Embed Size (px)
Citation preview
Course Co-DirectorsAnthony M. DiGioia III, MD
Tami Minnier RN, MSN, FACHE
Jointly Sponsored by:The AMD3 FoundationThe PFCC Partners @ the Innovation Center of UPMCThe University of Pittsburgh School of Medicine Center for Continuing Education in the Health Sciences
Friday, November 4, 20118:00am-2:30pm
Herberman Conference CenterUPMC Shadyside, Pittsburgh, PA
PFCC VisionQuest:How-To Guide for Providing Exceptional Care Experiences while Creating a Culture to Support Quality and Safety
Syllabus
PARTNERS
87 Overview and Objectives………………………………………………………….….….…..3 Who Should Attend.........................................................................................................4 Accreditation...................................................................................................................4 Disclaimer Statement......................................................................................................5 Program Agenda.............................................................................................................6 Faculty Listing……..........................................................................................................7 Faculty Disclosure ……………………………………………………………………………9 Parking Accommodations……………………………………………………………………10 Poster Presentations …………………………………………………………………………11
Program
Welcome and Introduction............................................................................................ Act I: PFCC Sneak Peak….......................................................................................... Act II: Setting the Stage............................................................................................... Act III: The Premier…………………………………………………….............................. The PFCC Challenge ……………………………………………………………………… Acknowledgement of Commercial Support …………………………………………….. For more information visit: pfccvisionquest.org
Table of Contents
A VisionQuest is a rite of passage that allows the individual to discover their purpose, seek guidance and renewal and begin a new direction. This PFCC VisionQuest supports these concepts, as it calls upon Care Givers to re-discover their mission and move beyond outmoded paradigms to find truth and balance in their journey as Care Givers by viewing all care through the eyes of Patients and Families. The PFCC Methodology and Practice (PFCC M/P) is a six-step process by which Care Givers break down the traditional “silos” of care and begin co-designing are experiences with patient and family perspectives at the core. An essential aspect of the PFCC M/P is the re-conceptualization of what it means to be a Care Giver, as Care Giver is defined as any person within the health care setting whose work touches the patient or family experience. Doctors, nurses, aides, diagnostic technicians, dieticians, secretaries and appointment schedulers are Care Givers, as are housekeepers, human resource professionals, finance and billing personnel, administrators and hospital leadership. In this workshop you will be immersed in “PFCC Live” – a live production that personifies PFCC M/P. Our PFCC Live cast will spotlight how the co-design of care experiences with Patients and Families will bring about the transformation of care using the Six Steps. Our “casting call” will bring you into the PFCC Live production through “Shadowing” – the premier technique for viewing all care through the eyes of Patients and Families. You will be called upon to make observations and use those observations as the basis for improving the Care Experience as well as to create the sense of urgency needed to drive and sustain transformational change. PFCC Live will teach you how the adoption of the PFCC Methodology and Practice will directly improve the care that you can deliver as well as transform the patient and family experience. You will challenge current methods, learn how the PFCC M/P supports the efforts of quality and safety while reducing waste, and begin the transformation that comes with co-designing care and viewing all care through the eyes of Patients and Families. We invite you to begin your PFCC VisionQuest and partner with Patients and Families in the co-design of care. It’s Live…and it begins with Six Steps! Program Objectives: Upon completion of this conference, participants will be able to:
• Identify ways to improve care from the perspective of Patients and Families and how that also improves patient safety, quality, efficiencies, waste reduction, staff turnover and market share.
• Use the PFCC Methodology and Practice to deliver exceptional care experiences for Patients and Families
• Develop a care experience Working Group using the Patient and Family Centered Care (PFCC)
Methodology and Practice.
• Demonstrate how to co-design care experiences with Patient and Family perspectives at the core
• Identify ways to overcome barriers using the PFCC Methodology via firsthand accounts
• Demonstrate proficiency in the key principles of the PFCC M/P
Overview and Objectives
• Physicians • Chief Medical Officers • Chairs and Chiefs of Service • Department Quality Leaders • Health Care Administrators
and Leadership • Health Care Related
Businesses
• Nurses and Managers • Department Quality Leaders • Allied Health Professionals • Chief Quality Officers • Executives • Students • Patients and Families
* In PFCC terms, a Care Giver is defined as anyone who comes into contact or "touches" a patient's and family member's care experiences, from a parking attendant to a physician to a nurse to the C-Suite of a hospital - and everyone in-between. The PFCC VisionQuest Series encourages participation across all health care constituencies.
Accreditation Continuing Education Credits: This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the University of Pittsburgh School of Medicine and the AMD3 Foundation. The University of Pittsburgh School of Medicine is accredited by the ACCME to provide continuing medical education for physicians. The University of Pittsburgh designates this live activity for a maximum of 6.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Other health care professionals are awarded 0.6 continuing education units (CEU's) which are equal to 6.0 contact hours.
Continuing Pharmacy Education Credits: This program is sponsored by the UPMC Center for Continuing Education in the Health Sciences. The UPMC Center for Continuing Education in the Health Sciences is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a Provider of continuing
pharmacy education. The assigned universal program number(s) are 0481-0000-11-051-L04-P. This program provides 6.0 contact hours (0.6 CEU) of continuing education credit. Upon successful completion of this program (attending the full session and completing and submitting a program evaluation and a CE verification form), participants will receive their statement of continuing education by UPMC Center for Continuing Education in the Health Sciences within two weeks by U.S. mail. A learning self-assessment tool is provided to enable participants to evaluate their successful achievement of the program objectives.
Nursing Contact Hours: This continuing nursing education activity has been approved for 6.0 contact hours by the University of Pittsburgh Medical Center (UPMC) an approved provider of continuing nursing education by PA State Nurses Association, an accredited approver by the American Nurses Credentialing Center’s commission on Accreditation. To receive contact hours, the participant must attend the entire session, complete the evaluation form and turn it in at the completion of the conference.
