Slide 2 Patient- and family-centered care is an approach to the
planning, delivery and evaluation of health care that is grounded
in mutually beneficial partnerships among patients, families, and
health care practitioners. It is founded on the understanding that
the family plays a vital role in ensuring the health and well being
of patients of all ages. The ultimate goal of patient- and
family-centered care is to create partnerships among health care
practitioners, patients and families that will lead to the best
outcomes and enhance the quality and safety of health care. What is
Patient- and Family-Centered Care? Slide 3 Four Core Concepts D I G
N I T Y A N D R E S P E C T Health care practitioners listen to and
honor patient and family perspectives Health care practitioners
listen to and honor patient and family perspectives and choices.
Patient and family knowledge, values, beliefs and cultural and
choices. Patient and family knowledge, values, beliefs and cultural
backgrounds are incorporated into the planning and delivery of
care. backgrounds are incorporated into the planning and delivery
of care. I N F O R M AT I O N S H A R I N G Health care
practitioners communicate and share complete and unbiased Health
care practitioners communicate and share complete and unbiased
information with patients and families in ways that are affirming
and useful. information with patients and families in ways that are
affirming and useful. Patients and families receive timely,
complete and accurate information in Patients and families receive
timely, complete and accurate information in order to effectively
participate in care and decision-making. order to effectively
participate in care and decision-making. PA R T I C I PAT I O N
Patients and families are encouraged and supported in participating
in care Patients and families are encouraged and supported in
participating in care and decision-making at the level they choose.
and decision-making at the level they choose. CO L L A B O R AT I O
N Patients, families, health care practitioners, and hospital
leaders collaborate Patients, families, health care practitioners,
and hospital leaders collaborate in policy and program development,
implementation and evaluation; in in policy and program
development, implementation and evaluation; in health care facility
design; and in professional education, as well as in the health
care facility design; and in professional education, as well as in
the delivery of care. delivery of care. Slide 4 Patient- and
Family-Centered Care: Why Is It Needed? ... Care must be delivered
by systems that are carefully and consciously designed to provide
care that is safe, effective, patient-centered, timely, efficient,
and equitable. efficient, and equitable. Such systems must be
designed to serve the needs of patients, and to ensure that they
are fully informed, retain control and participate in care delivery
whenever possible, and receive care that is respectful of their
values and preferences. Such systems must be designed to serve the
needs of patients, and to ensure that they are fully informed,
retain control and participate in care delivery whenever possible,
and receive care that is respectful of their values and
preferences. Institute of Medicine, Crossing the Quality Chasm
(2001) Institute of Medicine, Crossing the Quality Chasm (2001)
Slide 5 Crossing the Quality Chasm 1. Safe avoiding injuries to
patients from care that is intended to help them. that is intended
to help them. 2. Effective providing services based on scientific
knowledge to all who could benefit and knowledge to all who could
benefit and refraining from providing services to those not
refraining from providing services to those not likely to benefit.
likely to benefit. 3. Patient-centered providing care that is
respectful of and responsive to individual patient respectful of
and responsive to individual patient preferences, needs and values,
and ensuring that preferences, needs and values, and ensuring that
patient values guide all clinical decisions. patient values guide
all clinical decisions. 4. Timely reducing waits and sometimes
harmful delays for both those who receive and those who give care.
5. Efficient avoiding waste, in particular waste of equipment,
supplies, ideas, and energy. 6. Equitable providing care that does
not vary in quality because of personal characteristics such as
gender, ethnicity, geographical location, and socioeconomic status.
Slide 6 The real business of health care is about preventing
illness, healing those who are ill, meeting the needs of people who
must live their lives with disabilities or chronic disease, and
helping people in our communities achieve better health.
Patient-centered care includes: respect for patients values,
preferences, and expressed needs; coordination and integration of
care; information, communication, and education; physical comfort;
emotional support; and the involvement of family and friends.
Patient Centeredness Slide 7 R U L E S TO R E D E S I G N A N D I M
P R O V E C A R E 1. Care based on continuous healing
relationships. Patients should receive care whenever they need it
and in many forms, not just face-to-face visits. 2. Customization
based on patient needs and values. The system of care should be
designed to meet the most common types of needs, but have the
capability to respond to individual patient choices and
preferences. 3. The patient should be the source of control.
Patients should be given the necessary information and the
opportunity to choice over their health care decisions. Slide 8 4.
Shared knowledge and the free flow of information. Patients should
have unfettered access to their own medical information and to
clinical knowledge. Clinicians and patients should communicate
effectively and share information. 5. Evidence-based decision
making. Patients should receive care based on the best available
scientific knowledge. 6. Safety as a system property Patients
should be safe from injury caused by their care system. Slide 9
7.The need for transparency. The health care system should make
information available to the pts and family that allows them to
make informed decisions when selecting a health plan, hospital or
clinical practice, or choosing among alternative treatments. 8.
