Embed Size (px)
Citation preview
2/7/2012
1
Session Three
Foundational Element: Engagement
Kelly McCutcheon Adams, MSW, LICSW, IHI Director
Barbara Balik, RN, EdD, IHI Faculty
February 8, 2012
2:00 – 3:00pm EST
David Kim
David Kim, Institute for Healthcare Improvement
(IHI), is responsible for managing and
coordinating a variety of programs based on Key
Processes on the IHI Improvement Map. Mr. Kim
is a graduate of Boston University. He has been
with the IHI for 2 years. He enjoys sports, food,
and travel.
2
2/7/2012
2
3
WebEx Quick Reference
• Welcome to today‟s session!
• Please use Chat to “All
Participants” for questions
• For technology issues only,
please Chat to “Host”
• WebEx Technical Support:
866-569-3239
• Dial-in Info: Communicate /
Join Teleconference (in menu)
Raise your hand
Select Chat recipient
Enter Text
When Chatting…
Please send your message to
All Participants
4
2/7/2012
3
Kelly McCutcheon Adams, MSW, LICSW
Kelly McCutcheon Adams, MSW,
LICSW, Director, Institute for Healthcare
Improvement (IHI), has served in this
capacity for eight years for a variety of IHI
Collaboratives and programs, particularly
those focused on critical care. She is a
medical social worker with experience in
hospice, nursing home, sub-acute
rehabilitation, emergency department, and
ICU settings. She has also served as
faculty for the US Department of Health
and Human Services Organ Donation
Collaborative and for the Gift of Life Institute.
5
Barbara Balik, RN, EdD
Barbara Balik, RN, EdD, Principal, Common
Fire Healthcare Consulting, is also Senior
Faculty at the Institute of Healthcare
Improvement. Her areas of expertise include
leadership and systems for a culture of quality
and safety, including patient- and family-
centered care, patient experience, systems to
improve transitions in care, and transforming
care prior to or with optimization of an electronic
health record implementation. She works with
leaders to develop adaptive systems to excel
and innovate in complex organizations, and to
ensure sustained improvement and innovation
every day. Ms. Balik's publications include the
book, The Heart of Leadership, and the IHI white
paper on “Achieving an Exceptional Patient and
Family Experience of Inpatient Hospital Care,”
among others. Previously, she served in senior
leadership roles at Allina Hospitals and Clinics,
United Hospital, and Minneapolis Children's Medical Center.
6
2/7/2012
4
Martha Donovan Hayward
Martha Hayward joined the Institute for
Healthcare Improvement (IHI) in March 2011 as
the Lead for Public and Patient Engagement. A
cancer survivor herself, she is a founding board
member of the nonprofit Women‟s Health
Exchange and served on the Patient and Family
Advisory Council of Dana-Farber Cancer Institute
in Boston. Her career experience includes over
20 years in marketing and fundraising in the
areas of health, politics, and education. As a
partner at Donovan & Vicenti, a branding and
web design firm on Boston‟s North Shore, Ms.
Hayward works with a variety of small
businesses and nonprofits. Most recently, as
Executive Director at The Partnership for
Healthcare Excellence, she brought a particular
focus on, and considerable experience in, the
area of patient advocacy.
7
Overall Objectives
8
At the end of this program, participants would be able to:
• Articulate key foundational elements in support of all
domains of patient experience improvement
• Share specific testable ideas for improving nurse
communication, pain management, and cleanliness
• Plan small tests of change to try during the Expedition
2/7/2012
5
Session Agenda
• Homework – What did you learn?
• Patient Experience Change Package
o Our focus today
• Engagement learning from the Patient Experience Collaborative
o Martha Donovan Hayward, IHI Lead/Public and Patient
Engagement
• Hear from successful hospitals
o Sandee Moore, Eastern Idaho Regional Medical Center
o Cathy Denesia and Rob McEver, Overland Park Regional Medical
Center
• Time for Q&A
8
Homework for this call
• Test one of the Leadership Key Change
• Share what you learned from the test
• Complete an additional patient shadowing
activity
10
2/7/2012
6
11
Patient Experience Change Package
• Overview
oOriginal work:
Patient Experience White Paper and Driver
Diagram
o Focused content – 48 hospital collaborative
Nurse Communication
Pain Management
Cleanliness
Exceptional patient and family inpatient hospital experience
(safe, effective, patient centered, timely, efficient,
equitable) as measured by
HCAHPS willingness to recommend
Governance and executive leaders demonstrate that EVERYTHING in the
culture is focused on patient and family
centered care, practiced
everywhere in the hospital (individual,
microsystem, organization)
In words and actions leaders communicate that the patient’s safety and well being is the critical decision
guiding all decision making
Patients and families are treated as partners in care at every level: on decision making bodies to team members with individual care
PFCC is publicly verifiable, rewarded, and celebrated with relentless focus
on measurement, learning, and improvement with transparent
patient feedback
Sufficient staff are available with the tools and skills to deliver the care the
patient needs when they need it
The hearts and minds of staff and providers
are fully engaged
Staff and providers are recruited for values and talent, supported for
success, and accountable individually and collectively for results
Compassionate communication and teamwork are essential competencies
Every care interaction is anchored in a
respectful partnership
anticipating and responding to
patient and family needs (physical
comfort, emotional, informational,
cultural, spiritual, and learning)
Patients and families are part of care team and participate at the level the
patient chooses
Care for each patient is based on a customized interdisciplinary shared care plan with patients educated,
enabled and confident to carry out their care plans
Communication uses words and phrases that the patient understands
and meets their emotional needs
Hospital systems deliver reliable
quality care 24/7
The physical environment supports care and healing
Patients are able to access care and say that there were not long and unreasonable waits and delays
Patients say “there were staff available to give the care I needed”
The care team instills confidence by
providing collaborative,
evidenced based care
Care is safe, concerns are addressed and if things go wrong, there is open
communication and apology
Care is coordinated and integrated through use of a shared can plan and everyone on the patient’s care team,
including the patient, has the information they need
Patients get the outcomes of care they expect
The Patient always means
patient and those they
choose to call family
IHI Patient
Experience
Driver
Diagram
2/7/2012
7
Patient Experience Change Package
• Faculty, exemplars, teams experience:
o Foundational cross-cutting work – address all
domains
Leadership commitment and behaviors
Engaging patients in their definition of:
– family, pain management, cleanliness
o Successful use of the Driver Diagram and
White Paper to assess current state and
develop implementation plans
13
Patient Experience Change Package: Overview
Key areas for improving specific domains of
patient experience: Nurse Communication,
Cleanliness, and Pain Management
Staff and Physicians Patient and Family Connection
Leadership Engagement Improvement/
Infrastructure
Foundational Elements for Improving Patient Experience
Today’s Session
2/7/2012
8
Foundational Elements for Improving Patient Experience
Leaders take ownership of defining
purpose of work and modeling
desired behaviors.