Who Should Attend – All Care Givers*
Should Attend The information presented at this CME program represents the views and opinions of the individual presenters and does not constitute the opinion or endorsement of, or promotion by, the UPMC Center for Continuing Education in the Health Sciences, UPMC/University of Pittsburgh Medical Center or Affiliates or the University of Pittsburgh School of Medicine. Reasonable efforts have been taken, intending for educational subject matter to be presented in a balanced, unbiased fashion and in compliance with regulatory requirements. However, each program attendee must always use his/her own personal and professional judgment when considering further application of this information, particularly as it may relate to patient diagnostic or treatment decisions including, without limitation, FDA-approved uses and any off-label uses. The University of Pittsburgh, as an educational institution and as an employer, values equality of opportunity, human dignity, and racial/ethnic and cultural diversity. Accordingly, the University prohibits and will not engage in discrimination or harassment on the basis of race, color, religion, national origin, ancestry, sex, age, marital status, familial status, sexual orientation, disability or status as a disabled veteran or a veteran of the Vietnam era. Further, the University will continue to take affirmative steps to support and advance these values consistent with the University’s mission. This policy applies to admissions, employment, and access to and treatment in University programs and activities. This is a commitment made by the University and is in accordance with federal, state, and/or local laws and regulations. For information on University equal opportunity and affirmative action programs and complaint/grievance procedures, please contact William A. Savage, Assistant to the Chancellor and Director of Affirmative Action (and Title IX and 504 Coordinator), Office of Affirmative Action, 901 William Pitt Union, University of Pittsburgh, Pittsburgh, PA 15260, (412) 648-7860. POSTER PAVILION
Disclaimer Statement
Agenda 7:15 AM – 8:00 AM Registration 8:00 AM – 9:15 AM Introduction Act I: The PFCC Sneak Peek Anthony M. DiGioia III, MD
9:15 AM – 10:30 AM Act II: Setting the Stage Mike Celender and PFCC Partners Team
10:30 AM – 10:45 AM Break
10:45 AM – 12:15 PM Act III: The Premier Mike Celender and PFCC Partners Team
12:15 PM – 12:30 PM Break and Set-Up for Lunch Session
12:30 PM– 1:45 PM Act IV: Lunch Session
PFCC Expert Panel Discussion Q&A
1:45 PM – 2:30 PM Act V: The PFCC Challenge “Patient and Family Feud”
2:30 PM Conference Adjournment
Anthony M. DiGioia III, MD Medical Director PFCC Partners @ The Innovation Center of UPMC Pittsburgh, PA Louis Alarcon, MD Medical Director, Trauma Surgery UPMC Presbyterian Pittsburgh, PA Sarah Ball Director of Ambulatory Services Childrens Hospital of Pittsburgh of UPMC Pittsburgh, PA David Bertoty Clinical Director, Emergency and Trauma Services UPMC Presbyterian Pittsburgh, PA Michelle Bulger Training Coordinator PFCC Partners @ The Innovation Center of UPMC Pittsburgh, PA Michael Celender Organizational Development Consultant PFCC Partners @ The Innovation Center of UPMC Pittsburgh, PA Lindsey DelBene Project Coordinator Assistant PFCC Partners@ The Innovation Center of UPMC Pittsburgh, PA Joseph Dominick Unit Director, Neurological Continuous Care UPMC Presbyterian Pittsburgh, PA
Faculty Listing
Patricia Embree Senior Director, PFCC Project Management PFCC Partners @ The Innovation Center of UPMC Pittsburgh, PA Michelle Giarrusso Senior Project Manager PFCC Partners @ The Innovation Center of UPMC Pittsburgh, PA Anne Hast Vice President, Patient Care Services The Washington Hospital Washington, PA Meghan Kelley Senior Project Coordinator PFCC Partners @ The Innovation Center of UPMC Pittsburgh, PA Holly Lorenz Chief Nursing Executive UPMC CNO/ Vice President Patient Care Experiences, UPMC Presbyterian Pittsburgh, PA Tami Minnier Chief Quality Officer UPMC Pittsburgh, PA Dederia Nicholas Trauma Nurse Coordinator UPMC Presbyterian Pittsburgh, PA Stephen Pedaline Project Coordinator Assistant PFCC Partners @ The Innovation Center of UPMC Pittsburgh PA
Lisa Schraeder Organization Development Consultant The Innovation Center of UPMC Pittsburgh, PA Alisa Vickrey Project Coordinator Assistant PFCC Partners@ The Innovation Center of UPMC Pittsburgh, PA Michelle Yakelis Project Coordinator PFCC Partners @ The Innovation Center of UPMC Pittsburgh, PA Faculty for this activity have been required to disclose all relationships with any proprietary entity producing health care goods or services, with the exemption of non-profit or government organizations and non-health care related companies. No significant financial relationships with commercial entities were disclosed by: Louis Alarcon, MD Sarah Ball David Bertoty Michelle Bulger Mike Celender Lindsey DelBene Stephen DiGioia
Joseph Dominick Patty Embree Michelle Giarrusso Anne Hast Meghan Kelley Holly Lorenz Tami Minnier
Dederia Nicholas Steve Pedaline Lisa Schraeder Alisa Vickrey Michelle Yakelis
The following faculty made these disclosures: Anthony DiGioia, MD - Stockholder, Blue Belt Technologies
Faculty Disclosure
Parking will be provided at a reduced rate. Please be sure to park in the Centre Avenue Parking Garage, near the Shadyside Medical Building. You will receive your validated parking ticket upon arrival to the registration table on the day of the conference.
