For hospitals, providing high quality, safe, patient-centered care is paramount. According to the Centers for Medicare and Medicaid Services (CMS), studies show that providing patient-centered care has a positive impact on patient satisfaction, length of stay and cost per case. Across Minnesota, hospitals are engaging patients and their families as essential partners in efforts to continually improve the quality and safety of care in our hospitals.   

What is patient-family centered care?

According to the Agency for Healthcare Research and Quality, patient and family engagement creates an environment where patients, families, clinicians and hospital staff work together as partners to improve the quality and safety of hospital care. The Institute of Medicine describes patient and family centered care as a partnership among practitioners, patients and their families to ensure that decisions respect patients’ wants, needs and preferences and that patients have the education and support they need to make decisions and participate in their own care.  

Four key characteristics are at the foundation of patient and family centered care:

• Dignity and respect – listen and honor choices
• Information sharing – tailor information based on what has value to the patient; communicate and share accurate, unbiased and timely knowledge
• Participation – encourage shared decision making in all planning, delivery and evaluation of health care services and programs
• Collaboration – patients and families are at the table at all levels — the bedside, the quality improvement table, the board table, etc.  

To create an environment that reflects these characteristics, hospitals share patient stories, create patient and family advisory councils and patient safety committees and task forces, hold focus groups, improve patient education materials, and in general change the way they view patients and families served by the hospital. According to Jay Scott, director of patient experience and engagement at Allina Health, it means using the patient voice to guide their safety and quality improvement work. “We have a number of patient and family advisory councils that we aim to drive improvement efforts,” said Scott. “We’re constantly looking for new ways to listen to patients.”  

“Patient and family engagement is becoming a necessary as opposed to a nice to have,” said Sue Collier, a patient and family engagement specialist advising the Minnesota Hospital Association on its patient and family engagement efforts. “Essentially, it means hospitals see patients as team members; that they are partners, not just passive recipients of care.”  

When Maple Grove Hospital opened its doors in 2009, patient experience was at the heart of its operations. A Patient Experience Advisory Team was formed to identify opportunities to create a better experience. In looking at the hospital’s Hospital Consumer Assessment of Healthcare Providers and System (HCAHPS), or patient satisfaction, survey results pain management was identified as a focus area. A multidisciplinary team formed to brainstorm what pain management means to people. Out of those conversations came the realization that it really means comfort, thus RUC (are you comfortable?) was born.  

“The vision with this effort was to tailor care to meet the patient’s needs, said Jennifer Krippner, director of physician development and guest/public relations at Maple Grove Hospital. “In some cases that might mean giving them another blanket or pillow; or for family to go to the waiting room so the patient can rest. The focus is really on responding to the patient’s individual needs.”  

Sharing patient stories

In an era acutely focused on improvement and outcomes, patient stories have the ability to connect health care professionals to the reality that they are caring for a person and not just a number or outcome on a scorecard.  

One small change Allina Health made as a result of its conversations with patients, and one that made a big impact for patients, was to implement one-day notification following a mammogram or biopsy. Previously, patients could wait as long as three-five days before learning their results. Feedback from patients showed this caused anxiety and added stress. Knowing their results sooner reduces fear and eliminates the uncertainty of waiting for test results.  

Maple Grove Hospital begins every quarterly all-team meeting with a patient story. “That is so powerful to have storytelling front and center at everything you do,” said Maple Grove’s Krippner. “We believe it’s important to share both the good and bad.”  

Communication is a vital piece of engaging patients and families. Following a recommendation by the Patient Family Advisory Council, nurses at St. Francis Healthcare in Breckenridge began meeting at the bedside to discuss the patient’s status and next steps for his or her care. “We believe involving patients in their own health care can improve their hospital experience and success in following their plan of care at home,” explains Mary Helland, vice president of Healthcare Services for St. Francis and co-lead of the Patient Family Advisory Council.  

How to get started

In a survey of member hospitals, MHA found about 20 percent of hospitals in Minnesota are actively pursuing patient and family engagement. The first step a hospital can take to begin engaging patients and families is to identify at least one person who is dedicated to and proactively responsible for patient and family engagement. Additionally, hospitals can do the following:

• Prior to admission, provide and discuss a planning check list with every patient that has a scheduled admission — allowing for questions or comments from the patient or family.
• Conduct shift change huddles and do bedside reporting with patients and family members in all feasible cases.
• Form an active patient and family engagement committee or at appoint at least one former patient to serve on a patient safety and quality improvement committee.
• Appoint at least one patient to serve on a governing or leadership board as a patient representative.  

To raise awareness of its Patient and Family Member Advisory Council, Essentia Health has developed flyers that feature patient partners and why they think it’s important to serve as a patient partner. One such flyer features Sue and describes how pleased she is with the variety of topics and care aspects discussed by the group. “It is clear that patients and family members are being included in care and when changes need to be made they are done for the better of all,” the flyer reads. According to Essentia Health, these flyers posted throughout the hospital have been an effective way to draw interest in becoming involved as a patient partner.  

Scott with Allina Health says it’s important to make it easy for patients to find information and to get involved. “You need to be flexible and make it easy for them to participate. For example, we recognize that our heart failure patients often don’t drive so we’ll hold conference calls to get their feedback instead of in-person meetings. We know our new moms don’t have a lot of time to commit to a long-term committee so we hold focus groups so we can get their input without a huge commitment on their part.”