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?
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
key characteristics are at the foundation of patient and family centered care:
and respect – listen and honor choices
– 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.
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
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.
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.
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.”