Parking Accommodations
UPMC Shadyside Campus Map
Poster Presentations
PFCC: You Can Do it! A Four Poster Series Presented By: Dr. Cartland Burns, Richard Cunningham, Patricia
Fustich, JoAnn Stiles, and James Majsak Children’s Hospital of Pittsburgh of UPMC
Pediatric Surgery Care Experience Working Group
1) Our first PFCC Year in Review 2) Portal Experience Project Team: Completed Projects—It’s
Easier than you Think! 3) Portal Experience Project Team: Active Projects—We’re
Cookin’ Now 4) Portal Experience Project Team: Future Projects—Our
Patients and Families will Love This!
Bedside Nursing Shift Report: A Patient and Family Centered Care Experience and Safety
Initiative Topic
Presented By: Janet Frontera - Quality Process Improvement Specialist
Children's Hospital of Pittsburgh of UPMC Department of Nursing Quality
Today’s Logistics • Registration and CME (please sign up) • Accreditation for CME/CEU/CPE • Cell-phones (on vibrate please) • Restrooms (hallway on right) • Parking (discount voucher for today) • Name badges (place in basket upon exit) • Note cards (questions for the expert
panel) • Evaluations (your feedback is valuable)
Session Objectives • Learn how the Patient and Family Centered Care
Methodology and Practice is an experience based design approach that enables the “co- designing” of experiences with patients, families and care givers.
• Learn how PFCC is the performance improvement tool that creates the culture to also improve the quality of care, patient safety, efficiencies and waste reduction.
• Discover Care Givers are also Patients and Family members, having a unique dual view.
• Learn how Shadowing creates real-time Patient and Family Advisory Councils.
8:00 – 9:00 AM Welcome and Intro Act I: The PFCC Sneak Peek
9:00 – 10:30 AM Act II: Setting the Stage
10:45 – 12:15 PM Act III: The Premier
12:30 – 1:45 PM Act IV: Lunch Session PFCC Expert Panel Discussion Q&A
1:45 – 2:30 PM Act V: The PFCC Challenge “Patient and Family Feud”
2:30 PM Conference Adjournment
Program Agenda
Special Thanks to our Expert Panel
• Louis Alarcon, MD
• Sarah Ball
• David Bertoty
• Richard Cunningham
• Joseph Dominick
• Anne Hast
• Holly Lorenz
• Dederia Nicholas
• Carol Scholle
UPMC Center for Quality Improvement and Innovation
The University of Pittsburgh
School of Medicine, Center
for Continuing Education in
the Health Sciences
SPONSORS
A Special Thanks! SUPPORTERS
Scholarships The AMD3 Foundation is pleased to provide over 20
attendees with complimentary registration for today’s VisionQuest event to further the adoption of Patient & Family Centered Care Methodology
and Practice (PFCC M/P).
Scholarships provided by the AMD3 Foundation include funding from the PNC Charitable Trust
J. Samuel and Rose Y. Cox Foundation
GRANTING THE WISH TO WALK
2009 Guatemala 50 Pa/ents
63 Total Joints
2010 Guatemala 47 Pa/ents
57 Total Joints
2011 Panama 45 Pa/ents
55 Total Joints
2010 Pi:sburgh 3 Pa/ents
3 Total Joints
Providing free hip and knee replacement surgery to people in need…
in Pi:sburgh and around the world.
www.OperationWalkPgh.org
Upcoming Efforts Pittsburgh, Pennsylvania November 2011
Central America, Summer 2012 Donations are 100% tax deductible.
For more information visit:
Ready…Set…Go Live!
• We are not delivering the basics in a very complex system
• We must focus on providing a full cycle of care
• Real Value? Transitions of Care and Communications
Why Change? Just Ask Our Patients And Families
• No industry has survived without focusing on the needs, wants and desires of their end users...in health care? Lost along the way…
• We must begin to listen to our patients and families (and Care Givers) as
our end users…and actually engage all in the design of new approaches
Word of Warning on the Current State…
Where would you start and what would you do?
DocuDrama A Patient and Family Story
Michele Can’t Be Here Today
Emillie – Before it all began!
A Smile No Matter What
So Many Appointments, So Little Time! 2/12/2010 UNIVERSITY OF PITTSBUR 2/11/2010 CHILDRENS HOSPITAL OF 2/11/2010 UNIVERSITY OF PITTSBUR 2/11/2010 UPP PEDIATRICS 2/11/2010 UPMC ST MARGARET 2/10/2010 UPMC COMMUNITY MEDICINE 2/9/2010 VIRGINIA KOENIG 2/5/2010 CHILDRENS HOSPITAL OF 2/5/2010 UPP PEDIATRICS 2/5/2010 UNIVERSITY OF PITTSBUR 2/5/2010 UPP ANESTHESIA 2/5/2010 UPP PEDIATRICS 2/5/2010 UPP PEDIATRICS 2/4/2010 UNIVERSITY OF PITTSBUR 2/3/2010 UPP PEDIATRICS 2/3/2010 UNIVERSITY OF PITTSBUR 2/3/2010 UNIVERSITY OF PITTSBUR 2/3/2010 UNIVERSITY OF PITTSBUR 2/3/2010 UPP PEDIATRICS 2/3/2010 CHILDRENS HOSPITAL OF 1/28/2010 UPMC COMMUNITY MEDICINE 1/22/2010 UNIVERSITY OF PITTSBUR 1/21/2010 UPMC ST MARGARET 1/21/2010 UNIVERSITY OF PITTSBUR 1/21/2010 UPMCS EMERGENCY MEDICI 1/19/2010 SAILAJA ALLANKI, MD 1/12/2010 VIRGINIA KOENIG 1/6/2010 NEUROLOGICAL NEURODIAG 12/28/2009 NEUROLOGICAL NEURODIAG
