CARE PARADIGM

Understand the findings and conclusions of the Patientand FamilyCentered Care (PFCC) Benchmarking Project Learn about effective methods for im lementing the core conce ts of PFCC across the organi!ation "ignity and res ect #nformation sharing Partici ation Collaboration

The Institute for FamilyCentered Care (IFCC) defines* atientand family!entered !are (PFCC) as" $%n innovative a roach to the lanning& delivery& and evaluation of health care that is grounded in mutually beneficial artnershi s among health care atients& families& and roviders'( #u!!essfully im lementin$ PFCC !on!e ts re%uires a ma&or aradi$m shift" PFCC means develo ing collaborative artnershi s )ith atients and families to im rove care and o erational efficiency and recogni!ing atients and families as e*ual& im ortant members of the care team'

PatientCenteredness +ealth care should be based on continuous healing relationshi s' Care should be individuali!ed' #t is im ortant for atients to be involved in their o)n care decisions' Patients and families should have better access to information' +ealth care should become more trans arent' #,-.s $/i0 %ims for +ealthcare #m rovement( are safety& atient!enteredness& efficiency& effectiveness& timeliness& and e*uity'

Communication roblems may lead to legal action for mal ractice12 Failing to understand atients. or families. ers ectives "elivering information oorly "evaluing atient and3or family vie)s

"esertion

4he roject.s steering committee focused the study on the follo)ing key objectives1 4o assist U+C members in determining their PFCC strengths and im rovement o ortunities 4o identify useful metrics for monitoring rogress in achieving PFCC goals 4o develo an aggregate database of PFCC ractices in academic health centers

4o discover ho) organi!ations are successfully im lementing PFCC.s core conce ts to address the rinci les of *uality care as outlined by the #nstitute of -edicine

Colla'orate (ith atients and family ad)isors to" #ncor orate PFCC conce ts into mission& vision& values& lans& safety initiatives& hiloso hy& and sco e of care for each area Create and describe a aid atient and family leader osition (su orted by a ro riate budget and resources) and )ith rimary res onsibility for overseeing& coordinating& and im lementing PFCC initiatives across the enter rise /elect leaders and roviders )ho ractice PFCC conce ts& e'g'& outsourced service3e*ui ment vendors& administrative leaders& and caregiversincluding medical staff Leaders must believe in and ractice PFCC conce ts and act as role models for the organi!ation

+old staff and vendors accountable by including PFCC goals in job descri tions& evaluations& credentialing rocedures& and contracts

Di$nity and Res e!t" +ealth care ractitioners listen to and honor atient and family ers ectives and choices

Patient and family kno)ledge& values& beliefs& and cultural backgrounds are incor orated into the lanning and delivery of care 567 agreed that effective rocesses are in lace to ensure atients3families are greeted in a friendly manner' 897 agreed that the ethnic3cultural diversity of staff is consistent )ith the atient o ulations served' 6:7 agreed that the facility offers a healing& su ortive d;cor'

6:7 agreed that conversations about atients are conducted a)ay from ublic areas' 897 agreed that confidential registration discussions are held in rivate locations'

<97 agreed that care settings rovide rivacy' Partner (ith atients and family ad)isors to" Put effective rocesses in lace to ensure all staff and em loyees al)ays introduce themselves to the atient and family and e0 lain their roles in his3her care #m lement friendly olicies and rocedures that res ect the cultural and lifestyle needs of atients and families #m lement ractices to encourage family artici ation in the care team and endure that other team members listen to and res ect their o inions Put organi!ation=)ide ractices in lace that are designed to rovide atient3family rivacy and res ect confidentiality Information #harin$" +ealth care ractitioners communicate and share com lete and unbiased information )ith atients and families in )ays that are affirming and useful

Patients and families receive timely& com lete& and accurate information to allo) them to effectively artici ate in care and decision making >>7 have a standard rocedure in lace to communicate errors& near misses& and adverse events to atients3families'

>67 have a rocess in lace for atients and families to re ort safety concerns consistent )ith ?ational Patient /afety @oal A< (Patient #nvolvement)

Room Desi$n and *isitation Poli!ies +ften Don,t Pro)ide Pri)a!y- Family #lee # a!e- or A!!ess to In atients Total staffed in atient a!ute !are rooms that are ri)ate rooms" -edian B 8:7 -ean B 897 -inimum B 87

-a0imum B A::7 In atient rooms (ith family slee s a!e" -edian B A:7 -ean B <87 -inimum B :7 -a0imum B A::7

