wwwplanetreeorg

Framework for Change May 13 200 ndash 600 PM Susan Frampton PhD President Planetree Alan Manning MPA Executive Vice President Planetree

wwwplanetreeorg

bull Welcome amp Introduction

bull Logic model for patient and family centered care culture

bull Essential structures and functions

bull Patient preferred practices

bull Measuring patient centered care

wwwplanetreeorg

The lsquoideal patientrsquo circa 1990s

ldquohellipthe ideal patient has no family asks no questions and does exactly what the doctor tells them to dohelliprdquo

wwwplanetreeorg

Advocacy efforts in the 1970rsquos challenged the status quo of lsquopatients as passive recipientsrsquo of care

ldquohellipwe should all demand to be treated as competent adults and take an active part in our healinghellipwe should insist on hospitals meeting our human need for respect control warm and supportive carehelliprdquo

-Angelica Thieriot 1978

Founder Planetree

The 1st patient-centered advocacy organization in the USA

wwwplanetreeorg

The core of a patient-centric approach the lived experience of patients family and staff

o Compassionate Human Interactions

o Access to Meaningful Information

o Support amp Participation of Family Friends

o Healing Environment

o Support for body mind amp spirit

o Arts and Entertainment o Spirituality o Caring Touch o Integrative Therapies o Healthy Food and Nutrition

o Healthy Communities

wwwplanetreeorg

IA A multi-disciplinary task force is established to oversee and assist with implementation and maintenance of patient -resident-centered practices which includes a mix of non -supervisory and management staff and meets regularly (every 4-6 weeks) on an ongoing basis IB A patient-resident-centered care coordinator or point person is designated who is able to commit the time required to champion related activities on an ongoing basis

IC Patientresident family and staff focus groups are conducted on -site by Planetree or another qualif ied independent vendor periodically (at 12-18 month intervals) and the results are shared at a minimum with senior management the governing body and staff ID Information on patient-resident-centered care implementation and progress is shared periodically with key organizational stakeholders cultivating an understanding of patient -resident-centered initiatives underway in the organization This informat ion is communicated regularly to staff (and in continuing care environments also to residents and families) and at a minimu m annually to the governing board of the organization

IE An ongoing mechanism is in place to solicit meaningful dialogue input and reactions from patientsresidents families and the community on current practices and new initiatives This may be achieved via an active patientresidentfamily or community advisory council with regular meetings or some other effective mechanism to obtain regular input from patientsresidents and community IIA All staff including off -shift and support staff are given an opportunity to participate in a minimum of eight hours of p atient-resident-centered staff retreat experiences or an equivalent with a minimum concurrent completion rate of 85 IIB An independently administered physician experience survey is conducted at least once every f ive years using a validated survey instrument and physicians are oriented and regularly educated about and encouraged to participate in patient -resident-centered initiatives

IIC Continuing education to reinforce and revitalize staff engagement in patient -resident-centered behaviors and practices an d build competence around the communityrsquos evolving needs is offered on a regular and ongoing basis to all staff in meaningful ways determined by the organization IID A comprehensive presentation on patient -resident-centered care concepts practices and initiatives is provided for all new staff (and in continuing care settings new residents) as a part of orientation In continuing care environments resident s and family members are included in a meaningful way in the new employee orientation program

IIE Active teams are in place that address patient -resident-centered initiatives as necessary and include non -supervisory staff input IIF A model of care delivery is adopted that embraces continuity consistency and accountability-based care and allows staff the opportunity and responsibility for personalizing care for each patientresident IIG A mechanism is in place to provide s taff support services that include elements identified by s taff as priority areas Examples include access to concierge or amenity services such as meals-to-go massage space to recharge away from patients res idents and families emotional support such as bereavement services and s taff support groups and personal and profess ional deve lopment programming such as a career ladder program

IIH Human resource systems including job descriptions and evaluations ref lect the organizationrsquos patient -resident-centered care philosophy Other examples include behavioral standards recruitment and retention efforts staff selection tools and criteria In continuing care environments residents play a role in the hiring and evaluation of staff

III Numerous opportunities both formal and informal are provided for staff reward and recognition In continuing care en vironments recognition programs extend to and integrate residents and family members IIJ Independently administered staff surveys using a validated survey instrument or other structured staff feedback mechan isms are conducted at least once every two years IIK a process is in place for providing support as necessary to patientsresidents families and staff affected by an adverse event

IIL Processes are in place to help patientsresidents anticipate the costs of care and assistance is available for those wh o need to make f inancial arrangements Financial communications are concise clear and respectful IIM The organization has processes in place focusing on prevention of medical errors as well as on keeping patientsresidents and staff safe from harm from self and others

II N Effective 24-hour shift-to notshift communication processes are in place to ensure patientsrsquoresidentsrsquo individualized needs are evaluated discussed and met Opportunities for patientresident and family involvement in shift -to-shift communication are addressed II O Effective communication mechanisms are in place to keep all staff ( including off -site and all shifts) informed about organizational priorities IIPndashApplies only to continuing care sites In continuing care settings residents are given an opportunity to participate as appropriate in a retreat experience or an equivalent to assist with internalizing resident -centered care concepts and to enhance sensitivity to the needs of the entire community Resident retreats are conducted at a minimum annually

IIQndashApplies only to continuing care sites Residents are provided with the choice of where they are going to live and with whom with staff input provided as appropriate IIRndash Applies only to continuing care sites In continuing care settings processes are in place for evaluating identifying and effectively integrating into the care plan what is important to each resident based on hisher identity decision-maknoting ability and mastery skills and what is meannotingful to that resident in the living environment and in daily activities

IIIA A policy for sharing clinical information including the medical record and the care plan with patientsresidents has been approved an effective system is in place to make patientsresidents aware that they may review this information a system is in place to monitor staff communication to patientsresidents of this choice and patientresident participation levels and a process is in place to facilitate patientsresidents documenting their comments IIIA-Behavioral Health Application In behavioral health settings decisions about the extent of the clinical information shared and the mechanism used for sharing this information are made on an individualized basis A range of options are available for sharing such information including the medical record and the treatment plan to ensure that patients of varying competency levels have access to information that will help them to

understand their symptoms diagnosis and treatment IIIB A community health resource library or signif icant consumer health collection is established either based at the hosp ital or provided by the site in partnership with other organizations The hospital has implemented strategies to make patients residents families and community members aware that the library is free and open to the public Printed material is available on the sitersquos ten most common diagnoses and there are

systems in place to enable patientsresidents to obtain information both with assistance and on their own IIIC A range of educational materials is available for patientsresidents and families and is easily accessible to staff Staff is knowledgeable about the availability of these resources IIID Patientsresidents are provided with meaningful discharge instructions

IIIE A process is in place to disclose unanticipated outcomes to patientsresidents (and family members as appropriate) III FThe site has a process to assist patientsresidents and families in managing their medical information and coordinating their car e among multiple physicians including the patientrsquos admitting physician primary care provider and appropriate specialists

IVA Flexible 24-hour patient-resident-directed visiting hours are in place and children are permitted to visit (exceptions for psychiatric f acilities NICU and in cases of communicable disease) In continuing care settings accommodations are made for intimate vis its by a spousepartner IVA-Behavioral Health Application In behavioral health settings visiting hours are consistent with the patientrsquos treatment plan and f lexible to accommodate patient and family visitation preferences Restrictions to visitation are determined by the t reatment plan and patient preferences and the rationale for any restrictions is clearly communicated to patients and families IVB A comprehensive formalized approach to involving families in all aspects of the patientrsquos residentrsquos care and tailored to the needs and abilities of the organization and its facility is developed at a minimum on pediatric oncology medical-surgical and rehabilitation units An example is a Care Partner Program

IVB-Behavioral Health Application A comprehensive formalized approach to providing families with psychoeducation and when clinically appropriate involving them in the patientrsquos care is developed and tailored to the needs and abilities of the organization and its facility An example is a Care Partner Program IVC Kitchenspantries and lounges are available for families to use

IVD A process is in place to encourage patientsresidents and families to communicate with staff about any concerns related to their care including any concerns related to residentpatient safety VA A system is in place to provide patientsresidents families and staff with 24-hour access to a variety of foods and beverages (unless doing so conflicts with the treatment plan) Patientsrsquoresidentsrsquo personal preferences and routines around mealtimes are considered and accommodated to the extent possible VB The organization has a system to provide patientsresidents and staff with fresh healthy food at appropriate temperatur es and provides patients with a variety of food choices

VIA Healing healthcare design standards are developed that at a minimum address interior f inishes and lighting In continuing care settings these standards also provide for personalization of living areas by residents VIB The auditory environment has been reviewed and a noise control protocol is in place

VIC The olfactory environment has been reviewed and odors have been addressed VID As remodeling is done symbolic and real barriers are removed Examples include implementing open nursesrsquo stations family lounges unit-based kitchens indirect lighting In continuing care environments each residentrsquos living area features a view to the outside VIE Signage both leading to facility entrances as well as throughout the interior of the facility is clear and understand able to patients residents and visitors

VIF Ample parking adjacent to entrances is available When nearby parking is limited accommodations such as valet service or golf carts to transport visitors to and from the building are made available VIG The environment is designed to accommodate privacy needs and provides for patientresident dignity and modesty particu larly in common areas patientresident rooms and bathrooms

VIH The organization considers progressive facility management practices and specif ies products that promote safe non -toxic approaches to facility cleaning maintenance renovation and construction which recognize the potential health impact on patientsresidents families and staff members VII Patientsresidents have access to nature Examples include an indoor or outdoor garden VIJndash Applies only to behavioral health sites Common spaces are available and feature a sense of spaciousness and light In add ition they satisfy patientsrsquo needs for both private spaces and spaces that support social interaction

VIKndash Applies only to behavioral health sites Protocols are in place for reducing coercive intervention Examples may include a provision of a comfort room Snoezelen or low-stimulation environment VIIA an active arts component (music visual arts crafts animal visitation bedside reading) is in place In continuing care environments the array of activities is dynamic driven by residentsrsquo individual interests and inclusive of family and staf f The activities program allows for spontaneity and self -directed opportunities for residents 24-hours a day 7 days a week

VIIBndashApplies only to continuing care sites A f lexible transportation system is provided that enables residents to satisfy pers onal wishes to participate in off -site activities and to volunteer VIIIA A plan is developed and implemented that recognizes the spiritual dimension of patientsresidents families and staff in the healthcare environment In acute care and continuing care settings this plan includes practices around death and dying VIIIB The special needs of the communityrsquos diverse cultural groups are investigated documented and addressed in specif ic and appropriate ways

IXA The interests and current utilization patterns of patientsresidents and medical staff in the areas of alternative com plementary and integrative healing modalities are assessed and a plan is developed to address these needs Examples could include providing direct services developing a process for responding to patientresident requests for in -hospital treatment by the patientrsquosresidentrsquos existing practitioner(s) and evaluation of patientsresidentsrsquo herbal remedies as part of the medication reconciliation process

IXB A plan for caring touch is developed and implemented as appropriate (Exceptions include behavioral health patients) Examples of caring touch include massage M technique and Reiki XA Based on the interests and needs of the community a plan is developed to improve community health Examples include pr ovision of direct services educational information or referral and collaboration with local agencies XBndash Applies only to behavioral health sites Mechanisms are in place to give public voice to and advocate for the importance of behavioral health initiatives and the need for more comprehensive stigma free and humane approaches to this care

XIA-Acute Care Application Patient satisfaction (both inpatient and outpatient) is regularly assessed using a validated survey instrument which includes the HCAHPS questions Performance on each of the domains in the HCAHPS questionnaire meets or exc eeds national averages XIA-Behavioral Health Application Patientsrsquo perspectives of care (both inpatient and outpatient) are regularly assessed using a validated survey instrument

XIB-Acute Care Application The hospital monitors and reports its performance on the full set of CMS Quality Measures to CMS and shares data on all available indicators with Planetree The hospitalrsquos performance for the most recent twelve month period for which data is available exceeds the ldquoNational Averagerdquo performance as reported on the US Department of Health and Human Services Hospital Compare web site on 75 of the indicators for which the hospital has more than 25 eligible patients for the 12 month period (an n of gt25) XIB-Behavioral Health Application The hospital monitors and reports its performance on appropriate quality measures and provid es benchmarks for comparison purposes The hospital meets or exceeds benchmarks Sites accredited by The Joint Commission m ay submit their ORYX Performance Measure Report with both the control chart to demonstrate internal trending and the comparison chart to demonstrate performance that

meets or exceeds benchmarks to satisfy the criteria XIC-Acute Care Behavioral Health Application The hospital regularly solicits information from staff about patient safety and uses the information generated to improve safety practices in the organization The hospital has a process for encouraging s taff to report quality and patient safety issues The hospital conducts a survey to assess its patient safety culture at a minimum once every two years

XID Applies only to continuing care sites A system is established to broadly communicate performance improvement information to all members of the continuing care community and to the public

Designation- a structured pathway

IF Leadership exemplifies approaches that motivate and inspire others promote positive morale mentor and enhance performance of others recognize the knowledge and decision-making authority of others and model organizational values

IIH Human resource systems including job descriptions and evaluations reflect the organizationrsquos patient-centered care philosophy Other examples include behavioral standards recruitment and retention efforts staff selection tools and criteria and conducting team interviews

XID Staff and patientresidentfamily members are actively involved in the design ongoing assessment and communication of performance improvement efforts The organization consistently utilizes data to identify and prioritize improvement over time

IIIA A policy for sharing clinical information including the medical record and the care plan with patients has been approved staff are educated on this policy and the process for sharing the record and care plan an effective system is in place to make patients aware that they may review this information and a process is in place to facilitate patients documenting their comments

IVB A comprehensive formalized approach for partnering with families in all aspects of the patientrsquos care and tailored to the needs and abilities of the organization and its facility is developed An example is a Care Partner Program

IA A multi-disciplinary task force including patients and family members is established to oversee and assist with implementation and maintenance of patient-centered practices

IIE Active teams are in place that address patient-centered initiatives and include participation by nonsupervisory staff and patients and families

IIF Formalized processes are in place to promote continuity consistency and accountability in care delivery and which all ow staff the opportunity and responsibility for personalizing care in partnership with each patientresident

wwwplanetreeorg

bull Welcome amp Introduction

bull Logic model for patient and family centered care culture

bull Essential structures and functions

bull Patient preferred practices

bull Measuring patient centered care

wwwplanetreeorg

The lsquoideal patientrsquo circa 1990s

ldquohellipthe ideal patient has no family asks no questions and does exactly what the doctor tells them to dohelliprdquo

wwwplanetreeorg

Advocacy efforts in the 1970rsquos challenged the status quo of lsquopatients as passive recipientsrsquo of care

ldquohellipwe should all demand to be treated as competent adults and take an active part in our healinghellipwe should insist on hospitals meeting our human need for respect control warm and supportive carehelliprdquo

-Angelica Thieriot 1978

Founder Planetree

The 1st patient-centered advocacy organization in the USA

wwwplanetreeorg

The core of a patient-centric approach the lived experience of patients family and staff

o Compassionate Human Interactions

o Access to Meaningful Information

o Support amp Participation of Family Friends

o Healing Environment

o Support for body mind amp spirit

o Arts and Entertainment o Spirituality o Caring Touch o Integrative Therapies o Healthy Food and Nutrition

o Healthy Communities

wwwplanetreeorg

IA A multi-disciplinary task force is established to oversee and assist with implementation and maintenance of patient -resident-centered practices which includes a mix of non -supervisory and management staff and meets regularly (every 4-6 weeks) on an ongoing basis IB A patient-resident-centered care coordinator or point person is designated who is able to commit the time required to champion related activities on an ongoing basis

IC Patientresident family and staff focus groups are conducted on -site by Planetree or another qualif ied independent vendor periodically (at 12-18 month intervals) and the results are shared at a minimum with senior management the governing body and staff ID Information on patient-resident-centered care implementation and progress is shared periodically with key organizational stakeholders cultivating an understanding of patient -resident-centered initiatives underway in the organization This informat ion is communicated regularly to staff (and in continuing care environments also to residents and families) and at a minimu m annually to the governing board of the organization

IE An ongoing mechanism is in place to solicit meaningful dialogue input and reactions from patientsresidents families and the community on current practices and new initiatives This may be achieved via an active patientresidentfamily or community advisory council with regular meetings or some other effective mechanism to obtain regular input from patientsresidents and community IIA All staff including off -shift and support staff are given an opportunity to participate in a minimum of eight hours of p atient-resident-centered staff retreat experiences or an equivalent with a minimum concurrent completion rate of 85 IIB An independently administered physician experience survey is conducted at least once every f ive years using a validated survey instrument and physicians are oriented and regularly educated about and encouraged to participate in patient -resident-centered initiatives

IIC Continuing education to reinforce and revitalize staff engagement in patient -resident-centered behaviors and practices an d build competence around the communityrsquos evolving needs is offered on a regular and ongoing basis to all staff in meaningful ways determined by the organization IID A comprehensive presentation on patient -resident-centered care concepts practices and initiatives is provided for all new staff (and in continuing care settings new residents) as a part of orientation In continuing care environments resident s and family members are included in a meaningful way in the new employee orientation program

IIE Active teams are in place that address patient -resident-centered initiatives as necessary and include non -supervisory staff input IIF A model of care delivery is adopted that embraces continuity consistency and accountability-based care and allows staff the opportunity and responsibility for personalizing care for each patientresident IIG A mechanism is in place to provide s taff support services that include elements identified by s taff as priority areas Examples include access to concierge or amenity services such as meals-to-go massage space to recharge away from patients res idents and families emotional support such as bereavement services and s taff support groups and personal and profess ional deve lopment programming such as a career ladder program

IIH Human resource systems including job descriptions and evaluations ref lect the organizationrsquos patient -resident-centered care philosophy Other examples include behavioral standards recruitment and retention efforts staff selection tools and criteria In continuing care environments residents play a role in the hiring and evaluation of staff

III Numerous opportunities both formal and informal are provided for staff reward and recognition In continuing care en vironments recognition programs extend to and integrate residents and family members IIJ Independently administered staff surveys using a validated survey instrument or other structured staff feedback mechan isms are conducted at least once every two years IIK a process is in place for providing support as necessary to patientsresidents families and staff affected by an adverse event

IIL Processes are in place to help patientsresidents anticipate the costs of care and assistance is available for those wh o need to make f inancial arrangements Financial communications are concise clear and respectful IIM The organization has processes in place focusing on prevention of medical errors as well as on keeping patientsresidents and staff safe from harm from self and others

II N Effective 24-hour shift-to notshift communication processes are in place to ensure patientsrsquoresidentsrsquo individualized needs are evaluated discussed and met Opportunities for patientresident and family involvement in shift -to-shift communication are addressed II O Effective communication mechanisms are in place to keep all staff ( including off -site and all shifts) informed about organizational priorities IIPndashApplies only to continuing care sites In continuing care settings residents are given an opportunity to participate as appropriate in a retreat experience or an equivalent to assist with internalizing resident -centered care concepts and to enhance sensitivity to the needs of the entire community Resident retreats are conducted at a minimum annually

IIQndashApplies only to continuing care sites Residents are provided with the choice of where they are going to live and with whom with staff input provided as appropriate IIRndash Applies only to continuing care sites In continuing care settings processes are in place for evaluating identifying and effectively integrating into the care plan what is important to each resident based on hisher identity decision-maknoting ability and mastery skills and what is meannotingful to that resident in the living environment and in daily activities

IIIA A policy for sharing clinical information including the medical record and the care plan with patientsresidents has been approved an effective system is in place to make patientsresidents aware that they may review this information a system is in place to monitor staff communication to patientsresidents of this choice and patientresident participation levels and a process is in place to facilitate patientsresidents documenting their comments IIIA-Behavioral Health Application In behavioral health settings decisions about the extent of the clinical information shared and the mechanism used for sharing this information are made on an individualized basis A range of options are available for sharing such information including the medical record and the treatment plan to ensure that patients of varying competency levels have access to information that will help them to

understand their symptoms diagnosis and treatment IIIB A community health resource library or signif icant consumer health collection is established either based at the hosp ital or provided by the site in partnership with other organizations The hospital has implemented strategies to make patients residents families and community members aware that the library is free and open to the public Printed material is available on the sitersquos ten most common diagnoses and there are

systems in place to enable patientsresidents to obtain information both with assistance and on their own IIIC A range of educational materials is available for patientsresidents and families and is easily accessible to staff Staff is knowledgeable about the availability of these resources IIID Patientsresidents are provided with meaningful discharge instructions

IIIE A process is in place to disclose unanticipated outcomes to patientsresidents (and family members as appropriate) III FThe site has a process to assist patientsresidents and families in managing their medical information and coordinating their car e among multiple physicians including the patientrsquos admitting physician primary care provider and appropriate specialists

IVA Flexible 24-hour patient-resident-directed visiting hours are in place and children are permitted to visit (exceptions for psychiatric f acilities NICU and in cases of communicable disease) In continuing care settings accommodations are made for intimate vis its by a spousepartner IVA-Behavioral Health Application In behavioral health settings visiting hours are consistent with the patientrsquos treatment plan and f lexible to accommodate patient and family visitation preferences Restrictions to visitation are determined by the t reatment plan and patient preferences and the rationale for any restrictions is clearly communicated to patients and families IVB A comprehensive formalized approach to involving families in all aspects of the patientrsquos residentrsquos care and tailored to the needs and abilities of the organization and its facility is developed at a minimum on pediatric oncology medical-surgical and rehabilitation units An example is a Care Partner Program

IVB-Behavioral Health Application A comprehensive formalized approach to providing families with psychoeducation and when clinically appropriate involving them in the patientrsquos care is developed and tailored to the needs and abilities of the organization and its facility An example is a Care Partner Program IVC Kitchenspantries and lounges are available for families to use

IVD A process is in place to encourage patientsresidents and families to communicate with staff about any concerns related to their care including any concerns related to residentpatient safety VA A system is in place to provide patientsresidents families and staff with 24-hour access to a variety of foods and beverages (unless doing so conflicts with the treatment plan) Patientsrsquoresidentsrsquo personal preferences and routines around mealtimes are considered and accommodated to the extent possible VB The organization has a system to provide patientsresidents and staff with fresh healthy food at appropriate temperatur es and provides patients with a variety of food choices

VIA Healing healthcare design standards are developed that at a minimum address interior f inishes and lighting In continuing care settings these standards also provide for personalization of living areas by residents VIB The auditory environment has been reviewed and a noise control protocol is in place

VIC The olfactory environment has been reviewed and odors have been addressed VID As remodeling is done symbolic and real barriers are removed Examples include implementing open nursesrsquo stations family lounges unit-based kitchens indirect lighting In continuing care environments each residentrsquos living area features a view to the outside VIE Signage both leading to facility entrances as well as throughout the interior of the facility is clear and understand able to patients residents and visitors

VIF Ample parking adjacent to entrances is available When nearby parking is limited accommodations such as valet service or golf carts to transport visitors to and from the building are made available VIG The environment is designed to accommodate privacy needs and provides for patientresident dignity and modesty particu larly in common areas patientresident rooms and bathrooms

VIH The organization considers progressive facility management practices and specif ies products that promote safe non -toxic approaches to facility cleaning maintenance renovation and construction which recognize the potential health impact on patientsresidents families and staff members VII Patientsresidents have access to nature Examples include an indoor or outdoor garden VIJndash Applies only to behavioral health sites Common spaces are available and feature a sense of spaciousness and light In add ition they satisfy patientsrsquo needs for both private spaces and spaces that support social interaction

VIKndash Applies only to behavioral health sites Protocols are in place for reducing coercive intervention Examples may include a provision of a comfort room Snoezelen or low-stimulation environment VIIA an active arts component (music visual arts crafts animal visitation bedside reading) is in place In continuing care environments the array of activities is dynamic driven by residentsrsquo individual interests and inclusive of family and staf f The activities program allows for spontaneity and self -directed opportunities for residents 24-hours a day 7 days a week

VIIBndashApplies only to continuing care sites A f lexible transportation system is provided that enables residents to satisfy pers onal wishes to participate in off -site activities and to volunteer VIIIA A plan is developed and implemented that recognizes the spiritual dimension of patientsresidents families and staff in the healthcare environment In acute care and continuing care settings this plan includes practices around death and dying VIIIB The special needs of the communityrsquos diverse cultural groups are investigated documented and addressed in specif ic and appropriate ways

IXA The interests and current utilization patterns of patientsresidents and medical staff in the areas of alternative com plementary and integrative healing modalities are assessed and a plan is developed to address these needs Examples could include providing direct services developing a process for responding to patientresident requests for in -hospital treatment by the patientrsquosresidentrsquos existing practitioner(s) and evaluation of patientsresidentsrsquo herbal remedies as part of the medication reconciliation process

IXB A plan for caring touch is developed and implemented as appropriate (Exceptions include behavioral health patients) Examples of caring touch include massage M technique and Reiki XA Based on the interests and needs of the community a plan is developed to improve community health Examples include pr ovision of direct services educational information or referral and collaboration with local agencies XBndash Applies only to behavioral health sites Mechanisms are in place to give public voice to and advocate for the importance of behavioral health initiatives and the need for more comprehensive stigma free and humane approaches to this care

XIA-Acute Care Application Patient satisfaction (both inpatient and outpatient) is regularly assessed using a validated survey instrument which includes the HCAHPS questions Performance on each of the domains in the HCAHPS questionnaire meets or exc eeds national averages XIA-Behavioral Health Application Patientsrsquo perspectives of care (both inpatient and outpatient) are regularly assessed using a validated survey instrument

XIB-Acute Care Application The hospital monitors and reports its performance on the full set of CMS Quality Measures to CMS and shares data on all available indicators with Planetree The hospitalrsquos performance for the most recent twelve month period for which data is available exceeds the ldquoNational Averagerdquo performance as reported on the US Department of Health and Human Services Hospital Compare web site on 75 of the indicators for which the hospital has more than 25 eligible patients for the 12 month period (an n of gt25) XIB-Behavioral Health Application The hospital monitors and reports its performance on appropriate quality measures and provid es benchmarks for comparison purposes The hospital meets or exceeds benchmarks Sites accredited by The Joint Commission m ay submit their ORYX Performance Measure Report with both the control chart to demonstrate internal trending and the comparison chart to demonstrate performance that

meets or exceeds benchmarks to satisfy the criteria XIC-Acute Care Behavioral Health Application The hospital regularly solicits information from staff about patient safety and uses the information generated to improve safety practices in the organization The hospital has a process for encouraging s taff to report quality and patient safety issues The hospital conducts a survey to assess its patient safety culture at a minimum once every two years

XID Applies only to continuing care sites A system is established to broadly communicate performance improvement information to all members of the continuing care community and to the public

Designation- a structured pathway

IF Leadership exemplifies approaches that motivate and inspire others promote positive morale mentor and enhance performance of others recognize the knowledge and decision-making authority of others and model organizational values

IIH Human resource systems including job descriptions and evaluations reflect the organizationrsquos patient-centered care philosophy Other examples include behavioral standards recruitment and retention efforts staff selection tools and criteria and conducting team interviews

XID Staff and patientresidentfamily members are actively involved in the design ongoing assessment and communication of performance improvement efforts The organization consistently utilizes data to identify and prioritize improvement over time

IIIA A policy for sharing clinical information including the medical record and the care plan with patients has been approved staff are educated on this policy and the process for sharing the record and care plan an effective system is in place to make patients aware that they may review this information and a process is in place to facilitate patients documenting their comments

IVB A comprehensive formalized approach for partnering with families in all aspects of the patientrsquos care and tailored to the needs and abilities of the organization and its facility is developed An example is a Care Partner Program

IA A multi-disciplinary task force including patients and family members is established to oversee and assist with implementation and maintenance of patient-centered practices

IIE Active teams are in place that address patient-centered initiatives and include participation by nonsupervisory staff and patients and families

IIF Formalized processes are in place to promote continuity consistency and accountability in care delivery and which all ow staff the opportunity and responsibility for personalizing care in partnership with each patientresident

wwwplanetreeorg

The lsquoideal patientrsquo circa 1990s

ldquohellipthe ideal patient has no family asks no questions and does exactly what the doctor tells them to dohelliprdquo

wwwplanetreeorg

Advocacy efforts in the 1970rsquos challenged the status quo of lsquopatients as passive recipientsrsquo of care

ldquohellipwe should all demand to be treated as competent adults and take an active part in our healinghellipwe should insist on hospitals meeting our human need for respect control warm and supportive carehelliprdquo

-Angelica Thieriot 1978

Founder Planetree

The 1st patient-centered advocacy organization in the USA

wwwplanetreeorg

The core of a patient-centric approach the lived experience of patients family and staff

o Compassionate Human Interactions

o Access to Meaningful Information

o Support amp Participation of Family Friends

o Healing Environment

o Support for body mind amp spirit

o Arts and Entertainment o Spirituality o Caring Touch o Integrative Therapies o Healthy Food and Nutrition

o Healthy Communities

wwwplanetreeorg

IA A multi-disciplinary task force is established to oversee and assist with implementation and maintenance of patient -resident-centered practices which includes a mix of non -supervisory and management staff and meets regularly (every 4-6 weeks) on an ongoing basis IB A patient-resident-centered care coordinator or point person is designated who is able to commit the time required to champion related activities on an ongoing basis

IC Patientresident family and staff focus groups are conducted on -site by Planetree or another qualif ied independent vendor periodically (at 12-18 month intervals) and the results are shared at a minimum with senior management the governing body and staff ID Information on patient-resident-centered care implementation and progress is shared periodically with key organizational stakeholders cultivating an understanding of patient -resident-centered initiatives underway in the organization This informat ion is communicated regularly to staff (and in continuing care environments also to residents and families) and at a minimu m annually to the governing board of the organization

IE An ongoing mechanism is in place to solicit meaningful dialogue input and reactions from patientsresidents families and the community on current practices and new initiatives This may be achieved via an active patientresidentfamily or community advisory council with regular meetings or some other effective mechanism to obtain regular input from patientsresidents and community IIA All staff including off -shift and support staff are given an opportunity to participate in a minimum of eight hours of p atient-resident-centered staff retreat experiences or an equivalent with a minimum concurrent completion rate of 85 IIB An independently administered physician experience survey is conducted at least once every f ive years using a validated survey instrument and physicians are oriented and regularly educated about and encouraged to participate in patient -resident-centered initiatives

IIC Continuing education to reinforce and revitalize staff engagement in patient -resident-centered behaviors and practices an d build competence around the communityrsquos evolving needs is offered on a regular and ongoing basis to all staff in meaningful ways determined by the organization IID A comprehensive presentation on patient -resident-centered care concepts practices and initiatives is provided for all new staff (and in continuing care settings new residents) as a part of orientation In continuing care environments resident s and family members are included in a meaningful way in the new employee orientation program

IIE Active teams are in place that address patient -resident-centered initiatives as necessary and include non -supervisory staff input IIF A model of care delivery is adopted that embraces continuity consistency and accountability-based care and allows staff the opportunity and responsibility for personalizing care for each patientresident IIG A mechanism is in place to provide s taff support services that include elements identified by s taff as priority areas Examples include access to concierge or amenity services such as meals-to-go massage space to recharge away from patients res idents and families emotional support such as bereavement services and s taff support groups and personal and profess ional deve lopment programming such as a career ladder program

IIH Human resource systems including job descriptions and evaluations ref lect the organizationrsquos patient -resident-centered care philosophy Other examples include behavioral standards recruitment and retention efforts staff selection tools and criteria In continuing care environments residents play a role in the hiring and evaluation of staff

III Numerous opportunities both formal and informal are provided for staff reward and recognition In continuing care en vironments recognition programs extend to and integrate residents and family members IIJ Independently administered staff surveys using a validated survey instrument or other structured staff feedback mechan isms are conducted at least once every two years IIK a process is in place for providing support as necessary to patientsresidents families and staff affected by an adverse event

IIL Processes are in place to help patientsresidents anticipate the costs of care and assistance is available for those wh o need to make f inancial arrangements Financial communications are concise clear and respectful IIM The organization has processes in place focusing on prevention of medical errors as well as on keeping patientsresidents and staff safe from harm from self and others

II N Effective 24-hour shift-to notshift communication processes are in place to ensure patientsrsquoresidentsrsquo individualized needs are evaluated discussed and met Opportunities for patientresident and family involvement in shift -to-shift communication are addressed II O Effective communication mechanisms are in place to keep all staff ( including off -site and all shifts) informed about organizational priorities IIPndashApplies only to continuing care sites In continuing care settings residents are given an opportunity to participate as appropriate in a retreat experience or an equivalent to assist with internalizing resident -centered care concepts and to enhance sensitivity to the needs of the entire community Resident retreats are conducted at a minimum annually

IIQndashApplies only to continuing care sites Residents are provided with the choice of where they are going to live and with whom with staff input provided as appropriate IIRndash Applies only to continuing care sites In continuing care settings processes are in place for evaluating identifying and effectively integrating into the care plan what is important to each resident based on hisher identity decision-maknoting ability and mastery skills and what is meannotingful to that resident in the living environment and in daily activities

IIIA A policy for sharing clinical information including the medical record and the care plan with patientsresidents has been approved an effective system is in place to make patientsresidents aware that they may review this information a system is in place to monitor staff communication to patientsresidents of this choice and patientresident participation levels and a process is in place to facilitate patientsresidents documenting their comments IIIA-Behavioral Health Application In behavioral health settings decisions about the extent of the clinical information shared and the mechanism used for sharing this information are made on an individualized basis A range of options are available for sharing such information including the medical record and the treatment plan to ensure that patients of varying competency levels have access to information that will help them to

understand their symptoms diagnosis and treatment IIIB A community health resource library or signif icant consumer health collection is established either based at the hosp ital or provided by the site in partnership with other organizations The hospital has implemented strategies to make patients residents families and community members aware that the library is free and open to the public Printed material is available on the sitersquos ten most common diagnoses and there are

systems in place to enable patientsresidents to obtain information both with assistance and on their own IIIC A range of educational materials is available for patientsresidents and families and is easily accessible to staff Staff is knowledgeable about the availability of these resources IIID Patientsresidents are provided with meaningful discharge instructions

IIIE A process is in place to disclose unanticipated outcomes to patientsresidents (and family members as appropriate) III FThe site has a process to assist patientsresidents and families in managing their medical information and coordinating their car e among multiple physicians including the patientrsquos admitting physician primary care provider and appropriate specialists

IVA Flexible 24-hour patient-resident-directed visiting hours are in place and children are permitted to visit (exceptions for psychiatric f acilities NICU and in cases of communicable disease) In continuing care settings accommodations are made for intimate vis its by a spousepartner IVA-Behavioral Health Application In behavioral health settings visiting hours are consistent with the patientrsquos treatment plan and f lexible to accommodate patient and family visitation preferences Restrictions to visitation are determined by the t reatment plan and patient preferences and the rationale for any restrictions is clearly communicated to patients and families IVB A comprehensive formalized approach to involving families in all aspects of the patientrsquos residentrsquos care and tailored to the needs and abilities of the organization and its facility is developed at a minimum on pediatric oncology medical-surgical and rehabilitation units An example is a Care Partner Program

IVB-Behavioral Health Application A comprehensive formalized approach to providing families with psychoeducation and when clinically appropriate involving them in the patientrsquos care is developed and tailored to the needs and abilities of the organization and its facility An example is a Care Partner Program IVC Kitchenspantries and lounges are available for families to use

IVD A process is in place to encourage patientsresidents and families to communicate with staff about any concerns related to their care including any concerns related to residentpatient safety VA A system is in place to provide patientsresidents families and staff with 24-hour access to a variety of foods and beverages (unless doing so conflicts with the treatment plan) Patientsrsquoresidentsrsquo personal preferences and routines around mealtimes are considered and accommodated to the extent possible VB The organization has a system to provide patientsresidents and staff with fresh healthy food at appropriate temperatur es and provides patients with a variety of food choices

VIA Healing healthcare design standards are developed that at a minimum address interior f inishes and lighting In continuing care settings these standards also provide for personalization of living areas by residents VIB The auditory environment has been reviewed and a noise control protocol is in place

VIC The olfactory environment has been reviewed and odors have been addressed VID As remodeling is done symbolic and real barriers are removed Examples include implementing open nursesrsquo stations family lounges unit-based kitchens indirect lighting In continuing care environments each residentrsquos living area features a view to the outside VIE Signage both leading to facility entrances as well as throughout the interior of the facility is clear and understand able to patients residents and visitors

VIF Ample parking adjacent to entrances is available When nearby parking is limited accommodations such as valet service or golf carts to transport visitors to and from the building are made available VIG The environment is designed to accommodate privacy needs and provides for patientresident dignity and modesty particu larly in common areas patientresident rooms and bathrooms

VIH The organization considers progressive facility management practices and specif ies products that promote safe non -toxic approaches to facility cleaning maintenance renovation and construction which recognize the potential health impact on patientsresidents families and staff members VII Patientsresidents have access to nature Examples include an indoor or outdoor garden VIJndash Applies only to behavioral health sites Common spaces are available and feature a sense of spaciousness and light In add ition they satisfy patientsrsquo needs for both private spaces and spaces that support social interaction

VIKndash Applies only to behavioral health sites Protocols are in place for reducing coercive intervention Examples may include a provision of a comfort room Snoezelen or low-stimulation environment VIIA an active arts component (music visual arts crafts animal visitation bedside reading) is in place In continuing care environments the array of activities is dynamic driven by residentsrsquo individual interests and inclusive of family and staf f The activities program allows for spontaneity and self -directed opportunities for residents 24-hours a day 7 days a week

VIIBndashApplies only to continuing care sites A f lexible transportation system is provided that enables residents to satisfy pers onal wishes to participate in off -site activities and to volunteer VIIIA A plan is developed and implemented that recognizes the spiritual dimension of patientsresidents families and staff in the healthcare environment In acute care and continuing care settings this plan includes practices around death and dying VIIIB The special needs of the communityrsquos diverse cultural groups are investigated documented and addressed in specif ic and appropriate ways