12/17/2009 UPMC COMMUNITY MEDICINE 12/16/2009 UNIVERSITY OF PITTSBUR 12/16/2009 UNIVERSITY OF PITTSBUR 12/16/2009 UPMC ST MARGARET 12/16/2009 UNIVERSITY OF PITTSBUR 12/10/2009 SAILAJA ALLANKI, MD 11/13/2009 SAILAJA ALLANKI, MD 11/10/2009 VIRGINIA KOENIG 11/5/2009 UPMC COMMUNITY MEDICINE 10/6/2009 UPMC COMMUNITY MEDICINE 10/1/2009 UPMC ST MARGARET 10/1/2009 UNIVERSITY OF PITTSBUR 9/16/2009 UPMC COMMUNITY MEDICINE 9/16/2009 QUEST DIAGNOSTICS VENT 9/16/2009 QUEST DIAGNOSTICS VENT 9/16/2009 QUEST DIAGNOSTICS VENT 9/2/2009 VIRGINIA KOENIG 9/1/2009 MEDEXPRESS URGENT CARE 8/19/2009 UPMC COMMUNITY MEDICINE 7/9/2009 VIRGINIA KOENIG 6/11/2009 VIRGINIA KOENIG 6/5/2009 UPMC COMMUNITY MEDICINE 3/17/2009 UPMC COMMUNITY MEDICINE 2/5/2009 UPMC COMMUNITY MEDICINE 12/24/2008 UPMC COMMUNITY MEDICINE 12/24/2008 QUEST DIAGNOSTICS VENT 12/12/2008 UPMC COMMUNITY MEDICINE 11/26/2008 UPP PEDIATRICS 11/26/2008 CHILDRENS HOSPITAL OF 11/25/2008 UPMC COMMUNITY MEDICINE 11/21/2008 UPMC COMMUNITY MEDICINE 11/21/2008 UNIVERSITY OF PITTSBUR 11/21/2008 UPMC PRESBYTERIAN SHAD 11/18/2008 UNIVERSITY OF PITTSBUR 11/17/2008 UPMC ST MARGARET 11/17/2008 UPMCS EMERGENCY MEDICI 9/29/2008 DEBORAH L WITCHEL 9/23/2008 UPMC COMMUNITY MEDICINE 9/18/2008 UPMC COMMUNITY MEDICINE 9/18/2008 QUEST DIAGNOSTICS VENT
Even MORE Appointments!
3/18/2010 UNIVERSITY OF PITTSBUR
3/18/2010 UNIVERSITY OF PITTSBUR
3/18/2010 UPP ANESTHESIA
3/18/2010 CHILDRENS HOSPITAL OF
3/18/2010 UPP ANESTHESIA
3/15/2010 UPP PEDIATRICS
3/10/2010 UPP ANESTHESIA
3/9/2010 UNIVERSITY OF PITTSBUR
3/9/2010 UNIVERSITY OF PITTSBUR
3/9/2010 UPP ANESTHESIA
3/9/2010 UPP ANESTHESIA
3/8/2010 UPP PEDIATRICS
3/8/2010 UPP PEDIATRICS
3/8/2010 UPP PEDIATRICS
3/5/2010 UNIVERSITY OF PITTSBUR 3/5/2010 CHILDRENS HOSPITAL OF 3/3/2010 CHILDRENS HOSPITAL OF 3/3/2010 CHILDRENS HOSPITAL OF 3/3/2010 UNIVERSITY OF PITTSBUR 2/24/2010 UPP ANESTHESIA 2/24/2010 UNIVERSITY OF PITTSBUR 2/24/2010 CHILDRENS HOSPITAL OF 2/24/2010 UNIVERSITY OF PITTSBUR 2/24/2010 UNIVERSITY OF PITTSBUR 2/21/2010 MEDEXPRESS URGENT CARE 2/19/2010 UNIVERSITY OF PITTSBUR 2/18/2010 CHILDRENS HOSPITAL OF 2/16/2010 UPMC COMMUNITY MEDICINE 2/15/2010 UPP PEDIATRICS 2/12/2010 CHILDRENS HOSPITAL OF
Testing and More Testing DATE PROCEDURE
11/18/2008 Ct Scan Of The Pelvis 11/18/2008 Ct Scan Of The Abdomen 1/22/2010 Ct Scan Of The Pelvis 1/22/2010 Ct Scan Of The Abdomen 2/3/2010 Ct Scan Of The Pelvis 2/3/2010 Ct Scan Of The Abdomen 3/3/2010 MRI Of The Pelvis 3/3/2010 MRI Of The Abdomen
Another Scan Dr. Rodebear – Ready for Surgery
Inpatient Hospitalizations and Surgeries
DATE PROCEDURE
2/3/2010 Esophagogastroduodenoscopy(EGD) With Closed Biopsy
2/24/2010 Rectal Biopsy 3/5/2010 Laparoscopy
3/18/2010 Repair Of Hernia
A Smile No Matter What
Mom Rests Before Another Test Post Accident - Always Think Positively
Sleep Study Prom – May 2011
Homecoming – October 2011
Where would you start and what would you do?
ACT I
The PFCC Preview
Would You Be Interested If…
You could develop the system to deliver better outcomes, safety, quality, reduce waste and develop high performance teams while delivering great care experiences for patients and their families…
Exceptional Care Experiences from the Patient’s and Family’s Perspective Includes Much More*
*PFCC v2.0: The New Operating System for Health Care
Design Science
Clinical Process
The New Third Pillar For Health Care
The First Two Sciences Clinical and Process
• Evidence Based Medicine • Clinical Pathways • Re-Engineering, Process Improvement, Lean, TPS, CMI
• Quality and Safety Efforts
What Is This New “Design” Science? It’s the Basis for OS v2.0
• Designing services, interactions, processes and environments for the complete experience
• Making it better for the end user • Expanding on but not replacing the
concept of clinical sciences and process
• Provides tools for first understanding and then acting
• Strength: Implementation
Sciences of the Artificial By Dr. Herb Simon
Natural Science
Study of a Forest Study of the
Human Body
Design Science Farming
Health Care Delivery
We should never just try to be a “service line” because the value is that we stage experiences and we guide transformations for our patients and their families
What does Experience Based Design Teach Us in Health Care?