Staff, leaders, and physicians engage
patients and families so that efforts to
improve patient experience reflect
actual patient experience.
Improvement teams are solidly
grounded in skills to effect reliable
change and gain meaningful
understanding of data
Leadership Engagement Improvement/
Infrastructure
Today’s Session
Engagement learning from the Patient
Experience Collaborative
• Martha Donovan Hayward, IHI Lead/Public and
Patient Engagement
• DO MORE. DO LESS.
16
2/7/2012
9
Cathy Denesia and Rob McEver
The story:
• We shadowed an 83 year old woman and her husband and life partner of 54 years. This patient entered
through the Emergency Department with stroke-like symptoms. The shadow experience began in the ED,
followed through procedural areas, and eventually ended up in the ICU.
How we communicated the story: • Photos and quotes from the patient and
her husband
Getting Started:
• Just Do It!
• Work with the ED director and triage nurse to identify patients
• Introduce to the patient or family that shadowing is a way to improve services to our patients by stepping
through this hospital experience with them
Take-aways: • This experience allowed us to link several initiatives within the organization (LEAN,
Joint Commission preparation, cleanliness, & patient centered care) with IHI principles
Patient Shadow Experience
2/7/2012
10
The story:
• 51 year old man admitted to Med/Surg unit for acute appendicitis. Upon admission to room, patient‟s
roommate required Rapid Response Team. During these events patient‟s room was „disheveled‟ and
equipment along with medical supplies left lying in bathroom area blocking patient access to the toilet.
Patient‟s bathroom not cleaned during his over-night stay. Patient later expressed he had history of
infection acquired after knee surgery and this situation caused him anxiety about another infection.
How we communicated the story:
• Patient initially reported complaint to staff and unit director. Patient did not feel staff was responsive.
• After discharge patient invited in for a “dinner” with nursing and EVS staff.
• Patient told staff in his own words about his experience
Take-aways: • Patient felt empowered & that he had an impact on future patient care
• Staff related to patient story and spoke about how this would impact their practice
• Overall positive experience for both staff and patient
Getting Started:
• Just Do It! • Identify patients who can articulate their story in constructive way.
• Patient had a vested interested in improving “his” hospital
Patient Advisor Experience
Eastern Idaho Regional Medical Center Patient and Family Engagement
2/7/2012
11
IHI Collaborative
• Initial spark to support our cultural change with better structure for process change
• Setting a framework to support accountability
• Much more digestible and approachable compared to past efforts: small-scale rapid cycle testing.
• Inspires sense of “We can do this, a bite at a time!”
• Data-rich
• Sharing and networking
• Introduction of Patient Advisor role
EIRMC’s New Structure
2/7/2012
12
Lots of Teams, Doing Heaps of Work
• Patient-Family Advisory Council • Communication Team • Pain Management Team • Care Coordination Team • Cleanliness & Quiet Team • Leader Rounding Team • Lab Services Team • Imaging Team • Same Day Surgery Team • Emergency Department Team • Marketing & Communications Team • Inpatient Unit Based Teams
Listening to Patients & Families: Patient & Family Advisory Council
Not pictured: Mary Kelley Russell Hillman Kelly Martin
2/7/2012
13
PFAC: Putting Patients & Families at the Center of Everything
• Intentionally force consideration of, “What will give best experience for the patient and family?” in every hospital decision we make
• PFAC drives/participates in: – Every Patient Experience Team
– Patient Family Advisory Newsletter
– New Employee Orientation
– Patient Rounding/Environmental Rounds
– Healing spaces
Helping Design More Patient and Family-Focused Care
• PFAC advises and provides recommendations on: – Bedside shift report
– Patient Handbooks
– Whiteboards
– Family presence during resuscitations
– Visitor guidelines
– Pain Team consults
– Patient-Family Liaison on Surgical Services
– Patient call-backs
– Leader rounding on patients and families
– 2-hour window for inpatient imaging exams
2/7/2012
14
Discussion/ Q&A
• To ask a question or make a comment,
please either chat your question/comment
into the Chat Box to All Participants, or …
• Click the Raise Hand icon and we can call
on you to ask your question aloud.
Thanks!
Homework for the next call
• Test one of the Engagement Changes
• Share what you learned from the test
28
2/7/2012
15
Next Call
Session 4 - Foundational Element:
Improvement Infrastructure
Date: Wednesday February 22, 2012
2:00 PM - 3:00 PM Eastern US time
29
Listserv
• Send and receive questions and
comments to/from faculty and participants
• To be added to the listserv please email
30