IXA The interests and current utilization patterns of patientsresidents and medical staff in the areas of alternative com plementary and integrative healing modalities are assessed and a plan is developed to address these needs Examples could include providing direct services developing a process for responding to patientresident requests for in -hospital treatment by the patientrsquosresidentrsquos existing practitioner(s) and evaluation of patientsresidentsrsquo herbal remedies as part of the medication reconciliation process

IXB A plan for caring touch is developed and implemented as appropriate (Exceptions include behavioral health patients) Examples of caring touch include massage M technique and Reiki XA Based on the interests and needs of the community a plan is developed to improve community health Examples include pr ovision of direct services educational information or referral and collaboration with local agencies XBndash Applies only to behavioral health sites Mechanisms are in place to give public voice to and advocate for the importance of behavioral health initiatives and the need for more comprehensive stigma free and humane approaches to this care

XIA-Acute Care Application Patient satisfaction (both inpatient and outpatient) is regularly assessed using a validated survey instrument which includes the HCAHPS questions Performance on each of the domains in the HCAHPS questionnaire meets or exc eeds national averages XIA-Behavioral Health Application Patientsrsquo perspectives of care (both inpatient and outpatient) are regularly assessed using a validated survey instrument

XIB-Acute Care Application The hospital monitors and reports its performance on the full set of CMS Quality Measures to CMS and shares data on all available indicators with Planetree The hospitalrsquos performance for the most recent twelve month period for which data is available exceeds the ldquoNational Averagerdquo performance as reported on the US Department of Health and Human Services Hospital Compare web site on 75 of the indicators for which the hospital has more than 25 eligible patients for the 12 month period (an n of gt25) XIB-Behavioral Health Application The hospital monitors and reports its performance on appropriate quality measures and provid es benchmarks for comparison purposes The hospital meets or exceeds benchmarks Sites accredited by The Joint Commission m ay submit their ORYX Performance Measure Report with both the control chart to demonstrate internal trending and the comparison chart to demonstrate performance that

meets or exceeds benchmarks to satisfy the criteria XIC-Acute Care Behavioral Health Application The hospital regularly solicits information from staff about patient safety and uses the information generated to improve safety practices in the organization The hospital has a process for encouraging s taff to report quality and patient safety issues The hospital conducts a survey to assess its patient safety culture at a minimum once every two years

XID Applies only to continuing care sites A system is established to broadly communicate performance improvement information to all members of the continuing care community and to the public

Designation- a structured pathway

IF Leadership exemplifies approaches that motivate and inspire others promote positive morale mentor and enhance performance of others recognize the knowledge and decision-making authority of others and model organizational values

IIH Human resource systems including job descriptions and evaluations reflect the organizationrsquos patient-centered care philosophy Other examples include behavioral standards recruitment and retention efforts staff selection tools and criteria and conducting team interviews

XID Staff and patientresidentfamily members are actively involved in the design ongoing assessment and communication of performance improvement efforts The organization consistently utilizes data to identify and prioritize improvement over time

IIIA A policy for sharing clinical information including the medical record and the care plan with patients has been approved staff are educated on this policy and the process for sharing the record and care plan an effective system is in place to make patients aware that they may review this information and a process is in place to facilitate patients documenting their comments

IVB A comprehensive formalized approach for partnering with families in all aspects of the patientrsquos care and tailored to the needs and abilities of the organization and its facility is developed An example is a Care Partner Program

IA A multi-disciplinary task force including patients and family members is established to oversee and assist with implementation and maintenance of patient-centered practices

IIE Active teams are in place that address patient-centered initiatives and include participation by nonsupervisory staff and patients and families

IIF Formalized processes are in place to promote continuity consistency and accountability in care delivery and which all ow staff the opportunity and responsibility for personalizing care in partnership with each patientresident

wwwplanetreeorg

Advocacy efforts in the 1970rsquos challenged the status quo of lsquopatients as passive recipientsrsquo of care

ldquohellipwe should all demand to be treated as competent adults and take an active part in our healinghellipwe should insist on hospitals meeting our human need for respect control warm and supportive carehelliprdquo

-Angelica Thieriot 1978

Founder Planetree

The 1st patient-centered advocacy organization in the USA

wwwplanetreeorg

The core of a patient-centric approach the lived experience of patients family and staff

o Compassionate Human Interactions

o Access to Meaningful Information

o Support amp Participation of Family Friends

o Healing Environment

o Support for body mind amp spirit

o Arts and Entertainment o Spirituality o Caring Touch o Integrative Therapies o Healthy Food and Nutrition

o Healthy Communities

wwwplanetreeorg

IA A multi-disciplinary task force is established to oversee and assist with implementation and maintenance of patient -resident-centered practices which includes a mix of non -supervisory and management staff and meets regularly (every 4-6 weeks) on an ongoing basis IB A patient-resident-centered care coordinator or point person is designated who is able to commit the time required to champion related activities on an ongoing basis

IC Patientresident family and staff focus groups are conducted on -site by Planetree or another qualif ied independent vendor periodically (at 12-18 month intervals) and the results are shared at a minimum with senior management the governing body and staff ID Information on patient-resident-centered care implementation and progress is shared periodically with key organizational stakeholders cultivating an understanding of patient -resident-centered initiatives underway in the organization This informat ion is communicated regularly to staff (and in continuing care environments also to residents and families) and at a minimu m annually to the governing board of the organization

IE An ongoing mechanism is in place to solicit meaningful dialogue input and reactions from patientsresidents families and the community on current practices and new initiatives This may be achieved via an active patientresidentfamily or community advisory council with regular meetings or some other effective mechanism to obtain regular input from patientsresidents and community IIA All staff including off -shift and support staff are given an opportunity to participate in a minimum of eight hours of p atient-resident-centered staff retreat experiences or an equivalent with a minimum concurrent completion rate of 85 IIB An independently administered physician experience survey is conducted at least once every f ive years using a validated survey instrument and physicians are oriented and regularly educated about and encouraged to participate in patient -resident-centered initiatives

IIC Continuing education to reinforce and revitalize staff engagement in patient -resident-centered behaviors and practices an d build competence around the communityrsquos evolving needs is offered on a regular and ongoing basis to all staff in meaningful ways determined by the organization IID A comprehensive presentation on patient -resident-centered care concepts practices and initiatives is provided for all new staff (and in continuing care settings new residents) as a part of orientation In continuing care environments resident s and family members are included in a meaningful way in the new employee orientation program

IIE Active teams are in place that address patient -resident-centered initiatives as necessary and include non -supervisory staff input IIF A model of care delivery is adopted that embraces continuity consistency and accountability-based care and allows staff the opportunity and responsibility for personalizing care for each patientresident IIG A mechanism is in place to provide s taff support services that include elements identified by s taff as priority areas Examples include access to concierge or amenity services such as meals-to-go massage space to recharge away from patients res idents and families emotional support such as bereavement services and s taff support groups and personal and profess ional deve lopment programming such as a career ladder program

IIH Human resource systems including job descriptions and evaluations ref lect the organizationrsquos patient -resident-centered care philosophy Other examples include behavioral standards recruitment and retention efforts staff selection tools and criteria In continuing care environments residents play a role in the hiring and evaluation of staff

III Numerous opportunities both formal and informal are provided for staff reward and recognition In continuing care en vironments recognition programs extend to and integrate residents and family members IIJ Independently administered staff surveys using a validated survey instrument or other structured staff feedback mechan isms are conducted at least once every two years IIK a process is in place for providing support as necessary to patientsresidents families and staff affected by an adverse event

IIL Processes are in place to help patientsresidents anticipate the costs of care and assistance is available for those wh o need to make f inancial arrangements Financial communications are concise clear and respectful IIM The organization has processes in place focusing on prevention of medical errors as well as on keeping patientsresidents and staff safe from harm from self and others

II N Effective 24-hour shift-to notshift communication processes are in place to ensure patientsrsquoresidentsrsquo individualized needs are evaluated discussed and met Opportunities for patientresident and family involvement in shift -to-shift communication are addressed II O Effective communication mechanisms are in place to keep all staff ( including off -site and all shifts) informed about organizational priorities IIPndashApplies only to continuing care sites In continuing care settings residents are given an opportunity to participate as appropriate in a retreat experience or an equivalent to assist with internalizing resident -centered care concepts and to enhance sensitivity to the needs of the entire community Resident retreats are conducted at a minimum annually

IIQndashApplies only to continuing care sites Residents are provided with the choice of where they are going to live and with whom with staff input provided as appropriate IIRndash Applies only to continuing care sites In continuing care settings processes are in place for evaluating identifying and effectively integrating into the care plan what is important to each resident based on hisher identity decision-maknoting ability and mastery skills and what is meannotingful to that resident in the living environment and in daily activities

IIIA A policy for sharing clinical information including the medical record and the care plan with patientsresidents has been approved an effective system is in place to make patientsresidents aware that they may review this information a system is in place to monitor staff communication to patientsresidents of this choice and patientresident participation levels and a process is in place to facilitate patientsresidents documenting their comments IIIA-Behavioral Health Application In behavioral health settings decisions about the extent of the clinical information shared and the mechanism used for sharing this information are made on an individualized basis A range of options are available for sharing such information including the medical record and the treatment plan to ensure that patients of varying competency levels have access to information that will help them to

understand their symptoms diagnosis and treatment IIIB A community health resource library or signif icant consumer health collection is established either based at the hosp ital or provided by the site in partnership with other organizations The hospital has implemented strategies to make patients residents families and community members aware that the library is free and open to the public Printed material is available on the sitersquos ten most common diagnoses and there are

systems in place to enable patientsresidents to obtain information both with assistance and on their own IIIC A range of educational materials is available for patientsresidents and families and is easily accessible to staff Staff is knowledgeable about the availability of these resources IIID Patientsresidents are provided with meaningful discharge instructions

IIIE A process is in place to disclose unanticipated outcomes to patientsresidents (and family members as appropriate) III FThe site has a process to assist patientsresidents and families in managing their medical information and coordinating their car e among multiple physicians including the patientrsquos admitting physician primary care provider and appropriate specialists

IVA Flexible 24-hour patient-resident-directed visiting hours are in place and children are permitted to visit (exceptions for psychiatric f acilities NICU and in cases of communicable disease) In continuing care settings accommodations are made for intimate vis its by a spousepartner IVA-Behavioral Health Application In behavioral health settings visiting hours are consistent with the patientrsquos treatment plan and f lexible to accommodate patient and family visitation preferences Restrictions to visitation are determined by the t reatment plan and patient preferences and the rationale for any restrictions is clearly communicated to patients and families IVB A comprehensive formalized approach to involving families in all aspects of the patientrsquos residentrsquos care and tailored to the needs and abilities of the organization and its facility is developed at a minimum on pediatric oncology medical-surgical and rehabilitation units An example is a Care Partner Program

IVB-Behavioral Health Application A comprehensive formalized approach to providing families with psychoeducation and when clinically appropriate involving them in the patientrsquos care is developed and tailored to the needs and abilities of the organization and its facility An example is a Care Partner Program IVC Kitchenspantries and lounges are available for families to use

IVD A process is in place to encourage patientsresidents and families to communicate with staff about any concerns related to their care including any concerns related to residentpatient safety VA A system is in place to provide patientsresidents families and staff with 24-hour access to a variety of foods and beverages (unless doing so conflicts with the treatment plan) Patientsrsquoresidentsrsquo personal preferences and routines around mealtimes are considered and accommodated to the extent possible VB The organization has a system to provide patientsresidents and staff with fresh healthy food at appropriate temperatur es and provides patients with a variety of food choices

VIA Healing healthcare design standards are developed that at a minimum address interior f inishes and lighting In continuing care settings these standards also provide for personalization of living areas by residents VIB The auditory environment has been reviewed and a noise control protocol is in place

VIC The olfactory environment has been reviewed and odors have been addressed VID As remodeling is done symbolic and real barriers are removed Examples include implementing open nursesrsquo stations family lounges unit-based kitchens indirect lighting In continuing care environments each residentrsquos living area features a view to the outside VIE Signage both leading to facility entrances as well as throughout the interior of the facility is clear and understand able to patients residents and visitors

VIF Ample parking adjacent to entrances is available When nearby parking is limited accommodations such as valet service or golf carts to transport visitors to and from the building are made available VIG The environment is designed to accommodate privacy needs and provides for patientresident dignity and modesty particu larly in common areas patientresident rooms and bathrooms

VIH The organization considers progressive facility management practices and specif ies products that promote safe non -toxic approaches to facility cleaning maintenance renovation and construction which recognize the potential health impact on patientsresidents families and staff members VII Patientsresidents have access to nature Examples include an indoor or outdoor garden VIJndash Applies only to behavioral health sites Common spaces are available and feature a sense of spaciousness and light In add ition they satisfy patientsrsquo needs for both private spaces and spaces that support social interaction

VIKndash Applies only to behavioral health sites Protocols are in place for reducing coercive intervention Examples may include a provision of a comfort room Snoezelen or low-stimulation environment VIIA an active arts component (music visual arts crafts animal visitation bedside reading) is in place In continuing care environments the array of activities is dynamic driven by residentsrsquo individual interests and inclusive of family and staf f The activities program allows for spontaneity and self -directed opportunities for residents 24-hours a day 7 days a week

VIIBndashApplies only to continuing care sites A f lexible transportation system is provided that enables residents to satisfy pers onal wishes to participate in off -site activities and to volunteer VIIIA A plan is developed and implemented that recognizes the spiritual dimension of patientsresidents families and staff in the healthcare environment In acute care and continuing care settings this plan includes practices around death and dying VIIIB The special needs of the communityrsquos diverse cultural groups are investigated documented and addressed in specif ic and appropriate ways

IXA The interests and current utilization patterns of patientsresidents and medical staff in the areas of alternative com plementary and integrative healing modalities are assessed and a plan is developed to address these needs Examples could include providing direct services developing a process for responding to patientresident requests for in -hospital treatment by the patientrsquosresidentrsquos existing practitioner(s) and evaluation of patientsresidentsrsquo herbal remedies as part of the medication reconciliation process

IXB A plan for caring touch is developed and implemented as appropriate (Exceptions include behavioral health patients) Examples of caring touch include massage M technique and Reiki XA Based on the interests and needs of the community a plan is developed to improve community health Examples include pr ovision of direct services educational information or referral and collaboration with local agencies XBndash Applies only to behavioral health sites Mechanisms are in place to give public voice to and advocate for the importance of behavioral health initiatives and the need for more comprehensive stigma free and humane approaches to this care

XIA-Acute Care Application Patient satisfaction (both inpatient and outpatient) is regularly assessed using a validated survey instrument which includes the HCAHPS questions Performance on each of the domains in the HCAHPS questionnaire meets or exc eeds national averages XIA-Behavioral Health Application Patientsrsquo perspectives of care (both inpatient and outpatient) are regularly assessed using a validated survey instrument

XIB-Acute Care Application The hospital monitors and reports its performance on the full set of CMS Quality Measures to CMS and shares data on all available indicators with Planetree The hospitalrsquos performance for the most recent twelve month period for which data is available exceeds the ldquoNational Averagerdquo performance as reported on the US Department of Health and Human Services Hospital Compare web site on 75 of the indicators for which the hospital has more than 25 eligible patients for the 12 month period (an n of gt25) XIB-Behavioral Health Application The hospital monitors and reports its performance on appropriate quality measures and provid es benchmarks for comparison purposes The hospital meets or exceeds benchmarks Sites accredited by The Joint Commission m ay submit their ORYX Performance Measure Report with both the control chart to demonstrate internal trending and the comparison chart to demonstrate performance that

meets or exceeds benchmarks to satisfy the criteria XIC-Acute Care Behavioral Health Application The hospital regularly solicits information from staff about patient safety and uses the information generated to improve safety practices in the organization The hospital has a process for encouraging s taff to report quality and patient safety issues The hospital conducts a survey to assess its patient safety culture at a minimum once every two years

XID Applies only to continuing care sites A system is established to broadly communicate performance improvement information to all members of the continuing care community and to the public

Designation- a structured pathway

IF Leadership exemplifies approaches that motivate and inspire others promote positive morale mentor and enhance performance of others recognize the knowledge and decision-making authority of others and model organizational values

IIH Human resource systems including job descriptions and evaluations reflect the organizationrsquos patient-centered care philosophy Other examples include behavioral standards recruitment and retention efforts staff selection tools and criteria and conducting team interviews

XID Staff and patientresidentfamily members are actively involved in the design ongoing assessment and communication of performance improvement efforts The organization consistently utilizes data to identify and prioritize improvement over time

IIIA A policy for sharing clinical information including the medical record and the care plan with patients has been approved staff are educated on this policy and the process for sharing the record and care plan an effective system is in place to make patients aware that they may review this information and a process is in place to facilitate patients documenting their comments

IVB A comprehensive formalized approach for partnering with families in all aspects of the patientrsquos care and tailored to the needs and abilities of the organization and its facility is developed An example is a Care Partner Program

IA A multi-disciplinary task force including patients and family members is established to oversee and assist with implementation and maintenance of patient-centered practices

IIE Active teams are in place that address patient-centered initiatives and include participation by nonsupervisory staff and patients and families

IIF Formalized processes are in place to promote continuity consistency and accountability in care delivery and which all ow staff the opportunity and responsibility for personalizing care in partnership with each patientresident

wwwplanetreeorg

The core of a patient-centric approach the lived experience of patients family and staff

o Compassionate Human Interactions

o Access to Meaningful Information

o Support amp Participation of Family Friends

o Healing Environment

o Support for body mind amp spirit

o Arts and Entertainment o Spirituality o Caring Touch o Integrative Therapies o Healthy Food and Nutrition

o Healthy Communities

wwwplanetreeorg

IA A multi-disciplinary task force is established to oversee and assist with implementation and maintenance of patient -resident-centered practices which includes a mix of non -supervisory and management staff and meets regularly (every 4-6 weeks) on an ongoing basis IB A patient-resident-centered care coordinator or point person is designated who is able to commit the time required to champion related activities on an ongoing basis

IC Patientresident family and staff focus groups are conducted on -site by Planetree or another qualif ied independent vendor periodically (at 12-18 month intervals) and the results are shared at a minimum with senior management the governing body and staff ID Information on patient-resident-centered care implementation and progress is shared periodically with key organizational stakeholders cultivating an understanding of patient -resident-centered initiatives underway in the organization This informat ion is communicated regularly to staff (and in continuing care environments also to residents and families) and at a minimu m annually to the governing board of the organization

IE An ongoing mechanism is in place to solicit meaningful dialogue input and reactions from patientsresidents families and the community on current practices and new initiatives This may be achieved via an active patientresidentfamily or community advisory council with regular meetings or some other effective mechanism to obtain regular input from patientsresidents and community IIA All staff including off -shift and support staff are given an opportunity to participate in a minimum of eight hours of p atient-resident-centered staff retreat experiences or an equivalent with a minimum concurrent completion rate of 85 IIB An independently administered physician experience survey is conducted at least once every f ive years using a validated survey instrument and physicians are oriented and regularly educated about and encouraged to participate in patient -resident-centered initiatives

IIC Continuing education to reinforce and revitalize staff engagement in patient -resident-centered behaviors and practices an d build competence around the communityrsquos evolving needs is offered on a regular and ongoing basis to all staff in meaningful ways determined by the organization IID A comprehensive presentation on patient -resident-centered care concepts practices and initiatives is provided for all new staff (and in continuing care settings new residents) as a part of orientation In continuing care environments resident s and family members are included in a meaningful way in the new employee orientation program

IIE Active teams are in place that address patient -resident-centered initiatives as necessary and include non -supervisory staff input IIF A model of care delivery is adopted that embraces continuity consistency and accountability-based care and allows staff the opportunity and responsibility for personalizing care for each patientresident IIG A mechanism is in place to provide s taff support services that include elements identified by s taff as priority areas Examples include access to concierge or amenity services such as meals-to-go massage space to recharge away from patients res idents and families emotional support such as bereavement services and s taff support groups and personal and profess ional deve lopment programming such as a career ladder program

IIH Human resource systems including job descriptions and evaluations ref lect the organizationrsquos patient -resident-centered care philosophy Other examples include behavioral standards recruitment and retention efforts staff selection tools and criteria In continuing care environments residents play a role in the hiring and evaluation of staff

III Numerous opportunities both formal and informal are provided for staff reward and recognition In continuing care en vironments recognition programs extend to and integrate residents and family members IIJ Independently administered staff surveys using a validated survey instrument or other structured staff feedback mechan isms are conducted at least once every two years IIK a process is in place for providing support as necessary to patientsresidents families and staff affected by an adverse event

IIL Processes are in place to help patientsresidents anticipate the costs of care and assistance is available for those wh o need to make f inancial arrangements Financial communications are concise clear and respectful IIM The organization has processes in place focusing on prevention of medical errors as well as on keeping patientsresidents and staff safe from harm from self and others

II N Effective 24-hour shift-to notshift communication processes are in place to ensure patientsrsquoresidentsrsquo individualized needs are evaluated discussed and met Opportunities for patientresident and family involvement in shift -to-shift communication are addressed II O Effective communication mechanisms are in place to keep all staff ( including off -site and all shifts) informed about organizational priorities IIPndashApplies only to continuing care sites In continuing care settings residents are given an opportunity to participate as appropriate in a retreat experience or an equivalent to assist with internalizing resident -centered care concepts and to enhance sensitivity to the needs of the entire community Resident retreats are conducted at a minimum annually

IIQndashApplies only to continuing care sites Residents are provided with the choice of where they are going to live and with whom with staff input provided as appropriate IIRndash Applies only to continuing care sites In continuing care settings processes are in place for evaluating identifying and effectively integrating into the care plan what is important to each resident based on hisher identity decision-maknoting ability and mastery skills and what is meannotingful to that resident in the living environment and in daily activities

IIIA A policy for sharing clinical information including the medical record and the care plan with patientsresidents has been approved an effective system is in place to make patientsresidents aware that they may review this information a system is in place to monitor staff communication to patientsresidents of this choice and patientresident participation levels and a process is in place to facilitate patientsresidents documenting their comments IIIA-Behavioral Health Application In behavioral health settings decisions about the extent of the clinical information shared and the mechanism used for sharing this information are made on an individualized basis A range of options are available for sharing such information including the medical record and the treatment plan to ensure that patients of varying competency levels have access to information that will help them to

understand their symptoms diagnosis and treatment IIIB A community health resource library or signif icant consumer health collection is established either based at the hosp ital or provided by the site in partnership with other organizations The hospital has implemented strategies to make patients residents families and community members aware that the library is free and open to the public Printed material is available on the sitersquos ten most common diagnoses and there are

systems in place to enable patientsresidents to obtain information both with assistance and on their own IIIC A range of educational materials is available for patientsresidents and families and is easily accessible to staff Staff is knowledgeable about the availability of these resources IIID Patientsresidents are provided with meaningful discharge instructions

IIIE A process is in place to disclose unanticipated outcomes to patientsresidents (and family members as appropriate) III FThe site has a process to assist patientsresidents and families in managing their medical information and coordinating their car e among multiple physicians including the patientrsquos admitting physician primary care provider and appropriate specialists

IVA Flexible 24-hour patient-resident-directed visiting hours are in place and children are permitted to visit (exceptions for psychiatric f acilities NICU and in cases of communicable disease) In continuing care settings accommodations are made for intimate vis its by a spousepartner IVA-Behavioral Health Application In behavioral health settings visiting hours are consistent with the patientrsquos treatment plan and f lexible to accommodate patient and family visitation preferences Restrictions to visitation are determined by the t reatment plan and patient preferences and the rationale for any restrictions is clearly communicated to patients and families IVB A comprehensive formalized approach to involving families in all aspects of the patientrsquos residentrsquos care and tailored to the needs and abilities of the organization and its facility is developed at a minimum on pediatric oncology medical-surgical and rehabilitation units An example is a Care Partner Program

IVB-Behavioral Health Application A comprehensive formalized approach to providing families with psychoeducation and when clinically appropriate involving them in the patientrsquos care is developed and tailored to the needs and abilities of the organization and its facility An example is a Care Partner Program IVC Kitchenspantries and lounges are available for families to use

IVD A process is in place to encourage patientsresidents and families to communicate with staff about any concerns related to their care including any concerns related to residentpatient safety VA A system is in place to provide patientsresidents families and staff with 24-hour access to a variety of foods and beverages (unless doing so conflicts with the treatment plan) Patientsrsquoresidentsrsquo personal preferences and routines around mealtimes are considered and accommodated to the extent possible VB The organization has a system to provide patientsresidents and staff with fresh healthy food at appropriate temperatur es and provides patients with a variety of food choices

VIA Healing healthcare design standards are developed that at a minimum address interior f inishes and lighting In continuing care settings these standards also provide for personalization of living areas by residents VIB The auditory environment has been reviewed and a noise control protocol is in place

VIC The olfactory environment has been reviewed and odors have been addressed VID As remodeling is done symbolic and real barriers are removed Examples include implementing open nursesrsquo stations family lounges unit-based kitchens indirect lighting In continuing care environments each residentrsquos living area features a view to the outside VIE Signage both leading to facility entrances as well as throughout the interior of the facility is clear and understand able to patients residents and visitors

VIF Ample parking adjacent to entrances is available When nearby parking is limited accommodations such as valet service or golf carts to transport visitors to and from the building are made available VIG The environment is designed to accommodate privacy needs and provides for patientresident dignity and modesty particu larly in common areas patientresident rooms and bathrooms

VIH The organization considers progressive facility management practices and specif ies products that promote safe non -toxic approaches to facility cleaning maintenance renovation and construction which recognize the potential health impact on patientsresidents families and staff members VII Patientsresidents have access to nature Examples include an indoor or outdoor garden VIJndash Applies only to behavioral health sites Common spaces are available and feature a sense of spaciousness and light In add ition they satisfy patientsrsquo needs for both private spaces and spaces that support social interaction

VIKndash Applies only to behavioral health sites Protocols are in place for reducing coercive intervention Examples may include a provision of a comfort room Snoezelen or low-stimulation environment VIIA an active arts component (music visual arts crafts animal visitation bedside reading) is in place In continuing care environments the array of activities is dynamic driven by residentsrsquo individual interests and inclusive of family and staf f The activities program allows for spontaneity and self -directed opportunities for residents 24-hours a day 7 days a week

VIIBndashApplies only to continuing care sites A f lexible transportation system is provided that enables residents to satisfy pers onal wishes to participate in off -site activities and to volunteer VIIIA A plan is developed and implemented that recognizes the spiritual dimension of patientsresidents families and staff in the healthcare environment In acute care and continuing care settings this plan includes practices around death and dying VIIIB The special needs of the communityrsquos diverse cultural groups are investigated documented and addressed in specif ic and appropriate ways

IXA The interests and current utilization patterns of patientsresidents and medical staff in the areas of alternative com plementary and integrative healing modalities are assessed and a plan is developed to address these needs Examples could include providing direct services developing a process for responding to patientresident requests for in -hospital treatment by the patientrsquosresidentrsquos existing practitioner(s) and evaluation of patientsresidentsrsquo herbal remedies as part of the medication reconciliation process

IXB A plan for caring touch is developed and implemented as appropriate (Exceptions include behavioral health patients) Examples of caring touch include massage M technique and Reiki XA Based on the interests and needs of the community a plan is developed to improve community health Examples include pr ovision of direct services educational information or referral and collaboration with local agencies XBndash Applies only to behavioral health sites Mechanisms are in place to give public voice to and advocate for the importance of behavioral health initiatives and the need for more comprehensive stigma free and humane approaches to this care

XIA-Acute Care Application Patient satisfaction (both inpatient and outpatient) is regularly assessed using a validated survey instrument which includes the HCAHPS questions Performance on each of the domains in the HCAHPS questionnaire meets or exc eeds national averages XIA-Behavioral Health Application Patientsrsquo perspectives of care (both inpatient and outpatient) are regularly assessed using a validated survey instrument

XIB-Acute Care Application The hospital monitors and reports its performance on the full set of CMS Quality Measures to CMS and shares data on all available indicators with Planetree The hospitalrsquos performance for the most recent twelve month period for which data is available exceeds the ldquoNational Averagerdquo performance as reported on the US Department of Health and Human Services Hospital Compare web site on 75 of the indicators for which the hospital has more than 25 eligible patients for the 12 month period (an n of gt25) XIB-Behavioral Health Application The hospital monitors and reports its performance on appropriate quality measures and provid es benchmarks for comparison purposes The hospital meets or exceeds benchmarks Sites accredited by The Joint Commission m ay submit their ORYX Performance Measure Report with both the control chart to demonstrate internal trending and the comparison chart to demonstrate performance that

meets or exceeds benchmarks to satisfy the criteria XIC-Acute Care Behavioral Health Application The hospital regularly solicits information from staff about patient safety and uses the information generated to improve safety practices in the organization The hospital has a process for encouraging s taff to report quality and patient safety issues The hospital conducts a survey to assess its patient safety culture at a minimum once every two years

XID Applies only to continuing care sites A system is established to broadly communicate performance improvement information to all members of the continuing care community and to the public

Designation- a structured pathway

IF Leadership exemplifies approaches that motivate and inspire others promote positive morale mentor and enhance performance of others recognize the knowledge and decision-making authority of others and model organizational values

IIH Human resource systems including job descriptions and evaluations reflect the organizationrsquos patient-centered care philosophy Other examples include behavioral standards recruitment and retention efforts staff selection tools and criteria and conducting team interviews

XID Staff and patientresidentfamily members are actively involved in the design ongoing assessment and communication of performance improvement efforts The organization consistently utilizes data to identify and prioritize improvement over time

IIIA A policy for sharing clinical information including the medical record and the care plan with patients has been approved staff are educated on this policy and the process for sharing the record and care plan an effective system is in place to make patients aware that they may review this information and a process is in place to facilitate patients documenting their comments

IVB A comprehensive formalized approach for partnering with families in all aspects of the patientrsquos care and tailored to the needs and abilities of the organization and its facility is developed An example is a Care Partner Program

IA A multi-disciplinary task force including patients and family members is established to oversee and assist with implementation and maintenance of patient-centered practices

IIE Active teams are in place that address patient-centered initiatives and include participation by nonsupervisory staff and patients and families

IIF Formalized processes are in place to promote continuity consistency and accountability in care delivery and which all ow staff the opportunity and responsibility for personalizing care in partnership with each patientresident

wwwplanetreeorg

IA A multi-disciplinary task force is established to oversee and assist with implementation and maintenance of patient -resident-centered practices which includes a mix of non -supervisory and management staff and meets regularly (every 4-6 weeks) on an ongoing basis IB A patient-resident-centered care coordinator or point person is designated who is able to commit the time required to champion related activities on an ongoing basis

IC Patientresident family and staff focus groups are conducted on -site by Planetree or another qualif ied independent vendor periodically (at 12-18 month intervals) and the results are shared at a minimum with senior management the governing body and staff ID Information on patient-resident-centered care implementation and progress is shared periodically with key organizational stakeholders cultivating an understanding of patient -resident-centered initiatives underway in the organization This informat ion is communicated regularly to staff (and in continuing care environments also to residents and families) and at a minimu m annually to the governing board of the organization

IE An ongoing mechanism is in place to solicit meaningful dialogue input and reactions from patientsresidents families and the community on current practices and new initiatives This may be achieved via an active patientresidentfamily or community advisory council with regular meetings or some other effective mechanism to obtain regular input from patientsresidents and community IIA All staff including off -shift and support staff are given an opportunity to participate in a minimum of eight hours of p atient-resident-centered staff retreat experiences or an equivalent with a minimum concurrent completion rate of 85 IIB An independently administered physician experience survey is conducted at least once every f ive years using a validated survey instrument and physicians are oriented and regularly educated about and encouraged to participate in patient -resident-centered initiatives

IIC Continuing education to reinforce and revitalize staff engagement in patient -resident-centered behaviors and practices an d build competence around the communityrsquos evolving needs is offered on a regular and ongoing basis to all staff in meaningful ways determined by the organization IID A comprehensive presentation on patient -resident-centered care concepts practices and initiatives is provided for all new staff (and in continuing care settings new residents) as a part of orientation In continuing care environments resident s and family members are included in a meaningful way in the new employee orientation program

IIE Active teams are in place that address patient -resident-centered initiatives as necessary and include non -supervisory staff input IIF A model of care delivery is adopted that embraces continuity consistency and accountability-based care and allows staff the opportunity and responsibility for personalizing care for each patientresident IIG A mechanism is in place to provide s taff support services that include elements identified by s taff as priority areas Examples include access to concierge or amenity services such as meals-to-go massage space to recharge away from patients res idents and families emotional support such as bereavement services and s taff support groups and personal and profess ional deve lopment programming such as a career ladder program

IIH Human resource systems including job descriptions and evaluations ref lect the organizationrsquos patient -resident-centered care philosophy Other examples include behavioral standards recruitment and retention efforts staff selection tools and criteria In continuing care environments residents play a role in the hiring and evaluation of staff

III Numerous opportunities both formal and informal are provided for staff reward and recognition In continuing care en vironments recognition programs extend to and integrate residents and family members IIJ Independently administered staff surveys using a validated survey instrument or other structured staff feedback mechan isms are conducted at least once every two years IIK a process is in place for providing support as necessary to patientsresidents families and staff affected by an adverse event

IIL Processes are in place to help patientsresidents anticipate the costs of care and assistance is available for those wh o need to make f inancial arrangements Financial communications are concise clear and respectful IIM The organization has processes in place focusing on prevention of medical errors as well as on keeping patientsresidents and staff safe from harm from self and others

II N Effective 24-hour shift-to notshift communication processes are in place to ensure patientsrsquoresidentsrsquo individualized needs are evaluated discussed and met Opportunities for patientresident and family involvement in shift -to-shift communication are addressed II O Effective communication mechanisms are in place to keep all staff ( including off -site and all shifts) informed about organizational priorities IIPndashApplies only to continuing care sites In continuing care settings residents are given an opportunity to participate as appropriate in a retreat experience or an equivalent to assist with internalizing resident -centered care concepts and to enhance sensitivity to the needs of the entire community Resident retreats are conducted at a minimum annually

IIQndashApplies only to continuing care sites Residents are provided with the choice of where they are going to live and with whom with staff input provided as appropriate IIRndash Applies only to continuing care sites In continuing care settings processes are in place for evaluating identifying and effectively integrating into the care plan what is important to each resident based on hisher identity decision-maknoting ability and mastery skills and what is meannotingful to that resident in the living environment and in daily activities

IIIA A policy for sharing clinical information including the medical record and the care plan with patientsresidents has been approved an effective system is in place to make patientsresidents aware that they may review this information a system is in place to monitor staff communication to patientsresidents of this choice and patientresident participation levels and a process is in place to facilitate patientsresidents documenting their comments IIIA-Behavioral Health Application In behavioral health settings decisions about the extent of the clinical information shared and the mechanism used for sharing this information are made on an individualized basis A range of options are available for sharing such information including the medical record and the treatment plan to ensure that patients of varying competency levels have access to information that will help them to

understand their symptoms diagnosis and treatment IIIB A community health resource library or signif icant consumer health collection is established either based at the hosp ital or provided by the site in partnership with other organizations The hospital has implemented strategies to make patients residents families and community members aware that the library is free and open to the public Printed material is available on the sitersquos ten most common diagnoses and there are

systems in place to enable patientsresidents to obtain information both with assistance and on their own IIIC A range of educational materials is available for patientsresidents and families and is easily accessible to staff Staff is knowledgeable about the availability of these resources IIID Patientsresidents are provided with meaningful discharge instructions

IIIE A process is in place to disclose unanticipated outcomes to patientsresidents (and family members as appropriate) III FThe site has a process to assist patientsresidents and families in managing their medical information and coordinating their car e among multiple physicians including the patientrsquos admitting physician primary care provider and appropriate specialists

IVA Flexible 24-hour patient-resident-directed visiting hours are in place and children are permitted to visit (exceptions for psychiatric f acilities NICU and in cases of communicable disease) In continuing care settings accommodations are made for intimate vis its by a spousepartner IVA-Behavioral Health Application In behavioral health settings visiting hours are consistent with the patientrsquos treatment plan and f lexible to accommodate patient and family visitation preferences Restrictions to visitation are determined by the t reatment plan and patient preferences and the rationale for any restrictions is clearly communicated to patients and families IVB A comprehensive formalized approach to involving families in all aspects of the patientrsquos residentrsquos care and tailored to the needs and abilities of the organization and its facility is developed at a minimum on pediatric oncology medical-surgical and rehabilitation units An example is a Care Partner Program

IVB-Behavioral Health Application A comprehensive formalized approach to providing families with psychoeducation and when clinically appropriate involving them in the patientrsquos care is developed and tailored to the needs and abilities of the organization and its facility An example is a Care Partner Program IVC Kitchenspantries and lounges are available for families to use

IVD A process is in place to encourage patientsresidents and families to communicate with staff about any concerns related to their care including any concerns related to residentpatient safety VA A system is in place to provide patientsresidents families and staff with 24-hour access to a variety of foods and beverages (unless doing so conflicts with the treatment plan) Patientsrsquoresidentsrsquo personal preferences and routines around mealtimes are considered and accommodated to the extent possible VB The organization has a system to provide patientsresidents and staff with fresh healthy food at appropriate temperatur es and provides patients with a variety of food choices

VIA Healing healthcare design standards are developed that at a minimum address interior f inishes and lighting In continuing care settings these standards also provide for personalization of living areas by residents VIB The auditory environment has been reviewed and a noise control protocol is in place

VIC The olfactory environment has been reviewed and odors have been addressed VID As remodeling is done symbolic and real barriers are removed Examples include implementing open nursesrsquo stations family lounges unit-based kitchens indirect lighting In continuing care environments each residentrsquos living area features a view to the outside VIE Signage both leading to facility entrances as well as throughout the interior of the facility is clear and understand able to patients residents and visitors

VIF Ample parking adjacent to entrances is available When nearby parking is limited accommodations such as valet service or golf carts to transport visitors to and from the building are made available VIG The environment is designed to accommodate privacy needs and provides for patientresident dignity and modesty particu larly in common areas patientresident rooms and bathrooms