When the Patient is at the Center in the PFCC OS v2.0
• With transformations patients are engaged and changed
• Forces us to look at the whole experience i.e. full cycle of care
• Nothing is more important than the knowledge required to transform and this comes from “co-design”
The Push: HCAHPS* and CMS
*Hospital Consumer Assessments of Healthcare Providers and Systems (HCAHPS)
Care Experiences = HCAHPS
(Think ± 2% of Medicare $’s)
The Three Keys to Success for PFCC OS v2.0 Key #1
View All Care as an Experience and Through the Eyes of Patients and
Their Families
Key #2: Co-Design with Patients and Families (and Care Givers) Engagement to Partnerships
Giving Information
Listening and
Responding
Consulting and Advising
. . . .
Complaining Experience Based
Co-Design
(Adapted from Bate and Robert Quality Safety Health Care 2006;15:307-310)
• Most efforts were successful because they focused on the patient and family care experience…but can’t explicitly explain how they got there…“no methodology”
• Will solutions from one region work somewhere else and everyone is starting at a different current state
• The difficulty is to teach others how to get there and to have widespread and rapid adoption…
Key #3: There Are Individual Success Stories But How Can We All Get There?
Need a Methodology
Current State
Methodology (PFCC M/P)
Ideal State
Organizational Transformation Current State
Ideal Experience
Simple Solutions in a Complex System
Key #3: Implementation
- Methodology - Co-Design - Overcome Hurdles
The Way to Get Started
PFCC…amazingly simple. Simply
amazing.
An Experienced Based Design for Health Care: Patient and Family Centered Care
Methodology and Practice (PFCC M/P)
The PFCC Methodology and Practice is Our New OS for Health Care
• Singular goal to provide exceptional care experiences for patients and their families
• Which also delivers better outcomes and quality, safety and reduces waste
• Re-focus existing resources…not new ones
• You will identify, solve and implement the solutions with the help of patients and families
• Process Improvement = Manage Objects or Things • Performance Improvement
= People AND Processes • Performance is the Engine
to Change the Culture
PFCC M/P is all about Performance
Care Giver PFCC Methodology and Practice
Any person within a care setting whose work touches a patient’s or family’s experience.
As examples, Care Givers include not only
the traditional care providers, (i.e., doctors), but also parking attendants and those the patients and families may never see such as hospital leaders.
Touchpoints PFCC Methodology and Practice
Key moments and places in any care setting where patient and family care experiences are directly or indirectly affected by any Care Giver.
As some examples, getting directions from the parking attendant in the parking garage or going to the radiology department for tests.
Current State
PFCC Methodology and Practice
Ideal Experience
1. Define Care Experience
2. Guiding Council
3. Current State, View Care, Urgency
4. Working Group thru Touchpoints
5. Shared Vision for the Ideal
6. PFCC Projects and …Improvement Teams Six Steps
To Transform Care
Use the Same Six Steps to Form PFCC Project Improvement Teams
1. Select Care Experience 2. Co-leaders 3. Evaluate the Current
State 4. Project Team based on
Touchpoints 5. Shared Vision of the Ideal 6. PFCC Improvement Projects
Function Drives Structure
Care Experience
Guiding Council and Working Group
Project Team 1
Project Team #
Project Team 2
Project Team 3
Cycle Within a Cycle and Never Ending Continuous Performance Improvement
PFCC Project Teams
PFCC Working Group
PFCC Project Teams
PFCC Project Teams
PFCC Project Teams
PFCC Project Teams
Entire Care Experience
Project Teams Focus on Segments of the Defined Care Experience “Genome”
Project Team
Project Team
Project Team
Project Team
Go Viral: Working Groups, Project Teams and Transformational
Projects Projects
Project Teams
Working Groups
Wayfinding
Signage Wayfinding Kiosks
Pay station signage
Portal Aroma Therapy for Lobby and Tunnel
Surgical Care Family Experience
Family Lounge Patient Tracking
OR Scheduling
Case Length Reporting
IT/Discharge Experience
Customized Post-op Order Sets
Portal Experience Dedicated Patient Parking
• Delivering exceptional care experiences is simple…the complexity is largely a reflection of the environment in which we find ourselves
• Focusing on the patient and family is a transformational approach for your
organization…which means there are “special” challenges
There Will be Hurdles and a BIG One: Our Organizations and…Artificial Silos
PFCC Cuts Across Your Organization and Breaks Down Silos and Changes the Culture…
Hospital Care Delivery Care Experience WG #2
Experience WG #3
Care Experience WG #1
Care
PFCC Cuts Across Silos and Creates Care Experience Based Teams*
Home
Silos and PFCC M/P
Health
Insurance Pharmacy Home
Health Outpt
Therapy
Rehab or Skilled Nursing Facility
Physician
Office
Acute
Hospital
*Follow the Patient and their Family
PFCC M/P Improves Care Givers’ Experiences too.... The Untapped Co-Design Resource
…is us! We are Care Givers and we are:
• Patients • Family Members of Patients
Sit Back….And Think About A Recent Care Experience…
As a Patient or Family Member? As a Care Giver?
This Can be Your Story Too…
• Customized for health care and focuses on why we are in health care, i.e. taking care of patients
• Simple to learn and builds great care teams
• Generates a sense of urgency • Drives transformational change • Breaks down silos
PFCC M/P on the Practical Side: Doing More with Less
The PFCC Methodology and Practice as a Design Science
You, along with patients and families will determine the opportunities for improvement, propose and test solutions, implement changes that will change the culture and transform care
PFCC Working Group Membership
05101520253035
2006 2007 2008 2009 20100100200300400500600700800
# Total Working Groups # of Total Working Group Members
PFCC M/P is Making a Difference PFCC is a grassroots effort to change the culture...