<A7 don.t rovide family slee s ace in critical care units Colla'oration1 Patients& families& health care ractitioners and hos ital leaders collaborate in1 Policy and rogram develo ment #m lementation and evaluation +ealth care facility design Professional education 4he delivery of care PFCC rin!i les are in!luded in !urri!ulum" ?ursing B 8:7 /chool of medicine B 9C7 %llied health B 9<7 "ental B >7

Patients.families arti!i ate as fa!ulty in orientation.edu!ation"

 67 of trustees

A87 of em loyees A97 of volunteers >7 of tem orary staff and students3trainees >7 of medical staff

Patients and Families Rarely Colla'orate in Pro)ider #ele!tion Pra!ti!es >7 invite atient3family advisors to intervie) clinical and administrative leaders' 67 ask atient3family advisors to hel in the selection of residents' 67 include atient3family advisors in selecting outsourced service and e*ui ment vendors'

A57 indicated that rocesses are in lace to ensure that outsourced service and e*ui ment vendors ractice PFCC rinci les'

/elf=assessment and survey data revealed many o conce ts in non=clinical areas1

ortunities to im lement PFCC

Degistration& scheduling& and access to services& e'g'& the need for sim le& consistent& and confidential registration and scheduling roceduresE convenient access to servicesE coordinated su ort during scheduling and care transition& etc' Finance& charge& billing& and ayment rocedures& e'g'& the need for consistent& easy and convenient ractices (sim le language& combined co ay& fle0ible& online ayment o tions& etc')

/0 or$ani1ations that arti!i ate in Press Ganey Adult In atient #atisfa!tion #ur)eys su'mitted their most re!ent s!ores for 2ey PFCC %uestions" F0 lanation of tests and treatments #nformation given to family about condition and treatment #nstructions given for care at home #nclusion in treatment decisions

?urses ke t you informed Physician.s concern for *uestions and )orries

A)era$e PFCC s!ores (ere !al!ulated" 6 organi!ations (997)1 G >8': (range >8'9 to >>'8) A: organi!ations (857)1 G >:': and H >8': (range >A': to >6'5)

6 organi!ations (997)1 H >:': (range C5'8 to CI'6) Fstablish& evaluate& and routinely monitor PFCC erformance measures Degularly collect com laint and customer satisfaction information in all care settings& including com arative e0ternal satisfaction benchmarks versus other roviders ortunities& and design&

Jork )ith atients and families to revie) data& identify o im lement& and monitor erformance im rovements

#t may be difficult to discuss satisfaction data )ith atients and families but this is essential to better understand the information and create solutions that )ill successfully address atient and family needs

4he #nstitute of -edicine endorses trans arency in health care organi!ations to im rove *uality and safety The Most Im ortant Ta2e3A(ays From This #tudy Patients and families are im ortant& e*ual members of the care team and have the right to artici ate in decisions affecting the lanning& delivery& and evaluation of care'

"on.t assume that you understand and can effectively address atient and family needs and concerns )ithout sharing the data& asking their o inions& and involving them in designing solutions to create a friendlier& more effective& efficient& and safer health care organi!ation'

Di$nity and Res e!t" +ealth care ractitioners listen to and honor atient and family ers ectives and choices' Patient and family kno)ledge& values& beliefs& and cultural backgrounds are incor orated into the lanning and delivery of care' Information #harin$" +ealth care ractitioners communicate and share com lete and unbiased information )ith atients and families in )ays that are affirming and useful' Patients and families receive timely& com lete& and accurate information to allo) them to effectively artici ate in care and decision making' Parti!i ation" Patients and families are encouraged and su care and decision making at the level they choose' orted in artici ating in

Colla'oration" Patients& families& health care ractitioners& and hos ital leaders collaborate in olicy and rogram develo ment& im lementation and evaluationE health care facility designE rofessional educationE as )ell and in the delivery of care'

Deli)era'le
/urvey results Project results and findings Kno)ledge transfer resentations3Jeb conferences Com endium of #nnovative /trategy re orts Performance , ortunity /ummary3/corecard

Field Book& F0ecutive /ummary& and %ction Plan U+C.s PFCC listserver& roviding a net)orking forum for members U+C PFCC #m lementation /u ort Collaborative (enroll by 53A)

%lso see the many PFCC resources& assessments& and training materials available from the #nstitute for Family=Centered Care at htt 133)))'familycenteredcare'org3inde0'html'