VIH The organization considers progressive facility management practices and specif ies products that promote safe non -toxic approaches to facility cleaning maintenance renovation and construction which recognize the potential health impact on patientsresidents families and staff members VII Patientsresidents have access to nature Examples include an indoor or outdoor garden VIJndash Applies only to behavioral health sites Common spaces are available and feature a sense of spaciousness and light In add ition they satisfy patientsrsquo needs for both private spaces and spaces that support social interaction

VIKndash Applies only to behavioral health sites Protocols are in place for reducing coercive intervention Examples may include a provision of a comfort room Snoezelen or low-stimulation environment VIIA an active arts component (music visual arts crafts animal visitation bedside reading) is in place In continuing care environments the array of activities is dynamic driven by residentsrsquo individual interests and inclusive of family and staf f The activities program allows for spontaneity and self -directed opportunities for residents 24-hours a day 7 days a week

VIIBndashApplies only to continuing care sites A f lexible transportation system is provided that enables residents to satisfy pers onal wishes to participate in off -site activities and to volunteer VIIIA A plan is developed and implemented that recognizes the spiritual dimension of patientsresidents families and staff in the healthcare environment In acute care and continuing care settings this plan includes practices around death and dying VIIIB The special needs of the communityrsquos diverse cultural groups are investigated documented and addressed in specif ic and appropriate ways

IXA The interests and current utilization patterns of patientsresidents and medical staff in the areas of alternative com plementary and integrative healing modalities are assessed and a plan is developed to address these needs Examples could include providing direct services developing a process for responding to patientresident requests for in -hospital treatment by the patientrsquosresidentrsquos existing practitioner(s) and evaluation of patientsresidentsrsquo herbal remedies as part of the medication reconciliation process

IXB A plan for caring touch is developed and implemented as appropriate (Exceptions include behavioral health patients) Examples of caring touch include massage M technique and Reiki XA Based on the interests and needs of the community a plan is developed to improve community health Examples include pr ovision of direct services educational information or referral and collaboration with local agencies XBndash Applies only to behavioral health sites Mechanisms are in place to give public voice to and advocate for the importance of behavioral health initiatives and the need for more comprehensive stigma free and humane approaches to this care

XIA-Acute Care Application Patient satisfaction (both inpatient and outpatient) is regularly assessed using a validated survey instrument which includes the HCAHPS questions Performance on each of the domains in the HCAHPS questionnaire meets or exc eeds national averages XIA-Behavioral Health Application Patientsrsquo perspectives of care (both inpatient and outpatient) are regularly assessed using a validated survey instrument

XIB-Acute Care Application The hospital monitors and reports its performance on the full set of CMS Quality Measures to CMS and shares data on all available indicators with Planetree The hospitalrsquos performance for the most recent twelve month period for which data is available exceeds the ldquoNational Averagerdquo performance as reported on the US Department of Health and Human Services Hospital Compare web site on 75 of the indicators for which the hospital has more than 25 eligible patients for the 12 month period (an n of gt25) XIB-Behavioral Health Application The hospital monitors and reports its performance on appropriate quality measures and provid es benchmarks for comparison purposes The hospital meets or exceeds benchmarks Sites accredited by The Joint Commission m ay submit their ORYX Performance Measure Report with both the control chart to demonstrate internal trending and the comparison chart to demonstrate performance that

meets or exceeds benchmarks to satisfy the criteria XIC-Acute Care Behavioral Health Application The hospital regularly solicits information from staff about patient safety and uses the information generated to improve safety practices in the organization The hospital has a process for encouraging s taff to report quality and patient safety issues The hospital conducts a survey to assess its patient safety culture at a minimum once every two years

XID Applies only to continuing care sites A system is established to broadly communicate performance improvement information to all members of the continuing care community and to the public

Designation- a structured pathway

IF Leadership exemplifies approaches that motivate and inspire others promote positive morale mentor and enhance performance of others recognize the knowledge and decision-making authority of others and model organizational values

IIH Human resource systems including job descriptions and evaluations reflect the organizationrsquos patient-centered care philosophy Other examples include behavioral standards recruitment and retention efforts staff selection tools and criteria and conducting team interviews

XID Staff and patientresidentfamily members are actively involved in the design ongoing assessment and communication of performance improvement efforts The organization consistently utilizes data to identify and prioritize improvement over time

IIIA A policy for sharing clinical information including the medical record and the care plan with patients has been approved staff are educated on this policy and the process for sharing the record and care plan an effective system is in place to make patients aware that they may review this information and a process is in place to facilitate patients documenting their comments

IVB A comprehensive formalized approach for partnering with families in all aspects of the patientrsquos care and tailored to the needs and abilities of the organization and its facility is developed An example is a Care Partner Program

IA A multi-disciplinary task force including patients and family members is established to oversee and assist with implementation and maintenance of patient-centered practices

IIE Active teams are in place that address patient-centered initiatives and include participation by nonsupervisory staff and patients and families

IIF Formalized processes are in place to promote continuity consistency and accountability in care delivery and which all ow staff the opportunity and responsibility for personalizing care in partnership with each patientresident

wwwplanetreeorg

Excellence defined and assessed by patients

ldquoItrsquos not just what we do but how we do it treating patients with dignity and respectrdquo

- Jane Cummings Chief Nursing Officer for England

wwwplanetreeorg

Experience Base

Evidence Base

Why Patient-Centered Hospital Designation is Unique Experience Based Criteria

I Structures and Functions Necessary for Culture Change

II Human Interactions Independence Dignity and Choice

III Promoting PatientResident Education Choice amp Responsibility

IV Family Involvement

V Food Dining amp Nutrition

VI Healing Environment Architecture and Design

VII Arts ProgramMeaningful Activities and Entertainment

VIII Spirituality amp Diversity

IX Integrative Therapies Paths to Well-Being

X Healthy Communities Enhancement of Lifersquos Journey

XI Measurement

bull 60+ criteria for acute care hospitals bull Establishes a high bar for PCC Excellence bull Applies across the continuum bull Encourages innovation

wwwplanetreeorg

ldquohellipproviding care that is respectful of and responsive to individual patient preferences

needs and values and ensuring that patient values guide all clinical decisionshelliprdquo (IOM 2001)

ldquohellipcare designed with patient involvement to ensure timely convenient well-coordinated

engagement of a personrsquos health and health care needs preferences and values it

includes explicit and partnered determination of patient goals and care options and it

requires ongoing assessment of the care match with patient goalsrdquo (IOMNAM 2015)

IOMNational Academy of Medicine Revises Definition of Patient-Centered Care

wwwplanetreeorg

Institute of Medicinersquos Roundtable on Value amp Science-Driven Health Care bull Care Culture and Decision-making Innovation Collaborative (CCDmIC)

bull Patient amp Family Council Leaders National Network bull Scientific Advisory Panel on the Evidence-Base for Patient and Family

Engaged Care

IOM-National Academy of Medicine PFE Agenda

wwwplanetreeorg

The Scientific Evidence-Base for

Patient and Family Centered Approaches to

Care

NATIONAL ACADEMY OF MEDICINE

wwwplanetreeorg

bull Use the Planetree model of care to develop a common understanding of essential elements for

creating and sustaining patient and family-centered culture in healthcare settings

bull Integrate this into a logic model as an organizing framework for identifying essential elements of

Patient and Family Centered Care and the outcomes these elements influence

bull Engage a panel of scientific experts to share and compile existing and emerging research in

support of the essential elements identified in the logic model and in identifying evidence gaps

bull Develop criteria for assessing strength of evidence identified

Goals for IOMNAM Scientific Advisory Panel

wwwplanetreeorg

1 Shortell et al October 201

2 McClelland L and Vogus T Compassion Practices and HCAHPS Does Rewarding and Supporting Workplace Compassion Influence Patient Perceptions Healt h Services Research Volume 49 Issue 5 pages 1670ndash1683 October 2014

3 Shortell et al Early Assessment of ACOsrsquo Efforts to Engage Patients and Their Families Med Care Res Rev October 2015 vol 72 no 5 580-604

4 Riess H Kelley JM Bailey RW Dunn EJ Phillips M (2012 Oct) ldquoEmpathy training for resident physicians a randomized controlled trial of a neuroscience-informed curriculumrdquo J Gen Intern Med 27(10)1280-6

5 Riess H Marci CD The Neurobiology and Physiology of the Patient ndashDoctor Relationship Measuring Empathy Medical Encounter 2007 21(3)38-41

6 Riess H Herman JB Teaching the teachers A model course for psychotherapy supervisors Academic Psychiatry 2008 32259-264

7 Shortell et al October 2015

8 Hibbard J and Green J What The Evidence Shows About Patient Activation Hlth Aff Feb 2013 vol 32 no 2 207-214

9 Rakel and Barrett et al in Patient Education and Counseling 2011

10 Hojat et al in Academic Medicine 2011

11 Haslam in Medical Journal of Australia 2007

12 Stone S Annual Nursing Report Sharp Memorial Hospital 2014

13 Lim L and Zimring C Healthcare Design of the Future ARCH 4833ARCH 6271ID 6271BMED 8813 HF 2015

14 Berwick D and Kotagal M JAMA 2004292(6)736-737 doi101001jama2926736 L

15 Stone S 2014

16 Stone S 2014

17 Hankinson T Development of a sleep menu and the impact on sleep quality VA NJ 2013

18 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001)

19 Veroff David Amy Marr and David E Wennberg Enhanced Support for Shared Decision Making Reduced Costs of Care for Patients with Preference-Sensitive Conditions Health Affairs 32 no 2 (2013) 285-93

20 Singer Sara J and Timothy J Vogus Reducing hospital errors interventions that build safety culture Annual review of public health 34 (2013) 373-396

21 Greene J Hibbard J et al When Patient Activation Levels Change Health Outcomes And Costs Change Too Health Aff March 2015 vol 34 no 3431-437

22 Veroff et al 2013)

23 Rakel and Barrett et al 2011

24 Stone S Annual Nursing Report Sharp Memorial Hospital 2014

25 Hojat et al 2011

26 Haslam 2007

27 Stone S Patient Falls Reduction Initiative Sharp Healthcare Annual Nursing Report 2011

28 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001)

29 Stone S 2014

30 CMS Office of Information Products and Data Analytics -May 2014 Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

31 McClelland L and Vogus T October 2014

32 Williams JA Meltzer D Arora V Chung G and Culrin F (2011 Nov) ldquoAttention to Inpatientsrsquo Religious and Spiritual Concerns Predictors and Association with Patient Satisfaction J Gen Intern Med 26(11) 1265-1271

33 Greene J Hibbard J et al When Patient Activation Levels Change Health Outcomes And Costs Change Too Health Aff March 2015 vol 34 no 3431-437

34 Veroff David Amy Marr and David E Wennberg Enhanced Support for Shared Decision Making Reduced Costs of Care for Patients with Preference-Sensitive Conditions Health Affairs 32 no 2 (2013) 285-93

Logic Model Evidence Base for Patient amp Family Engaged Care

wwwplanetreeorg

Experience Base

Evidence Base

Why Patient-Centered Hospital Designation is Unique Experience Based Criteria

I Structures and Functions Necessary for Culture Change

II Human Interactions Independence Dignity and Choice

III Promoting PatientResident Education Choice amp Responsibility

IV Family Involvement

V Food Dining amp Nutrition

VI Healing Environment Architecture and Design

VII Arts ProgramMeaningful Activities and Entertainment

VIII Spirituality amp Diversity

IX Integrative Therapies Paths to Well-Being

X Healthy Communities Enhancement of Lifersquos Journey

XI Measurement

bull 60+ criteria for acute care hospitals bull Establishes a high bar for PCC Excellence bull Applies across the continuum bull Encourages innovation

wwwplanetreeorg

ldquohellipproviding care that is respectful of and responsive to individual patient preferences

needs and values and ensuring that patient values guide all clinical decisionshelliprdquo (IOM 2001)

ldquohellipcare designed with patient involvement to ensure timely convenient well-coordinated

engagement of a personrsquos health and health care needs preferences and values it

includes explicit and partnered determination of patient goals and care options and it

requires ongoing assessment of the care match with patient goalsrdquo (IOMNAM 2015)

IOMNational Academy of Medicine Revises Definition of Patient-Centered Care

wwwplanetreeorg

Institute of Medicinersquos Roundtable on Value amp Science-Driven Health Care bull Care Culture and Decision-making Innovation Collaborative (CCDmIC)

bull Patient amp Family Council Leaders National Network bull Scientific Advisory Panel on the Evidence-Base for Patient and Family

Engaged Care

IOM-National Academy of Medicine PFE Agenda

wwwplanetreeorg

The Scientific Evidence-Base for

Patient and Family Centered Approaches to

Care

NATIONAL ACADEMY OF MEDICINE

wwwplanetreeorg

bull Use the Planetree model of care to develop a common understanding of essential elements for

creating and sustaining patient and family-centered culture in healthcare settings

bull Integrate this into a logic model as an organizing framework for identifying essential elements of

Patient and Family Centered Care and the outcomes these elements influence

bull Engage a panel of scientific experts to share and compile existing and emerging research in

support of the essential elements identified in the logic model and in identifying evidence gaps

bull Develop criteria for assessing strength of evidence identified

Goals for IOMNAM Scientific Advisory Panel

wwwplanetreeorg

1 Shortell et al October 201

2 McClelland L and Vogus T Compassion Practices and HCAHPS Does Rewarding and Supporting Workplace Compassion Influence Patient Perceptions Healt h Services Research Volume 49 Issue 5 pages 1670ndash1683 October 2014

3 Shortell et al Early Assessment of ACOsrsquo Efforts to Engage Patients and Their Families Med Care Res Rev October 2015 vol 72 no 5 580-604

4 Riess H Kelley JM Bailey RW Dunn EJ Phillips M (2012 Oct) ldquoEmpathy training for resident physicians a randomized controlled trial of a neuroscience-informed curriculumrdquo J Gen Intern Med 27(10)1280-6

5 Riess H Marci CD The Neurobiology and Physiology of the Patient ndashDoctor Relationship Measuring Empathy Medical Encounter 2007 21(3)38-41

6 Riess H Herman JB Teaching the teachers A model course for psychotherapy supervisors Academic Psychiatry 2008 32259-264

7 Shortell et al October 2015

8 Hibbard J and Green J What The Evidence Shows About Patient Activation Hlth Aff Feb 2013 vol 32 no 2 207-214

9 Rakel and Barrett et al in Patient Education and Counseling 2011

10 Hojat et al in Academic Medicine 2011

11 Haslam in Medical Journal of Australia 2007

12 Stone S Annual Nursing Report Sharp Memorial Hospital 2014

13 Lim L and Zimring C Healthcare Design of the Future ARCH 4833ARCH 6271ID 6271BMED 8813 HF 2015

14 Berwick D and Kotagal M JAMA 2004292(6)736-737 doi101001jama2926736 L

15 Stone S 2014

16 Stone S 2014

17 Hankinson T Development of a sleep menu and the impact on sleep quality VA NJ 2013

18 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001)

19 Veroff David Amy Marr and David E Wennberg Enhanced Support for Shared Decision Making Reduced Costs of Care for Patients with Preference-Sensitive Conditions Health Affairs 32 no 2 (2013) 285-93

20 Singer Sara J and Timothy J Vogus Reducing hospital errors interventions that build safety culture Annual review of public health 34 (2013) 373-396

21 Greene J Hibbard J et al When Patient Activation Levels Change Health Outcomes And Costs Change Too Health Aff March 2015 vol 34 no 3431-437

22 Veroff et al 2013)

23 Rakel and Barrett et al 2011

24 Stone S Annual Nursing Report Sharp Memorial Hospital 2014

25 Hojat et al 2011

26 Haslam 2007

27 Stone S Patient Falls Reduction Initiative Sharp Healthcare Annual Nursing Report 2011

28 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001)

29 Stone S 2014

30 CMS Office of Information Products and Data Analytics -May 2014 Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

31 McClelland L and Vogus T October 2014

32 Williams JA Meltzer D Arora V Chung G and Culrin F (2011 Nov) ldquoAttention to Inpatientsrsquo Religious and Spiritual Concerns Predictors and Association with Patient Satisfaction J Gen Intern Med 26(11) 1265-1271

33 Greene J Hibbard J et al When Patient Activation Levels Change Health Outcomes And Costs Change Too Health Aff March 2015 vol 34 no 3431-437

34 Veroff David Amy Marr and David E Wennberg Enhanced Support for Shared Decision Making Reduced Costs of Care for Patients with Preference-Sensitive Conditions Health Affairs 32 no 2 (2013) 285-93

Logic Model Evidence Base for Patient amp Family Engaged Care

wwwplanetreeorg

ldquohellipproviding care that is respectful of and responsive to individual patient preferences

needs and values and ensuring that patient values guide all clinical decisionshelliprdquo (IOM 2001)

ldquohellipcare designed with patient involvement to ensure timely convenient well-coordinated

engagement of a personrsquos health and health care needs preferences and values it

includes explicit and partnered determination of patient goals and care options and it

requires ongoing assessment of the care match with patient goalsrdquo (IOMNAM 2015)

IOMNational Academy of Medicine Revises Definition of Patient-Centered Care

wwwplanetreeorg

Institute of Medicinersquos Roundtable on Value amp Science-Driven Health Care bull Care Culture and Decision-making Innovation Collaborative (CCDmIC)

bull Patient amp Family Council Leaders National Network bull Scientific Advisory Panel on the Evidence-Base for Patient and Family

Engaged Care

IOM-National Academy of Medicine PFE Agenda

wwwplanetreeorg

The Scientific Evidence-Base for

Patient and Family Centered Approaches to

Care

NATIONAL ACADEMY OF MEDICINE

wwwplanetreeorg

bull Use the Planetree model of care to develop a common understanding of essential elements for

creating and sustaining patient and family-centered culture in healthcare settings

bull Integrate this into a logic model as an organizing framework for identifying essential elements of

Patient and Family Centered Care and the outcomes these elements influence

bull Engage a panel of scientific experts to share and compile existing and emerging research in

support of the essential elements identified in the logic model and in identifying evidence gaps

bull Develop criteria for assessing strength of evidence identified

Goals for IOMNAM Scientific Advisory Panel

wwwplanetreeorg

1 Shortell et al October 201

2 McClelland L and Vogus T Compassion Practices and HCAHPS Does Rewarding and Supporting Workplace Compassion Influence Patient Perceptions Healt h Services Research Volume 49 Issue 5 pages 1670ndash1683 October 2014

3 Shortell et al Early Assessment of ACOsrsquo Efforts to Engage Patients and Their Families Med Care Res Rev October 2015 vol 72 no 5 580-604

4 Riess H Kelley JM Bailey RW Dunn EJ Phillips M (2012 Oct) ldquoEmpathy training for resident physicians a randomized controlled trial of a neuroscience-informed curriculumrdquo J Gen Intern Med 27(10)1280-6

5 Riess H Marci CD The Neurobiology and Physiology of the Patient ndashDoctor Relationship Measuring Empathy Medical Encounter 2007 21(3)38-41

6 Riess H Herman JB Teaching the teachers A model course for psychotherapy supervisors Academic Psychiatry 2008 32259-264

7 Shortell et al October 2015

8 Hibbard J and Green J What The Evidence Shows About Patient Activation Hlth Aff Feb 2013 vol 32 no 2 207-214

9 Rakel and Barrett et al in Patient Education and Counseling 2011

10 Hojat et al in Academic Medicine 2011

11 Haslam in Medical Journal of Australia 2007

12 Stone S Annual Nursing Report Sharp Memorial Hospital 2014

13 Lim L and Zimring C Healthcare Design of the Future ARCH 4833ARCH 6271ID 6271BMED 8813 HF 2015

14 Berwick D and Kotagal M JAMA 2004292(6)736-737 doi101001jama2926736 L

15 Stone S 2014

16 Stone S 2014

17 Hankinson T Development of a sleep menu and the impact on sleep quality VA NJ 2013

18 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001)

19 Veroff David Amy Marr and David E Wennberg Enhanced Support for Shared Decision Making Reduced Costs of Care for Patients with Preference-Sensitive Conditions Health Affairs 32 no 2 (2013) 285-93

20 Singer Sara J and Timothy J Vogus Reducing hospital errors interventions that build safety culture Annual review of public health 34 (2013) 373-396

21 Greene J Hibbard J et al When Patient Activation Levels Change Health Outcomes And Costs Change Too Health Aff March 2015 vol 34 no 3431-437

22 Veroff et al 2013)

23 Rakel and Barrett et al 2011

24 Stone S Annual Nursing Report Sharp Memorial Hospital 2014

25 Hojat et al 2011

26 Haslam 2007

27 Stone S Patient Falls Reduction Initiative Sharp Healthcare Annual Nursing Report 2011

28 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001)

29 Stone S 2014

30 CMS Office of Information Products and Data Analytics -May 2014 Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

31 McClelland L and Vogus T October 2014

32 Williams JA Meltzer D Arora V Chung G and Culrin F (2011 Nov) ldquoAttention to Inpatientsrsquo Religious and Spiritual Concerns Predictors and Association with Patient Satisfaction J Gen Intern Med 26(11) 1265-1271

33 Greene J Hibbard J et al When Patient Activation Levels Change Health Outcomes And Costs Change Too Health Aff March 2015 vol 34 no 3431-437

34 Veroff David Amy Marr and David E Wennberg Enhanced Support for Shared Decision Making Reduced Costs of Care for Patients with Preference-Sensitive Conditions Health Affairs 32 no 2 (2013) 285-93

Logic Model Evidence Base for Patient amp Family Engaged Care

wwwplanetreeorg

Institute of Medicinersquos Roundtable on Value amp Science-Driven Health Care bull Care Culture and Decision-making Innovation Collaborative (CCDmIC)

bull Patient amp Family Council Leaders National Network bull Scientific Advisory Panel on the Evidence-Base for Patient and Family

Engaged Care

IOM-National Academy of Medicine PFE Agenda

wwwplanetreeorg

The Scientific Evidence-Base for

Patient and Family Centered Approaches to

Care

NATIONAL ACADEMY OF MEDICINE

wwwplanetreeorg

bull Use the Planetree model of care to develop a common understanding of essential elements for

creating and sustaining patient and family-centered culture in healthcare settings

bull Integrate this into a logic model as an organizing framework for identifying essential elements of

Patient and Family Centered Care and the outcomes these elements influence

bull Engage a panel of scientific experts to share and compile existing and emerging research in

support of the essential elements identified in the logic model and in identifying evidence gaps

bull Develop criteria for assessing strength of evidence identified

Goals for IOMNAM Scientific Advisory Panel

wwwplanetreeorg

1 Shortell et al October 201

2 McClelland L and Vogus T Compassion Practices and HCAHPS Does Rewarding and Supporting Workplace Compassion Influence Patient Perceptions Healt h Services Research Volume 49 Issue 5 pages 1670ndash1683 October 2014

3 Shortell et al Early Assessment of ACOsrsquo Efforts to Engage Patients and Their Families Med Care Res Rev October 2015 vol 72 no 5 580-604

4 Riess H Kelley JM Bailey RW Dunn EJ Phillips M (2012 Oct) ldquoEmpathy training for resident physicians a randomized controlled trial of a neuroscience-informed curriculumrdquo J Gen Intern Med 27(10)1280-6

5 Riess H Marci CD The Neurobiology and Physiology of the Patient ndashDoctor Relationship Measuring Empathy Medical Encounter 2007 21(3)38-41

6 Riess H Herman JB Teaching the teachers A model course for psychotherapy supervisors Academic Psychiatry 2008 32259-264

7 Shortell et al October 2015

8 Hibbard J and Green J What The Evidence Shows About Patient Activation Hlth Aff Feb 2013 vol 32 no 2 207-214

9 Rakel and Barrett et al in Patient Education and Counseling 2011

10 Hojat et al in Academic Medicine 2011

11 Haslam in Medical Journal of Australia 2007

12 Stone S Annual Nursing Report Sharp Memorial Hospital 2014

13 Lim L and Zimring C Healthcare Design of the Future ARCH 4833ARCH 6271ID 6271BMED 8813 HF 2015

14 Berwick D and Kotagal M JAMA 2004292(6)736-737 doi101001jama2926736 L

15 Stone S 2014

16 Stone S 2014

17 Hankinson T Development of a sleep menu and the impact on sleep quality VA NJ 2013

18 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001)

19 Veroff David Amy Marr and David E Wennberg Enhanced Support for Shared Decision Making Reduced Costs of Care for Patients with Preference-Sensitive Conditions Health Affairs 32 no 2 (2013) 285-93

20 Singer Sara J and Timothy J Vogus Reducing hospital errors interventions that build safety culture Annual review of public health 34 (2013) 373-396

21 Greene J Hibbard J et al When Patient Activation Levels Change Health Outcomes And Costs Change Too Health Aff March 2015 vol 34 no 3431-437

22 Veroff et al 2013)

23 Rakel and Barrett et al 2011

24 Stone S Annual Nursing Report Sharp Memorial Hospital 2014

25 Hojat et al 2011

26 Haslam 2007

27 Stone S Patient Falls Reduction Initiative Sharp Healthcare Annual Nursing Report 2011

28 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001)

29 Stone S 2014

30 CMS Office of Information Products and Data Analytics -May 2014 Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

31 McClelland L and Vogus T October 2014

32 Williams JA Meltzer D Arora V Chung G and Culrin F (2011 Nov) ldquoAttention to Inpatientsrsquo Religious and Spiritual Concerns Predictors and Association with Patient Satisfaction J Gen Intern Med 26(11) 1265-1271

33 Greene J Hibbard J et al When Patient Activation Levels Change Health Outcomes And Costs Change Too Health Aff March 2015 vol 34 no 3431-437

34 Veroff David Amy Marr and David E Wennberg Enhanced Support for Shared Decision Making Reduced Costs of Care for Patients with Preference-Sensitive Conditions Health Affairs 32 no 2 (2013) 285-93

Logic Model Evidence Base for Patient amp Family Engaged Care

wwwplanetreeorg

The Scientific Evidence-Base for

Patient and Family Centered Approaches to

Care

NATIONAL ACADEMY OF MEDICINE

wwwplanetreeorg

bull Use the Planetree model of care to develop a common understanding of essential elements for

creating and sustaining patient and family-centered culture in healthcare settings

bull Integrate this into a logic model as an organizing framework for identifying essential elements of

Patient and Family Centered Care and the outcomes these elements influence

bull Engage a panel of scientific experts to share and compile existing and emerging research in

support of the essential elements identified in the logic model and in identifying evidence gaps

bull Develop criteria for assessing strength of evidence identified

Goals for IOMNAM Scientific Advisory Panel

wwwplanetreeorg

1 Shortell et al October 201

2 McClelland L and Vogus T Compassion Practices and HCAHPS Does Rewarding and Supporting Workplace Compassion Influence Patient Perceptions Healt h Services Research Volume 49 Issue 5 pages 1670ndash1683 October 2014

3 Shortell et al Early Assessment of ACOsrsquo Efforts to Engage Patients and Their Families Med Care Res Rev October 2015 vol 72 no 5 580-604

4 Riess H Kelley JM Bailey RW Dunn EJ Phillips M (2012 Oct) ldquoEmpathy training for resident physicians a randomized controlled trial of a neuroscience-informed curriculumrdquo J Gen Intern Med 27(10)1280-6

5 Riess H Marci CD The Neurobiology and Physiology of the Patient ndashDoctor Relationship Measuring Empathy Medical Encounter 2007 21(3)38-41

6 Riess H Herman JB Teaching the teachers A model course for psychotherapy supervisors Academic Psychiatry 2008 32259-264

7 Shortell et al October 2015

8 Hibbard J and Green J What The Evidence Shows About Patient Activation Hlth Aff Feb 2013 vol 32 no 2 207-214

9 Rakel and Barrett et al in Patient Education and Counseling 2011

10 Hojat et al in Academic Medicine 2011

11 Haslam in Medical Journal of Australia 2007

12 Stone S Annual Nursing Report Sharp Memorial Hospital 2014

13 Lim L and Zimring C Healthcare Design of the Future ARCH 4833ARCH 6271ID 6271BMED 8813 HF 2015

14 Berwick D and Kotagal M JAMA 2004292(6)736-737 doi101001jama2926736 L

15 Stone S 2014

16 Stone S 2014

17 Hankinson T Development of a sleep menu and the impact on sleep quality VA NJ 2013

18 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001)

19 Veroff David Amy Marr and David E Wennberg Enhanced Support for Shared Decision Making Reduced Costs of Care for Patients with Preference-Sensitive Conditions Health Affairs 32 no 2 (2013) 285-93

20 Singer Sara J and Timothy J Vogus Reducing hospital errors interventions that build safety culture Annual review of public health 34 (2013) 373-396

21 Greene J Hibbard J et al When Patient Activation Levels Change Health Outcomes And Costs Change Too Health Aff March 2015 vol 34 no 3431-437

22 Veroff et al 2013)

23 Rakel and Barrett et al 2011

24 Stone S Annual Nursing Report Sharp Memorial Hospital 2014

25 Hojat et al 2011

26 Haslam 2007

27 Stone S Patient Falls Reduction Initiative Sharp Healthcare Annual Nursing Report 2011

28 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001)

29 Stone S 2014

30 CMS Office of Information Products and Data Analytics -May 2014 Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

31 McClelland L and Vogus T October 2014

32 Williams JA Meltzer D Arora V Chung G and Culrin F (2011 Nov) ldquoAttention to Inpatientsrsquo Religious and Spiritual Concerns Predictors and Association with Patient Satisfaction J Gen Intern Med 26(11) 1265-1271

33 Greene J Hibbard J et al When Patient Activation Levels Change Health Outcomes And Costs Change Too Health Aff March 2015 vol 34 no 3431-437

34 Veroff David Amy Marr and David E Wennberg Enhanced Support for Shared Decision Making Reduced Costs of Care for Patients with Preference-Sensitive Conditions Health Affairs 32 no 2 (2013) 285-93

Logic Model Evidence Base for Patient amp Family Engaged Care

wwwplanetreeorg

bull Use the Planetree model of care to develop a common understanding of essential elements for

creating and sustaining patient and family-centered culture in healthcare settings

bull Integrate this into a logic model as an organizing framework for identifying essential elements of

Patient and Family Centered Care and the outcomes these elements influence

bull Engage a panel of scientific experts to share and compile existing and emerging research in

support of the essential elements identified in the logic model and in identifying evidence gaps

bull Develop criteria for assessing strength of evidence identified

Goals for IOMNAM Scientific Advisory Panel

wwwplanetreeorg

1 Shortell et al October 201

2 McClelland L and Vogus T Compassion Practices and HCAHPS Does Rewarding and Supporting Workplace Compassion Influence Patient Perceptions Healt h Services Research Volume 49 Issue 5 pages 1670ndash1683 October 2014

3 Shortell et al Early Assessment of ACOsrsquo Efforts to Engage Patients and Their Families Med Care Res Rev October 2015 vol 72 no 5 580-604

4 Riess H Kelley JM Bailey RW Dunn EJ Phillips M (2012 Oct) ldquoEmpathy training for resident physicians a randomized controlled trial of a neuroscience-informed curriculumrdquo J Gen Intern Med 27(10)1280-6

5 Riess H Marci CD The Neurobiology and Physiology of the Patient ndashDoctor Relationship Measuring Empathy Medical Encounter 2007 21(3)38-41

6 Riess H Herman JB Teaching the teachers A model course for psychotherapy supervisors Academic Psychiatry 2008 32259-264

7 Shortell et al October 2015

8 Hibbard J and Green J What The Evidence Shows About Patient Activation Hlth Aff Feb 2013 vol 32 no 2 207-214

9 Rakel and Barrett et al in Patient Education and Counseling 2011

10 Hojat et al in Academic Medicine 2011

11 Haslam in Medical Journal of Australia 2007

12 Stone S Annual Nursing Report Sharp Memorial Hospital 2014

13 Lim L and Zimring C Healthcare Design of the Future ARCH 4833ARCH 6271ID 6271BMED 8813 HF 2015

14 Berwick D and Kotagal M JAMA 2004292(6)736-737 doi101001jama2926736 L

15 Stone S 2014

16 Stone S 2014

17 Hankinson T Development of a sleep menu and the impact on sleep quality VA NJ 2013

18 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001)

19 Veroff David Amy Marr and David E Wennberg Enhanced Support for Shared Decision Making Reduced Costs of Care for Patients with Preference-Sensitive Conditions Health Affairs 32 no 2 (2013) 285-93

20 Singer Sara J and Timothy J Vogus Reducing hospital errors interventions that build safety culture Annual review of public health 34 (2013) 373-396

21 Greene J Hibbard J et al When Patient Activation Levels Change Health Outcomes And Costs Change Too Health Aff March 2015 vol 34 no 3431-437

22 Veroff et al 2013)

23 Rakel and Barrett et al 2011

24 Stone S Annual Nursing Report Sharp Memorial Hospital 2014

25 Hojat et al 2011

26 Haslam 2007

27 Stone S Patient Falls Reduction Initiative Sharp Healthcare Annual Nursing Report 2011

28 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001)

29 Stone S 2014

30 CMS Office of Information Products and Data Analytics -May 2014 Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

31 McClelland L and Vogus T October 2014

32 Williams JA Meltzer D Arora V Chung G and Culrin F (2011 Nov) ldquoAttention to Inpatientsrsquo Religious and Spiritual Concerns Predictors and Association with Patient Satisfaction J Gen Intern Med 26(11) 1265-1271

33 Greene J Hibbard J et al When Patient Activation Levels Change Health Outcomes And Costs Change Too Health Aff March 2015 vol 34 no 3431-437

34 Veroff David Amy Marr and David E Wennberg Enhanced Support for Shared Decision Making Reduced Costs of Care for Patients with Preference-Sensitive Conditions Health Affairs 32 no 2 (2013) 285-93

Logic Model Evidence Base for Patient amp Family Engaged Care

wwwplanetreeorg

1 Shortell et al October 201

2 McClelland L and Vogus T Compassion Practices and HCAHPS Does Rewarding and Supporting Workplace Compassion Influence Patient Perceptions Healt h Services Research Volume 49 Issue 5 pages 1670ndash1683 October 2014

3 Shortell et al Early Assessment of ACOsrsquo Efforts to Engage Patients and Their Families Med Care Res Rev October 2015 vol 72 no 5 580-604

4 Riess H Kelley JM Bailey RW Dunn EJ Phillips M (2012 Oct) ldquoEmpathy training for resident physicians a randomized controlled trial of a neuroscience-informed curriculumrdquo J Gen Intern Med 27(10)1280-6

5 Riess H Marci CD The Neurobiology and Physiology of the Patient ndashDoctor Relationship Measuring Empathy Medical Encounter 2007 21(3)38-41

6 Riess H Herman JB Teaching the teachers A model course for psychotherapy supervisors Academic Psychiatry 2008 32259-264

7 Shortell et al October 2015

8 Hibbard J and Green J What The Evidence Shows About Patient Activation Hlth Aff Feb 2013 vol 32 no 2 207-214

9 Rakel and Barrett et al in Patient Education and Counseling 2011

10 Hojat et al in Academic Medicine 2011

11 Haslam in Medical Journal of Australia 2007

12 Stone S Annual Nursing Report Sharp Memorial Hospital 2014

13 Lim L and Zimring C Healthcare Design of the Future ARCH 4833ARCH 6271ID 6271BMED 8813 HF 2015

14 Berwick D and Kotagal M JAMA 2004292(6)736-737 doi101001jama2926736 L

15 Stone S 2014

16 Stone S 2014

17 Hankinson T Development of a sleep menu and the impact on sleep quality VA NJ 2013

18 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001)

19 Veroff David Amy Marr and David E Wennberg Enhanced Support for Shared Decision Making Reduced Costs of Care for Patients with Preference-Sensitive Conditions Health Affairs 32 no 2 (2013) 285-93

20 Singer Sara J and Timothy J Vogus Reducing hospital errors interventions that build safety culture Annual review of public health 34 (2013) 373-396

21 Greene J Hibbard J et al When Patient Activation Levels Change Health Outcomes And Costs Change Too Health Aff March 2015 vol 34 no 3431-437

22 Veroff et al 2013)

23 Rakel and Barrett et al 2011

24 Stone S Annual Nursing Report Sharp Memorial Hospital 2014

25 Hojat et al 2011

26 Haslam 2007

27 Stone S Patient Falls Reduction Initiative Sharp Healthcare Annual Nursing Report 2011

28 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001)

29 Stone S 2014

30 CMS Office of Information Products and Data Analytics -May 2014 Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

31 McClelland L and Vogus T October 2014

32 Williams JA Meltzer D Arora V Chung G and Culrin F (2011 Nov) ldquoAttention to Inpatientsrsquo Religious and Spiritual Concerns Predictors and Association with Patient Satisfaction J Gen Intern Med 26(11) 1265-1271

33 Greene J Hibbard J et al When Patient Activation Levels Change Health Outcomes And Costs Change Too Health Aff March 2015 vol 34 no 3431-437

34 Veroff David Amy Marr and David E Wennberg Enhanced Support for Shared Decision Making Reduced Costs of Care for Patients with Preference-Sensitive Conditions Health Affairs 32 no 2 (2013) 285-93

Logic Model Evidence Base for Patient amp Family Engaged Care

wwwplanetreeorg

wwwplanetreeorg

Antecedents

Leadership vision and behaviors aligned with Patient Centered Care

Logic Model for Patient and Family Engaged Care Culture

Questions amp Reflections

1 What is your vision of patient and person-

centered care in your organization

2 What do you do currently that supports this

vision

3 What prevents your organization from fully

implementing patient centered care

wwwplanetreeorg

wwwplanetreeorg

STRUCTURES that promote transparency visibility and inclusion among staff patients and families Patient-Family Advisory Councils