Over 35 Working Groups Over 156 Project Teams
Over 403 Completed Projects in 5 years
“If I Ran This Hospital…”
Where would you start and what would you do?
Patients and Families Working Together with Care Givers can Co-Design the Care
Delivery Systems That We All Need
PFCC M/P is the Upgraded Operating System v2.0 for
Health Care You!
The PFCC M/P and You Ideal
You can do this too….
Ready,
Set…
Go Live
ACT II
Setting the Stage
PFCC Partners @ The Innovation Center of UPMC
Meet your PFCC Partners Workshop Format
• Ready Learning
• Set Real World Example
• Go Your Turn (WorKit)
In Your Folder… Pre-Work
Let’s Get Started
Welcome to Black and Gold Hospital
Your Role for Today?
Step 1
• The first step is to decide which care experience you are ready
to transform for patients and families
Select a Care Experience
Patient and Family Centered Care Methodology and Practice (PFCC M/P)
Step 1: Select a Care Experience
• How do we define “Care Experience?”
• How do you choose one? – Patient and Family Feedback
• Consider Scope – Broad/Narrow
Inpatient Example of Step 1
Transplant Inpatient Care Experience
Begins: When the patient receives a call that they may have a donor Ends: When the patient is transferred to Critical Care
Outpatient Example of Step 1 Child and Family Services -
Behavioral Health
Begins: Upon 1st phone call for intake appointment
Ends: Once patient leaves facility after meeting with therapist
Care Giver Example of Step 1
Begins: When employee leaves home for work
Employee Inclusion
Ends: When employee arrives home after workday
Your examples from the pre-work?
Your Turn
Step 2 Establish a PFCC Care Experience Guiding Council
Patient and Family Centered Care Methodology and Practice (PFCC M/P)
• A PFCC Administrative Champion(s), such as a VP, COO or CEO since this can be a “disruptive” process
• A PFCC Clinical Champion(s), who will
inspire colleagues to make and sustain needed changes
• A PFCC Coordinator(s), who will help track
your journey and manage PFCC Working Group communications
Step 2: Select the Guiding Council Guiding Council Responsibilities
• “Refine” the Care Experience
• Shadowing
• Map the Care Experience Flow
• Establish the “PFCC Fund”
Step 2 Real World Example: Transplant PFCC Guiding Council
Administrative Champion = Program Administrator, Transplant Services
Clinical Champion = Clinical Director, Transplant and Dialysis Services
PFCC Coordinator = Data Quality Reviewer, United Network for Organ Sharing
Your examples from the pre-work?
Your Turn
Step 1: Care Experience and Step 2: Guiding Council
PFCC LIVE
Evaluate the Current PFCC Live Scene
• How did they define the Care Experience?
• Who is our Guiding Council?
PFCC LIVE
Go to page 3 & 4
The Heart Center PFCC Care Experience Working Group
Questions? Evaluate the Current State by Step 3
using the PFCC Tool Box that looks at everything through the eyes of the patient and family and develop a sense of urgency to drive change… current state requires evaluation over and over and over again…
Patient and Family Centered Care Methodology and Practice (PFCC M/P)
• Shadowing and Care Experience Mapping • Patient and Family Advisory Councils • Patients and Families on Working Groups
and Project Teams • Patient, Family and Care Giver Stories • Informal Surveys • HCAHPS and “Satisfaction” Surveys • Voice of Experience and Adopt a Patient
Programs
Co-Design: Patient and Family Partnerships (…and there is no one right answer for everywhere)
Shadowing is always the best way to assess your current state…and partner with patients, families, Care Givers
The place to start….
A PFCC Must: Shadowing and Care Experience Flow Mapping
• Walk the walk of patients and families…
• Shadow patients and families throughout the selected care experience, as well as for recording observations and insights
• High impact for the $’s and effort
“We watch what people do (and do not do) and listen to what they say (and do not say). The easiest thing about the search for insight – in contrast to the search for hard data – is that it’s everywhere and it’s free.”
- Tim Brown Change by Design
Viewing Care Experiences and Flow
Shadowing
Shadowing and PFCC M/P
Observations
Empathy
Insights
PFCC Actions and Implementation Thru
Working Groups
Who Can Shadow?… Anyone!
• Shadowing resources: health profession students, volunteers, summer interns, patient advocates
• Shadowing for new hires and light duty staff
• The more “uninformed” the better
• Shadowing Continuously Engages Patients, Families and Care Givers
• Creates “Real-Time” Patient and Family Advisory Councils
The First Steps Toward Co-Design…
Touchpoints • Counter 1 • Counter 2 • Main Waiting Area • Patient Room • Small Waiting Area
Care Givers • Registrar • Receptionist • Medical Assistant • Physician Assistant • Doctor • Nurse • Check- Out Receptionist • Lab Technician
Example of a Care Experience Flow Map Patient Flow in Outpatient Clinic
Patient and Family Shadowing Sets the Stage for Urgent Change
• Care Experience Flow Mapping • Comparison of True vs. Assumed • Follow the Patient and Family to
look behind the curtain…
Assumed Touchpoints
• Counter 1 • Counter 2 • Main Waiting Area • Patient Room • Small Waiting Area
True Touchpoints
• Parking Garage • Counter 1 • Counter 2 • Main Waiting Area • Vitals Room • Patient Room • Small Waiting Area • Discharge Desk • Pay Station
Assumed vs. True
- Suzanne Rocks, RN - Clinical Champion Surgical Care Experience Working Group
“Being a nurse for 25 years I thought I had a good understanding of what our patients and families wanted because I live it and work it every day. But I found out that there are some things that are more important to the patients than I thought they were. For example, I didn’t realize how many people were having a hard time just finding my unit. Or that parking was such a big issue.”
