has the information they need Patients get the outcomes of care they expect 6

7 Patient Experience Change Package Faculty, exemplars, teams experience: o Foundational cross-cutting work address all domains Leadership commitment and behaviors Engaging patients in their definition of: family, pain management, cleanliness o Successful use of the Driver Diagram and White Paper to assess current state and develop implementation plans 13 Patient Experience Change Package: Overview Key areas for improving specific domains of patient experience: Nurse Communication, Cleanliness, and Pain Management Staff and Physicians Connection Patient and Family Today s Session Leadership Engagement Improvement/ Infrastructure Foundational Elements for Improving Patient Experience 7

8 Foundational Elements for Improving Patient Experience Today s Session Leadership Engagement Improvement/ Infrastructure Leaders take ownership of defining purpose of work and modeling desired behaviors. Staff, leaders, and physicians engage patients and families so that efforts to improve patient experience reflect actual patient experience. Improvement teams are solidly grounded in skills to effect reliable change and gain meaningful understanding of data Engagement learning from the Patient Experience Collaborative Martha Donovan Hayward, IHI Lead/Public and Patient Engagement DO MORE. DO LESS. 16 8

9 Cathy Denesia and Rob McEver Patient Shadow Experience The story: We shadowed an 83 year old woman and her husband and life partner of 54 years. This patient entered through the Emergency Department with stroke-like symptoms. The shadow experience began in the ED, followed through procedural areas, and eventually ended up in the ICU. How we communicated the story: Photos and quotes from the patient and her husband Getting Started: Just Do It! Work with the ED director and triage nurse to identify patients Introduce to the patient or family that shadowing is a way to improve services to our patients by stepping through this hospital experience with them Take-aways: This experience allowed us to link several initiatives within the organization (LEAN, Joint Commission preparation, cleanliness, & patient centered care) with IHI principles 9

10 Patient Advisor Experience The story: 51 year old man admitted to Med/Surg unit for acute appendicitis. Upon admission to room, patient s roommate required Rapid Response Team. During these events patient s room was disheveled and equipment along with medical supplies left lying in bathroom area blocking patient access to the toilet. Patient s bathroom not cleaned during his over-night stay. Patient later expressed he had history of infection acquired after knee surgery and this situation caused him anxiety about another infection. How we communicated the story: Patient initially reported complaint to staff and unit director. Patient did not feel staff was responsive. After discharge patient invited in for a dinner with nursing and EVS staff. Patient told staff in his own words about his experience Take-aways: Patient felt empowered & that he had an impact on future patient care Staff related to patient story and spoke about how this would impact their practice Overall positive experience for both staff and patient Getting Started: Just Do It! Identify patients who can articulate their story in constructive way. Patient had a vested interested in improving his hospital Eastern Idaho Regional Medical Center Patient and Family Engagement 10

11 IHI Collaborative Initial spark to support our cultural change with better structure for process change Setting a framework to support accountability Much more digestible and approachable compared to past efforts: small-scale rapid cycle testing. Inspires sense of We can do this, a bite at a time! Data-rich Sharing and networking Introduction of Patient Advisor role EIRMC s New Structure 11

12 Lots of Teams, Doing Heaps of Work Patient-Family Advisory Council Communication Team Pain Management Team Care Coordination Team Cleanliness & Quiet Team Leader Rounding Team Lab Services Team Imaging Team Same Day Surgery Team Emergency Department Team Marketing & Communications Team Inpatient Unit Based Teams Listening to Patients & Families: Patient & Family Advisory Council Not pictured: Mary Kelley Russell Hillman Kelly Martin 12

13 PFAC: Putting Patients & Families at the Center of Everything Intentionally force consideration of, What will give best experience for the patient and family? in every hospital decision we make PFAC drives/participates in: Every Patient Experience Team Patient Family Advisory Newsletter New Employee Orientation Patient Rounding/Environmental Rounds Healing spaces Helping Design More Patient and Family-Focused Care PFAC advises and provides recommendations on: Bedside shift report Patient Handbooks Whiteboards Family presence during resuscitations Visitor guidelines Pain Team consults Patient-Family Liaison on Surgical Services Patient call-backs Leader rounding on patients and families 2-hour window for inpatient imaging exams 13

14 Discussion/ Q&A To ask a question or make a comment, please either chat your question/comment into the Chat Box to All Participants, or Click the Raise Hand icon and we can call on you to ask your question aloud. Thanks! Homework for the next call Test one of the Engagement Changes Share what you learned from the test 28 14

15 Next Call Session 4 - Foundational Element: Improvement Infrastructure Date: Wednesday February 22, :00 PM - 3:00 PM Eastern US time 29 Listserv Patient_experience@ls.ihi.org Send and receive questions and comments to/from faculty and participants To be added to the listserv please dkim@ihi.org 30 15