Enlisting patients and family members as partners in quality and process improvement strategic planning hiring and evaluation staff training and more to ensure that the voices of patients are a guiding force in mapping out the future of our healthcare organizations

wwwplanetreeorg

Beyond the council

Patientresidentfamily participation

bull On patient-centered initiative teams (eg wayfinding

patient friendly billing care partners creating patient

menus etc)

bull On safety quality and other organizational committees

bull In Lean rapid improvement events

bull On hiring teams

bull As faculty for staff education and training

wwwplanetreeorg

Quality Check your Partnership Efforts

wwwplanetreeorg

STRUCTURES -Adaptation of personnel management practices to align with Patient Centered Care2 Behavioral Interviewing

For Licensed Staff For Non-Licensed Caregiver Staff For ConciergeHousekeepingDining Staff

Reception

What are three positive things your last supervisor (teacher) would say about you

What does patient-centered care mean to you

A patient appears unhappy with the care they are receiving How do you make the patient

feel more comfortable

Tell me how you make them feel comfortable and reassured

Describe for me the way in which you would include family members in the care of the

patient

How do you learn about your patients and who they are

How would you on a personal and professional level bring patient-centered care to life

A patients family is concerned about the care a patient is getting How would you address

their concerns

Reception

What are three positive things your last boss (teacher) would say about you

What does patient-centered care mean to you

Tell me about a time that you assisted a patient that was feeling scared or frightened about

their illness

How would you create a positive experience for patients when dealing with multiple

requests at one time

How would you on a personal and professional level bring patient-centered care to life

A patient has soiled hisher self How would you approach this situation

You are meeting a patient for the first time Tell me how you make them feel comfortable

and reassured

A patients family is concerned about the care a patient is getting How would you address

their concerns

Reception

What are three positive things your last boss (teacher) would say about you

What does patient-centered care mean to you

Tell me how you would use patient-centered care in role to create a positive experience for

patients

You are meeting a patient for the first time Tell me how you make them feel comfortable

and reassured

How would you on a personal and professional level bring patient-centered care to life

Both phone lines are ringing at your station and a person is standing at the desk How do

you handle this situation or how have you handled this in the past

How do you embrace the differences of people you interact with

Knowledge

What was the best (worst) class that you took in school Why

Where do you see yourself in five (5) years

Do you speak another language How did you utilize this in a past jobclinical setting

How do you anticipate the needs of your patients and coworkers

Have you ever had difficulty with a supervisor or instructor How did you resolve the

conflict

What do you do when priorities change quickly Give me one example

Knowledge

Where do you see yourself in five (5) years

Do you speak another language How did you utilize this in a past jobclinical setting

How do you anticipate the needs of your patients and coworkers

Explain a time when you handled changing priorities at workschool

If you saw someone who appears lost in the hallway what would you do

A patient has coded (died) What could you do to assist with this situation

Knowledge

Where do you see yourself in five (5) years

Do you speak another language How did you utilize this in a past jobclinical setting

How do you anticipate the needs of your patients and coworkers

Explain a time when you handled changing priorities at workschool

What did you like about your previous job (if in healthcare field)

Why did you decide to get involved in the healthcare field

Technology

Describe a situation where you had to learn some new technology and apply it in a work

setting

Are you more energized by working with data or by collaborating with other individuals

Why

Attention to detail is an important component of this job Tell me about how you do this in

your current job

Our technology is state of the art how would you ensure that the human interactions with

your patient remain the focus

Technology

Describe a situation where you had to learn some new technology and apply it in a work

setting

Are you more energized by working with data or by collaborating with other individuals

Why

Attention to detail is an important component of this job Tell me about how you do this in

your current job

Our technology is state of the art how would you ensure that the human interactions with

your patient remain the focus

Technology

Describe a situation where you had to learn some new technology and apply it in a work

setting

Are you more energized by working with data or by collaborating with other individuals

Why

Attention to detail is an important component of this job Tell me about how you do this in

your current job

Our technology is state of the art how would you ensure that the human interactions with

your patient remain the focus

5

4

3

2

1

QuestionScore

DIV0Knowledge

DIV0Technology

DIV0Total Score

VALUEAverage score

VALUE

Reception

Each applicant is rated on three distinct sections each of these sections is composed of three questions A numerical scale is used to rank each of the applicants response totally to an overall composite score for the applicant Applicant score is basis for hiring in addition to credentially and background assessment as required by local law

Very Unsatisfcatory Response

11

Applicant Scoring Scale

Notes

Very Satisfactory Response

Candidates Name

Position

Satisfactory ResponseNeutralUnsatisfactory Response

13

12

22

23

31

32

33

Knowledge Subtotal

Technology Subtotal

Reception Subtotal21

wwwplanetreeorg

STRUCTURES ndash Supports for a healing environment

Participatory Design amp Community Design Assessment

Active Patient amp Family Involvement in Planning

Supportive of Continuous Improvement

wwwplanetreeorg

If we treat patients in healing environments why are hospital readmission rates so high

Source Horwitz et al Ann Intern Med 2014161S66-75

0

5

10

15

20

25

wwwplanetreeorg

What are the Causes of High Readmission Rates

bull Poor support

bull Poor preparation

bull Poor systems

bull Poor coordination

bull Poor communication

bull Poor access

wwwplanetreeorg

What if it Were More Than Thathellip

Source Krumholz N Engl J Med 2013368(2)100-2

wwwplanetreeorg

When a Stressful Hospital Stay Makes You Sick By DAVID H NEWMAN MD June 12 2014

Krumholz HM N Engl J Med 368100 - 102 | January 10 2013

What research tells us about the impact of the hospital environment on health outcomes

wwwplanetreeorg

Antecedents

Leadership vision and behaviors aligned with Patient Centered Care

Logic Model for Patient and Family Engaged Care Culture

Questions amp Reflections

1 What is your vision of patient and person-

centered care in your organization

2 What do you do currently that supports this

vision

3 What prevents your organization from fully

implementing patient centered care

wwwplanetreeorg

wwwplanetreeorg

STRUCTURES that promote transparency visibility and inclusion among staff patients and families Patient-Family Advisory Councils

Enlisting patients and family members as partners in quality and process improvement strategic planning hiring and evaluation staff training and more to ensure that the voices of patients are a guiding force in mapping out the future of our healthcare organizations

wwwplanetreeorg

Beyond the council

Patientresidentfamily participation

bull On patient-centered initiative teams (eg wayfinding

patient friendly billing care partners creating patient

menus etc)

bull On safety quality and other organizational committees

bull In Lean rapid improvement events

bull On hiring teams

bull As faculty for staff education and training

wwwplanetreeorg

Quality Check your Partnership Efforts

wwwplanetreeorg

STRUCTURES -Adaptation of personnel management practices to align with Patient Centered Care2 Behavioral Interviewing

For Licensed Staff For Non-Licensed Caregiver Staff For ConciergeHousekeepingDining Staff

Reception

What are three positive things your last supervisor (teacher) would say about you

What does patient-centered care mean to you

A patient appears unhappy with the care they are receiving How do you make the patient

feel more comfortable

Tell me how you make them feel comfortable and reassured

Describe for me the way in which you would include family members in the care of the

patient

How do you learn about your patients and who they are

How would you on a personal and professional level bring patient-centered care to life

A patients family is concerned about the care a patient is getting How would you address

their concerns

Reception

What are three positive things your last boss (teacher) would say about you

What does patient-centered care mean to you

Tell me about a time that you assisted a patient that was feeling scared or frightened about

their illness

How would you create a positive experience for patients when dealing with multiple

requests at one time

How would you on a personal and professional level bring patient-centered care to life

A patient has soiled hisher self How would you approach this situation

You are meeting a patient for the first time Tell me how you make them feel comfortable

and reassured

A patients family is concerned about the care a patient is getting How would you address

their concerns

Reception

What are three positive things your last boss (teacher) would say about you

What does patient-centered care mean to you

Tell me how you would use patient-centered care in role to create a positive experience for

patients

You are meeting a patient for the first time Tell me how you make them feel comfortable

and reassured

How would you on a personal and professional level bring patient-centered care to life

Both phone lines are ringing at your station and a person is standing at the desk How do

you handle this situation or how have you handled this in the past

How do you embrace the differences of people you interact with

Knowledge

What was the best (worst) class that you took in school Why

Where do you see yourself in five (5) years

Do you speak another language How did you utilize this in a past jobclinical setting

How do you anticipate the needs of your patients and coworkers

Have you ever had difficulty with a supervisor or instructor How did you resolve the

conflict

What do you do when priorities change quickly Give me one example

Knowledge

Where do you see yourself in five (5) years

Do you speak another language How did you utilize this in a past jobclinical setting

How do you anticipate the needs of your patients and coworkers

Explain a time when you handled changing priorities at workschool

If you saw someone who appears lost in the hallway what would you do

A patient has coded (died) What could you do to assist with this situation

Knowledge

Where do you see yourself in five (5) years

Do you speak another language How did you utilize this in a past jobclinical setting

How do you anticipate the needs of your patients and coworkers

Explain a time when you handled changing priorities at workschool

What did you like about your previous job (if in healthcare field)

Why did you decide to get involved in the healthcare field

Technology

Describe a situation where you had to learn some new technology and apply it in a work

setting

Are you more energized by working with data or by collaborating with other individuals

Why

Attention to detail is an important component of this job Tell me about how you do this in

your current job

Our technology is state of the art how would you ensure that the human interactions with

your patient remain the focus

Technology

Describe a situation where you had to learn some new technology and apply it in a work

setting

Are you more energized by working with data or by collaborating with other individuals

Why

Attention to detail is an important component of this job Tell me about how you do this in

your current job

Our technology is state of the art how would you ensure that the human interactions with

your patient remain the focus

Technology

Describe a situation where you had to learn some new technology and apply it in a work

setting

Are you more energized by working with data or by collaborating with other individuals

Why

Attention to detail is an important component of this job Tell me about how you do this in

your current job

Our technology is state of the art how would you ensure that the human interactions with

your patient remain the focus

5

4

3

2

1

QuestionScore

DIV0Knowledge

DIV0Technology

DIV0Total Score

VALUEAverage score

VALUE

Reception

Each applicant is rated on three distinct sections each of these sections is composed of three questions A numerical scale is used to rank each of the applicants response totally to an overall composite score for the applicant Applicant score is basis for hiring in addition to credentially and background assessment as required by local law

Very Unsatisfcatory Response

11

Applicant Scoring Scale

Notes

Very Satisfactory Response

Candidates Name

Position

Satisfactory ResponseNeutralUnsatisfactory Response

13

12

22

23

31

32

33

Knowledge Subtotal

Technology Subtotal

Reception Subtotal21

wwwplanetreeorg

STRUCTURES ndash Supports for a healing environment

Participatory Design amp Community Design Assessment

Active Patient amp Family Involvement in Planning

Supportive of Continuous Improvement

wwwplanetreeorg

If we treat patients in healing environments why are hospital readmission rates so high

Source Horwitz et al Ann Intern Med 2014161S66-75

0

5

10

15

20

25

wwwplanetreeorg

What are the Causes of High Readmission Rates

bull Poor support

bull Poor preparation

bull Poor systems

bull Poor coordination

bull Poor communication

bull Poor access

wwwplanetreeorg

What if it Were More Than Thathellip

Source Krumholz N Engl J Med 2013368(2)100-2

wwwplanetreeorg

When a Stressful Hospital Stay Makes You Sick By DAVID H NEWMAN MD June 12 2014

Krumholz HM N Engl J Med 368100 - 102 | January 10 2013

What research tells us about the impact of the hospital environment on health outcomes

wwwplanetreeorg

wwwplanetreeorg

STRUCTURES that promote transparency visibility and inclusion among staff patients and families Patient-Family Advisory Councils

Enlisting patients and family members as partners in quality and process improvement strategic planning hiring and evaluation staff training and more to ensure that the voices of patients are a guiding force in mapping out the future of our healthcare organizations

wwwplanetreeorg

Beyond the council

Patientresidentfamily participation

bull On patient-centered initiative teams (eg wayfinding

patient friendly billing care partners creating patient

menus etc)

bull On safety quality and other organizational committees

bull In Lean rapid improvement events

bull On hiring teams

bull As faculty for staff education and training

wwwplanetreeorg

Quality Check your Partnership Efforts

wwwplanetreeorg

STRUCTURES -Adaptation of personnel management practices to align with Patient Centered Care2 Behavioral Interviewing

For Licensed Staff For Non-Licensed Caregiver Staff For ConciergeHousekeepingDining Staff

Reception

What are three positive things your last supervisor (teacher) would say about you

What does patient-centered care mean to you

A patient appears unhappy with the care they are receiving How do you make the patient

feel more comfortable

Tell me how you make them feel comfortable and reassured

Describe for me the way in which you would include family members in the care of the

patient

How do you learn about your patients and who they are

How would you on a personal and professional level bring patient-centered care to life

A patients family is concerned about the care a patient is getting How would you address

their concerns

Reception

What are three positive things your last boss (teacher) would say about you

What does patient-centered care mean to you

Tell me about a time that you assisted a patient that was feeling scared or frightened about

their illness

How would you create a positive experience for patients when dealing with multiple

requests at one time

How would you on a personal and professional level bring patient-centered care to life

A patient has soiled hisher self How would you approach this situation

You are meeting a patient for the first time Tell me how you make them feel comfortable

and reassured

A patients family is concerned about the care a patient is getting How would you address

their concerns

Reception

What are three positive things your last boss (teacher) would say about you

What does patient-centered care mean to you

Tell me how you would use patient-centered care in role to create a positive experience for

patients

You are meeting a patient for the first time Tell me how you make them feel comfortable

and reassured

How would you on a personal and professional level bring patient-centered care to life

Both phone lines are ringing at your station and a person is standing at the desk How do

you handle this situation or how have you handled this in the past

How do you embrace the differences of people you interact with

Knowledge

What was the best (worst) class that you took in school Why

Where do you see yourself in five (5) years

Do you speak another language How did you utilize this in a past jobclinical setting

How do you anticipate the needs of your patients and coworkers

Have you ever had difficulty with a supervisor or instructor How did you resolve the

conflict

What do you do when priorities change quickly Give me one example

Knowledge

Where do you see yourself in five (5) years

Do you speak another language How did you utilize this in a past jobclinical setting

How do you anticipate the needs of your patients and coworkers

Explain a time when you handled changing priorities at workschool

If you saw someone who appears lost in the hallway what would you do

A patient has coded (died) What could you do to assist with this situation

Knowledge

Where do you see yourself in five (5) years

Do you speak another language How did you utilize this in a past jobclinical setting

How do you anticipate the needs of your patients and coworkers

Explain a time when you handled changing priorities at workschool

What did you like about your previous job (if in healthcare field)

Why did you decide to get involved in the healthcare field

Technology

Describe a situation where you had to learn some new technology and apply it in a work

setting

Are you more energized by working with data or by collaborating with other individuals

Why

Attention to detail is an important component of this job Tell me about how you do this in

your current job

Our technology is state of the art how would you ensure that the human interactions with

your patient remain the focus

Technology

Describe a situation where you had to learn some new technology and apply it in a work

setting

Are you more energized by working with data or by collaborating with other individuals

Why

Attention to detail is an important component of this job Tell me about how you do this in

your current job

Our technology is state of the art how would you ensure that the human interactions with

your patient remain the focus

Technology

Describe a situation where you had to learn some new technology and apply it in a work

setting

Are you more energized by working with data or by collaborating with other individuals

Why

Attention to detail is an important component of this job Tell me about how you do this in

your current job

Our technology is state of the art how would you ensure that the human interactions with

your patient remain the focus

5

4

3

2

1

QuestionScore

DIV0Knowledge

DIV0Technology

DIV0Total Score

VALUEAverage score

VALUE

Reception

Each applicant is rated on three distinct sections each of these sections is composed of three questions A numerical scale is used to rank each of the applicants response totally to an overall composite score for the applicant Applicant score is basis for hiring in addition to credentially and background assessment as required by local law

Very Unsatisfcatory Response

11

Applicant Scoring Scale

Notes

Very Satisfactory Response

Candidates Name

Position

Satisfactory ResponseNeutralUnsatisfactory Response

13

12

22

23

31

32

33

Knowledge Subtotal

Technology Subtotal

Reception Subtotal21

wwwplanetreeorg

STRUCTURES ndash Supports for a healing environment

Participatory Design amp Community Design Assessment

Active Patient amp Family Involvement in Planning

Supportive of Continuous Improvement

wwwplanetreeorg

If we treat patients in healing environments why are hospital readmission rates so high

Source Horwitz et al Ann Intern Med 2014161S66-75

0

5

10

15

20

25

wwwplanetreeorg

What are the Causes of High Readmission Rates

bull Poor support

bull Poor preparation

bull Poor systems

bull Poor coordination

bull Poor communication

bull Poor access

wwwplanetreeorg

What if it Were More Than Thathellip

Source Krumholz N Engl J Med 2013368(2)100-2

wwwplanetreeorg

When a Stressful Hospital Stay Makes You Sick By DAVID H NEWMAN MD June 12 2014

Krumholz HM N Engl J Med 368100 - 102 | January 10 2013

What research tells us about the impact of the hospital environment on health outcomes

wwwplanetreeorg

STRUCTURES that promote transparency visibility and inclusion among staff patients and families Patient-Family Advisory Councils

Enlisting patients and family members as partners in quality and process improvement strategic planning hiring and evaluation staff training and more to ensure that the voices of patients are a guiding force in mapping out the future of our healthcare organizations

wwwplanetreeorg

Beyond the council

Patientresidentfamily participation

bull On patient-centered initiative teams (eg wayfinding

patient friendly billing care partners creating patient

menus etc)

bull On safety quality and other organizational committees

bull In Lean rapid improvement events

bull On hiring teams

bull As faculty for staff education and training

wwwplanetreeorg

Quality Check your Partnership Efforts

wwwplanetreeorg

STRUCTURES -Adaptation of personnel management practices to align with Patient Centered Care2 Behavioral Interviewing

For Licensed Staff For Non-Licensed Caregiver Staff For ConciergeHousekeepingDining Staff

Reception

What are three positive things your last supervisor (teacher) would say about you

What does patient-centered care mean to you

A patient appears unhappy with the care they are receiving How do you make the patient

feel more comfortable

Tell me how you make them feel comfortable and reassured

Describe for me the way in which you would include family members in the care of the

patient

How do you learn about your patients and who they are

How would you on a personal and professional level bring patient-centered care to life

A patients family is concerned about the care a patient is getting How would you address

their concerns

Reception

What are three positive things your last boss (teacher) would say about you

What does patient-centered care mean to you

Tell me about a time that you assisted a patient that was feeling scared or frightened about

their illness

How would you create a positive experience for patients when dealing with multiple

requests at one time

How would you on a personal and professional level bring patient-centered care to life

A patient has soiled hisher self How would you approach this situation

You are meeting a patient for the first time Tell me how you make them feel comfortable

and reassured

A patients family is concerned about the care a patient is getting How would you address

their concerns

Reception

What are three positive things your last boss (teacher) would say about you

What does patient-centered care mean to you

Tell me how you would use patient-centered care in role to create a positive experience for

patients

You are meeting a patient for the first time Tell me how you make them feel comfortable

and reassured

How would you on a personal and professional level bring patient-centered care to life

Both phone lines are ringing at your station and a person is standing at the desk How do

you handle this situation or how have you handled this in the past

How do you embrace the differences of people you interact with

Knowledge

What was the best (worst) class that you took in school Why

Where do you see yourself in five (5) years

Do you speak another language How did you utilize this in a past jobclinical setting

How do you anticipate the needs of your patients and coworkers

Have you ever had difficulty with a supervisor or instructor How did you resolve the

conflict

What do you do when priorities change quickly Give me one example

Knowledge

Where do you see yourself in five (5) years

Do you speak another language How did you utilize this in a past jobclinical setting

How do you anticipate the needs of your patients and coworkers

Explain a time when you handled changing priorities at workschool

If you saw someone who appears lost in the hallway what would you do

A patient has coded (died) What could you do to assist with this situation

Knowledge

Where do you see yourself in five (5) years

Do you speak another language How did you utilize this in a past jobclinical setting

How do you anticipate the needs of your patients and coworkers

Explain a time when you handled changing priorities at workschool

What did you like about your previous job (if in healthcare field)

Why did you decide to get involved in the healthcare field

Technology

Describe a situation where you had to learn some new technology and apply it in a work

setting

Are you more energized by working with data or by collaborating with other individuals

Why

Attention to detail is an important component of this job Tell me about how you do this in

your current job

Our technology is state of the art how would you ensure that the human interactions with

your patient remain the focus

Technology

Describe a situation where you had to learn some new technology and apply it in a work

setting

Are you more energized by working with data or by collaborating with other individuals

Why

Attention to detail is an important component of this job Tell me about how you do this in

your current job

Our technology is state of the art how would you ensure that the human interactions with

your patient remain the focus

Technology

Describe a situation where you had to learn some new technology and apply it in a work

setting

Are you more energized by working with data or by collaborating with other individuals

Why

Attention to detail is an important component of this job Tell me about how you do this in

your current job

Our technology is state of the art how would you ensure that the human interactions with

your patient remain the focus

5

4

3

2

1

QuestionScore

DIV0Knowledge

DIV0Technology

DIV0Total Score

VALUEAverage score

VALUE

Reception

Each applicant is rated on three distinct sections each of these sections is composed of three questions A numerical scale is used to rank each of the applicants response totally to an overall composite score for the applicant Applicant score is basis for hiring in addition to credentially and background assessment as required by local law

Very Unsatisfcatory Response

11

Applicant Scoring Scale

Notes

Very Satisfactory Response

Candidates Name

Position

Satisfactory ResponseNeutralUnsatisfactory Response

13

12

22

23

31

32

33

Knowledge Subtotal

Technology Subtotal

Reception Subtotal21

wwwplanetreeorg

STRUCTURES ndash Supports for a healing environment

Participatory Design amp Community Design Assessment

Active Patient amp Family Involvement in Planning

Supportive of Continuous Improvement

wwwplanetreeorg

If we treat patients in healing environments why are hospital readmission rates so high

Source Horwitz et al Ann Intern Med 2014161S66-75

0

5

10

15

20

25

wwwplanetreeorg

What are the Causes of High Readmission Rates

bull Poor support

bull Poor preparation

bull Poor systems

bull Poor coordination

bull Poor communication

bull Poor access

wwwplanetreeorg

What if it Were More Than Thathellip

Source Krumholz N Engl J Med 2013368(2)100-2

wwwplanetreeorg

When a Stressful Hospital Stay Makes You Sick By DAVID H NEWMAN MD June 12 2014

Krumholz HM N Engl J Med 368100 - 102 | January 10 2013

What research tells us about the impact of the hospital environment on health outcomes

wwwplanetreeorg

Beyond the council

Patientresidentfamily participation

bull On patient-centered initiative teams (eg wayfinding

patient friendly billing care partners creating patient

menus etc)

bull On safety quality and other organizational committees

bull In Lean rapid improvement events

bull On hiring teams

bull As faculty for staff education and training

wwwplanetreeorg

Quality Check your Partnership Efforts

wwwplanetreeorg

STRUCTURES -Adaptation of personnel management practices to align with Patient Centered Care2 Behavioral Interviewing

For Licensed Staff For Non-Licensed Caregiver Staff For ConciergeHousekeepingDining Staff

Reception

What are three positive things your last supervisor (teacher) would say about you

What does patient-centered care mean to you

A patient appears unhappy with the care they are receiving How do you make the patient

feel more comfortable

Tell me how you make them feel comfortable and reassured

Describe for me the way in which you would include family members in the care of the

patient

How do you learn about your patients and who they are

How would you on a personal and professional level bring patient-centered care to life

A patients family is concerned about the care a patient is getting How would you address

their concerns

Reception

What are three positive things your last boss (teacher) would say about you

What does patient-centered care mean to you

Tell me about a time that you assisted a patient that was feeling scared or frightened about

their illness

How would you create a positive experience for patients when dealing with multiple

requests at one time

How would you on a personal and professional level bring patient-centered care to life

A patient has soiled hisher self How would you approach this situation

You are meeting a patient for the first time Tell me how you make them feel comfortable

and reassured

A patients family is concerned about the care a patient is getting How would you address

their concerns

Reception

What are three positive things your last boss (teacher) would say about you

What does patient-centered care mean to you

Tell me how you would use patient-centered care in role to create a positive experience for

patients

You are meeting a patient for the first time Tell me how you make them feel comfortable

and reassured

How would you on a personal and professional level bring patient-centered care to life

Both phone lines are ringing at your station and a person is standing at the desk How do

you handle this situation or how have you handled this in the past

How do you embrace the differences of people you interact with

Knowledge

What was the best (worst) class that you took in school Why

Where do you see yourself in five (5) years

Do you speak another language How did you utilize this in a past jobclinical setting

How do you anticipate the needs of your patients and coworkers

Have you ever had difficulty with a supervisor or instructor How did you resolve the

conflict

What do you do when priorities change quickly Give me one example

Knowledge

Where do you see yourself in five (5) years

Do you speak another language How did you utilize this in a past jobclinical setting

How do you anticipate the needs of your patients and coworkers

Explain a time when you handled changing priorities at workschool

If you saw someone who appears lost in the hallway what would you do

A patient has coded (died) What could you do to assist with this situation

Knowledge

Where do you see yourself in five (5) years

Do you speak another language How did you utilize this in a past jobclinical setting

How do you anticipate the needs of your patients and coworkers

Explain a time when you handled changing priorities at workschool

What did you like about your previous job (if in healthcare field)

Why did you decide to get involved in the healthcare field

Technology

Describe a situation where you had to learn some new technology and apply it in a work

setting

Are you more energized by working with data or by collaborating with other individuals

Why

Attention to detail is an important component of this job Tell me about how you do this in

your current job

Our technology is state of the art how would you ensure that the human interactions with

your patient remain the focus

Technology

Describe a situation where you had to learn some new technology and apply it in a work

setting

Are you more energized by working with data or by collaborating with other individuals

Why

Attention to detail is an important component of this job Tell me about how you do this in

your current job

Our technology is state of the art how would you ensure that the human interactions with

your patient remain the focus

Technology

Describe a situation where you had to learn some new technology and apply it in a work

setting

Are you more energized by working with data or by collaborating with other individuals

Why

Attention to detail is an important component of this job Tell me about how you do this in

your current job

Our technology is state of the art how would you ensure that the human interactions with

your patient remain the focus

5

4

3

2

1

QuestionScore

DIV0Knowledge

DIV0Technology

DIV0Total Score

VALUEAverage score

VALUE

Reception

Each applicant is rated on three distinct sections each of these sections is composed of three questions A numerical scale is used to rank each of the applicants response totally to an overall composite score for the applicant Applicant score is basis for hiring in addition to credentially and background assessment as required by local law

Very Unsatisfcatory Response

11

Applicant Scoring Scale

Notes

Very Satisfactory Response

Candidates Name

Position

Satisfactory ResponseNeutralUnsatisfactory Response

13

12

22

23

31

32

33

Knowledge Subtotal

Technology Subtotal

Reception Subtotal21

wwwplanetreeorg

STRUCTURES ndash Supports for a healing environment

Participatory Design amp Community Design Assessment

Active Patient amp Family Involvement in Planning

Supportive of Continuous Improvement

wwwplanetreeorg

If we treat patients in healing environments why are hospital readmission rates so high

Source Horwitz et al Ann Intern Med 2014161S66-75

0

5

10

15

20

25

wwwplanetreeorg

What are the Causes of High Readmission Rates

bull Poor support

bull Poor preparation

bull Poor systems

bull Poor coordination

bull Poor communication

bull Poor access

wwwplanetreeorg

What if it Were More Than Thathellip

Source Krumholz N Engl J Med 2013368(2)100-2

wwwplanetreeorg

When a Stressful Hospital Stay Makes You Sick By DAVID H NEWMAN MD June 12 2014

Krumholz HM N Engl J Med 368100 - 102 | January 10 2013

What research tells us about the impact of the hospital environment on health outcomes

wwwplanetreeorg

Quality Check your Partnership Efforts

wwwplanetreeorg

STRUCTURES -Adaptation of personnel management practices to align with Patient Centered Care2 Behavioral Interviewing

For Licensed Staff For Non-Licensed Caregiver Staff For ConciergeHousekeepingDining Staff

Reception

What are three positive things your last supervisor (teacher) would say about you

What does patient-centered care mean to you

A patient appears unhappy with the care they are receiving How do you make the patient

feel more comfortable

Tell me how you make them feel comfortable and reassured

Describe for me the way in which you would include family members in the care of the

patient

How do you learn about your patients and who they are

How would you on a personal and professional level bring patient-centered care to life

A patients family is concerned about the care a patient is getting How would you address

their concerns

Reception

What are three positive things your last boss (teacher) would say about you

What does patient-centered care mean to you

Tell me about a time that you assisted a patient that was feeling scared or frightened about

their illness

How would you create a positive experience for patients when dealing with multiple

requests at one time

How would you on a personal and professional level bring patient-centered care to life

A patient has soiled hisher self How would you approach this situation

You are meeting a patient for the first time Tell me how you make them feel comfortable

and reassured

A patients family is concerned about the care a patient is getting How would you address

their concerns

Reception

What are three positive things your last boss (teacher) would say about you

What does patient-centered care mean to you

Tell me how you would use patient-centered care in role to create a positive experience for

patients

You are meeting a patient for the first time Tell me how you make them feel comfortable

and reassured

How would you on a personal and professional level bring patient-centered care to life

Both phone lines are ringing at your station and a person is standing at the desk How do

you handle this situation or how have you handled this in the past

How do you embrace the differences of people you interact with

Knowledge

What was the best (worst) class that you took in school Why

Where do you see yourself in five (5) years

Do you speak another language How did you utilize this in a past jobclinical setting

How do you anticipate the needs of your patients and coworkers

Have you ever had difficulty with a supervisor or instructor How did you resolve the

conflict

What do you do when priorities change quickly Give me one example

Knowledge

Where do you see yourself in five (5) years

Do you speak another language How did you utilize this in a past jobclinical setting

How do you anticipate the needs of your patients and coworkers

Explain a time when you handled changing priorities at workschool

If you saw someone who appears lost in the hallway what would you do

A patient has coded (died) What could you do to assist with this situation

Knowledge

Where do you see yourself in five (5) years

Do you speak another language How did you utilize this in a past jobclinical setting

How do you anticipate the needs of your patients and coworkers

Explain a time when you handled changing priorities at workschool

What did you like about your previous job (if in healthcare field)

Why did you decide to get involved in the healthcare field

Technology

Describe a situation where you had to learn some new technology and apply it in a work

setting

Are you more energized by working with data or by collaborating with other individuals

Why

Attention to detail is an important component of this job Tell me about how you do this in

your current job

Our technology is state of the art how would you ensure that the human interactions with

your patient remain the focus

Technology

Describe a situation where you had to learn some new technology and apply it in a work

setting

Are you more energized by working with data or by collaborating with other individuals

Why

Attention to detail is an important component of this job Tell me about how you do this in

your current job

Our technology is state of the art how would you ensure that the human interactions with

your patient remain the focus

Technology

Describe a situation where you had to learn some new technology and apply it in a work

setting

Are you more energized by working with data or by collaborating with other individuals

Why

Attention to detail is an important component of this job Tell me about how you do this in

your current job

Our technology is state of the art how would you ensure that the human interactions with

your patient remain the focus

5

4

3

2

1

QuestionScore

DIV0Knowledge

DIV0Technology

DIV0Total Score

VALUEAverage score

VALUE

Reception

Each applicant is rated on three distinct sections each of these sections is composed of three questions A numerical scale is used to rank each of the applicants response totally to an overall composite score for the applicant Applicant score is basis for hiring in addition to credentially and background assessment as required by local law

Very Unsatisfcatory Response

11

Applicant Scoring Scale

Notes

Very Satisfactory Response

Candidates Name

Position

Satisfactory ResponseNeutralUnsatisfactory Response

13

12

22

23

31

32

33

Knowledge Subtotal

Technology Subtotal

Reception Subtotal21

wwwplanetreeorg

STRUCTURES ndash Supports for a healing environment

Participatory Design amp Community Design Assessment

Active Patient amp Family Involvement in Planning

Supportive of Continuous Improvement

wwwplanetreeorg

If we treat patients in healing environments why are hospital readmission rates so high

Source Horwitz et al Ann Intern Med 2014161S66-75

0

5

10

15

20

25

wwwplanetreeorg

What are the Causes of High Readmission Rates

bull Poor support

bull Poor preparation

bull Poor systems

bull Poor coordination

bull Poor communication

bull Poor access

wwwplanetreeorg

What if it Were More Than Thathellip

Source Krumholz N Engl J Med 2013368(2)100-2

wwwplanetreeorg

When a Stressful Hospital Stay Makes You Sick By DAVID H NEWMAN MD June 12 2014

Krumholz HM N Engl J Med 368100 - 102 | January 10 2013

What research tells us about the impact of the hospital environment on health outcomes

wwwplanetreeorg

STRUCTURES -Adaptation of personnel management practices to align with Patient Centered Care2 Behavioral Interviewing

For Licensed Staff For Non-Licensed Caregiver Staff For ConciergeHousekeepingDining Staff

Reception

What are three positive things your last supervisor (teacher) would say about you

What does patient-centered care mean to you

A patient appears unhappy with the care they are receiving How do you make the patient

feel more comfortable

Tell me how you make them feel comfortable and reassured

Describe for me the way in which you would include family members in the care of the

patient

How do you learn about your patients and who they are

How would you on a personal and professional level bring patient-centered care to life

A patients family is concerned about the care a patient is getting How would you address

their concerns

Reception

What are three positive things your last boss (teacher) would say about you

What does patient-centered care mean to you

Tell me about a time that you assisted a patient that was feeling scared or frightened about

their illness

How would you create a positive experience for patients when dealing with multiple

requests at one time

How would you on a personal and professional level bring patient-centered care to life

A patient has soiled hisher self How would you approach this situation

You are meeting a patient for the first time Tell me how you make them feel comfortable

and reassured

A patients family is concerned about the care a patient is getting How would you address

their concerns

Reception

What are three positive things your last boss (teacher) would say about you

What does patient-centered care mean to you

Tell me how you would use patient-centered care in role to create a positive experience for

patients

You are meeting a patient for the first time Tell me how you make them feel comfortable

and reassured

How would you on a personal and professional level bring patient-centered care to life

Both phone lines are ringing at your station and a person is standing at the desk How do

you handle this situation or how have you handled this in the past

How do you embrace the differences of people you interact with

Knowledge

What was the best (worst) class that you took in school Why

Where do you see yourself in five (5) years

Do you speak another language How did you utilize this in a past jobclinical setting

How do you anticipate the needs of your patients and coworkers

Have you ever had difficulty with a supervisor or instructor How did you resolve the

conflict

What do you do when priorities change quickly Give me one example

Knowledge

Where do you see yourself in five (5) years

Do you speak another language How did you utilize this in a past jobclinical setting

How do you anticipate the needs of your patients and coworkers

Explain a time when you handled changing priorities at workschool

If you saw someone who appears lost in the hallway what would you do

A patient has coded (died) What could you do to assist with this situation

Knowledge

Where do you see yourself in five (5) years

Do you speak another language How did you utilize this in a past jobclinical setting

How do you anticipate the needs of your patients and coworkers

Explain a time when you handled changing priorities at workschool

What did you like about your previous job (if in healthcare field)

Why did you decide to get involved in the healthcare field

Technology

Describe a situation where you had to learn some new technology and apply it in a work

setting

Are you more energized by working with data or by collaborating with other individuals

Why

Attention to detail is an important component of this job Tell me about how you do this in

your current job

Our technology is state of the art how would you ensure that the human interactions with

your patient remain the focus

Technology

Describe a situation where you had to learn some new technology and apply it in a work

setting

Are you more energized by working with data or by collaborating with other individuals

Why

Attention to detail is an important component of this job Tell me about how you do this in

your current job

Our technology is state of the art how would you ensure that the human interactions with

your patient remain the focus

Technology

Describe a situation where you had to learn some new technology and apply it in a work

setting

Are you more energized by working with data or by collaborating with other individuals

Why

Attention to detail is an important component of this job Tell me about how you do this in

your current job

Our technology is state of the art how would you ensure that the human interactions with

your patient remain the focus

5

4

3

2

1

QuestionScore

DIV0Knowledge

DIV0Technology

DIV0Total Score

VALUEAverage score

VALUE

Reception

Each applicant is rated on three distinct sections each of these sections is composed of three questions A numerical scale is used to rank each of the applicants response totally to an overall composite score for the applicant Applicant score is basis for hiring in addition to credentially and background assessment as required by local law

Very Unsatisfcatory Response

11

Applicant Scoring Scale

Notes

Very Satisfactory Response

Candidates Name

Position

Satisfactory ResponseNeutralUnsatisfactory Response

13

12

22

23

31

32

33

Knowledge Subtotal

Technology Subtotal

Reception Subtotal21

wwwplanetreeorg

STRUCTURES ndash Supports for a healing environment

Participatory Design amp Community Design Assessment

Active Patient amp Family Involvement in Planning

Supportive of Continuous Improvement

wwwplanetreeorg

If we treat patients in healing environments why are hospital readmission rates so high

Source Horwitz et al Ann Intern Med 2014161S66-75

0

5

10

15

20

25

wwwplanetreeorg

What are the Causes of High Readmission Rates

bull Poor support

bull Poor preparation

bull Poor systems

bull Poor coordination

bull Poor communication

bull Poor access

wwwplanetreeorg

What if it Were More Than Thathellip

Source Krumholz N Engl J Med 2013368(2)100-2

wwwplanetreeorg

When a Stressful Hospital Stay Makes You Sick By DAVID H NEWMAN MD June 12 2014

Krumholz HM N Engl J Med 368100 - 102 | January 10 2013

What research tells us about the impact of the hospital environment on health outcomes

wwwplanetreeorg

STRUCTURES ndash Supports for a healing environment

Participatory Design amp Community Design Assessment

Active Patient amp Family Involvement in Planning

Supportive of Continuous Improvement

wwwplanetreeorg

If we treat patients in healing environments why are hospital readmission rates so high