Step 3: Evaluate the Current State
PFCC LIVE
Your Journal for Patient and
Family Shadowing Go to page 5 & 6
PFCC Theatre
Mom’s Heartfelt Melodrama
PFCC Theatre
“Black and Gold Hospital” Heart Center
PFCC Theatre
Doctor’s Office
PFCC Theatre
Exam Room
PFCC Theatre
Ultrasound Hallway
PFCC Theatre
Exam Room
PFCC Theatre
Inpatient Cardiac Unit Hallway
PFCC Theatre
Patient Room
Photo of Michelle B at home for phone call.
PFCC Theatre
The End
What did you notice?
Touchpoints: • Call Center • Parking Garage • Doctor’s Office • Transport • Ultrasound • Cardiac Unit • Information Desk • Housekeeping • Lab • Dietary • Pharmacy
Care Experience Flow Map
Care Givers: • Scheduler • Parking Attendant • Receptionist, CRNP, Physician • Transporter • Technician • Unit Clerk, Nurse • Greeter • Housekeeper • Phlebotomist • Dietary Aid • Pharmacist
Care Experience Flow Map
Doctor’s Office
Transport
Cardiac Unit
Dietary
Call Center Reaches scheduler to make an appointment
Front desk receptionist checks patient in
CRNP assess patient and orders tests per Physician
Escorted to Ultrasound by Transporter
Escorted to Cardiac Unit by Transporter
Nurse informs patient of care plan
Escorted to Exam Room by Transporter
Moved to Room by Nurse
Greeted by Unit Clerk; waits for room
Touchpoints and Care Givers
Ultrasound Patient waits in hallway; Technician performs test
Phlebotomist ordered to draw blood
Parking
Information Desk
Parked car in parking garage
Family member went to cafeteria
Lab
Family member rcvd. directions from greeter
Meal order received for patient
Pharmacy
House-keeping
Room cleaned by Housekeeper
Patient medication changed
Questions? 1) Define the Care Experience 2) Establish Guiding Council 3) Evaluate the Current State
Re-cap Steps
• Use the Care Experience Flow Map and Shadowing to determine your Touchpoints. • Identify your WG Members from these Touchpoints. • Identify opportunities for improvement all from the patient and family perspective. • Plan and Schedule the PFCC kick-off meeting followed by weekly meetings.
Expand the Guiding Council into your PFCC Working Group
Step 4
Patient and Family Centered Care Methodology and Practice (PFCC M/P)
Step 4: Expand into PFCC Working Group
PFCC LIVE
Touchpoints: • Call Center • Parking • Doctor’s Office • Transport • Ultrasound • Cardiac Unit • Information Desk • Housekeeping • Lab • Dietary • Pharmacy
Care Givers: • Scheduler • Attendant • Physician • Transporter • Technician • Unit Clerk • Greeter • Housekeeper • Phlebotomist • Dietary Aide • Pharmacist
Care Experience Flow Map and Crosswalk to Member List
Care Giver “Guest List”
• Chris • Jess • Kelly • Alex • Taylor • Cam • Terry • Jordan • Casey • Sam • Jamie
Step 4: Exercise
• Invitation Letter
• Form Your Group!
BREAK
See you back soon!
Working Group
Members
Go to page 7
Patient and Family Engagement
"One of the attractions and advantages to participating with a Working Group, for me as a physician, is that Administration is at the table and on board to help tackle problems that we bring—before I became involved, I never knew who to take these problems or ideas to for assistance.”
--R. Cartland Burns, MD Associate Professor of Surgery
Benefit to Physicians and Other Care Givers
Working Group Formation
• Start with Kick Off
• Meet Weekly
Working Group Kick Off Meeting Sample Agenda
• Introduction and Welcome from Champions • PFCC Premier Presentation
– Background and concept of the Methodology – Overview of 6 steps – Success Stories
• Shadowing Report • Homework (5 min.)
– Read the Go Guide – Project Suggestions (Active & Future) – Attend an existing Care Experience Working Group
Meeting • Confirm Next Weeks Meeting
Step 4: Kick Off
PFCC LIVE
Step 5 Create a Shared Vision by writing the Story of the Ideal Patient and Family Experience as if you were the patient.
• Imagine what ideal care would look like in the perfect care experience (hospital, clinic, office…) in a perfect world. • As a Working Group, write the story as if you were the patient and their family. • Don’t be constrained by costs or by other considerations.
Patient and Family Centered Care Methodology and Practice (PFCC M/P)
“Stories are the creative conversion of life itself into a more powerful, clearer, more meaningful experience. They are the currency of human contact.”
— Robert McKee Award-winning film and television writer
No One Way to Craft the Ideal Story
• Can do collectively in a couple of meetings • Break it into project teams to segment the care
experience • With entire Working Group, brainstorm ideas that
can be later turned into a more comprehensive story
• Utilize a specific technique (i.e. compression planning, nominal group technique, etc.)
• Begin narrative then have each member contribute one sentence until you have the entire story
• Have a small team of members begin the story then email it to the next small team to continue it and so on
• Magee-Womens Hospital of UPMC ER Care Experience
• UPMC Presbyterian Imaging Procedure Care Experience
Ideal Story Examples Step 5: Ideal Story
PFCC LIVE
Ideal Story
Go to page 8-10
Questions?
Step 6 Identify your PFCC Projects and Form Project Improvement Teams
• Potential Projects are identified by comparing the Current State to the
Ideal
• Patient and Family Experience and prioritized by patients and families
as well.