Anticipation of needs. The health system should anticipate patient
needs, rather than simply reacting to events. 9. Continuous
decrease in waste. The health system should not waste resources or
patient time. Slide 10 10. Cooperation among clinicians. Clinicians
and institutions should actively collaborate and communicate to
ensure an appropriate exchange of information and coordination of
care. Adapted from Crossing the Quality Chasm: A New Health Care
System for the 21 st Century, 2001. Slide 11 Slide 12 LEAN=Quality
Improvement Slide 13 Slide 14 Slide 15 Slide 16 Slide 17 Slide 18
Slide 19 PATIENT-FAMILY CENTERED CARE TEAM Team Leader: June
Sharkey Debbie Kaszycki Minnie Frazier Julie Siggelkow Judy Downey
Kate Martin Krista Garner Ray Quintero Slide 20 Project: Opening 2D
ICU-Patient Family Centered Care Project: Opening 2D ICU-Patient
Family Centered Care Objectives: To coordinate the flow for the
family in 2D ICU Identify relationship between family, staff and
physician (Rounding, Dr. 99 presence, MD discussion w/ families)
Develop a plan for tools to facilitate communication for families
including scripting and pt./family literature Develop standards of
care utilizing best practices (EB) for patient family centered
care(Pastoral care, social services, Public safety) Developing
protocols for family room utilization (Facility management)
Objectives: To coordinate the flow for the family in 2D ICU
Identify relationship between family, staff and physician
(Rounding, Dr. 99 presence, MD discussion w/ families) Develop a
plan for tools to facilitate communication for families including
scripting and pt./family literature Develop standards of care
utilizing best practices (EB) for patient family centered
care(Pastoral care, social services, Public safety) Developing
protocols for family room utilization (Facility management)
Sponsor: Ray Quintero Team Members Team Members Debbie Kaszycki
Minnie Frazier Julie Siggelkow Judy Downey Kate Martin Krista
Garner Team Members Team Members Debbie Kaszycki Minnie Frazier
Julie Siggelkow Judy Downey Kate Martin Krista Garner Sensei: Sonia
Bergmann Project Date: November 13-16, 06 Scope: 2D ICU-from
initial contact with family and patient to D/C from ICU. Scope: 2D
ICU-from initial contact with family and patient to D/C from ICU.
CHARTER SUMMARY Champion: Susan Grant Team Leader: June Sharkey
Slide 21 Current Family Waiting Area Slide 22 Current Model vs.
Family-Centered Approach Historical models of patient care have
been organized around the needs of healthcare professionals.
Traditional methods of patient care delivery rarely involved family
in medical management. A family-centered approach has been
referenced to achieve high levels of quality care and increased
patient satisfaction. Family-centered care encourages a
collaborative team approach. Many aspects of patient and family
centered care are cost-efficient and simply require a paradigm
shift. Implementing a family centered approach to care is an
ongoing commitment. Slide 23 New Family Waiting Area Slide 24
Accomplishments Lean exercises: Value streams, spaghetti charts,
NVA / VA identification. Lean exercises: Value streams, spaghetti
charts, NVA / VA identification. Met with various individuals /
ancillary staff: Met with various individuals / ancillary staff:
Pastoral services, Rollins DD, nutrition, day surgery advocate, ER
patient administrative liason, patients family members. Pastoral
services, Rollins DD, nutrition, day surgery advocate, ER patient
administrative liason, patients family members. Family Process:
Quick Sheet for admission and guidebook. Family Process: Quick
Sheet for admission and guidebook. Staff Education for new culture
of family centered care. Staff Education for new culture of family
centered care. Slide 25 Examples of Accomplishments Rough drafts of
admission quick sheet for individual family members as well as for
laminated guidebooks to remain in family waiting areas. Rough
drafts of admission quick sheet for individual family members as
well as for laminated guidebooks to remain in family waiting areas.
Generated ideas for the job description of the family coordinator
Generated ideas for the job description of the family coordinator
Developed plan for staff education to promote a smooth transition
into family-centered care. Developed plan for staff education to
promote a smooth transition into family-centered care. Listed ideas
for signage throughout the mothership/2DICU Listed ideas for
signage throughout the mothership/2DICU Slide 26 Team
Responsibilities Slide 27 Key Metrics for the Unit Patient &
Family Satisfaction Patient & Family Satisfaction ICU Survey
ICU Survey Baseline 11/20 through December - Ray & Aaron
Baseline 11/20 through December - Ray & Aaron Employee
Satisfaction Employee Satisfaction Gallup Poll Survey Gallup Poll
Survey Baseline next week and then in Feb & Apr 07 Ray &
Marilyn Baseline next week and then in Feb & Apr 07 Ray &
Marilyn Stress Study Stress Study Georgia Tech. TBD Georgia Tech.
TBD MD Satisfaction ICU Admitting Surgeons & Neurologists MD
Satisfaction ICU Admitting Surgeons & Neurologists Obtain a
validated survey Marilyn Obtain a validated survey Marilyn Family
Member time spent with patient Family Member time spent with
patient Family sign in/out Family sign in/out Baseline units
2&3 11/20 thru Dec 07; Future collection Feb-Apr 07 Baseline
units 2&3 11/20 thru Dec 07; Future collection Feb-Apr 07 Julie
will create a form Julie will create a form Slide 28 Lessons
Learned Family-centered care relies upon COMMUNICATION amongst all
members involved in the care of the patient. Family-centered care
is a multidisciplinary group endeavor We can change the schematics
of an ICU and upgrade with all the fancy stuff in the world but if
we dont upgrade the way we practice, change will never occur for
the good of the patient. The LEAN project has encouraged us to
network ideas with ancillary staff throughout EUH to successfully
merge and create an innovative approach to patient care in the
neuroscience ICUs. Slide 29 Expectations The current model of
patient care will be transitioned to a family-incorporated
approach. The current model of patient care will be transitioned to
a family-incorporated approach. May be difficult at first May be
difficult at first In-services and continued staff education should
assist with integration of family-centered values into the units
standards and policies In-services and continued staff education
should assist with integration of family-centered values into the
units standards and policies Family-Centered care is an ongoing
journey. Family-Centered care is an ongoing journey. Slide 30