Source Horwitz et al Ann Intern Med 2014161S66-75

0

5

10

15

20

25

wwwplanetreeorg

What are the Causes of High Readmission Rates

bull Poor support

bull Poor preparation

bull Poor systems

bull Poor coordination

bull Poor communication

bull Poor access

wwwplanetreeorg

What if it Were More Than Thathellip

Source Krumholz N Engl J Med 2013368(2)100-2

wwwplanetreeorg

When a Stressful Hospital Stay Makes You Sick By DAVID H NEWMAN MD June 12 2014

Krumholz HM N Engl J Med 368100 - 102 | January 10 2013

What research tells us about the impact of the hospital environment on health outcomes

wwwplanetreeorg

If we treat patients in healing environments why are hospital readmission rates so high

Source Horwitz et al Ann Intern Med 2014161S66-75

0

5

10

15

20

25

wwwplanetreeorg

What are the Causes of High Readmission Rates

bull Poor support

bull Poor preparation

bull Poor systems

bull Poor coordination

bull Poor communication

bull Poor access

wwwplanetreeorg

What if it Were More Than Thathellip

Source Krumholz N Engl J Med 2013368(2)100-2

wwwplanetreeorg

When a Stressful Hospital Stay Makes You Sick By DAVID H NEWMAN MD June 12 2014

Krumholz HM N Engl J Med 368100 - 102 | January 10 2013

What research tells us about the impact of the hospital environment on health outcomes

wwwplanetreeorg

What are the Causes of High Readmission Rates

bull Poor support

bull Poor preparation

bull Poor systems

bull Poor coordination

bull Poor communication

bull Poor access

wwwplanetreeorg

What if it Were More Than Thathellip

Source Krumholz N Engl J Med 2013368(2)100-2

wwwplanetreeorg

When a Stressful Hospital Stay Makes You Sick By DAVID H NEWMAN MD June 12 2014

Krumholz HM N Engl J Med 368100 - 102 | January 10 2013

What research tells us about the impact of the hospital environment on health outcomes

wwwplanetreeorg

What if it Were More Than Thathellip

Source Krumholz N Engl J Med 2013368(2)100-2

wwwplanetreeorg

When a Stressful Hospital Stay Makes You Sick By DAVID H NEWMAN MD June 12 2014

Krumholz HM N Engl J Med 368100 - 102 | January 10 2013

What research tells us about the impact of the hospital environment on health outcomes

wwwplanetreeorg

When a Stressful Hospital Stay Makes You Sick By DAVID H NEWMAN MD June 12 2014

Krumholz HM N Engl J Med 368100 - 102 | January 10 2013

What research tells us about the impact of the hospital environment on health outcomes

wwwplanetreeorg

Condition at Initial Discharge vs 30-day Readmissions Diagnosis

37 291 362 211

63 709 638 789

0

20

40

60

80

100

Heart Failure Pneumonia COPD Gastrointestinalproblems

Readmissions for the same cause Readmission for other causes

Pati

ents

(

)

wwwplanetreeorg

Question How could the hospital experience increase risk

bull Sleep Interruptions

bull Loud noises

bull Bright lights

bull Mobility limitations

bull Foodwater restriction

bull Painful stimuli

bull Uncertainty(everywhere)

wwwplanetreeorg Courtesy of Deena Goldwater

wwwplanetreeorg Courtesy of Deena Goldwater

wwwplanetreeorg

wwwplanetreeorg

Acute Stress

Impact A Symptoms B Function C Quality of Life

Conceptual Model for Post-Hospital Syndrome

Patient Factors

Age chronic health conditions

geriatric impairments

psychosocial factors baseline

health status acute illness

severity

Hospital Experience

Sleep quality sound exposure

light exposure mobility forced

fasting pain uncertainty

wwwplanetreeorg

Next Improve Experience and Measure Outcomes bull Decrease sleep disruption amp increase access to natural light and dark cycles

ndash Observe lsquolights outrsquo based on patientrsquos normal sleep patterns

ndash Cluster nighttime activities of staff and provide task lighting and dimmers

ndash Provide ear plugs eye masks sound machines

ndash Close patient doors

ndash Noise level monitors

bull Reexamine evidence-base for food and water restrictions ndash Offer familiar ethnic menus

ndash Encourage lsquofood from homersquo make kitchen facilities available to family

bull Encourage familycare partnersvolunteer presence for emotional support and ambulation assistance

bull Staff narration of all procedures

bull Posted daily schedule of tests procedures activities

wwwplanetreeorg

Preserving sleep

A tool for enhancing shared decision-making between patients amp nursing to preserve patientsrsquo sleep amp facilitate healing

65 of patients rated their sleep quality as a 4 or 5

65 reported no sleep interruptions

63 of patients provided the sleep menu requested a sleep aid

Of those 88 rated their sleep quality as a 4 or 5

Top requests from sleep menu CD player warm blanket eye mask

wwwplanetreeorg

Creating a serene natural environment

Roger S Ulrich (1983) linked environmental attributes of healthcare environment to healing

finding a causal relationship between the patients that had a room with a view of trees and

the rate of healing and sense of wellbeing

Patients in rooms with views of trees had

o Fewer days in the hospital than patients with a view of a brick wall

o Were in better spirits (according to nurses)

o Used fewer analgesics during their stay

wwwplanetreeorg

wwwplanetreeorg

SKILL BUILDING amp AWARENESS BUILDING bullCaregiver training (Shared Decision Making empathy cultural competence patient centered practices) 3-6

bullExperiential learning to promote perspective-taking and connection to purpose

GROUP ACTIVITY

wwwplanetreeorg

Leadership satisfaction scores following baseline and bi-annual experiential learning sessions

60

65

70

75

80

85

90

Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8

Note Westchester Division outperforms organizational average

wwwplanetreeorg

0

20

40

60

80

100

2003 2005 2007 2009 2011 2013Patient Satisfaction Staff Satisfaction

Staff and patient satisfaction scores following experiential staff retreats

wwwplanetreeorg

69

70

71

72

73

74

75

76

Non Members Members Designated Members

Hospital Rating 9 or 10

68

69

70

71

72

73

74

75

76

77

Non Members Members Designated Members

Most Likely to Recommend

Staff commitment to patient-centered care improves hospital reputation

wwwplanetreeorg

What research tells us about clinician empathy and clinical outcomes

Trusting empathic relationships between clinicians and patients have increased patient engagement and improved health outcomes including diabetes management flu recovery times and reductions in major medical errors

Clinician empathy skills can be enhanced through training focused on self-reflection self-compassion and behavior modification

Compassion practices a measure of the extent to which a hospital rewards compassionate acts and compassionately supports its employees is significantly and positively associated with patientsrsquo ratings of the hospital and likelihood of recommending

Rakel and Barrett et al in Patient Education and Counseling 2011 Hojat et al in Academic Medicine 2011 Haslam in Medical Journal of Australia 2007 Riess H Marci CD The Neurobiology and Physiology of the Patient ndashDoctor Relationship Measuring Empathy Medical Encounter 2007 21(3)38-41 Riess H Herman JB Teaching the teachers A model course for psychotherapy supervisorsAcademic Psychiatry 2008 32259-264 McClelland L and Vogus T Compassion Practices and HCAHPS Does Rewarding and Supporting Workplace Compassion Influence Patient Perceptions Healt h Services Research Volume 49 Issue 5 pages 1670ndash1683 October 2014

wwwplanetreeorg

Question How could the hospital experience increase risk

bull Sleep Interruptions

bull Loud noises

bull Bright lights

bull Mobility limitations

bull Foodwater restriction

bull Painful stimuli

bull Uncertainty(everywhere)

wwwplanetreeorg Courtesy of Deena Goldwater

wwwplanetreeorg Courtesy of Deena Goldwater

wwwplanetreeorg

wwwplanetreeorg

Acute Stress

Impact A Symptoms B Function C Quality of Life

Conceptual Model for Post-Hospital Syndrome

Patient Factors

Age chronic health conditions

geriatric impairments

psychosocial factors baseline

health status acute illness

severity

Hospital Experience

Sleep quality sound exposure

light exposure mobility forced

fasting pain uncertainty

wwwplanetreeorg

Next Improve Experience and Measure Outcomes bull Decrease sleep disruption amp increase access to natural light and dark cycles

ndash Observe lsquolights outrsquo based on patientrsquos normal sleep patterns

ndash Cluster nighttime activities of staff and provide task lighting and dimmers

ndash Provide ear plugs eye masks sound machines

ndash Close patient doors

ndash Noise level monitors

bull Reexamine evidence-base for food and water restrictions ndash Offer familiar ethnic menus

ndash Encourage lsquofood from homersquo make kitchen facilities available to family

bull Encourage familycare partnersvolunteer presence for emotional support and ambulation assistance

bull Staff narration of all procedures

bull Posted daily schedule of tests procedures activities

wwwplanetreeorg

Preserving sleep

A tool for enhancing shared decision-making between patients amp nursing to preserve patientsrsquo sleep amp facilitate healing

65 of patients rated their sleep quality as a 4 or 5

65 reported no sleep interruptions

63 of patients provided the sleep menu requested a sleep aid

Of those 88 rated their sleep quality as a 4 or 5

Top requests from sleep menu CD player warm blanket eye mask

wwwplanetreeorg

Creating a serene natural environment

Roger S Ulrich (1983) linked environmental attributes of healthcare environment to healing

finding a causal relationship between the patients that had a room with a view of trees and

the rate of healing and sense of wellbeing

Patients in rooms with views of trees had

o Fewer days in the hospital than patients with a view of a brick wall

o Were in better spirits (according to nurses)

o Used fewer analgesics during their stay

wwwplanetreeorg

wwwplanetreeorg

SKILL BUILDING amp AWARENESS BUILDING bullCaregiver training (Shared Decision Making empathy cultural competence patient centered practices) 3-6

bullExperiential learning to promote perspective-taking and connection to purpose

GROUP ACTIVITY

wwwplanetreeorg

Leadership satisfaction scores following baseline and bi-annual experiential learning sessions

60

65

70

75

80

85

90

Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8

Note Westchester Division outperforms organizational average

wwwplanetreeorg

0

20

40

60

80

100

2003 2005 2007 2009 2011 2013Patient Satisfaction Staff Satisfaction

Staff and patient satisfaction scores following experiential staff retreats

wwwplanetreeorg

69

70

71

72

73

74

75

76

Non Members Members Designated Members

Hospital Rating 9 or 10

68

69

70

71

72

73

74

75

76

77

Non Members Members Designated Members

Most Likely to Recommend

Staff commitment to patient-centered care improves hospital reputation

wwwplanetreeorg

What research tells us about clinician empathy and clinical outcomes

Trusting empathic relationships between clinicians and patients have increased patient engagement and improved health outcomes including diabetes management flu recovery times and reductions in major medical errors

Clinician empathy skills can be enhanced through training focused on self-reflection self-compassion and behavior modification

Compassion practices a measure of the extent to which a hospital rewards compassionate acts and compassionately supports its employees is significantly and positively associated with patientsrsquo ratings of the hospital and likelihood of recommending

Rakel and Barrett et al in Patient Education and Counseling 2011 Hojat et al in Academic Medicine 2011 Haslam in Medical Journal of Australia 2007 Riess H Marci CD The Neurobiology and Physiology of the Patient ndashDoctor Relationship Measuring Empathy Medical Encounter 2007 21(3)38-41 Riess H Herman JB Teaching the teachers A model course for psychotherapy supervisorsAcademic Psychiatry 2008 32259-264 McClelland L and Vogus T Compassion Practices and HCAHPS Does Rewarding and Supporting Workplace Compassion Influence Patient Perceptions Healt h Services Research Volume 49 Issue 5 pages 1670ndash1683 October 2014

wwwplanetreeorg Courtesy of Deena Goldwater

wwwplanetreeorg Courtesy of Deena Goldwater

wwwplanetreeorg

wwwplanetreeorg

Acute Stress

Impact A Symptoms B Function C Quality of Life

Conceptual Model for Post-Hospital Syndrome

Patient Factors

Age chronic health conditions

geriatric impairments

psychosocial factors baseline

health status acute illness

severity

Hospital Experience

Sleep quality sound exposure

light exposure mobility forced

fasting pain uncertainty

wwwplanetreeorg

Next Improve Experience and Measure Outcomes bull Decrease sleep disruption amp increase access to natural light and dark cycles

ndash Observe lsquolights outrsquo based on patientrsquos normal sleep patterns

ndash Cluster nighttime activities of staff and provide task lighting and dimmers

ndash Provide ear plugs eye masks sound machines

ndash Close patient doors

ndash Noise level monitors

bull Reexamine evidence-base for food and water restrictions ndash Offer familiar ethnic menus

ndash Encourage lsquofood from homersquo make kitchen facilities available to family

bull Encourage familycare partnersvolunteer presence for emotional support and ambulation assistance

bull Staff narration of all procedures

bull Posted daily schedule of tests procedures activities

wwwplanetreeorg

Preserving sleep

A tool for enhancing shared decision-making between patients amp nursing to preserve patientsrsquo sleep amp facilitate healing

65 of patients rated their sleep quality as a 4 or 5

65 reported no sleep interruptions

63 of patients provided the sleep menu requested a sleep aid

Of those 88 rated their sleep quality as a 4 or 5

Top requests from sleep menu CD player warm blanket eye mask

wwwplanetreeorg

Creating a serene natural environment

Roger S Ulrich (1983) linked environmental attributes of healthcare environment to healing

finding a causal relationship between the patients that had a room with a view of trees and

the rate of healing and sense of wellbeing

Patients in rooms with views of trees had

o Fewer days in the hospital than patients with a view of a brick wall

o Were in better spirits (according to nurses)

o Used fewer analgesics during their stay

wwwplanetreeorg

wwwplanetreeorg

SKILL BUILDING amp AWARENESS BUILDING bullCaregiver training (Shared Decision Making empathy cultural competence patient centered practices) 3-6

bullExperiential learning to promote perspective-taking and connection to purpose

GROUP ACTIVITY

wwwplanetreeorg

Leadership satisfaction scores following baseline and bi-annual experiential learning sessions

60

65

70

75

80

85

90

Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8

Note Westchester Division outperforms organizational average

wwwplanetreeorg

0

20

40

60

80

100

2003 2005 2007 2009 2011 2013Patient Satisfaction Staff Satisfaction

Staff and patient satisfaction scores following experiential staff retreats

wwwplanetreeorg

69

70

71

72

73

74

75

76

Non Members Members Designated Members

Hospital Rating 9 or 10

68

69

70

71

72

73

74

75

76

77

Non Members Members Designated Members

Most Likely to Recommend

Staff commitment to patient-centered care improves hospital reputation

wwwplanetreeorg

What research tells us about clinician empathy and clinical outcomes

Trusting empathic relationships between clinicians and patients have increased patient engagement and improved health outcomes including diabetes management flu recovery times and reductions in major medical errors

Clinician empathy skills can be enhanced through training focused on self-reflection self-compassion and behavior modification

Compassion practices a measure of the extent to which a hospital rewards compassionate acts and compassionately supports its employees is significantly and positively associated with patientsrsquo ratings of the hospital and likelihood of recommending

Rakel and Barrett et al in Patient Education and Counseling 2011 Hojat et al in Academic Medicine 2011 Haslam in Medical Journal of Australia 2007 Riess H Marci CD The Neurobiology and Physiology of the Patient ndashDoctor Relationship Measuring Empathy Medical Encounter 2007 21(3)38-41 Riess H Herman JB Teaching the teachers A model course for psychotherapy supervisorsAcademic Psychiatry 2008 32259-264 McClelland L and Vogus T Compassion Practices and HCAHPS Does Rewarding and Supporting Workplace Compassion Influence Patient Perceptions Healt h Services Research Volume 49 Issue 5 pages 1670ndash1683 October 2014

wwwplanetreeorg Courtesy of Deena Goldwater

wwwplanetreeorg

wwwplanetreeorg

Acute Stress

Impact A Symptoms B Function C Quality of Life

Conceptual Model for Post-Hospital Syndrome

Patient Factors

Age chronic health conditions

geriatric impairments

psychosocial factors baseline

health status acute illness

severity

Hospital Experience

Sleep quality sound exposure

light exposure mobility forced

fasting pain uncertainty

wwwplanetreeorg

Next Improve Experience and Measure Outcomes bull Decrease sleep disruption amp increase access to natural light and dark cycles

ndash Observe lsquolights outrsquo based on patientrsquos normal sleep patterns

ndash Cluster nighttime activities of staff and provide task lighting and dimmers

ndash Provide ear plugs eye masks sound machines

ndash Close patient doors

ndash Noise level monitors

bull Reexamine evidence-base for food and water restrictions ndash Offer familiar ethnic menus

ndash Encourage lsquofood from homersquo make kitchen facilities available to family

bull Encourage familycare partnersvolunteer presence for emotional support and ambulation assistance

bull Staff narration of all procedures

bull Posted daily schedule of tests procedures activities

wwwplanetreeorg

Preserving sleep

A tool for enhancing shared decision-making between patients amp nursing to preserve patientsrsquo sleep amp facilitate healing

65 of patients rated their sleep quality as a 4 or 5

65 reported no sleep interruptions

63 of patients provided the sleep menu requested a sleep aid

Of those 88 rated their sleep quality as a 4 or 5

Top requests from sleep menu CD player warm blanket eye mask

wwwplanetreeorg

Creating a serene natural environment

Roger S Ulrich (1983) linked environmental attributes of healthcare environment to healing

finding a causal relationship between the patients that had a room with a view of trees and

the rate of healing and sense of wellbeing

Patients in rooms with views of trees had

o Fewer days in the hospital than patients with a view of a brick wall

o Were in better spirits (according to nurses)

o Used fewer analgesics during their stay

wwwplanetreeorg

wwwplanetreeorg

SKILL BUILDING amp AWARENESS BUILDING bullCaregiver training (Shared Decision Making empathy cultural competence patient centered practices) 3-6

bullExperiential learning to promote perspective-taking and connection to purpose

GROUP ACTIVITY

wwwplanetreeorg

Leadership satisfaction scores following baseline and bi-annual experiential learning sessions

60

65

70

75

80

85

90

Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8

Note Westchester Division outperforms organizational average

wwwplanetreeorg

0

20

40

60

80

100

2003 2005 2007 2009 2011 2013Patient Satisfaction Staff Satisfaction

Staff and patient satisfaction scores following experiential staff retreats

wwwplanetreeorg

69

70

71

72

73

74

75

76

Non Members Members Designated Members

Hospital Rating 9 or 10

68

69

70

71

72

73

74

75

76

77

Non Members Members Designated Members

Most Likely to Recommend

Staff commitment to patient-centered care improves hospital reputation

wwwplanetreeorg

What research tells us about clinician empathy and clinical outcomes

Trusting empathic relationships between clinicians and patients have increased patient engagement and improved health outcomes including diabetes management flu recovery times and reductions in major medical errors

Clinician empathy skills can be enhanced through training focused on self-reflection self-compassion and behavior modification

Compassion practices a measure of the extent to which a hospital rewards compassionate acts and compassionately supports its employees is significantly and positively associated with patientsrsquo ratings of the hospital and likelihood of recommending

Rakel and Barrett et al in Patient Education and Counseling 2011 Hojat et al in Academic Medicine 2011 Haslam in Medical Journal of Australia 2007 Riess H Marci CD The Neurobiology and Physiology of the Patient ndashDoctor Relationship Measuring Empathy Medical Encounter 2007 21(3)38-41 Riess H Herman JB Teaching the teachers A model course for psychotherapy supervisorsAcademic Psychiatry 2008 32259-264 McClelland L and Vogus T Compassion Practices and HCAHPS Does Rewarding and Supporting Workplace Compassion Influence Patient Perceptions Healt h Services Research Volume 49 Issue 5 pages 1670ndash1683 October 2014

wwwplanetreeorg

wwwplanetreeorg

Acute Stress

Impact A Symptoms B Function C Quality of Life

Conceptual Model for Post-Hospital Syndrome

Patient Factors

Age chronic health conditions

geriatric impairments

psychosocial factors baseline

health status acute illness

severity

Hospital Experience

Sleep quality sound exposure

light exposure mobility forced

fasting pain uncertainty

wwwplanetreeorg

Next Improve Experience and Measure Outcomes bull Decrease sleep disruption amp increase access to natural light and dark cycles

ndash Observe lsquolights outrsquo based on patientrsquos normal sleep patterns

ndash Cluster nighttime activities of staff and provide task lighting and dimmers

ndash Provide ear plugs eye masks sound machines

ndash Close patient doors

ndash Noise level monitors

bull Reexamine evidence-base for food and water restrictions ndash Offer familiar ethnic menus

ndash Encourage lsquofood from homersquo make kitchen facilities available to family

bull Encourage familycare partnersvolunteer presence for emotional support and ambulation assistance

bull Staff narration of all procedures

bull Posted daily schedule of tests procedures activities

wwwplanetreeorg

Preserving sleep

A tool for enhancing shared decision-making between patients amp nursing to preserve patientsrsquo sleep amp facilitate healing

65 of patients rated their sleep quality as a 4 or 5

65 reported no sleep interruptions

63 of patients provided the sleep menu requested a sleep aid

Of those 88 rated their sleep quality as a 4 or 5

Top requests from sleep menu CD player warm blanket eye mask

wwwplanetreeorg

Creating a serene natural environment

Roger S Ulrich (1983) linked environmental attributes of healthcare environment to healing

finding a causal relationship between the patients that had a room with a view of trees and

the rate of healing and sense of wellbeing

Patients in rooms with views of trees had

o Fewer days in the hospital than patients with a view of a brick wall

o Were in better spirits (according to nurses)

o Used fewer analgesics during their stay

wwwplanetreeorg

wwwplanetreeorg

SKILL BUILDING amp AWARENESS BUILDING bullCaregiver training (Shared Decision Making empathy cultural competence patient centered practices) 3-6

bullExperiential learning to promote perspective-taking and connection to purpose

GROUP ACTIVITY

wwwplanetreeorg

Leadership satisfaction scores following baseline and bi-annual experiential learning sessions

60

65

70

75

80

85

90

Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8

Note Westchester Division outperforms organizational average

wwwplanetreeorg

0

20

40

60

80

100

2003 2005 2007 2009 2011 2013Patient Satisfaction Staff Satisfaction

Staff and patient satisfaction scores following experiential staff retreats

wwwplanetreeorg

69

70

71

72

73

74

75

76

Non Members Members Designated Members

Hospital Rating 9 or 10

68

69

70

71

72

73

74

75

76

77

Non Members Members Designated Members

Most Likely to Recommend

Staff commitment to patient-centered care improves hospital reputation

wwwplanetreeorg

What research tells us about clinician empathy and clinical outcomes

Trusting empathic relationships between clinicians and patients have increased patient engagement and improved health outcomes including diabetes management flu recovery times and reductions in major medical errors

Clinician empathy skills can be enhanced through training focused on self-reflection self-compassion and behavior modification

Compassion practices a measure of the extent to which a hospital rewards compassionate acts and compassionately supports its employees is significantly and positively associated with patientsrsquo ratings of the hospital and likelihood of recommending

Rakel and Barrett et al in Patient Education and Counseling 2011 Hojat et al in Academic Medicine 2011 Haslam in Medical Journal of Australia 2007 Riess H Marci CD The Neurobiology and Physiology of the Patient ndashDoctor Relationship Measuring Empathy Medical Encounter 2007 21(3)38-41 Riess H Herman JB Teaching the teachers A model course for psychotherapy supervisorsAcademic Psychiatry 2008 32259-264 McClelland L and Vogus T Compassion Practices and HCAHPS Does Rewarding and Supporting Workplace Compassion Influence Patient Perceptions Healt h Services Research Volume 49 Issue 5 pages 1670ndash1683 October 2014

wwwplanetreeorg

Acute Stress

Impact A Symptoms B Function C Quality of Life

Conceptual Model for Post-Hospital Syndrome

Patient Factors

Age chronic health conditions

geriatric impairments

psychosocial factors baseline

health status acute illness

severity

Hospital Experience

Sleep quality sound exposure

light exposure mobility forced

fasting pain uncertainty

wwwplanetreeorg

Next Improve Experience and Measure Outcomes bull Decrease sleep disruption amp increase access to natural light and dark cycles

ndash Observe lsquolights outrsquo based on patientrsquos normal sleep patterns

ndash Cluster nighttime activities of staff and provide task lighting and dimmers

ndash Provide ear plugs eye masks sound machines

ndash Close patient doors

ndash Noise level monitors

bull Reexamine evidence-base for food and water restrictions ndash Offer familiar ethnic menus

ndash Encourage lsquofood from homersquo make kitchen facilities available to family

bull Encourage familycare partnersvolunteer presence for emotional support and ambulation assistance

bull Staff narration of all procedures

bull Posted daily schedule of tests procedures activities

wwwplanetreeorg

Preserving sleep

A tool for enhancing shared decision-making between patients amp nursing to preserve patientsrsquo sleep amp facilitate healing

65 of patients rated their sleep quality as a 4 or 5

65 reported no sleep interruptions

63 of patients provided the sleep menu requested a sleep aid

Of those 88 rated their sleep quality as a 4 or 5

Top requests from sleep menu CD player warm blanket eye mask

wwwplanetreeorg

Creating a serene natural environment

Roger S Ulrich (1983) linked environmental attributes of healthcare environment to healing

finding a causal relationship between the patients that had a room with a view of trees and

the rate of healing and sense of wellbeing

Patients in rooms with views of trees had

o Fewer days in the hospital than patients with a view of a brick wall

o Were in better spirits (according to nurses)

o Used fewer analgesics during their stay

wwwplanetreeorg

wwwplanetreeorg

SKILL BUILDING amp AWARENESS BUILDING bullCaregiver training (Shared Decision Making empathy cultural competence patient centered practices) 3-6

bullExperiential learning to promote perspective-taking and connection to purpose

GROUP ACTIVITY

wwwplanetreeorg

Leadership satisfaction scores following baseline and bi-annual experiential learning sessions

60

65

70

75

80

85

90

Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8

Note Westchester Division outperforms organizational average

wwwplanetreeorg

0

20

40

60

80

100

2003 2005 2007 2009 2011 2013Patient Satisfaction Staff Satisfaction

Staff and patient satisfaction scores following experiential staff retreats

wwwplanetreeorg

69

70

71

72

73

74

75

76

Non Members Members Designated Members

Hospital Rating 9 or 10

68

69

70

71

72

73

74

75

76

77

Non Members Members Designated Members

Most Likely to Recommend

Staff commitment to patient-centered care improves hospital reputation

wwwplanetreeorg

What research tells us about clinician empathy and clinical outcomes

Trusting empathic relationships between clinicians and patients have increased patient engagement and improved health outcomes including diabetes management flu recovery times and reductions in major medical errors

Clinician empathy skills can be enhanced through training focused on self-reflection self-compassion and behavior modification

Compassion practices a measure of the extent to which a hospital rewards compassionate acts and compassionately supports its employees is significantly and positively associated with patientsrsquo ratings of the hospital and likelihood of recommending

Rakel and Barrett et al in Patient Education and Counseling 2011 Hojat et al in Academic Medicine 2011 Haslam in Medical Journal of Australia 2007 Riess H Marci CD The Neurobiology and Physiology of the Patient ndashDoctor Relationship Measuring Empathy Medical Encounter 2007 21(3)38-41 Riess H Herman JB Teaching the teachers A model course for psychotherapy supervisorsAcademic Psychiatry 2008 32259-264 McClelland L and Vogus T Compassion Practices and HCAHPS Does Rewarding and Supporting Workplace Compassion Influence Patient Perceptions Healt h Services Research Volume 49 Issue 5 pages 1670ndash1683 October 2014

wwwplanetreeorg

Next Improve Experience and Measure Outcomes bull Decrease sleep disruption amp increase access to natural light and dark cycles

ndash Observe lsquolights outrsquo based on patientrsquos normal sleep patterns

ndash Cluster nighttime activities of staff and provide task lighting and dimmers

ndash Provide ear plugs eye masks sound machines

ndash Close patient doors

ndash Noise level monitors

bull Reexamine evidence-base for food and water restrictions ndash Offer familiar ethnic menus

ndash Encourage lsquofood from homersquo make kitchen facilities available to family

bull Encourage familycare partnersvolunteer presence for emotional support and ambulation assistance

bull Staff narration of all procedures

bull Posted daily schedule of tests procedures activities

wwwplanetreeorg

Preserving sleep

A tool for enhancing shared decision-making between patients amp nursing to preserve patientsrsquo sleep amp facilitate healing

65 of patients rated their sleep quality as a 4 or 5

65 reported no sleep interruptions

63 of patients provided the sleep menu requested a sleep aid

Of those 88 rated their sleep quality as a 4 or 5

Top requests from sleep menu CD player warm blanket eye mask

wwwplanetreeorg

Creating a serene natural environment

Roger S Ulrich (1983) linked environmental attributes of healthcare environment to healing

finding a causal relationship between the patients that had a room with a view of trees and

the rate of healing and sense of wellbeing

Patients in rooms with views of trees had

o Fewer days in the hospital than patients with a view of a brick wall

o Were in better spirits (according to nurses)

o Used fewer analgesics during their stay

wwwplanetreeorg

wwwplanetreeorg

SKILL BUILDING amp AWARENESS BUILDING bullCaregiver training (Shared Decision Making empathy cultural competence patient centered practices) 3-6

bullExperiential learning to promote perspective-taking and connection to purpose

GROUP ACTIVITY

wwwplanetreeorg

Leadership satisfaction scores following baseline and bi-annual experiential learning sessions

60

65

70

75

80

85

90

Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8

Note Westchester Division outperforms organizational average

wwwplanetreeorg

0

20

40

60

80

100

2003 2005 2007 2009 2011 2013Patient Satisfaction Staff Satisfaction

Staff and patient satisfaction scores following experiential staff retreats

wwwplanetreeorg

69

70

71

72

73

74

75

76

Non Members Members Designated Members

Hospital Rating 9 or 10

68

69

70

71

72

73

74

75

76

77

Non Members Members Designated Members

Most Likely to Recommend

Staff commitment to patient-centered care improves hospital reputation

wwwplanetreeorg

What research tells us about clinician empathy and clinical outcomes

Trusting empathic relationships between clinicians and patients have increased patient engagement and improved health outcomes including diabetes management flu recovery times and reductions in major medical errors

Clinician empathy skills can be enhanced through training focused on self-reflection self-compassion and behavior modification

Compassion practices a measure of the extent to which a hospital rewards compassionate acts and compassionately supports its employees is significantly and positively associated with patientsrsquo ratings of the hospital and likelihood of recommending

Rakel and Barrett et al in Patient Education and Counseling 2011 Hojat et al in Academic Medicine 2011 Haslam in Medical Journal of Australia 2007 Riess H Marci CD The Neurobiology and Physiology of the Patient ndashDoctor Relationship Measuring Empathy Medical Encounter 2007 21(3)38-41 Riess H Herman JB Teaching the teachers A model course for psychotherapy supervisorsAcademic Psychiatry 2008 32259-264 McClelland L and Vogus T Compassion Practices and HCAHPS Does Rewarding and Supporting Workplace Compassion Influence Patient Perceptions Healt h Services Research Volume 49 Issue 5 pages 1670ndash1683 October 2014

wwwplanetreeorg

Preserving sleep

A tool for enhancing shared decision-making between patients amp nursing to preserve patientsrsquo sleep amp facilitate healing

65 of patients rated their sleep quality as a 4 or 5

65 reported no sleep interruptions

63 of patients provided the sleep menu requested a sleep aid

Of those 88 rated their sleep quality as a 4 or 5

Top requests from sleep menu CD player warm blanket eye mask

wwwplanetreeorg

Creating a serene natural environment

Roger S Ulrich (1983) linked environmental attributes of healthcare environment to healing

finding a causal relationship between the patients that had a room with a view of trees and

the rate of healing and sense of wellbeing

Patients in rooms with views of trees had

o Fewer days in the hospital than patients with a view of a brick wall

o Were in better spirits (according to nurses)

o Used fewer analgesics during their stay

wwwplanetreeorg

wwwplanetreeorg

SKILL BUILDING amp AWARENESS BUILDING bullCaregiver training (Shared Decision Making empathy cultural competence patient centered practices) 3-6

bullExperiential learning to promote perspective-taking and connection to purpose

GROUP ACTIVITY

wwwplanetreeorg

Leadership satisfaction scores following baseline and bi-annual experiential learning sessions

60

65

70

75

80

85

90

Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8

Note Westchester Division outperforms organizational average

wwwplanetreeorg

0

20

40

60

80

100

2003 2005 2007 2009 2011 2013Patient Satisfaction Staff Satisfaction

Staff and patient satisfaction scores following experiential staff retreats

wwwplanetreeorg

69

70

71

72

73

74

75

76

Non Members Members Designated Members

Hospital Rating 9 or 10

68

69

70

71

72

73

74

75

76

77

Non Members Members Designated Members

Most Likely to Recommend

Staff commitment to patient-centered care improves hospital reputation

wwwplanetreeorg

What research tells us about clinician empathy and clinical outcomes

Trusting empathic relationships between clinicians and patients have increased patient engagement and improved health outcomes including diabetes management flu recovery times and reductions in major medical errors

Clinician empathy skills can be enhanced through training focused on self-reflection self-compassion and behavior modification

Compassion practices a measure of the extent to which a hospital rewards compassionate acts and compassionately supports its employees is significantly and positively associated with patientsrsquo ratings of the hospital and likelihood of recommending

Rakel and Barrett et al in Patient Education and Counseling 2011 Hojat et al in Academic Medicine 2011 Haslam in Medical Journal of Australia 2007 Riess H Marci CD The Neurobiology and Physiology of the Patient ndashDoctor Relationship Measuring Empathy Medical Encounter 2007 21(3)38-41 Riess H Herman JB Teaching the teachers A model course for psychotherapy supervisorsAcademic Psychiatry 2008 32259-264 McClelland L and Vogus T Compassion Practices and HCAHPS Does Rewarding and Supporting Workplace Compassion Influence Patient Perceptions Healt h Services Research Volume 49 Issue 5 pages 1670ndash1683 October 2014

wwwplanetreeorg

Creating a serene natural environment

Roger S Ulrich (1983) linked environmental attributes of healthcare environment to healing

finding a causal relationship between the patients that had a room with a view of trees and

the rate of healing and sense of wellbeing

Patients in rooms with views of trees had

o Fewer days in the hospital than patients with a view of a brick wall

o Were in better spirits (according to nurses)

o Used fewer analgesics during their stay

wwwplanetreeorg

wwwplanetreeorg

SKILL BUILDING amp AWARENESS BUILDING bullCaregiver training (Shared Decision Making empathy cultural competence patient centered practices) 3-6

bullExperiential learning to promote perspective-taking and connection to purpose

GROUP ACTIVITY

wwwplanetreeorg

Leadership satisfaction scores following baseline and bi-annual experiential learning sessions

60

65

70

75

80

85

90

Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8

Note Westchester Division outperforms organizational average

wwwplanetreeorg

0

20

40

60

80

100

2003 2005 2007 2009 2011 2013Patient Satisfaction Staff Satisfaction

Staff and patient satisfaction scores following experiential staff retreats

wwwplanetreeorg

69

70

71

72

73

74

75

76

Non Members Members Designated Members

Hospital Rating 9 or 10

68

69

70

71

72

73

74

75

76

77

Non Members Members Designated Members

Most Likely to Recommend

Staff commitment to patient-centered care improves hospital reputation

wwwplanetreeorg

What research tells us about clinician empathy and clinical outcomes

Trusting empathic relationships between clinicians and patients have increased patient engagement and improved health outcomes including diabetes management flu recovery times and reductions in major medical errors

Clinician empathy skills can be enhanced through training focused on self-reflection self-compassion and behavior modification

Compassion practices a measure of the extent to which a hospital rewards compassionate acts and compassionately supports its employees is significantly and positively associated with patientsrsquo ratings of the hospital and likelihood of recommending

Rakel and Barrett et al in Patient Education and Counseling 2011 Hojat et al in Academic Medicine 2011 Haslam in Medical Journal of Australia 2007 Riess H Marci CD The Neurobiology and Physiology of the Patient ndashDoctor Relationship Measuring Empathy Medical Encounter 2007 21(3)38-41 Riess H Herman JB Teaching the teachers A model course for psychotherapy supervisorsAcademic Psychiatry 2008 32259-264 McClelland L and Vogus T Compassion Practices and HCAHPS Does Rewarding and Supporting Workplace Compassion Influence Patient Perceptions Healt h Services Research Volume 49 Issue 5 pages 1670ndash1683 October 2014

wwwplanetreeorg

wwwplanetreeorg

SKILL BUILDING amp AWARENESS BUILDING bullCaregiver training (Shared Decision Making empathy cultural competence patient centered practices) 3-6

bullExperiential learning to promote perspective-taking and connection to purpose

GROUP ACTIVITY

wwwplanetreeorg

Leadership satisfaction scores following baseline and bi-annual experiential learning sessions

60

65

70

75

80

85

90

Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8

Note Westchester Division outperforms organizational average

wwwplanetreeorg

0

20

40

60

80

100

2003 2005 2007 2009 2011 2013Patient Satisfaction Staff Satisfaction

Staff and patient satisfaction scores following experiential staff retreats

wwwplanetreeorg

69

70

71

72

73

74

75

76

Non Members Members Designated Members

Hospital Rating 9 or 10

68

69

70

71

72

73

74

75

76

77

Non Members Members Designated Members

Most Likely to Recommend

Staff commitment to patient-centered care improves hospital reputation

wwwplanetreeorg

What research tells us about clinician empathy and clinical outcomes

Trusting empathic relationships between clinicians and patients have increased patient engagement and improved health outcomes including diabetes management flu recovery times and reductions in major medical errors

Clinician empathy skills can be enhanced through training focused on self-reflection self-compassion and behavior modification

Compassion practices a measure of the extent to which a hospital rewards compassionate acts and compassionately supports its employees is significantly and positively associated with patientsrsquo ratings of the hospital and likelihood of recommending