Patient and Family Centered Care Methodology and Practice (PFCC M/P) Working Group Project Lists
• Future
• Active
• Completed
Use the Same Six Steps to Form PFCC Project Improvement Teams
1. Select Care Experience 2. Co-leaders 3. Evaluate the Current
State 4. Project Team based on
Touchpoints 5. Shared Vision of the Ideal 6. PFCC Improvement Projects
Function Drives Structure
Care Experience
Guiding Council and Working Group
Project Team 1
Project Team #
Project Team 2
Project Team 3
Cycle within a Cycle and never ending Continuous Performance Improvement
PFCC Project Teams
PFCC Working Group
PFCC Project Teams
PFCC Project Teams
PFCC Project Teams
PFCC Project Teams
Guardian Angel Project • Gap – Tremendous room for improvement in communication and transitions of care for Transplant Patients • Patient comment to shadower – “You were like my guardian angel!”
PFCC Project Example
This Can be Your Story Too… This Can be Your Story Too…
Step 6: Project Teams
PFCC LIVE
Project Lists
Go to page 11
The Heart Center Experience Working
Group
Patient and Family
Amenities
Wayfinding
(Maps and Directions)
First Contact
(Phone tree and Call Center)
PFCC Methodology and Practice Function Drives Structure
The Portal Experience
( Entrance into facility)
Rule #1:
Project Teams meet each week (outside of the PFCC Working
Group) and report to the Working Group.
Project Team rules to play by…
ER Experience Working Group meets Fridays at 10:00 AM
• “Meet Your Care Givers” project team meets each week on Tuesdays at 1:00 PM
Rule #1: Example
Project Team rules to play by…
Rule #2:
Focus on the easy to do, low tech solutions to start.
Pediatric ENT Experience Working Group (other WGs too)
• Uses “distraction” items to help keep children occupied like coloring book pages that were downloaded and printed from the internet.
Rule #2: Example Project Team rules to play by…
Rule #3:
Propose pilot projects and creative solutions.
Orthopaedic Experience Working Group
• Ortho unit piloted whiteboards with Care Giver and other care specific information relative to patient then concept was expanded to entire hospital.
Rule #3: Example Project Team rules to play by…
Rule #4:
Send weekly updates to the PFCC Coordinator who
maintains the project lists.
Maintain future, active, and completed project lists.
Rule #4: Example
Rule #5:
If needed, present proposals for purchases to the
Working Group for review and approval and use the
PFCC Fund.
Project Team rules to play by…
Rule #5: Example
Rule #6:
Metrics – Measure and evaluate and re-evaluate
your changes.
Project Team rules to play by…
Rule #6: Example
0%5%
10%15%20%25%30%35%
%
of
Total
Discharges
Time of Discharge
Trauma Discharge Comparison Aug/Sep 2009
August % of total D/C
September MTD % of total D/C
Rule #7:
Remember, Project Improvement Teams can disband if their work
has been completed or reform to address new projects.
Care Experience Working Groups are forever.
Project Team rules to play by…
Transplant Experience Working Group
• The Pre-Transplant Packet project team formed to improve the information provided to the patient prior to their surgery. After creating the most informative yet not overwhelming packet of materials the group disbanded and members joined a new team.
Rule #7: Example ACT III
The Premier
PFCC LIVE
Step 6: Project Teams (continued)
Breaking Down Barriers
• Executive Support • Time Commitment • Financial Empowerment • Knowledge Sharing
Working Group
PFCC LIVE
You
The PFCC M/P and you! Ideal
You can do this too
Patient and Family
Amenities Project Team
Exercise Go to page 12 -13
Questions?
Testimonials from PFCC Champions
THANK YOU! Family House Donation Raffle
Grab your ticket……
LUNCH SESSION
See you back soon:
• Pick up Boxed lunches • See you back here for the Expert Panel
PFCC Expert Panel Louis Alarcon, MD
Medical Director, Trauma Surgery
Sarah Ball Director of Ambulatory Services
David Bertoty Clinical Director, Emergency and
Trauma Services
Richard Cunningham Parking Attendant and Family
Member
Anne Hast Chief Nursing Officer
Holly Lorenz Chief Nursing Executive
Dederia Nicholas Trauma Nurse Coordinator
Carol Scholle Clinical Director, Transplant
Services
Joseph Dominick Unit Director
The Patient and Family Feud
The Game that tests your knowledge of
The PFCC Methodology and Practice
Ready, Set…Play!
Test Your Knowledge On The PFCC M/P
Let’s Play!
The Patient and
The Patient and You Will Have Questions!
Your Answers Will Be Found Here!
Join the PFCC Ready, Set… Go Live! Webinars:
January 12, 2012 – Steps 1-3 January 26, 2012 – Steps 4-6
Stay tuned for details!
Thank you from your PFCC Partners We Are Here For You!
• We are ready and available to support the start up of your new PFCC Working Group!
• We have the tools and you have the talent!
• We are just a click away at…
• Email: [email protected]
VisionQuest Workshop NOTES
__________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________
Course Co-DirectorsAnthony M. DiGioia III, MD
Tami Minnier RN, MSN, FACHE
Jointly Sponsored by:
The AMD3 FoundationThe Innovation Center and PFCC Partners at UPMCThe University of Pittsburgh School of Medicine Center
for Continuing Education in the Health Sciences
Friday, June 1, 20128:00am-2:30pm
Herberman Conference CenterUPMC Shadyside, Pittsburgh, PA
The Journey Continues...
PFCC VisionQuest:How-To Guide for Providing Exceptional Care Experienceswhile Creating a Culture to Support Quality and Safety
To register please visit:VisionQuest.amd3.orgor call 412-641-1924
Save the Date!Friday, June 1
CINCINNNATI · LOUISVILLE · LEXINGTON · PITTSBURGH · BEIJING
WWW.GBBN.COM
architects Join Our Team!www.OperationWalkPgh.org
For More Information
Granting the Wish to Walk...In Pittsburgh and Around the World
To learn more about Patientand Family Centered Care
(PFCC) please visit:www.visionquest.amd3.org
www.innovationctr.orgwww.amd3.org