Rakel and Barrett et al in Patient Education and Counseling 2011 Hojat et al in Academic Medicine 2011 Haslam in Medical Journal of Australia 2007 Riess H Marci CD The Neurobiology and Physiology of the Patient ndashDoctor Relationship Measuring Empathy Medical Encounter 2007 21(3)38-41 Riess H Herman JB Teaching the teachers A model course for psychotherapy supervisorsAcademic Psychiatry 2008 32259-264 McClelland L and Vogus T Compassion Practices and HCAHPS Does Rewarding and Supporting Workplace Compassion Influence Patient Perceptions Healt h Services Research Volume 49 Issue 5 pages 1670ndash1683 October 2014

wwwplanetreeorg

SKILL BUILDING amp AWARENESS BUILDING bullCaregiver training (Shared Decision Making empathy cultural competence patient centered practices) 3-6

bullExperiential learning to promote perspective-taking and connection to purpose

GROUP ACTIVITY

wwwplanetreeorg

Leadership satisfaction scores following baseline and bi-annual experiential learning sessions

60

65

70

75

80

85

90

Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8

Note Westchester Division outperforms organizational average

wwwplanetreeorg

0

20

40

60

80

100

2003 2005 2007 2009 2011 2013Patient Satisfaction Staff Satisfaction

Staff and patient satisfaction scores following experiential staff retreats

wwwplanetreeorg

69

70

71

72

73

74

75

76

Non Members Members Designated Members

Hospital Rating 9 or 10

68

69

70

71

72

73

74

75

76

77

Non Members Members Designated Members

Most Likely to Recommend

Staff commitment to patient-centered care improves hospital reputation

wwwplanetreeorg

What research tells us about clinician empathy and clinical outcomes

Trusting empathic relationships between clinicians and patients have increased patient engagement and improved health outcomes including diabetes management flu recovery times and reductions in major medical errors

Clinician empathy skills can be enhanced through training focused on self-reflection self-compassion and behavior modification

Compassion practices a measure of the extent to which a hospital rewards compassionate acts and compassionately supports its employees is significantly and positively associated with patientsrsquo ratings of the hospital and likelihood of recommending

Rakel and Barrett et al in Patient Education and Counseling 2011 Hojat et al in Academic Medicine 2011 Haslam in Medical Journal of Australia 2007 Riess H Marci CD The Neurobiology and Physiology of the Patient ndashDoctor Relationship Measuring Empathy Medical Encounter 2007 21(3)38-41 Riess H Herman JB Teaching the teachers A model course for psychotherapy supervisorsAcademic Psychiatry 2008 32259-264 McClelland L and Vogus T Compassion Practices and HCAHPS Does Rewarding and Supporting Workplace Compassion Influence Patient Perceptions Healt h Services Research Volume 49 Issue 5 pages 1670ndash1683 October 2014

wwwplanetreeorg

Leadership satisfaction scores following baseline and bi-annual experiential learning sessions

60

65

70

75

80

85

90

Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8

Note Westchester Division outperforms organizational average

wwwplanetreeorg

0

20

40

60

80

100

2003 2005 2007 2009 2011 2013Patient Satisfaction Staff Satisfaction

Staff and patient satisfaction scores following experiential staff retreats

wwwplanetreeorg

69

70

71

72

73

74

75

76

Non Members Members Designated Members

Hospital Rating 9 or 10

68

69

70

71

72

73

74

75

76

77

Non Members Members Designated Members

Most Likely to Recommend

Staff commitment to patient-centered care improves hospital reputation

wwwplanetreeorg

What research tells us about clinician empathy and clinical outcomes

Trusting empathic relationships between clinicians and patients have increased patient engagement and improved health outcomes including diabetes management flu recovery times and reductions in major medical errors

Clinician empathy skills can be enhanced through training focused on self-reflection self-compassion and behavior modification

Compassion practices a measure of the extent to which a hospital rewards compassionate acts and compassionately supports its employees is significantly and positively associated with patientsrsquo ratings of the hospital and likelihood of recommending

Rakel and Barrett et al in Patient Education and Counseling 2011 Hojat et al in Academic Medicine 2011 Haslam in Medical Journal of Australia 2007 Riess H Marci CD The Neurobiology and Physiology of the Patient ndashDoctor Relationship Measuring Empathy Medical Encounter 2007 21(3)38-41 Riess H Herman JB Teaching the teachers A model course for psychotherapy supervisorsAcademic Psychiatry 2008 32259-264 McClelland L and Vogus T Compassion Practices and HCAHPS Does Rewarding and Supporting Workplace Compassion Influence Patient Perceptions Healt h Services Research Volume 49 Issue 5 pages 1670ndash1683 October 2014

wwwplanetreeorg

0

20

40

60

80

100

2003 2005 2007 2009 2011 2013Patient Satisfaction Staff Satisfaction

Staff and patient satisfaction scores following experiential staff retreats

wwwplanetreeorg

69

70

71

72

73

74

75

76

Non Members Members Designated Members

Hospital Rating 9 or 10

68

69

70

71

72

73

74

75

76

77

Non Members Members Designated Members

Most Likely to Recommend

Staff commitment to patient-centered care improves hospital reputation

wwwplanetreeorg

What research tells us about clinician empathy and clinical outcomes

Trusting empathic relationships between clinicians and patients have increased patient engagement and improved health outcomes including diabetes management flu recovery times and reductions in major medical errors

Clinician empathy skills can be enhanced through training focused on self-reflection self-compassion and behavior modification

Compassion practices a measure of the extent to which a hospital rewards compassionate acts and compassionately supports its employees is significantly and positively associated with patientsrsquo ratings of the hospital and likelihood of recommending

Rakel and Barrett et al in Patient Education and Counseling 2011 Hojat et al in Academic Medicine 2011 Haslam in Medical Journal of Australia 2007 Riess H Marci CD The Neurobiology and Physiology of the Patient ndashDoctor Relationship Measuring Empathy Medical Encounter 2007 21(3)38-41 Riess H Herman JB Teaching the teachers A model course for psychotherapy supervisorsAcademic Psychiatry 2008 32259-264 McClelland L and Vogus T Compassion Practices and HCAHPS Does Rewarding and Supporting Workplace Compassion Influence Patient Perceptions Healt h Services Research Volume 49 Issue 5 pages 1670ndash1683 October 2014

wwwplanetreeorg

69

70

71

72

73

74

75

76

Non Members Members Designated Members

Hospital Rating 9 or 10

68

69

70

71

72

73

74

75

76

77

Non Members Members Designated Members

Most Likely to Recommend

Staff commitment to patient-centered care improves hospital reputation

wwwplanetreeorg

What research tells us about clinician empathy and clinical outcomes

Trusting empathic relationships between clinicians and patients have increased patient engagement and improved health outcomes including diabetes management flu recovery times and reductions in major medical errors

Clinician empathy skills can be enhanced through training focused on self-reflection self-compassion and behavior modification

Compassion practices a measure of the extent to which a hospital rewards compassionate acts and compassionately supports its employees is significantly and positively associated with patientsrsquo ratings of the hospital and likelihood of recommending

Rakel and Barrett et al in Patient Education and Counseling 2011 Hojat et al in Academic Medicine 2011 Haslam in Medical Journal of Australia 2007 Riess H Marci CD The Neurobiology and Physiology of the Patient ndashDoctor Relationship Measuring Empathy Medical Encounter 2007 21(3)38-41 Riess H Herman JB Teaching the teachers A model course for psychotherapy supervisorsAcademic Psychiatry 2008 32259-264 McClelland L and Vogus T Compassion Practices and HCAHPS Does Rewarding and Supporting Workplace Compassion Influence Patient Perceptions Healt h Services Research Volume 49 Issue 5 pages 1670ndash1683 October 2014

wwwplanetreeorg

What research tells us about clinician empathy and clinical outcomes

Trusting empathic relationships between clinicians and patients have increased patient engagement and improved health outcomes including diabetes management flu recovery times and reductions in major medical errors

Clinician empathy skills can be enhanced through training focused on self-reflection self-compassion and behavior modification

Compassion practices a measure of the extent to which a hospital rewards compassionate acts and compassionately supports its employees is significantly and positively associated with patientsrsquo ratings of the hospital and likelihood of recommending

Rakel and Barrett et al in Patient Education and Counseling 2011 Hojat et al in Academic Medicine 2011 Haslam in Medical Journal of Australia 2007 Riess H Marci CD The Neurobiology and Physiology of the Patient ndashDoctor Relationship Measuring Empathy Medical Encounter 2007 21(3)38-41 Riess H Herman JB Teaching the teachers A model course for psychotherapy supervisorsAcademic Psychiatry 2008 32259-264 McClelland L and Vogus T Compassion Practices and HCAHPS Does Rewarding and Supporting Workplace Compassion Influence Patient Perceptions Healt h Services Research Volume 49 Issue 5 pages 1670ndash1683 October 2014

wwwplanetreeorg

Physiciansrsquo Empathy and Clinical Outcomes

Findings from two key studies in the US and Italy

using the Jefferson Scale of Empathy

Dr Mohammadreza Hojat

Sidney Kimmel Medical College at Thomas Jefferson University February 2016

wwwplanetreeorg

Empathy versus Sympathy Empathy - entering into a patientrsquos mind and understanding their pain from within as if their pain were ours but remains theirs

Sympathy - sharing feelings together with the patient as if the pain is ours and remains so

Jefferson Scale of Patients Perceptions of Physician Empathy is a 5 question psychometrically valid tool

bull Wilmer 1968 British Journal of Medical Psychology41 243-248)

bull Kane et al Croat Med J 2007 Feb 48(1) 81ndash86 PMCID PMC2080494 Jefferson Scale of Patientrsquos Perceptions of Physician Empathy Preliminary Psychometric Data

wwwplanetreeorg

Physicians Empathy and

Clinical Outcomes for Diabetic Patients

Mohammadreza Hojat PhD Daniel Z Louis MS

Fred W Markham MD Richard Wender MD

Carol Rabinowitz Joseph S Gonnella MD

(March 2011)

Acad Med 201186359ndash364

wwwplanetreeorg

Primary care physician (n=29) empathy scores and Hemoglobin A1c for 7269 patients with diabetes mellitus

56 49 40

29 35

34

15 16 26

0

20

40

60

80

100

High empathy Moderate empathy Lower empathy

Poor (gt 90)

70 - 90

Good (lt 70)

wwwplanetreeorg

The Relationship Between Physician Empathy and Disease Complications An Empirical Study of Primary Care Physicians

and Their Diabetic Patients in Parma Italy

Stefano Del Canale MD PhD Daniel Z Louis MS Vittorio Maio PharmD MS MSPH Xiaohong Wang MS Giuseppina Rossi MD Mohammadreza Hojat PhD

Joseph S Gonnella MD

(September 2012)

Acad Med 2012871243ndash1249

wwwplanetreeorg

Association between physician empathy scores (n = 242) and hopitalization for acute metabolic complications of diabetes mellitus (n = 20961) Parma Italia

40 per 1000

71 per 1000

65 per 1000

-

10

20

30

40

50

60

70

80

High empathy Moderate empathy Lower empathy

Rate of acute metabolic

complications per 1000 diabetic patients

wwwplanetreeorg

Empathy is associated with positive clinical outcomes for patients with

diabetes mellitus

Empathy is an important element in patient care and physician

competence that must be enhanced during education for physicians

and other staff who interact with patients

Conclusions and Implications

wwwplanetreeorg

Influence of Patient-Clinician Relationship on Healthcare Outcomes Systematic Review and Meta-analysis of RCTrsquos

Author (year) Medical Outcome Intervention Type p-Value

Bolognesi et al (2006)

Obesity Motivational Interviewing

Trust Patient-Centered Care Trans-theoretical Model [stages of change])

00

Chassany et al (2007)

Osteoarthritis

Improve Communication Empathy Group discussion led by facilitator focused on patient-physician relationship pain evaluation prescribing and

negotiating a therapeutic contract

01

Cals et al (2009) Lower Resp Infection Improve Communication

Empathy and Shared Decision Making Patient Centered Approach

02

Cleland et al (2007) Asthma Improve Communication

Written Material role playing patient resources

03

(Kelley Kraft-Todd Shapira Kossowsky Riess 2014 Plos One)

wwwplanetreeorg

At todayrsquos meeting how was your doctor at hellip p-value

Making you feel at ease 002

Really listening 002

Being positive 002

Explaining things clearly 002

Letting you tell your story 003

Showing care and compassion 004

Helping you to take control 005

Making a plan of action with you 006

Fully understanding your concerns 007

Being interested in you as a whole person 011

Empathy Training for Resident Physicians A RCT of a Neuroscience Informed Curriculum (Patient-Rated CARE Items)

(Riess et al JGIM 2012))

wwwplanetreeorg

Program Evaluation and Self-Assessment of Improvement

91 91 96 91 94

91 91

0

10

20

30

40

50

60

70

80

90

100

Listening carefullyto patients

withoutinterrupting

Interpreting non-verbal cues (toneof voice posture

affect)

Being aware ofyour physiological

reactions tochallengingpatients

Being able tomanage yourphysiologicalreactions tochallengingpatients

Being aware ofyour emotional

reactions tochallengingpatients

Being able tomanage your

emotionalreactions tochallengingpatients

Understanding thelatest research onthe neurobiology

of empathy

After the training did you improve in

(Riess Kelley et al JGIM 2012)

wwwplanetreeorg

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Patient directed visitation and Care Partners

Patient-Directed Visiting elimination of broad restrictions to visiting patients (based on age relationship and number) with any limitations imposed on a case-by-case basis and in collaboration with the patient according to personal preferences and in consideration of their healthcare needs

wwwplanetreeorg

Care Partner Program bull Family formally engaged as integral member of

care team

bull A partnership between family and staff

bull Provides a source of continuity

bull Prepares loved one for post-discharge

ldquoThey showed my husband how to do my dressing

changes so I donrsquot have to come here every day They

asked him questions Can you see it Do you

understand For him to see he was very informedrdquo

wwwplanetreeorg

Alegent Health System Ethnography Project

What was your biggest fear while hospitalized

Being alone

wwwplanetreeorg

Exploring patient-directed visitation

GROUP ACTIVITY

With a partner decide who will be lsquoforrsquo and who will be lsquoagainstrsquo 247 patient-directed visitation

If you are assigned lsquoforrsquo take 5 minutes and develop a list of every reason you can think of why this practice could be beneficial

If you are assigned to be lsquoagainstrsquo take 5 minutes and develop a list of every reason that you can thing of why this practice could be a bad idea

With your partner discuss the pros and cons of this practice

wwwplanetreeorg

What research tells us about the impact of visitation

bull In a study that examined the benefits of unrestricted patient visitation 88 of families stated it had a positive benefit to their overall experience and decreased their anxiety by 65

bull Family presence in the ICU decreases psychological stress of patients and family members

bull Family presence in the clinical setting is reported to improve medical decision making patient care communication with patientsrsquo family members and to reduce patient falls

bull No clinical evidence suggests negative clinical outcomes No research concludes that allowing patients to choose who can visit them and when these visits occur results in negative outcomes

Berwick D Kotagal M (2004) ―Restricted visiting hours in ICUs time to change JAMA 292 736-737 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672 Stone S Annual Nursing Report Sharp Memorial Hospital 2014 Lim L and Zimring C Healthcare Design of the Future ARCH 4833ARCH 6271ID 6271BMED 8813 HF 2015

wwwplanetreeorg

What research tells us about the impact of involvement of the patientrsquos family

Engagement of hospitalized patientrsquos family in care activities and care coordination

ndasha lsquoCare Partnerrsquo program- improved patient outcomes including

bull better pain management

bull improved sleep

bull increased health literacy

bull more effective transition to home

Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672

wwwplanetreeorg

Checklists to better prepare patients and family caregivers for discharge

wwwplanetreeorg

wwwplanetreeorg

Legislating Professional-Family Partnerships 15 states enact FamilyCaregivers Legislation

bull At admission patient-designated care

partner documented in medical record

bull At discharge staff notify and offer to meet with care partner to discuss plan of care

bull Prior to discharge staff offer lsquoadequate trainingrsquo in aftercare tasks to care partner

wwwplanetreeorg

Why involve patients and families

Highly ldquoactivatedrdquo patients are 30ndash40 less likely to report care coordination problems than those ldquoless activatedrdquo

Raceethnicity employment insurance status income and length of illness were not significantly associated with self‐reported care coordination problems

Maeng Martsolf Scanlon Christianson Care coordination for the chronically ill understanding the patientrsquos perspective Health Serv Res 2012 47(5)1960ndash79

wwwplanetreeorg

All-Cause 30-day Readmission Rates Fall as Patient ndash Family Engagement in Discharge Planning Increases

bull Shared Teaching Tool utilizing 4th grade literacy

bull ldquoTeach Backrdquo by patients

bull Follow-up MD appointments made before discharge

bull HF protocol included in discharge packet for next provider

bull Scales provided for home care patients

bull Follow-up phone calls to patients amp families

Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

wwwplanetreeorg

All-Cause 30-day Readmissions 2007-2014

US Department of Health amp Human Services May 7 2014 ldquoNew HHS Data Shows Major Strides Made in Patient Safety Leading to Improved Care and Savingsrdquo

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Shared Decision-Making

wwwplanetreeorg

The ultimate patient-engagement tool Shared decision making (SDM) A 2013 study published in the February issue of Health Affairs found bull providing shared decision making-based health coaching for patients

with conditions that frequently require major treatment decisions reduces the overall costs of care hospitalizations and surgeries significantly

bull patients who received enhanced support had 53 lower overall medical costs than patients who received the usual level of support

bull patients receiving enhanced support had 125 fewer hospital admissions than the usual support group and 99 fewer preference-sensitive surgeries including 209 fewer preference-sensitive heart surgeries

wwwplanetreeorg

Empathy versus Sympathy Empathy - entering into a patientrsquos mind and understanding their pain from within as if their pain were ours but remains theirs

Sympathy - sharing feelings together with the patient as if the pain is ours and remains so

Jefferson Scale of Patients Perceptions of Physician Empathy is a 5 question psychometrically valid tool

bull Wilmer 1968 British Journal of Medical Psychology41 243-248)

bull Kane et al Croat Med J 2007 Feb 48(1) 81ndash86 PMCID PMC2080494 Jefferson Scale of Patientrsquos Perceptions of Physician Empathy Preliminary Psychometric Data

wwwplanetreeorg

Physicians Empathy and

Clinical Outcomes for Diabetic Patients

Mohammadreza Hojat PhD Daniel Z Louis MS

Fred W Markham MD Richard Wender MD

Carol Rabinowitz Joseph S Gonnella MD

(March 2011)

Acad Med 201186359ndash364

wwwplanetreeorg

Primary care physician (n=29) empathy scores and Hemoglobin A1c for 7269 patients with diabetes mellitus

56 49 40

29 35

34

15 16 26

0

20

40

60

80

100

High empathy Moderate empathy Lower empathy

Poor (gt 90)

70 - 90

Good (lt 70)

wwwplanetreeorg

The Relationship Between Physician Empathy and Disease Complications An Empirical Study of Primary Care Physicians

and Their Diabetic Patients in Parma Italy

Stefano Del Canale MD PhD Daniel Z Louis MS Vittorio Maio PharmD MS MSPH Xiaohong Wang MS Giuseppina Rossi MD Mohammadreza Hojat PhD

Joseph S Gonnella MD

(September 2012)

Acad Med 2012871243ndash1249

wwwplanetreeorg

Association between physician empathy scores (n = 242) and hopitalization for acute metabolic complications of diabetes mellitus (n = 20961) Parma Italia

40 per 1000

71 per 1000

65 per 1000

-

10

20

30

40

50

60

70

80

High empathy Moderate empathy Lower empathy

Rate of acute metabolic

complications per 1000 diabetic patients

wwwplanetreeorg

Empathy is associated with positive clinical outcomes for patients with

diabetes mellitus

Empathy is an important element in patient care and physician

competence that must be enhanced during education for physicians

and other staff who interact with patients

Conclusions and Implications

wwwplanetreeorg

Influence of Patient-Clinician Relationship on Healthcare Outcomes Systematic Review and Meta-analysis of RCTrsquos

Author (year) Medical Outcome Intervention Type p-Value

Bolognesi et al (2006)

Obesity Motivational Interviewing

Trust Patient-Centered Care Trans-theoretical Model [stages of change])

00

Chassany et al (2007)

Osteoarthritis

Improve Communication Empathy Group discussion led by facilitator focused on patient-physician relationship pain evaluation prescribing and

negotiating a therapeutic contract

01

Cals et al (2009) Lower Resp Infection Improve Communication

Empathy and Shared Decision Making Patient Centered Approach

02

Cleland et al (2007) Asthma Improve Communication

Written Material role playing patient resources

03

(Kelley Kraft-Todd Shapira Kossowsky Riess 2014 Plos One)

wwwplanetreeorg

At todayrsquos meeting how was your doctor at hellip p-value

Making you feel at ease 002

Really listening 002

Being positive 002

Explaining things clearly 002

Letting you tell your story 003

Showing care and compassion 004

Helping you to take control 005

Making a plan of action with you 006

Fully understanding your concerns 007

Being interested in you as a whole person 011

Empathy Training for Resident Physicians A RCT of a Neuroscience Informed Curriculum (Patient-Rated CARE Items)

(Riess et al JGIM 2012))

wwwplanetreeorg

Program Evaluation and Self-Assessment of Improvement

91 91 96 91 94

91 91

0

10

20

30

40

50

60

70

80

90

100

Listening carefullyto patients

withoutinterrupting

Interpreting non-verbal cues (toneof voice posture

affect)

Being aware ofyour physiological

reactions tochallengingpatients

Being able tomanage yourphysiologicalreactions tochallengingpatients

Being aware ofyour emotional

reactions tochallengingpatients

Being able tomanage your

emotionalreactions tochallengingpatients

Understanding thelatest research onthe neurobiology

of empathy

After the training did you improve in

(Riess Kelley et al JGIM 2012)

wwwplanetreeorg

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Patient directed visitation and Care Partners

Patient-Directed Visiting elimination of broad restrictions to visiting patients (based on age relationship and number) with any limitations imposed on a case-by-case basis and in collaboration with the patient according to personal preferences and in consideration of their healthcare needs

wwwplanetreeorg

Care Partner Program bull Family formally engaged as integral member of

care team

bull A partnership between family and staff

bull Provides a source of continuity

bull Prepares loved one for post-discharge

ldquoThey showed my husband how to do my dressing

changes so I donrsquot have to come here every day They

asked him questions Can you see it Do you

understand For him to see he was very informedrdquo

wwwplanetreeorg

Alegent Health System Ethnography Project

What was your biggest fear while hospitalized

Being alone

wwwplanetreeorg

Exploring patient-directed visitation

GROUP ACTIVITY

With a partner decide who will be lsquoforrsquo and who will be lsquoagainstrsquo 247 patient-directed visitation

If you are assigned lsquoforrsquo take 5 minutes and develop a list of every reason you can think of why this practice could be beneficial

If you are assigned to be lsquoagainstrsquo take 5 minutes and develop a list of every reason that you can thing of why this practice could be a bad idea

With your partner discuss the pros and cons of this practice

wwwplanetreeorg

What research tells us about the impact of visitation

bull In a study that examined the benefits of unrestricted patient visitation 88 of families stated it had a positive benefit to their overall experience and decreased their anxiety by 65

bull Family presence in the ICU decreases psychological stress of patients and family members

bull Family presence in the clinical setting is reported to improve medical decision making patient care communication with patientsrsquo family members and to reduce patient falls

bull No clinical evidence suggests negative clinical outcomes No research concludes that allowing patients to choose who can visit them and when these visits occur results in negative outcomes

Berwick D Kotagal M (2004) ―Restricted visiting hours in ICUs time to change JAMA 292 736-737 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672 Stone S Annual Nursing Report Sharp Memorial Hospital 2014 Lim L and Zimring C Healthcare Design of the Future ARCH 4833ARCH 6271ID 6271BMED 8813 HF 2015

wwwplanetreeorg

What research tells us about the impact of involvement of the patientrsquos family

Engagement of hospitalized patientrsquos family in care activities and care coordination

ndasha lsquoCare Partnerrsquo program- improved patient outcomes including

bull better pain management

bull improved sleep

bull increased health literacy

bull more effective transition to home

Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672

wwwplanetreeorg

Checklists to better prepare patients and family caregivers for discharge

wwwplanetreeorg

wwwplanetreeorg

Legislating Professional-Family Partnerships 15 states enact FamilyCaregivers Legislation

bull At admission patient-designated care

partner documented in medical record

bull At discharge staff notify and offer to meet with care partner to discuss plan of care

bull Prior to discharge staff offer lsquoadequate trainingrsquo in aftercare tasks to care partner

wwwplanetreeorg

Why involve patients and families

Highly ldquoactivatedrdquo patients are 30ndash40 less likely to report care coordination problems than those ldquoless activatedrdquo

Raceethnicity employment insurance status income and length of illness were not significantly associated with self‐reported care coordination problems

Maeng Martsolf Scanlon Christianson Care coordination for the chronically ill understanding the patientrsquos perspective Health Serv Res 2012 47(5)1960ndash79

wwwplanetreeorg

All-Cause 30-day Readmission Rates Fall as Patient ndash Family Engagement in Discharge Planning Increases

bull Shared Teaching Tool utilizing 4th grade literacy

bull ldquoTeach Backrdquo by patients

bull Follow-up MD appointments made before discharge

bull HF protocol included in discharge packet for next provider

bull Scales provided for home care patients

bull Follow-up phone calls to patients amp families

Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

wwwplanetreeorg

All-Cause 30-day Readmissions 2007-2014

US Department of Health amp Human Services May 7 2014 ldquoNew HHS Data Shows Major Strides Made in Patient Safety Leading to Improved Care and Savingsrdquo

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Shared Decision-Making

wwwplanetreeorg

The ultimate patient-engagement tool Shared decision making (SDM) A 2013 study published in the February issue of Health Affairs found bull providing shared decision making-based health coaching for patients

with conditions that frequently require major treatment decisions reduces the overall costs of care hospitalizations and surgeries significantly

bull patients who received enhanced support had 53 lower overall medical costs than patients who received the usual level of support

bull patients receiving enhanced support had 125 fewer hospital admissions than the usual support group and 99 fewer preference-sensitive surgeries including 209 fewer preference-sensitive heart surgeries

wwwplanetreeorg

Physicians Empathy and

Clinical Outcomes for Diabetic Patients

Mohammadreza Hojat PhD Daniel Z Louis MS

Fred W Markham MD Richard Wender MD

Carol Rabinowitz Joseph S Gonnella MD

(March 2011)

Acad Med 201186359ndash364

wwwplanetreeorg

Primary care physician (n=29) empathy scores and Hemoglobin A1c for 7269 patients with diabetes mellitus

56 49 40

29 35

34

15 16 26

0

20

40

60

80

100

High empathy Moderate empathy Lower empathy

Poor (gt 90)

70 - 90

Good (lt 70)

wwwplanetreeorg

The Relationship Between Physician Empathy and Disease Complications An Empirical Study of Primary Care Physicians

and Their Diabetic Patients in Parma Italy

Stefano Del Canale MD PhD Daniel Z Louis MS Vittorio Maio PharmD MS MSPH Xiaohong Wang MS Giuseppina Rossi MD Mohammadreza Hojat PhD

Joseph S Gonnella MD

(September 2012)

Acad Med 2012871243ndash1249

wwwplanetreeorg

Association between physician empathy scores (n = 242) and hopitalization for acute metabolic complications of diabetes mellitus (n = 20961) Parma Italia

40 per 1000

71 per 1000

65 per 1000

-

10

20

30

40

50

60

70

80

High empathy Moderate empathy Lower empathy

Rate of acute metabolic

complications per 1000 diabetic patients

wwwplanetreeorg

Empathy is associated with positive clinical outcomes for patients with

diabetes mellitus

Empathy is an important element in patient care and physician

competence that must be enhanced during education for physicians

and other staff who interact with patients

Conclusions and Implications

wwwplanetreeorg

Influence of Patient-Clinician Relationship on Healthcare Outcomes Systematic Review and Meta-analysis of RCTrsquos

Author (year) Medical Outcome Intervention Type p-Value

Bolognesi et al (2006)

Obesity Motivational Interviewing

Trust Patient-Centered Care Trans-theoretical Model [stages of change])

00

Chassany et al (2007)

Osteoarthritis

Improve Communication Empathy Group discussion led by facilitator focused on patient-physician relationship pain evaluation prescribing and

negotiating a therapeutic contract

01

Cals et al (2009) Lower Resp Infection Improve Communication

Empathy and Shared Decision Making Patient Centered Approach

02

Cleland et al (2007) Asthma Improve Communication

Written Material role playing patient resources

03

(Kelley Kraft-Todd Shapira Kossowsky Riess 2014 Plos One)

wwwplanetreeorg

At todayrsquos meeting how was your doctor at hellip p-value

Making you feel at ease 002

Really listening 002

Being positive 002

Explaining things clearly 002

Letting you tell your story 003

Showing care and compassion 004

Helping you to take control 005

Making a plan of action with you 006

Fully understanding your concerns 007

Being interested in you as a whole person 011

Empathy Training for Resident Physicians A RCT of a Neuroscience Informed Curriculum (Patient-Rated CARE Items)

(Riess et al JGIM 2012))

wwwplanetreeorg

Program Evaluation and Self-Assessment of Improvement

91 91 96 91 94

91 91

0

10

20

30

40

50

60

70

80

90

100

Listening carefullyto patients

withoutinterrupting

Interpreting non-verbal cues (toneof voice posture

affect)

Being aware ofyour physiological

reactions tochallengingpatients

Being able tomanage yourphysiologicalreactions tochallengingpatients

Being aware ofyour emotional

reactions tochallengingpatients

Being able tomanage your

emotionalreactions tochallengingpatients

Understanding thelatest research onthe neurobiology

of empathy

After the training did you improve in

(Riess Kelley et al JGIM 2012)

wwwplanetreeorg

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Patient directed visitation and Care Partners

Patient-Directed Visiting elimination of broad restrictions to visiting patients (based on age relationship and number) with any limitations imposed on a case-by-case basis and in collaboration with the patient according to personal preferences and in consideration of their healthcare needs

wwwplanetreeorg

Care Partner Program bull Family formally engaged as integral member of

care team

bull A partnership between family and staff

bull Provides a source of continuity

bull Prepares loved one for post-discharge

ldquoThey showed my husband how to do my dressing

changes so I donrsquot have to come here every day They

asked him questions Can you see it Do you

understand For him to see he was very informedrdquo

wwwplanetreeorg

Alegent Health System Ethnography Project

What was your biggest fear while hospitalized

Being alone

wwwplanetreeorg

Exploring patient-directed visitation

GROUP ACTIVITY

With a partner decide who will be lsquoforrsquo and who will be lsquoagainstrsquo 247 patient-directed visitation

If you are assigned lsquoforrsquo take 5 minutes and develop a list of every reason you can think of why this practice could be beneficial

If you are assigned to be lsquoagainstrsquo take 5 minutes and develop a list of every reason that you can thing of why this practice could be a bad idea

With your partner discuss the pros and cons of this practice

wwwplanetreeorg

What research tells us about the impact of visitation

bull In a study that examined the benefits of unrestricted patient visitation 88 of families stated it had a positive benefit to their overall experience and decreased their anxiety by 65

bull Family presence in the ICU decreases psychological stress of patients and family members

bull Family presence in the clinical setting is reported to improve medical decision making patient care communication with patientsrsquo family members and to reduce patient falls

bull No clinical evidence suggests negative clinical outcomes No research concludes that allowing patients to choose who can visit them and when these visits occur results in negative outcomes

Berwick D Kotagal M (2004) ―Restricted visiting hours in ICUs time to change JAMA 292 736-737 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672 Stone S Annual Nursing Report Sharp Memorial Hospital 2014 Lim L and Zimring C Healthcare Design of the Future ARCH 4833ARCH 6271ID 6271BMED 8813 HF 2015

wwwplanetreeorg

What research tells us about the impact of involvement of the patientrsquos family

Engagement of hospitalized patientrsquos family in care activities and care coordination

ndasha lsquoCare Partnerrsquo program- improved patient outcomes including

bull better pain management

bull improved sleep

bull increased health literacy

bull more effective transition to home

Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672

wwwplanetreeorg

Checklists to better prepare patients and family caregivers for discharge

wwwplanetreeorg

wwwplanetreeorg

Legislating Professional-Family Partnerships 15 states enact FamilyCaregivers Legislation

bull At admission patient-designated care

partner documented in medical record

bull At discharge staff notify and offer to meet with care partner to discuss plan of care

bull Prior to discharge staff offer lsquoadequate trainingrsquo in aftercare tasks to care partner

wwwplanetreeorg

Why involve patients and families

Highly ldquoactivatedrdquo patients are 30ndash40 less likely to report care coordination problems than those ldquoless activatedrdquo

Raceethnicity employment insurance status income and length of illness were not significantly associated with self‐reported care coordination problems

Maeng Martsolf Scanlon Christianson Care coordination for the chronically ill understanding the patientrsquos perspective Health Serv Res 2012 47(5)1960ndash79

wwwplanetreeorg

All-Cause 30-day Readmission Rates Fall as Patient ndash Family Engagement in Discharge Planning Increases

bull Shared Teaching Tool utilizing 4th grade literacy

bull ldquoTeach Backrdquo by patients

bull Follow-up MD appointments made before discharge

bull HF protocol included in discharge packet for next provider

bull Scales provided for home care patients

bull Follow-up phone calls to patients amp families

Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

wwwplanetreeorg

All-Cause 30-day Readmissions 2007-2014

US Department of Health amp Human Services May 7 2014 ldquoNew HHS Data Shows Major Strides Made in Patient Safety Leading to Improved Care and Savingsrdquo

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Shared Decision-Making

wwwplanetreeorg

The ultimate patient-engagement tool Shared decision making (SDM) A 2013 study published in the February issue of Health Affairs found bull providing shared decision making-based health coaching for patients

with conditions that frequently require major treatment decisions reduces the overall costs of care hospitalizations and surgeries significantly

bull patients who received enhanced support had 53 lower overall medical costs than patients who received the usual level of support

bull patients receiving enhanced support had 125 fewer hospital admissions than the usual support group and 99 fewer preference-sensitive surgeries including 209 fewer preference-sensitive heart surgeries

wwwplanetreeorg

Primary care physician (n=29) empathy scores and Hemoglobin A1c for 7269 patients with diabetes mellitus

56 49 40

29 35

34

15 16 26

0

20

40

60

80

100

High empathy Moderate empathy Lower empathy

Poor (gt 90)

70 - 90

Good (lt 70)

wwwplanetreeorg

The Relationship Between Physician Empathy and Disease Complications An Empirical Study of Primary Care Physicians

and Their Diabetic Patients in Parma Italy

Stefano Del Canale MD PhD Daniel Z Louis MS Vittorio Maio PharmD MS MSPH Xiaohong Wang MS Giuseppina Rossi MD Mohammadreza Hojat PhD

Joseph S Gonnella MD

(September 2012)

Acad Med 2012871243ndash1249

wwwplanetreeorg

Association between physician empathy scores (n = 242) and hopitalization for acute metabolic complications of diabetes mellitus (n = 20961) Parma Italia

40 per 1000

71 per 1000

65 per 1000

-

10

20

30

40

50

60

70

80

High empathy Moderate empathy Lower empathy

Rate of acute metabolic

complications per 1000 diabetic patients

wwwplanetreeorg

Empathy is associated with positive clinical outcomes for patients with

diabetes mellitus

Empathy is an important element in patient care and physician

competence that must be enhanced during education for physicians

and other staff who interact with patients

Conclusions and Implications

wwwplanetreeorg

Influence of Patient-Clinician Relationship on Healthcare Outcomes Systematic Review and Meta-analysis of RCTrsquos

Author (year) Medical Outcome Intervention Type p-Value

Bolognesi et al (2006)

Obesity Motivational Interviewing

Trust Patient-Centered Care Trans-theoretical Model [stages of change])

00

Chassany et al (2007)

Osteoarthritis

Improve Communication Empathy Group discussion led by facilitator focused on patient-physician relationship pain evaluation prescribing and

negotiating a therapeutic contract

01

Cals et al (2009) Lower Resp Infection Improve Communication

Empathy and Shared Decision Making Patient Centered Approach

02

Cleland et al (2007) Asthma Improve Communication

Written Material role playing patient resources

03

(Kelley Kraft-Todd Shapira Kossowsky Riess 2014 Plos One)

wwwplanetreeorg

At todayrsquos meeting how was your doctor at hellip p-value

Making you feel at ease 002

Really listening 002

Being positive 002

Explaining things clearly 002

Letting you tell your story 003

Showing care and compassion 004

Helping you to take control 005

Making a plan of action with you 006

Fully understanding your concerns 007

Being interested in you as a whole person 011

Empathy Training for Resident Physicians A RCT of a Neuroscience Informed Curriculum (Patient-Rated CARE Items)

(Riess et al JGIM 2012))

wwwplanetreeorg

Program Evaluation and Self-Assessment of Improvement

91 91 96 91 94

91 91

0

10

20

30

40

50

60

70

80

90

100

Listening carefullyto patients

withoutinterrupting

Interpreting non-verbal cues (toneof voice posture

affect)

Being aware ofyour physiological

reactions tochallengingpatients

Being able tomanage yourphysiologicalreactions tochallengingpatients

Being aware ofyour emotional

reactions tochallengingpatients

Being able tomanage your

emotionalreactions tochallengingpatients

Understanding thelatest research onthe neurobiology

of empathy

After the training did you improve in

(Riess Kelley et al JGIM 2012)

wwwplanetreeorg

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Patient directed visitation and Care Partners

Patient-Directed Visiting elimination of broad restrictions to visiting patients (based on age relationship and number) with any limitations imposed on a case-by-case basis and in collaboration with the patient according to personal preferences and in consideration of their healthcare needs

wwwplanetreeorg

Care Partner Program bull Family formally engaged as integral member of

care team

bull A partnership between family and staff

bull Provides a source of continuity

bull Prepares loved one for post-discharge

ldquoThey showed my husband how to do my dressing

changes so I donrsquot have to come here every day They

asked him questions Can you see it Do you

understand For him to see he was very informedrdquo

wwwplanetreeorg

Alegent Health System Ethnography Project

What was your biggest fear while hospitalized

Being alone

wwwplanetreeorg

Exploring patient-directed visitation

GROUP ACTIVITY

With a partner decide who will be lsquoforrsquo and who will be lsquoagainstrsquo 247 patient-directed visitation

If you are assigned lsquoforrsquo take 5 minutes and develop a list of every reason you can think of why this practice could be beneficial

If you are assigned to be lsquoagainstrsquo take 5 minutes and develop a list of every reason that you can thing of why this practice could be a bad idea

With your partner discuss the pros and cons of this practice

wwwplanetreeorg

What research tells us about the impact of visitation

bull In a study that examined the benefits of unrestricted patient visitation 88 of families stated it had a positive benefit to their overall experience and decreased their anxiety by 65

bull Family presence in the ICU decreases psychological stress of patients and family members

bull Family presence in the clinical setting is reported to improve medical decision making patient care communication with patientsrsquo family members and to reduce patient falls

bull No clinical evidence suggests negative clinical outcomes No research concludes that allowing patients to choose who can visit them and when these visits occur results in negative outcomes

Berwick D Kotagal M (2004) ―Restricted visiting hours in ICUs time to change JAMA 292 736-737 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672 Stone S Annual Nursing Report Sharp Memorial Hospital 2014 Lim L and Zimring C Healthcare Design of the Future ARCH 4833ARCH 6271ID 6271BMED 8813 HF 2015

wwwplanetreeorg

What research tells us about the impact of involvement of the patientrsquos family

Engagement of hospitalized patientrsquos family in care activities and care coordination

ndasha lsquoCare Partnerrsquo program- improved patient outcomes including

bull better pain management

bull improved sleep

bull increased health literacy

bull more effective transition to home

Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672

wwwplanetreeorg

Checklists to better prepare patients and family caregivers for discharge

wwwplanetreeorg

wwwplanetreeorg

Legislating Professional-Family Partnerships 15 states enact FamilyCaregivers Legislation

bull At admission patient-designated care

partner documented in medical record

bull At discharge staff notify and offer to meet with care partner to discuss plan of care

bull Prior to discharge staff offer lsquoadequate trainingrsquo in aftercare tasks to care partner

wwwplanetreeorg

Why involve patients and families

Highly ldquoactivatedrdquo patients are 30ndash40 less likely to report care coordination problems than those ldquoless activatedrdquo

Raceethnicity employment insurance status income and length of illness were not significantly associated with self‐reported care coordination problems

Maeng Martsolf Scanlon Christianson Care coordination for the chronically ill understanding the patientrsquos perspective Health Serv Res 2012 47(5)1960ndash79

wwwplanetreeorg

All-Cause 30-day Readmission Rates Fall as Patient ndash Family Engagement in Discharge Planning Increases

bull Shared Teaching Tool utilizing 4th grade literacy

bull ldquoTeach Backrdquo by patients

bull Follow-up MD appointments made before discharge

bull HF protocol included in discharge packet for next provider

bull Scales provided for home care patients

bull Follow-up phone calls to patients amp families

Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

wwwplanetreeorg

All-Cause 30-day Readmissions 2007-2014

US Department of Health amp Human Services May 7 2014 ldquoNew HHS Data Shows Major Strides Made in Patient Safety Leading to Improved Care and Savingsrdquo

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Shared Decision-Making

wwwplanetreeorg

The ultimate patient-engagement tool Shared decision making (SDM) A 2013 study published in the February issue of Health Affairs found bull providing shared decision making-based health coaching for patients

with conditions that frequently require major treatment decisions reduces the overall costs of care hospitalizations and surgeries significantly

bull patients who received enhanced support had 53 lower overall medical costs than patients who received the usual level of support

bull patients receiving enhanced support had 125 fewer hospital admissions than the usual support group and 99 fewer preference-sensitive surgeries including 209 fewer preference-sensitive heart surgeries

wwwplanetreeorg

The Relationship Between Physician Empathy and Disease Complications An Empirical Study of Primary Care Physicians

and Their Diabetic Patients in Parma Italy

Stefano Del Canale MD PhD Daniel Z Louis MS Vittorio Maio PharmD MS MSPH Xiaohong Wang MS Giuseppina Rossi MD Mohammadreza Hojat PhD

Joseph S Gonnella MD

(September 2012)

Acad Med 2012871243ndash1249

wwwplanetreeorg

Association between physician empathy scores (n = 242) and hopitalization for acute metabolic complications of diabetes mellitus (n = 20961) Parma Italia

40 per 1000

71 per 1000

65 per 1000

-

10

20

30

40

50

60

70

80

High empathy Moderate empathy Lower empathy

Rate of acute metabolic

complications per 1000 diabetic patients

wwwplanetreeorg

Empathy is associated with positive clinical outcomes for patients with

diabetes mellitus

Empathy is an important element in patient care and physician

competence that must be enhanced during education for physicians

and other staff who interact with patients

Conclusions and Implications

wwwplanetreeorg

Influence of Patient-Clinician Relationship on Healthcare Outcomes Systematic Review and Meta-analysis of RCTrsquos

Author (year) Medical Outcome Intervention Type p-Value

Bolognesi et al (2006)

Obesity Motivational Interviewing

Trust Patient-Centered Care Trans-theoretical Model [stages of change])

00

Chassany et al (2007)

Osteoarthritis

Improve Communication Empathy Group discussion led by facilitator focused on patient-physician relationship pain evaluation prescribing and

negotiating a therapeutic contract

01

Cals et al (2009) Lower Resp Infection Improve Communication

Empathy and Shared Decision Making Patient Centered Approach

02

Cleland et al (2007) Asthma Improve Communication

Written Material role playing patient resources

03

(Kelley Kraft-Todd Shapira Kossowsky Riess 2014 Plos One)

wwwplanetreeorg

At todayrsquos meeting how was your doctor at hellip p-value

Making you feel at ease 002

Really listening 002

Being positive 002

Explaining things clearly 002

Letting you tell your story 003

Showing care and compassion 004

Helping you to take control 005

Making a plan of action with you 006

Fully understanding your concerns 007

Being interested in you as a whole person 011

Empathy Training for Resident Physicians A RCT of a Neuroscience Informed Curriculum (Patient-Rated CARE Items)

(Riess et al JGIM 2012))

wwwplanetreeorg

Program Evaluation and Self-Assessment of Improvement

91 91 96 91 94

91 91

0

10

20

30

40

50

60

70

80

90

100

Listening carefullyto patients

withoutinterrupting

Interpreting non-verbal cues (toneof voice posture

affect)

Being aware ofyour physiological

reactions tochallengingpatients

Being able tomanage yourphysiologicalreactions tochallengingpatients

Being aware ofyour emotional

reactions tochallengingpatients

Being able tomanage your

emotionalreactions tochallengingpatients

Understanding thelatest research onthe neurobiology

of empathy

After the training did you improve in

(Riess Kelley et al JGIM 2012)

wwwplanetreeorg

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Patient directed visitation and Care Partners

Patient-Directed Visiting elimination of broad restrictions to visiting patients (based on age relationship and number) with any limitations imposed on a case-by-case basis and in collaboration with the patient according to personal preferences and in consideration of their healthcare needs

wwwplanetreeorg

Care Partner Program bull Family formally engaged as integral member of

care team

bull A partnership between family and staff

bull Provides a source of continuity

bull Prepares loved one for post-discharge

ldquoThey showed my husband how to do my dressing

changes so I donrsquot have to come here every day They

asked him questions Can you see it Do you

understand For him to see he was very informedrdquo

wwwplanetreeorg

Alegent Health System Ethnography Project

What was your biggest fear while hospitalized

Being alone

wwwplanetreeorg

Exploring patient-directed visitation

GROUP ACTIVITY

With a partner decide who will be lsquoforrsquo and who will be lsquoagainstrsquo 247 patient-directed visitation

If you are assigned lsquoforrsquo take 5 minutes and develop a list of every reason you can think of why this practice could be beneficial

If you are assigned to be lsquoagainstrsquo take 5 minutes and develop a list of every reason that you can thing of why this practice could be a bad idea

With your partner discuss the pros and cons of this practice

wwwplanetreeorg

What research tells us about the impact of visitation

bull In a study that examined the benefits of unrestricted patient visitation 88 of families stated it had a positive benefit to their overall experience and decreased their anxiety by 65

bull Family presence in the ICU decreases psychological stress of patients and family members

bull Family presence in the clinical setting is reported to improve medical decision making patient care communication with patientsrsquo family members and to reduce patient falls

bull No clinical evidence suggests negative clinical outcomes No research concludes that allowing patients to choose who can visit them and when these visits occur results in negative outcomes

Berwick D Kotagal M (2004) ―Restricted visiting hours in ICUs time to change JAMA 292 736-737 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672 Stone S Annual Nursing Report Sharp Memorial Hospital 2014 Lim L and Zimring C Healthcare Design of the Future ARCH 4833ARCH 6271ID 6271BMED 8813 HF 2015

wwwplanetreeorg

What research tells us about the impact of involvement of the patientrsquos family

Engagement of hospitalized patientrsquos family in care activities and care coordination

ndasha lsquoCare Partnerrsquo program- improved patient outcomes including

bull better pain management

bull improved sleep

bull increased health literacy

bull more effective transition to home

Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672

wwwplanetreeorg

Checklists to better prepare patients and family caregivers for discharge

wwwplanetreeorg

wwwplanetreeorg

Legislating Professional-Family Partnerships 15 states enact FamilyCaregivers Legislation

bull At admission patient-designated care

partner documented in medical record

bull At discharge staff notify and offer to meet with care partner to discuss plan of care

bull Prior to discharge staff offer lsquoadequate trainingrsquo in aftercare tasks to care partner

wwwplanetreeorg

Why involve patients and families

Highly ldquoactivatedrdquo patients are 30ndash40 less likely to report care coordination problems than those ldquoless activatedrdquo

Raceethnicity employment insurance status income and length of illness were not significantly associated with self‐reported care coordination problems

Maeng Martsolf Scanlon Christianson Care coordination for the chronically ill understanding the patientrsquos perspective Health Serv Res 2012 47(5)1960ndash79

wwwplanetreeorg

All-Cause 30-day Readmission Rates Fall as Patient ndash Family Engagement in Discharge Planning Increases

bull Shared Teaching Tool utilizing 4th grade literacy

bull ldquoTeach Backrdquo by patients

bull Follow-up MD appointments made before discharge

bull HF protocol included in discharge packet for next provider

bull Scales provided for home care patients

bull Follow-up phone calls to patients amp families

Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

wwwplanetreeorg

All-Cause 30-day Readmissions 2007-2014

US Department of Health amp Human Services May 7 2014 ldquoNew HHS Data Shows Major Strides Made in Patient Safety Leading to Improved Care and Savingsrdquo

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Shared Decision-Making

wwwplanetreeorg

The ultimate patient-engagement tool Shared decision making (SDM) A 2013 study published in the February issue of Health Affairs found bull providing shared decision making-based health coaching for patients

with conditions that frequently require major treatment decisions reduces the overall costs of care hospitalizations and surgeries significantly

bull patients who received enhanced support had 53 lower overall medical costs than patients who received the usual level of support

bull patients receiving enhanced support had 125 fewer hospital admissions than the usual support group and 99 fewer preference-sensitive surgeries including 209 fewer preference-sensitive heart surgeries

wwwplanetreeorg

Association between physician empathy scores (n = 242) and hopitalization for acute metabolic complications of diabetes mellitus (n = 20961) Parma Italia

40 per 1000

71 per 1000

65 per 1000

-

10

20

30

40

50

60

70

80

High empathy Moderate empathy Lower empathy

Rate of acute metabolic

complications per 1000 diabetic patients

wwwplanetreeorg

Empathy is associated with positive clinical outcomes for patients with

diabetes mellitus

Empathy is an important element in patient care and physician

competence that must be enhanced during education for physicians

and other staff who interact with patients

Conclusions and Implications

wwwplanetreeorg

Influence of Patient-Clinician Relationship on Healthcare Outcomes Systematic Review and Meta-analysis of RCTrsquos

Author (year) Medical Outcome Intervention Type p-Value

Bolognesi et al (2006)

Obesity Motivational Interviewing

Trust Patient-Centered Care Trans-theoretical Model [stages of change])

00

Chassany et al (2007)

Osteoarthritis

Improve Communication Empathy Group discussion led by facilitator focused on patient-physician relationship pain evaluation prescribing and

negotiating a therapeutic contract

01

Cals et al (2009) Lower Resp Infection Improve Communication

Empathy and Shared Decision Making Patient Centered Approach

02

Cleland et al (2007) Asthma Improve Communication

Written Material role playing patient resources

03

(Kelley Kraft-Todd Shapira Kossowsky Riess 2014 Plos One)

wwwplanetreeorg

At todayrsquos meeting how was your doctor at hellip p-value

Making you feel at ease 002

Really listening 002

Being positive 002

Explaining things clearly 002

Letting you tell your story 003

Showing care and compassion 004

Helping you to take control 005

Making a plan of action with you 006

Fully understanding your concerns 007

Being interested in you as a whole person 011

Empathy Training for Resident Physicians A RCT of a Neuroscience Informed Curriculum (Patient-Rated CARE Items)

(Riess et al JGIM 2012))

wwwplanetreeorg

Program Evaluation and Self-Assessment of Improvement

91 91 96 91 94

91 91

0

10

20

30

40

50

60

70

80

90

100

Listening carefullyto patients

withoutinterrupting

Interpreting non-verbal cues (toneof voice posture

affect)

Being aware ofyour physiological

reactions tochallengingpatients

Being able tomanage yourphysiologicalreactions tochallengingpatients

Being aware ofyour emotional

reactions tochallengingpatients

Being able tomanage your

emotionalreactions tochallengingpatients

Understanding thelatest research onthe neurobiology

of empathy

After the training did you improve in

(Riess Kelley et al JGIM 2012)

wwwplanetreeorg

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Patient directed visitation and Care Partners

Patient-Directed Visiting elimination of broad restrictions to visiting patients (based on age relationship and number) with any limitations imposed on a case-by-case basis and in collaboration with the patient according to personal preferences and in consideration of their healthcare needs

wwwplanetreeorg

Care Partner Program bull Family formally engaged as integral member of

care team

bull A partnership between family and staff

bull Provides a source of continuity

bull Prepares loved one for post-discharge

ldquoThey showed my husband how to do my dressing

changes so I donrsquot have to come here every day They

asked him questions Can you see it Do you

understand For him to see he was very informedrdquo

wwwplanetreeorg

Alegent Health System Ethnography Project

What was your biggest fear while hospitalized

Being alone

wwwplanetreeorg

Exploring patient-directed visitation

GROUP ACTIVITY

With a partner decide who will be lsquoforrsquo and who will be lsquoagainstrsquo 247 patient-directed visitation

If you are assigned lsquoforrsquo take 5 minutes and develop a list of every reason you can think of why this practice could be beneficial

If you are assigned to be lsquoagainstrsquo take 5 minutes and develop a list of every reason that you can thing of why this practice could be a bad idea

With your partner discuss the pros and cons of this practice

wwwplanetreeorg

What research tells us about the impact of visitation

bull In a study that examined the benefits of unrestricted patient visitation 88 of families stated it had a positive benefit to their overall experience and decreased their anxiety by 65

bull Family presence in the ICU decreases psychological stress of patients and family members

bull Family presence in the clinical setting is reported to improve medical decision making patient care communication with patientsrsquo family members and to reduce patient falls

bull No clinical evidence suggests negative clinical outcomes No research concludes that allowing patients to choose who can visit them and when these visits occur results in negative outcomes

Berwick D Kotagal M (2004) ―Restricted visiting hours in ICUs time to change JAMA 292 736-737 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672 Stone S Annual Nursing Report Sharp Memorial Hospital 2014 Lim L and Zimring C Healthcare Design of the Future ARCH 4833ARCH 6271ID 6271BMED 8813 HF 2015

wwwplanetreeorg

What research tells us about the impact of involvement of the patientrsquos family

Engagement of hospitalized patientrsquos family in care activities and care coordination

ndasha lsquoCare Partnerrsquo program- improved patient outcomes including

bull better pain management

bull improved sleep

bull increased health literacy

bull more effective transition to home

Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672

wwwplanetreeorg

Checklists to better prepare patients and family caregivers for discharge

wwwplanetreeorg

wwwplanetreeorg

Legislating Professional-Family Partnerships 15 states enact FamilyCaregivers Legislation

bull At admission patient-designated care

partner documented in medical record

bull At discharge staff notify and offer to meet with care partner to discuss plan of care

bull Prior to discharge staff offer lsquoadequate trainingrsquo in aftercare tasks to care partner

wwwplanetreeorg

Why involve patients and families

Highly ldquoactivatedrdquo patients are 30ndash40 less likely to report care coordination problems than those ldquoless activatedrdquo

Raceethnicity employment insurance status income and length of illness were not significantly associated with self‐reported care coordination problems

Maeng Martsolf Scanlon Christianson Care coordination for the chronically ill understanding the patientrsquos perspective Health Serv Res 2012 47(5)1960ndash79

wwwplanetreeorg

All-Cause 30-day Readmission Rates Fall as Patient ndash Family Engagement in Discharge Planning Increases

bull Shared Teaching Tool utilizing 4th grade literacy

bull ldquoTeach Backrdquo by patients

bull Follow-up MD appointments made before discharge

bull HF protocol included in discharge packet for next provider

bull Scales provided for home care patients

bull Follow-up phone calls to patients amp families

Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

wwwplanetreeorg

All-Cause 30-day Readmissions 2007-2014

US Department of Health amp Human Services May 7 2014 ldquoNew HHS Data Shows Major Strides Made in Patient Safety Leading to Improved Care and Savingsrdquo

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Shared Decision-Making

wwwplanetreeorg

The ultimate patient-engagement tool Shared decision making (SDM) A 2013 study published in the February issue of Health Affairs found bull providing shared decision making-based health coaching for patients

with conditions that frequently require major treatment decisions reduces the overall costs of care hospitalizations and surgeries significantly

bull patients who received enhanced support had 53 lower overall medical costs than patients who received the usual level of support

bull patients receiving enhanced support had 125 fewer hospital admissions than the usual support group and 99 fewer preference-sensitive surgeries including 209 fewer preference-sensitive heart surgeries

wwwplanetreeorg

Empathy is associated with positive clinical outcomes for patients with

diabetes mellitus

Empathy is an important element in patient care and physician

competence that must be enhanced during education for physicians

and other staff who interact with patients

Conclusions and Implications

wwwplanetreeorg

Influence of Patient-Clinician Relationship on Healthcare Outcomes Systematic Review and Meta-analysis of RCTrsquos

Author (year) Medical Outcome Intervention Type p-Value

Bolognesi et al (2006)

Obesity Motivational Interviewing

Trust Patient-Centered Care Trans-theoretical Model [stages of change])

00

Chassany et al (2007)

Osteoarthritis

Improve Communication Empathy Group discussion led by facilitator focused on patient-physician relationship pain evaluation prescribing and

negotiating a therapeutic contract

01

Cals et al (2009) Lower Resp Infection Improve Communication

Empathy and Shared Decision Making Patient Centered Approach

02

Cleland et al (2007) Asthma Improve Communication

Written Material role playing patient resources

03

(Kelley Kraft-Todd Shapira Kossowsky Riess 2014 Plos One)

wwwplanetreeorg

At todayrsquos meeting how was your doctor at hellip p-value

Making you feel at ease 002

Really listening 002

Being positive 002

Explaining things clearly 002

Letting you tell your story 003

Showing care and compassion 004

Helping you to take control 005

Making a plan of action with you 006

Fully understanding your concerns 007

Being interested in you as a whole person 011

Empathy Training for Resident Physicians A RCT of a Neuroscience Informed Curriculum (Patient-Rated CARE Items)

(Riess et al JGIM 2012))

wwwplanetreeorg

Program Evaluation and Self-Assessment of Improvement

91 91 96 91 94

91 91

0

10

20

30

40

50

60

70

80

90

100

Listening carefullyto patients

withoutinterrupting

Interpreting non-verbal cues (toneof voice posture

affect)

Being aware ofyour physiological

reactions tochallengingpatients

Being able tomanage yourphysiologicalreactions tochallengingpatients

Being aware ofyour emotional

reactions tochallengingpatients

Being able tomanage your

emotionalreactions tochallengingpatients

Understanding thelatest research onthe neurobiology

of empathy

After the training did you improve in

(Riess Kelley et al JGIM 2012)

wwwplanetreeorg

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Patient directed visitation and Care Partners

Patient-Directed Visiting elimination of broad restrictions to visiting patients (based on age relationship and number) with any limitations imposed on a case-by-case basis and in collaboration with the patient according to personal preferences and in consideration of their healthcare needs

wwwplanetreeorg

Care Partner Program bull Family formally engaged as integral member of

care team

bull A partnership between family and staff

bull Provides a source of continuity

bull Prepares loved one for post-discharge

ldquoThey showed my husband how to do my dressing

changes so I donrsquot have to come here every day They

asked him questions Can you see it Do you

understand For him to see he was very informedrdquo

wwwplanetreeorg

Alegent Health System Ethnography Project

What was your biggest fear while hospitalized

Being alone

wwwplanetreeorg

Exploring patient-directed visitation

GROUP ACTIVITY

With a partner decide who will be lsquoforrsquo and who will be lsquoagainstrsquo 247 patient-directed visitation

If you are assigned lsquoforrsquo take 5 minutes and develop a list of every reason you can think of why this practice could be beneficial

If you are assigned to be lsquoagainstrsquo take 5 minutes and develop a list of every reason that you can thing of why this practice could be a bad idea

With your partner discuss the pros and cons of this practice

wwwplanetreeorg

What research tells us about the impact of visitation

bull In a study that examined the benefits of unrestricted patient visitation 88 of families stated it had a positive benefit to their overall experience and decreased their anxiety by 65

bull Family presence in the ICU decreases psychological stress of patients and family members

bull Family presence in the clinical setting is reported to improve medical decision making patient care communication with patientsrsquo family members and to reduce patient falls

bull No clinical evidence suggests negative clinical outcomes No research concludes that allowing patients to choose who can visit them and when these visits occur results in negative outcomes

Berwick D Kotagal M (2004) ―Restricted visiting hours in ICUs time to change JAMA 292 736-737 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672 Stone S Annual Nursing Report Sharp Memorial Hospital 2014 Lim L and Zimring C Healthcare Design of the Future ARCH 4833ARCH 6271ID 6271BMED 8813 HF 2015

wwwplanetreeorg

What research tells us about the impact of involvement of the patientrsquos family

Engagement of hospitalized patientrsquos family in care activities and care coordination

ndasha lsquoCare Partnerrsquo program- improved patient outcomes including

bull better pain management

bull improved sleep

bull increased health literacy

bull more effective transition to home

Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672

wwwplanetreeorg

Checklists to better prepare patients and family caregivers for discharge

wwwplanetreeorg

wwwplanetreeorg

Legislating Professional-Family Partnerships 15 states enact FamilyCaregivers Legislation

bull At admission patient-designated care

partner documented in medical record

bull At discharge staff notify and offer to meet with care partner to discuss plan of care

bull Prior to discharge staff offer lsquoadequate trainingrsquo in aftercare tasks to care partner

wwwplanetreeorg

Why involve patients and families

Highly ldquoactivatedrdquo patients are 30ndash40 less likely to report care coordination problems than those ldquoless activatedrdquo

Raceethnicity employment insurance status income and length of illness were not significantly associated with self‐reported care coordination problems

Maeng Martsolf Scanlon Christianson Care coordination for the chronically ill understanding the patientrsquos perspective Health Serv Res 2012 47(5)1960ndash79

wwwplanetreeorg

All-Cause 30-day Readmission Rates Fall as Patient ndash Family Engagement in Discharge Planning Increases

bull Shared Teaching Tool utilizing 4th grade literacy

bull ldquoTeach Backrdquo by patients

bull Follow-up MD appointments made before discharge

bull HF protocol included in discharge packet for next provider

bull Scales provided for home care patients

bull Follow-up phone calls to patients amp families

Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

wwwplanetreeorg

All-Cause 30-day Readmissions 2007-2014

US Department of Health amp Human Services May 7 2014 ldquoNew HHS Data Shows Major Strides Made in Patient Safety Leading to Improved Care and Savingsrdquo

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Shared Decision-Making

wwwplanetreeorg

The ultimate patient-engagement tool Shared decision making (SDM) A 2013 study published in the February issue of Health Affairs found bull providing shared decision making-based health coaching for patients

with conditions that frequently require major treatment decisions reduces the overall costs of care hospitalizations and surgeries significantly

bull patients who received enhanced support had 53 lower overall medical costs than patients who received the usual level of support

bull patients receiving enhanced support had 125 fewer hospital admissions than the usual support group and 99 fewer preference-sensitive surgeries including 209 fewer preference-sensitive heart surgeries

wwwplanetreeorg

Influence of Patient-Clinician Relationship on Healthcare Outcomes Systematic Review and Meta-analysis of RCTrsquos

Author (year) Medical Outcome Intervention Type p-Value

Bolognesi et al (2006)

Obesity Motivational Interviewing

Trust Patient-Centered Care Trans-theoretical Model [stages of change])

00

Chassany et al (2007)

Osteoarthritis

Improve Communication Empathy Group discussion led by facilitator focused on patient-physician relationship pain evaluation prescribing and

negotiating a therapeutic contract

01

Cals et al (2009) Lower Resp Infection Improve Communication

Empathy and Shared Decision Making Patient Centered Approach

02

Cleland et al (2007) Asthma Improve Communication

Written Material role playing patient resources

03

(Kelley Kraft-Todd Shapira Kossowsky Riess 2014 Plos One)

wwwplanetreeorg

At todayrsquos meeting how was your doctor at hellip p-value

Making you feel at ease 002

Really listening 002

Being positive 002

Explaining things clearly 002

Letting you tell your story 003

Showing care and compassion 004

Helping you to take control 005

Making a plan of action with you 006

Fully understanding your concerns 007

Being interested in you as a whole person 011

Empathy Training for Resident Physicians A RCT of a Neuroscience Informed Curriculum (Patient-Rated CARE Items)

(Riess et al JGIM 2012))

wwwplanetreeorg

Program Evaluation and Self-Assessment of Improvement

91 91 96 91 94

91 91

0

10

20

30

40

50

60

70

80

90

100

Listening carefullyto patients

withoutinterrupting

Interpreting non-verbal cues (toneof voice posture

affect)

Being aware ofyour physiological

reactions tochallengingpatients

Being able tomanage yourphysiologicalreactions tochallengingpatients

Being aware ofyour emotional

reactions tochallengingpatients

Being able tomanage your

emotionalreactions tochallengingpatients

Understanding thelatest research onthe neurobiology

of empathy

After the training did you improve in

(Riess Kelley et al JGIM 2012)

wwwplanetreeorg

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Patient directed visitation and Care Partners

Patient-Directed Visiting elimination of broad restrictions to visiting patients (based on age relationship and number) with any limitations imposed on a case-by-case basis and in collaboration with the patient according to personal preferences and in consideration of their healthcare needs

wwwplanetreeorg

Care Partner Program bull Family formally engaged as integral member of

care team

bull A partnership between family and staff

bull Provides a source of continuity

bull Prepares loved one for post-discharge

ldquoThey showed my husband how to do my dressing

changes so I donrsquot have to come here every day They

asked him questions Can you see it Do you

understand For him to see he was very informedrdquo

wwwplanetreeorg

Alegent Health System Ethnography Project

What was your biggest fear while hospitalized

Being alone

wwwplanetreeorg

Exploring patient-directed visitation

GROUP ACTIVITY

With a partner decide who will be lsquoforrsquo and who will be lsquoagainstrsquo 247 patient-directed visitation

If you are assigned lsquoforrsquo take 5 minutes and develop a list of every reason you can think of why this practice could be beneficial

If you are assigned to be lsquoagainstrsquo take 5 minutes and develop a list of every reason that you can thing of why this practice could be a bad idea

With your partner discuss the pros and cons of this practice

wwwplanetreeorg

What research tells us about the impact of visitation

bull In a study that examined the benefits of unrestricted patient visitation 88 of families stated it had a positive benefit to their overall experience and decreased their anxiety by 65

bull Family presence in the ICU decreases psychological stress of patients and family members

bull Family presence in the clinical setting is reported to improve medical decision making patient care communication with patientsrsquo family members and to reduce patient falls

bull No clinical evidence suggests negative clinical outcomes No research concludes that allowing patients to choose who can visit them and when these visits occur results in negative outcomes

Berwick D Kotagal M (2004) ―Restricted visiting hours in ICUs time to change JAMA 292 736-737 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672 Stone S Annual Nursing Report Sharp Memorial Hospital 2014 Lim L and Zimring C Healthcare Design of the Future ARCH 4833ARCH 6271ID 6271BMED 8813 HF 2015

wwwplanetreeorg

What research tells us about the impact of involvement of the patientrsquos family

Engagement of hospitalized patientrsquos family in care activities and care coordination

ndasha lsquoCare Partnerrsquo program- improved patient outcomes including

bull better pain management

bull improved sleep

bull increased health literacy

bull more effective transition to home

Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672

wwwplanetreeorg

Checklists to better prepare patients and family caregivers for discharge

wwwplanetreeorg

wwwplanetreeorg

Legislating Professional-Family Partnerships 15 states enact FamilyCaregivers Legislation

bull At admission patient-designated care

partner documented in medical record

bull At discharge staff notify and offer to meet with care partner to discuss plan of care

bull Prior to discharge staff offer lsquoadequate trainingrsquo in aftercare tasks to care partner

wwwplanetreeorg

Why involve patients and families

Highly ldquoactivatedrdquo patients are 30ndash40 less likely to report care coordination problems than those ldquoless activatedrdquo

Raceethnicity employment insurance status income and length of illness were not significantly associated with self‐reported care coordination problems

Maeng Martsolf Scanlon Christianson Care coordination for the chronically ill understanding the patientrsquos perspective Health Serv Res 2012 47(5)1960ndash79

wwwplanetreeorg

All-Cause 30-day Readmission Rates Fall as Patient ndash Family Engagement in Discharge Planning Increases

bull Shared Teaching Tool utilizing 4th grade literacy

bull ldquoTeach Backrdquo by patients

bull Follow-up MD appointments made before discharge

bull HF protocol included in discharge packet for next provider

bull Scales provided for home care patients

bull Follow-up phone calls to patients amp families

Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

wwwplanetreeorg

All-Cause 30-day Readmissions 2007-2014

US Department of Health amp Human Services May 7 2014 ldquoNew HHS Data Shows Major Strides Made in Patient Safety Leading to Improved Care and Savingsrdquo

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Shared Decision-Making

wwwplanetreeorg

The ultimate patient-engagement tool Shared decision making (SDM) A 2013 study published in the February issue of Health Affairs found bull providing shared decision making-based health coaching for patients

with conditions that frequently require major treatment decisions reduces the overall costs of care hospitalizations and surgeries significantly

bull patients who received enhanced support had 53 lower overall medical costs than patients who received the usual level of support

bull patients receiving enhanced support had 125 fewer hospital admissions than the usual support group and 99 fewer preference-sensitive surgeries including 209 fewer preference-sensitive heart surgeries

wwwplanetreeorg

At todayrsquos meeting how was your doctor at hellip p-value

Making you feel at ease 002

Really listening 002

Being positive 002

Explaining things clearly 002

Letting you tell your story 003

Showing care and compassion 004

Helping you to take control 005

Making a plan of action with you 006

Fully understanding your concerns 007

Being interested in you as a whole person 011

Empathy Training for Resident Physicians A RCT of a Neuroscience Informed Curriculum (Patient-Rated CARE Items)

(Riess et al JGIM 2012))

wwwplanetreeorg

Program Evaluation and Self-Assessment of Improvement

91 91 96 91 94

91 91

0

10

20

30

40

50

60

70

80

90

100

Listening carefullyto patients

withoutinterrupting

Interpreting non-verbal cues (toneof voice posture

affect)

Being aware ofyour physiological

reactions tochallengingpatients

Being able tomanage yourphysiologicalreactions tochallengingpatients

Being aware ofyour emotional

reactions tochallengingpatients

Being able tomanage your

emotionalreactions tochallengingpatients

Understanding thelatest research onthe neurobiology

of empathy

After the training did you improve in

(Riess Kelley et al JGIM 2012)

wwwplanetreeorg

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Patient directed visitation and Care Partners

Patient-Directed Visiting elimination of broad restrictions to visiting patients (based on age relationship and number) with any limitations imposed on a case-by-case basis and in collaboration with the patient according to personal preferences and in consideration of their healthcare needs

wwwplanetreeorg

Care Partner Program bull Family formally engaged as integral member of

care team

bull A partnership between family and staff

bull Provides a source of continuity

bull Prepares loved one for post-discharge

ldquoThey showed my husband how to do my dressing

changes so I donrsquot have to come here every day They

asked him questions Can you see it Do you

understand For him to see he was very informedrdquo

wwwplanetreeorg

Alegent Health System Ethnography Project

What was your biggest fear while hospitalized

Being alone

wwwplanetreeorg

Exploring patient-directed visitation

GROUP ACTIVITY

With a partner decide who will be lsquoforrsquo and who will be lsquoagainstrsquo 247 patient-directed visitation

If you are assigned lsquoforrsquo take 5 minutes and develop a list of every reason you can think of why this practice could be beneficial

If you are assigned to be lsquoagainstrsquo take 5 minutes and develop a list of every reason that you can thing of why this practice could be a bad idea

With your partner discuss the pros and cons of this practice

wwwplanetreeorg

What research tells us about the impact of visitation

bull In a study that examined the benefits of unrestricted patient visitation 88 of families stated it had a positive benefit to their overall experience and decreased their anxiety by 65

bull Family presence in the ICU decreases psychological stress of patients and family members

bull Family presence in the clinical setting is reported to improve medical decision making patient care communication with patientsrsquo family members and to reduce patient falls

bull No clinical evidence suggests negative clinical outcomes No research concludes that allowing patients to choose who can visit them and when these visits occur results in negative outcomes

Berwick D Kotagal M (2004) ―Restricted visiting hours in ICUs time to change JAMA 292 736-737 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672 Stone S Annual Nursing Report Sharp Memorial Hospital 2014 Lim L and Zimring C Healthcare Design of the Future ARCH 4833ARCH 6271ID 6271BMED 8813 HF 2015

wwwplanetreeorg

What research tells us about the impact of involvement of the patientrsquos family

Engagement of hospitalized patientrsquos family in care activities and care coordination

ndasha lsquoCare Partnerrsquo program- improved patient outcomes including

bull better pain management

bull improved sleep

bull increased health literacy

bull more effective transition to home

Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672

wwwplanetreeorg

Checklists to better prepare patients and family caregivers for discharge

wwwplanetreeorg

wwwplanetreeorg

Legislating Professional-Family Partnerships 15 states enact FamilyCaregivers Legislation

bull At admission patient-designated care

partner documented in medical record

bull At discharge staff notify and offer to meet with care partner to discuss plan of care

bull Prior to discharge staff offer lsquoadequate trainingrsquo in aftercare tasks to care partner

wwwplanetreeorg

Why involve patients and families

Highly ldquoactivatedrdquo patients are 30ndash40 less likely to report care coordination problems than those ldquoless activatedrdquo

Raceethnicity employment insurance status income and length of illness were not significantly associated with self‐reported care coordination problems

Maeng Martsolf Scanlon Christianson Care coordination for the chronically ill understanding the patientrsquos perspective Health Serv Res 2012 47(5)1960ndash79

wwwplanetreeorg

All-Cause 30-day Readmission Rates Fall as Patient ndash Family Engagement in Discharge Planning Increases

bull Shared Teaching Tool utilizing 4th grade literacy

bull ldquoTeach Backrdquo by patients

bull Follow-up MD appointments made before discharge

bull HF protocol included in discharge packet for next provider

bull Scales provided for home care patients

bull Follow-up phone calls to patients amp families

Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

wwwplanetreeorg

All-Cause 30-day Readmissions 2007-2014

US Department of Health amp Human Services May 7 2014 ldquoNew HHS Data Shows Major Strides Made in Patient Safety Leading to Improved Care and Savingsrdquo

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Shared Decision-Making

wwwplanetreeorg

The ultimate patient-engagement tool Shared decision making (SDM) A 2013 study published in the February issue of Health Affairs found bull providing shared decision making-based health coaching for patients

with conditions that frequently require major treatment decisions reduces the overall costs of care hospitalizations and surgeries significantly

bull patients who received enhanced support had 53 lower overall medical costs than patients who received the usual level of support

bull patients receiving enhanced support had 125 fewer hospital admissions than the usual support group and 99 fewer preference-sensitive surgeries including 209 fewer preference-sensitive heart surgeries

wwwplanetreeorg

Program Evaluation and Self-Assessment of Improvement

91 91 96 91 94

91 91

0

10

20

30

40

50

60

70

80

90

100

Listening carefullyto patients

withoutinterrupting

Interpreting non-verbal cues (toneof voice posture

affect)

Being aware ofyour physiological

reactions tochallengingpatients

Being able tomanage yourphysiologicalreactions tochallengingpatients

Being aware ofyour emotional

reactions tochallengingpatients

Being able tomanage your

emotionalreactions tochallengingpatients

Understanding thelatest research onthe neurobiology

of empathy

After the training did you improve in

(Riess Kelley et al JGIM 2012)

wwwplanetreeorg

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Patient directed visitation and Care Partners

Patient-Directed Visiting elimination of broad restrictions to visiting patients (based on age relationship and number) with any limitations imposed on a case-by-case basis and in collaboration with the patient according to personal preferences and in consideration of their healthcare needs

wwwplanetreeorg

Care Partner Program bull Family formally engaged as integral member of

care team

bull A partnership between family and staff

bull Provides a source of continuity

bull Prepares loved one for post-discharge

ldquoThey showed my husband how to do my dressing

changes so I donrsquot have to come here every day They

asked him questions Can you see it Do you

understand For him to see he was very informedrdquo

wwwplanetreeorg

Alegent Health System Ethnography Project

What was your biggest fear while hospitalized

Being alone

wwwplanetreeorg

Exploring patient-directed visitation

GROUP ACTIVITY

With a partner decide who will be lsquoforrsquo and who will be lsquoagainstrsquo 247 patient-directed visitation

If you are assigned lsquoforrsquo take 5 minutes and develop a list of every reason you can think of why this practice could be beneficial

If you are assigned to be lsquoagainstrsquo take 5 minutes and develop a list of every reason that you can thing of why this practice could be a bad idea

With your partner discuss the pros and cons of this practice

wwwplanetreeorg

What research tells us about the impact of visitation

bull In a study that examined the benefits of unrestricted patient visitation 88 of families stated it had a positive benefit to their overall experience and decreased their anxiety by 65

bull Family presence in the ICU decreases psychological stress of patients and family members

bull Family presence in the clinical setting is reported to improve medical decision making patient care communication with patientsrsquo family members and to reduce patient falls

bull No clinical evidence suggests negative clinical outcomes No research concludes that allowing patients to choose who can visit them and when these visits occur results in negative outcomes

Berwick D Kotagal M (2004) ―Restricted visiting hours in ICUs time to change JAMA 292 736-737 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672 Stone S Annual Nursing Report Sharp Memorial Hospital 2014 Lim L and Zimring C Healthcare Design of the Future ARCH 4833ARCH 6271ID 6271BMED 8813 HF 2015

wwwplanetreeorg

What research tells us about the impact of involvement of the patientrsquos family

Engagement of hospitalized patientrsquos family in care activities and care coordination

ndasha lsquoCare Partnerrsquo program- improved patient outcomes including

bull better pain management

bull improved sleep

bull increased health literacy

bull more effective transition to home

Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672

wwwplanetreeorg

Checklists to better prepare patients and family caregivers for discharge

wwwplanetreeorg

wwwplanetreeorg

Legislating Professional-Family Partnerships 15 states enact FamilyCaregivers Legislation

bull At admission patient-designated care

partner documented in medical record

bull At discharge staff notify and offer to meet with care partner to discuss plan of care

bull Prior to discharge staff offer lsquoadequate trainingrsquo in aftercare tasks to care partner

wwwplanetreeorg

Why involve patients and families

Highly ldquoactivatedrdquo patients are 30ndash40 less likely to report care coordination problems than those ldquoless activatedrdquo

Raceethnicity employment insurance status income and length of illness were not significantly associated with self‐reported care coordination problems

Maeng Martsolf Scanlon Christianson Care coordination for the chronically ill understanding the patientrsquos perspective Health Serv Res 2012 47(5)1960ndash79

wwwplanetreeorg

All-Cause 30-day Readmission Rates Fall as Patient ndash Family Engagement in Discharge Planning Increases

bull Shared Teaching Tool utilizing 4th grade literacy

bull ldquoTeach Backrdquo by patients

bull Follow-up MD appointments made before discharge

bull HF protocol included in discharge packet for next provider

bull Scales provided for home care patients

bull Follow-up phone calls to patients amp families

Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

wwwplanetreeorg

All-Cause 30-day Readmissions 2007-2014

US Department of Health amp Human Services May 7 2014 ldquoNew HHS Data Shows Major Strides Made in Patient Safety Leading to Improved Care and Savingsrdquo

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Shared Decision-Making

wwwplanetreeorg

The ultimate patient-engagement tool Shared decision making (SDM) A 2013 study published in the February issue of Health Affairs found bull providing shared decision making-based health coaching for patients

with conditions that frequently require major treatment decisions reduces the overall costs of care hospitalizations and surgeries significantly

bull patients who received enhanced support had 53 lower overall medical costs than patients who received the usual level of support

bull patients receiving enhanced support had 125 fewer hospital admissions than the usual support group and 99 fewer preference-sensitive surgeries including 209 fewer preference-sensitive heart surgeries

wwwplanetreeorg

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Patient directed visitation and Care Partners

Patient-Directed Visiting elimination of broad restrictions to visiting patients (based on age relationship and number) with any limitations imposed on a case-by-case basis and in collaboration with the patient according to personal preferences and in consideration of their healthcare needs

wwwplanetreeorg

Care Partner Program bull Family formally engaged as integral member of

care team

bull A partnership between family and staff

bull Provides a source of continuity

bull Prepares loved one for post-discharge

ldquoThey showed my husband how to do my dressing

changes so I donrsquot have to come here every day They

asked him questions Can you see it Do you

understand For him to see he was very informedrdquo

wwwplanetreeorg

Alegent Health System Ethnography Project

What was your biggest fear while hospitalized

Being alone

wwwplanetreeorg

Exploring patient-directed visitation

GROUP ACTIVITY

With a partner decide who will be lsquoforrsquo and who will be lsquoagainstrsquo 247 patient-directed visitation

If you are assigned lsquoforrsquo take 5 minutes and develop a list of every reason you can think of why this practice could be beneficial

If you are assigned to be lsquoagainstrsquo take 5 minutes and develop a list of every reason that you can thing of why this practice could be a bad idea

With your partner discuss the pros and cons of this practice

wwwplanetreeorg

What research tells us about the impact of visitation

bull In a study that examined the benefits of unrestricted patient visitation 88 of families stated it had a positive benefit to their overall experience and decreased their anxiety by 65

bull Family presence in the ICU decreases psychological stress of patients and family members

bull Family presence in the clinical setting is reported to improve medical decision making patient care communication with patientsrsquo family members and to reduce patient falls

bull No clinical evidence suggests negative clinical outcomes No research concludes that allowing patients to choose who can visit them and when these visits occur results in negative outcomes

Berwick D Kotagal M (2004) ―Restricted visiting hours in ICUs time to change JAMA 292 736-737 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672 Stone S Annual Nursing Report Sharp Memorial Hospital 2014 Lim L and Zimring C Healthcare Design of the Future ARCH 4833ARCH 6271ID 6271BMED 8813 HF 2015

wwwplanetreeorg

What research tells us about the impact of involvement of the patientrsquos family

Engagement of hospitalized patientrsquos family in care activities and care coordination

ndasha lsquoCare Partnerrsquo program- improved patient outcomes including

bull better pain management

bull improved sleep

bull increased health literacy

bull more effective transition to home

Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672

wwwplanetreeorg

Checklists to better prepare patients and family caregivers for discharge

wwwplanetreeorg

wwwplanetreeorg

Legislating Professional-Family Partnerships 15 states enact FamilyCaregivers Legislation

bull At admission patient-designated care

partner documented in medical record

bull At discharge staff notify and offer to meet with care partner to discuss plan of care

bull Prior to discharge staff offer lsquoadequate trainingrsquo in aftercare tasks to care partner

wwwplanetreeorg

Why involve patients and families

Highly ldquoactivatedrdquo patients are 30ndash40 less likely to report care coordination problems than those ldquoless activatedrdquo

Raceethnicity employment insurance status income and length of illness were not significantly associated with self‐reported care coordination problems

Maeng Martsolf Scanlon Christianson Care coordination for the chronically ill understanding the patientrsquos perspective Health Serv Res 2012 47(5)1960ndash79

wwwplanetreeorg

All-Cause 30-day Readmission Rates Fall as Patient ndash Family Engagement in Discharge Planning Increases

bull Shared Teaching Tool utilizing 4th grade literacy

bull ldquoTeach Backrdquo by patients

bull Follow-up MD appointments made before discharge

bull HF protocol included in discharge packet for next provider

bull Scales provided for home care patients

bull Follow-up phone calls to patients amp families

Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

wwwplanetreeorg

All-Cause 30-day Readmissions 2007-2014

US Department of Health amp Human Services May 7 2014 ldquoNew HHS Data Shows Major Strides Made in Patient Safety Leading to Improved Care and Savingsrdquo

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Shared Decision-Making

wwwplanetreeorg

The ultimate patient-engagement tool Shared decision making (SDM) A 2013 study published in the February issue of Health Affairs found bull providing shared decision making-based health coaching for patients

with conditions that frequently require major treatment decisions reduces the overall costs of care hospitalizations and surgeries significantly

bull patients who received enhanced support had 53 lower overall medical costs than patients who received the usual level of support

bull patients receiving enhanced support had 125 fewer hospital admissions than the usual support group and 99 fewer preference-sensitive surgeries including 209 fewer preference-sensitive heart surgeries

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Patient directed visitation and Care Partners

Patient-Directed Visiting elimination of broad restrictions to visiting patients (based on age relationship and number) with any limitations imposed on a case-by-case basis and in collaboration with the patient according to personal preferences and in consideration of their healthcare needs

wwwplanetreeorg

Care Partner Program bull Family formally engaged as integral member of

care team

bull A partnership between family and staff

bull Provides a source of continuity

bull Prepares loved one for post-discharge

ldquoThey showed my husband how to do my dressing

changes so I donrsquot have to come here every day They

asked him questions Can you see it Do you

understand For him to see he was very informedrdquo

wwwplanetreeorg

Alegent Health System Ethnography Project

What was your biggest fear while hospitalized

Being alone

wwwplanetreeorg

Exploring patient-directed visitation

GROUP ACTIVITY

With a partner decide who will be lsquoforrsquo and who will be lsquoagainstrsquo 247 patient-directed visitation

If you are assigned lsquoforrsquo take 5 minutes and develop a list of every reason you can think of why this practice could be beneficial

If you are assigned to be lsquoagainstrsquo take 5 minutes and develop a list of every reason that you can thing of why this practice could be a bad idea

With your partner discuss the pros and cons of this practice

wwwplanetreeorg

What research tells us about the impact of visitation

bull In a study that examined the benefits of unrestricted patient visitation 88 of families stated it had a positive benefit to their overall experience and decreased their anxiety by 65

bull Family presence in the ICU decreases psychological stress of patients and family members

bull Family presence in the clinical setting is reported to improve medical decision making patient care communication with patientsrsquo family members and to reduce patient falls

bull No clinical evidence suggests negative clinical outcomes No research concludes that allowing patients to choose who can visit them and when these visits occur results in negative outcomes

Berwick D Kotagal M (2004) ―Restricted visiting hours in ICUs time to change JAMA 292 736-737 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672 Stone S Annual Nursing Report Sharp Memorial Hospital 2014 Lim L and Zimring C Healthcare Design of the Future ARCH 4833ARCH 6271ID 6271BMED 8813 HF 2015

wwwplanetreeorg

What research tells us about the impact of involvement of the patientrsquos family

Engagement of hospitalized patientrsquos family in care activities and care coordination

ndasha lsquoCare Partnerrsquo program- improved patient outcomes including

bull better pain management

bull improved sleep

bull increased health literacy

bull more effective transition to home

Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672

wwwplanetreeorg

Checklists to better prepare patients and family caregivers for discharge

wwwplanetreeorg

wwwplanetreeorg

Legislating Professional-Family Partnerships 15 states enact FamilyCaregivers Legislation

bull At admission patient-designated care

partner documented in medical record

bull At discharge staff notify and offer to meet with care partner to discuss plan of care

bull Prior to discharge staff offer lsquoadequate trainingrsquo in aftercare tasks to care partner

wwwplanetreeorg

Why involve patients and families

Highly ldquoactivatedrdquo patients are 30ndash40 less likely to report care coordination problems than those ldquoless activatedrdquo

Raceethnicity employment insurance status income and length of illness were not significantly associated with self‐reported care coordination problems

Maeng Martsolf Scanlon Christianson Care coordination for the chronically ill understanding the patientrsquos perspective Health Serv Res 2012 47(5)1960ndash79

wwwplanetreeorg

All-Cause 30-day Readmission Rates Fall as Patient ndash Family Engagement in Discharge Planning Increases

bull Shared Teaching Tool utilizing 4th grade literacy

bull ldquoTeach Backrdquo by patients

bull Follow-up MD appointments made before discharge

bull HF protocol included in discharge packet for next provider

bull Scales provided for home care patients

bull Follow-up phone calls to patients amp families

Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

wwwplanetreeorg

All-Cause 30-day Readmissions 2007-2014

US Department of Health amp Human Services May 7 2014 ldquoNew HHS Data Shows Major Strides Made in Patient Safety Leading to Improved Care and Savingsrdquo

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Shared Decision-Making

wwwplanetreeorg

The ultimate patient-engagement tool Shared decision making (SDM) A 2013 study published in the February issue of Health Affairs found bull providing shared decision making-based health coaching for patients

with conditions that frequently require major treatment decisions reduces the overall costs of care hospitalizations and surgeries significantly

bull patients who received enhanced support had 53 lower overall medical costs than patients who received the usual level of support

bull patients receiving enhanced support had 125 fewer hospital admissions than the usual support group and 99 fewer preference-sensitive surgeries including 209 fewer preference-sensitive heart surgeries

wwwplanetreeorg

Care Partner Program bull Family formally engaged as integral member of

care team

bull A partnership between family and staff

bull Provides a source of continuity

bull Prepares loved one for post-discharge

ldquoThey showed my husband how to do my dressing

changes so I donrsquot have to come here every day They

asked him questions Can you see it Do you

understand For him to see he was very informedrdquo

wwwplanetreeorg

Alegent Health System Ethnography Project

What was your biggest fear while hospitalized

Being alone

wwwplanetreeorg

Exploring patient-directed visitation

GROUP ACTIVITY

With a partner decide who will be lsquoforrsquo and who will be lsquoagainstrsquo 247 patient-directed visitation

If you are assigned lsquoforrsquo take 5 minutes and develop a list of every reason you can think of why this practice could be beneficial

If you are assigned to be lsquoagainstrsquo take 5 minutes and develop a list of every reason that you can thing of why this practice could be a bad idea

With your partner discuss the pros and cons of this practice

wwwplanetreeorg

What research tells us about the impact of visitation

bull In a study that examined the benefits of unrestricted patient visitation 88 of families stated it had a positive benefit to their overall experience and decreased their anxiety by 65

bull Family presence in the ICU decreases psychological stress of patients and family members

bull Family presence in the clinical setting is reported to improve medical decision making patient care communication with patientsrsquo family members and to reduce patient falls

bull No clinical evidence suggests negative clinical outcomes No research concludes that allowing patients to choose who can visit them and when these visits occur results in negative outcomes

Berwick D Kotagal M (2004) ―Restricted visiting hours in ICUs time to change JAMA 292 736-737 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672 Stone S Annual Nursing Report Sharp Memorial Hospital 2014 Lim L and Zimring C Healthcare Design of the Future ARCH 4833ARCH 6271ID 6271BMED 8813 HF 2015

wwwplanetreeorg

What research tells us about the impact of involvement of the patientrsquos family

Engagement of hospitalized patientrsquos family in care activities and care coordination

ndasha lsquoCare Partnerrsquo program- improved patient outcomes including

bull better pain management

bull improved sleep

bull increased health literacy

bull more effective transition to home

Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672

wwwplanetreeorg

Checklists to better prepare patients and family caregivers for discharge

wwwplanetreeorg

wwwplanetreeorg

Legislating Professional-Family Partnerships 15 states enact FamilyCaregivers Legislation

bull At admission patient-designated care

partner documented in medical record

bull At discharge staff notify and offer to meet with care partner to discuss plan of care

bull Prior to discharge staff offer lsquoadequate trainingrsquo in aftercare tasks to care partner

wwwplanetreeorg

Why involve patients and families

Highly ldquoactivatedrdquo patients are 30ndash40 less likely to report care coordination problems than those ldquoless activatedrdquo

Raceethnicity employment insurance status income and length of illness were not significantly associated with self‐reported care coordination problems

Maeng Martsolf Scanlon Christianson Care coordination for the chronically ill understanding the patientrsquos perspective Health Serv Res 2012 47(5)1960ndash79

wwwplanetreeorg

All-Cause 30-day Readmission Rates Fall as Patient ndash Family Engagement in Discharge Planning Increases

bull Shared Teaching Tool utilizing 4th grade literacy

bull ldquoTeach Backrdquo by patients

bull Follow-up MD appointments made before discharge

bull HF protocol included in discharge packet for next provider

bull Scales provided for home care patients

bull Follow-up phone calls to patients amp families

Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

wwwplanetreeorg

All-Cause 30-day Readmissions 2007-2014

US Department of Health amp Human Services May 7 2014 ldquoNew HHS Data Shows Major Strides Made in Patient Safety Leading to Improved Care and Savingsrdquo

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Shared Decision-Making

wwwplanetreeorg

The ultimate patient-engagement tool Shared decision making (SDM) A 2013 study published in the February issue of Health Affairs found bull providing shared decision making-based health coaching for patients

with conditions that frequently require major treatment decisions reduces the overall costs of care hospitalizations and surgeries significantly

bull patients who received enhanced support had 53 lower overall medical costs than patients who received the usual level of support

bull patients receiving enhanced support had 125 fewer hospital admissions than the usual support group and 99 fewer preference-sensitive surgeries including 209 fewer preference-sensitive heart surgeries

wwwplanetreeorg

Alegent Health System Ethnography Project

What was your biggest fear while hospitalized

Being alone

wwwplanetreeorg

Exploring patient-directed visitation

GROUP ACTIVITY

With a partner decide who will be lsquoforrsquo and who will be lsquoagainstrsquo 247 patient-directed visitation

If you are assigned lsquoforrsquo take 5 minutes and develop a list of every reason you can think of why this practice could be beneficial

If you are assigned to be lsquoagainstrsquo take 5 minutes and develop a list of every reason that you can thing of why this practice could be a bad idea

With your partner discuss the pros and cons of this practice

wwwplanetreeorg

What research tells us about the impact of visitation

bull In a study that examined the benefits of unrestricted patient visitation 88 of families stated it had a positive benefit to their overall experience and decreased their anxiety by 65

bull Family presence in the ICU decreases psychological stress of patients and family members

bull Family presence in the clinical setting is reported to improve medical decision making patient care communication with patientsrsquo family members and to reduce patient falls

bull No clinical evidence suggests negative clinical outcomes No research concludes that allowing patients to choose who can visit them and when these visits occur results in negative outcomes

Berwick D Kotagal M (2004) ―Restricted visiting hours in ICUs time to change JAMA 292 736-737 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672 Stone S Annual Nursing Report Sharp Memorial Hospital 2014 Lim L and Zimring C Healthcare Design of the Future ARCH 4833ARCH 6271ID 6271BMED 8813 HF 2015

wwwplanetreeorg

What research tells us about the impact of involvement of the patientrsquos family

Engagement of hospitalized patientrsquos family in care activities and care coordination

ndasha lsquoCare Partnerrsquo program- improved patient outcomes including

bull better pain management

bull improved sleep

bull increased health literacy

bull more effective transition to home

Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672

wwwplanetreeorg

Checklists to better prepare patients and family caregivers for discharge

wwwplanetreeorg

wwwplanetreeorg

Legislating Professional-Family Partnerships 15 states enact FamilyCaregivers Legislation

bull At admission patient-designated care

partner documented in medical record

bull At discharge staff notify and offer to meet with care partner to discuss plan of care

bull Prior to discharge staff offer lsquoadequate trainingrsquo in aftercare tasks to care partner

wwwplanetreeorg

Why involve patients and families

Highly ldquoactivatedrdquo patients are 30ndash40 less likely to report care coordination problems than those ldquoless activatedrdquo

Raceethnicity employment insurance status income and length of illness were not significantly associated with self‐reported care coordination problems

Maeng Martsolf Scanlon Christianson Care coordination for the chronically ill understanding the patientrsquos perspective Health Serv Res 2012 47(5)1960ndash79

wwwplanetreeorg

All-Cause 30-day Readmission Rates Fall as Patient ndash Family Engagement in Discharge Planning Increases

bull Shared Teaching Tool utilizing 4th grade literacy

bull ldquoTeach Backrdquo by patients

bull Follow-up MD appointments made before discharge

bull HF protocol included in discharge packet for next provider

bull Scales provided for home care patients

bull Follow-up phone calls to patients amp families

Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

wwwplanetreeorg

All-Cause 30-day Readmissions 2007-2014

US Department of Health amp Human Services May 7 2014 ldquoNew HHS Data Shows Major Strides Made in Patient Safety Leading to Improved Care and Savingsrdquo

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Shared Decision-Making

wwwplanetreeorg

The ultimate patient-engagement tool Shared decision making (SDM) A 2013 study published in the February issue of Health Affairs found bull providing shared decision making-based health coaching for patients

with conditions that frequently require major treatment decisions reduces the overall costs of care hospitalizations and surgeries significantly

bull patients who received enhanced support had 53 lower overall medical costs than patients who received the usual level of support

bull patients receiving enhanced support had 125 fewer hospital admissions than the usual support group and 99 fewer preference-sensitive surgeries including 209 fewer preference-sensitive heart surgeries

wwwplanetreeorg

Exploring patient-directed visitation

GROUP ACTIVITY

With a partner decide who will be lsquoforrsquo and who will be lsquoagainstrsquo 247 patient-directed visitation

If you are assigned lsquoforrsquo take 5 minutes and develop a list of every reason you can think of why this practice could be beneficial

If you are assigned to be lsquoagainstrsquo take 5 minutes and develop a list of every reason that you can thing of why this practice could be a bad idea

With your partner discuss the pros and cons of this practice

wwwplanetreeorg

What research tells us about the impact of visitation

bull In a study that examined the benefits of unrestricted patient visitation 88 of families stated it had a positive benefit to their overall experience and decreased their anxiety by 65

bull Family presence in the ICU decreases psychological stress of patients and family members

bull Family presence in the clinical setting is reported to improve medical decision making patient care communication with patientsrsquo family members and to reduce patient falls

bull No clinical evidence suggests negative clinical outcomes No research concludes that allowing patients to choose who can visit them and when these visits occur results in negative outcomes

Berwick D Kotagal M (2004) ―Restricted visiting hours in ICUs time to change JAMA 292 736-737 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672 Stone S Annual Nursing Report Sharp Memorial Hospital 2014 Lim L and Zimring C Healthcare Design of the Future ARCH 4833ARCH 6271ID 6271BMED 8813 HF 2015

wwwplanetreeorg

What research tells us about the impact of involvement of the patientrsquos family

Engagement of hospitalized patientrsquos family in care activities and care coordination

ndasha lsquoCare Partnerrsquo program- improved patient outcomes including

bull better pain management

bull improved sleep

bull increased health literacy

bull more effective transition to home

Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672

wwwplanetreeorg

Checklists to better prepare patients and family caregivers for discharge

wwwplanetreeorg

wwwplanetreeorg

Legislating Professional-Family Partnerships 15 states enact FamilyCaregivers Legislation

bull At admission patient-designated care

partner documented in medical record

bull At discharge staff notify and offer to meet with care partner to discuss plan of care

bull Prior to discharge staff offer lsquoadequate trainingrsquo in aftercare tasks to care partner

wwwplanetreeorg

Why involve patients and families

Highly ldquoactivatedrdquo patients are 30ndash40 less likely to report care coordination problems than those ldquoless activatedrdquo

Raceethnicity employment insurance status income and length of illness were not significantly associated with self‐reported care coordination problems

Maeng Martsolf Scanlon Christianson Care coordination for the chronically ill understanding the patientrsquos perspective Health Serv Res 2012 47(5)1960ndash79

wwwplanetreeorg

All-Cause 30-day Readmission Rates Fall as Patient ndash Family Engagement in Discharge Planning Increases

bull Shared Teaching Tool utilizing 4th grade literacy

bull ldquoTeach Backrdquo by patients

bull Follow-up MD appointments made before discharge

bull HF protocol included in discharge packet for next provider

bull Scales provided for home care patients

bull Follow-up phone calls to patients amp families

Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

wwwplanetreeorg

All-Cause 30-day Readmissions 2007-2014

US Department of Health amp Human Services May 7 2014 ldquoNew HHS Data Shows Major Strides Made in Patient Safety Leading to Improved Care and Savingsrdquo

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Shared Decision-Making

wwwplanetreeorg

The ultimate patient-engagement tool Shared decision making (SDM) A 2013 study published in the February issue of Health Affairs found bull providing shared decision making-based health coaching for patients

with conditions that frequently require major treatment decisions reduces the overall costs of care hospitalizations and surgeries significantly

bull patients who received enhanced support had 53 lower overall medical costs than patients who received the usual level of support

bull patients receiving enhanced support had 125 fewer hospital admissions than the usual support group and 99 fewer preference-sensitive surgeries including 209 fewer preference-sensitive heart surgeries

wwwplanetreeorg

What research tells us about the impact of visitation

bull In a study that examined the benefits of unrestricted patient visitation 88 of families stated it had a positive benefit to their overall experience and decreased their anxiety by 65

bull Family presence in the ICU decreases psychological stress of patients and family members

bull Family presence in the clinical setting is reported to improve medical decision making patient care communication with patientsrsquo family members and to reduce patient falls

bull No clinical evidence suggests negative clinical outcomes No research concludes that allowing patients to choose who can visit them and when these visits occur results in negative outcomes

Berwick D Kotagal M (2004) ―Restricted visiting hours in ICUs time to change JAMA 292 736-737 Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672 Stone S Annual Nursing Report Sharp Memorial Hospital 2014 Lim L and Zimring C Healthcare Design of the Future ARCH 4833ARCH 6271ID 6271BMED 8813 HF 2015

wwwplanetreeorg

What research tells us about the impact of involvement of the patientrsquos family

Engagement of hospitalized patientrsquos family in care activities and care coordination

ndasha lsquoCare Partnerrsquo program- improved patient outcomes including

bull better pain management

bull improved sleep

bull increased health literacy

bull more effective transition to home

Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672

wwwplanetreeorg

Checklists to better prepare patients and family caregivers for discharge

wwwplanetreeorg

wwwplanetreeorg

Legislating Professional-Family Partnerships 15 states enact FamilyCaregivers Legislation

bull At admission patient-designated care

partner documented in medical record

bull At discharge staff notify and offer to meet with care partner to discuss plan of care

bull Prior to discharge staff offer lsquoadequate trainingrsquo in aftercare tasks to care partner

wwwplanetreeorg

Why involve patients and families

Highly ldquoactivatedrdquo patients are 30ndash40 less likely to report care coordination problems than those ldquoless activatedrdquo

Raceethnicity employment insurance status income and length of illness were not significantly associated with self‐reported care coordination problems

Maeng Martsolf Scanlon Christianson Care coordination for the chronically ill understanding the patientrsquos perspective Health Serv Res 2012 47(5)1960ndash79

wwwplanetreeorg

All-Cause 30-day Readmission Rates Fall as Patient ndash Family Engagement in Discharge Planning Increases

bull Shared Teaching Tool utilizing 4th grade literacy

bull ldquoTeach Backrdquo by patients

bull Follow-up MD appointments made before discharge

bull HF protocol included in discharge packet for next provider

bull Scales provided for home care patients

bull Follow-up phone calls to patients amp families

Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

wwwplanetreeorg

All-Cause 30-day Readmissions 2007-2014

US Department of Health amp Human Services May 7 2014 ldquoNew HHS Data Shows Major Strides Made in Patient Safety Leading to Improved Care and Savingsrdquo

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Shared Decision-Making

wwwplanetreeorg

The ultimate patient-engagement tool Shared decision making (SDM) A 2013 study published in the February issue of Health Affairs found bull providing shared decision making-based health coaching for patients

with conditions that frequently require major treatment decisions reduces the overall costs of care hospitalizations and surgeries significantly

bull patients who received enhanced support had 53 lower overall medical costs than patients who received the usual level of support

bull patients receiving enhanced support had 125 fewer hospital admissions than the usual support group and 99 fewer preference-sensitive surgeries including 209 fewer preference-sensitive heart surgeries

wwwplanetreeorg

What research tells us about the impact of involvement of the patientrsquos family

Engagement of hospitalized patientrsquos family in care activities and care coordination

ndasha lsquoCare Partnerrsquo program- improved patient outcomes including

bull better pain management

bull improved sleep

bull increased health literacy

bull more effective transition to home

Meyers TA et al Family presence during invasive procedures Am J Nurs 2000100(2)32-42 Jabre P et al Family presence during cardiopulmonary resuscitation N Engl J Med 2013368(11)1008-1018 American Geriatrics Society (2001) Guideline for the prevention of falls in older persons Journal of the American Geriatrics Society 49 664ndash672

wwwplanetreeorg

Checklists to better prepare patients and family caregivers for discharge

wwwplanetreeorg

wwwplanetreeorg

Legislating Professional-Family Partnerships 15 states enact FamilyCaregivers Legislation

bull At admission patient-designated care

partner documented in medical record

bull At discharge staff notify and offer to meet with care partner to discuss plan of care

bull Prior to discharge staff offer lsquoadequate trainingrsquo in aftercare tasks to care partner

wwwplanetreeorg

Why involve patients and families

Highly ldquoactivatedrdquo patients are 30ndash40 less likely to report care coordination problems than those ldquoless activatedrdquo

Raceethnicity employment insurance status income and length of illness were not significantly associated with self‐reported care coordination problems

Maeng Martsolf Scanlon Christianson Care coordination for the chronically ill understanding the patientrsquos perspective Health Serv Res 2012 47(5)1960ndash79

wwwplanetreeorg

All-Cause 30-day Readmission Rates Fall as Patient ndash Family Engagement in Discharge Planning Increases

bull Shared Teaching Tool utilizing 4th grade literacy

bull ldquoTeach Backrdquo by patients

bull Follow-up MD appointments made before discharge

bull HF protocol included in discharge packet for next provider

bull Scales provided for home care patients

bull Follow-up phone calls to patients amp families

Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

wwwplanetreeorg

All-Cause 30-day Readmissions 2007-2014

US Department of Health amp Human Services May 7 2014 ldquoNew HHS Data Shows Major Strides Made in Patient Safety Leading to Improved Care and Savingsrdquo

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Shared Decision-Making

wwwplanetreeorg

The ultimate patient-engagement tool Shared decision making (SDM) A 2013 study published in the February issue of Health Affairs found bull providing shared decision making-based health coaching for patients

with conditions that frequently require major treatment decisions reduces the overall costs of care hospitalizations and surgeries significantly

bull patients who received enhanced support had 53 lower overall medical costs than patients who received the usual level of support

bull patients receiving enhanced support had 125 fewer hospital admissions than the usual support group and 99 fewer preference-sensitive surgeries including 209 fewer preference-sensitive heart surgeries

wwwplanetreeorg

Checklists to better prepare patients and family caregivers for discharge

wwwplanetreeorg

wwwplanetreeorg

Legislating Professional-Family Partnerships 15 states enact FamilyCaregivers Legislation

bull At admission patient-designated care

partner documented in medical record

bull At discharge staff notify and offer to meet with care partner to discuss plan of care

bull Prior to discharge staff offer lsquoadequate trainingrsquo in aftercare tasks to care partner

wwwplanetreeorg

Why involve patients and families

Highly ldquoactivatedrdquo patients are 30ndash40 less likely to report care coordination problems than those ldquoless activatedrdquo

Raceethnicity employment insurance status income and length of illness were not significantly associated with self‐reported care coordination problems

Maeng Martsolf Scanlon Christianson Care coordination for the chronically ill understanding the patientrsquos perspective Health Serv Res 2012 47(5)1960ndash79

wwwplanetreeorg

All-Cause 30-day Readmission Rates Fall as Patient ndash Family Engagement in Discharge Planning Increases

bull Shared Teaching Tool utilizing 4th grade literacy

bull ldquoTeach Backrdquo by patients

bull Follow-up MD appointments made before discharge

bull HF protocol included in discharge packet for next provider

bull Scales provided for home care patients

bull Follow-up phone calls to patients amp families

Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

wwwplanetreeorg

All-Cause 30-day Readmissions 2007-2014

US Department of Health amp Human Services May 7 2014 ldquoNew HHS Data Shows Major Strides Made in Patient Safety Leading to Improved Care and Savingsrdquo

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Shared Decision-Making

wwwplanetreeorg

The ultimate patient-engagement tool Shared decision making (SDM) A 2013 study published in the February issue of Health Affairs found bull providing shared decision making-based health coaching for patients

with conditions that frequently require major treatment decisions reduces the overall costs of care hospitalizations and surgeries significantly

bull patients who received enhanced support had 53 lower overall medical costs than patients who received the usual level of support

bull patients receiving enhanced support had 125 fewer hospital admissions than the usual support group and 99 fewer preference-sensitive surgeries including 209 fewer preference-sensitive heart surgeries

wwwplanetreeorg

wwwplanetreeorg

Legislating Professional-Family Partnerships 15 states enact FamilyCaregivers Legislation

bull At admission patient-designated care

partner documented in medical record

bull At discharge staff notify and offer to meet with care partner to discuss plan of care

bull Prior to discharge staff offer lsquoadequate trainingrsquo in aftercare tasks to care partner

wwwplanetreeorg

Why involve patients and families

Highly ldquoactivatedrdquo patients are 30ndash40 less likely to report care coordination problems than those ldquoless activatedrdquo

Raceethnicity employment insurance status income and length of illness were not significantly associated with self‐reported care coordination problems

Maeng Martsolf Scanlon Christianson Care coordination for the chronically ill understanding the patientrsquos perspective Health Serv Res 2012 47(5)1960ndash79

wwwplanetreeorg

All-Cause 30-day Readmission Rates Fall as Patient ndash Family Engagement in Discharge Planning Increases

bull Shared Teaching Tool utilizing 4th grade literacy

bull ldquoTeach Backrdquo by patients

bull Follow-up MD appointments made before discharge

bull HF protocol included in discharge packet for next provider

bull Scales provided for home care patients

bull Follow-up phone calls to patients amp families

Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

wwwplanetreeorg

All-Cause 30-day Readmissions 2007-2014

US Department of Health amp Human Services May 7 2014 ldquoNew HHS Data Shows Major Strides Made in Patient Safety Leading to Improved Care and Savingsrdquo

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Shared Decision-Making

wwwplanetreeorg

The ultimate patient-engagement tool Shared decision making (SDM) A 2013 study published in the February issue of Health Affairs found bull providing shared decision making-based health coaching for patients

with conditions that frequently require major treatment decisions reduces the overall costs of care hospitalizations and surgeries significantly

bull patients who received enhanced support had 53 lower overall medical costs than patients who received the usual level of support

bull patients receiving enhanced support had 125 fewer hospital admissions than the usual support group and 99 fewer preference-sensitive surgeries including 209 fewer preference-sensitive heart surgeries

wwwplanetreeorg

Legislating Professional-Family Partnerships 15 states enact FamilyCaregivers Legislation

bull At admission patient-designated care

partner documented in medical record

bull At discharge staff notify and offer to meet with care partner to discuss plan of care

bull Prior to discharge staff offer lsquoadequate trainingrsquo in aftercare tasks to care partner

wwwplanetreeorg

Why involve patients and families

Highly ldquoactivatedrdquo patients are 30ndash40 less likely to report care coordination problems than those ldquoless activatedrdquo

Raceethnicity employment insurance status income and length of illness were not significantly associated with self‐reported care coordination problems

Maeng Martsolf Scanlon Christianson Care coordination for the chronically ill understanding the patientrsquos perspective Health Serv Res 2012 47(5)1960ndash79

wwwplanetreeorg

All-Cause 30-day Readmission Rates Fall as Patient ndash Family Engagement in Discharge Planning Increases

bull Shared Teaching Tool utilizing 4th grade literacy

bull ldquoTeach Backrdquo by patients

bull Follow-up MD appointments made before discharge

bull HF protocol included in discharge packet for next provider

bull Scales provided for home care patients

bull Follow-up phone calls to patients amp families

Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

wwwplanetreeorg

All-Cause 30-day Readmissions 2007-2014

US Department of Health amp Human Services May 7 2014 ldquoNew HHS Data Shows Major Strides Made in Patient Safety Leading to Improved Care and Savingsrdquo

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Shared Decision-Making

wwwplanetreeorg

The ultimate patient-engagement tool Shared decision making (SDM) A 2013 study published in the February issue of Health Affairs found bull providing shared decision making-based health coaching for patients

with conditions that frequently require major treatment decisions reduces the overall costs of care hospitalizations and surgeries significantly

bull patients who received enhanced support had 53 lower overall medical costs than patients who received the usual level of support

bull patients receiving enhanced support had 125 fewer hospital admissions than the usual support group and 99 fewer preference-sensitive surgeries including 209 fewer preference-sensitive heart surgeries

wwwplanetreeorg

Why involve patients and families

Highly ldquoactivatedrdquo patients are 30ndash40 less likely to report care coordination problems than those ldquoless activatedrdquo

Raceethnicity employment insurance status income and length of illness were not significantly associated with self‐reported care coordination problems

Maeng Martsolf Scanlon Christianson Care coordination for the chronically ill understanding the patientrsquos perspective Health Serv Res 2012 47(5)1960ndash79

wwwplanetreeorg

All-Cause 30-day Readmission Rates Fall as Patient ndash Family Engagement in Discharge Planning Increases

bull Shared Teaching Tool utilizing 4th grade literacy

bull ldquoTeach Backrdquo by patients

bull Follow-up MD appointments made before discharge

bull HF protocol included in discharge packet for next provider

bull Scales provided for home care patients

bull Follow-up phone calls to patients amp families

Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

wwwplanetreeorg

All-Cause 30-day Readmissions 2007-2014

US Department of Health amp Human Services May 7 2014 ldquoNew HHS Data Shows Major Strides Made in Patient Safety Leading to Improved Care and Savingsrdquo

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Shared Decision-Making

wwwplanetreeorg

The ultimate patient-engagement tool Shared decision making (SDM) A 2013 study published in the February issue of Health Affairs found bull providing shared decision making-based health coaching for patients

with conditions that frequently require major treatment decisions reduces the overall costs of care hospitalizations and surgeries significantly

bull patients who received enhanced support had 53 lower overall medical costs than patients who received the usual level of support

bull patients receiving enhanced support had 125 fewer hospital admissions than the usual support group and 99 fewer preference-sensitive surgeries including 209 fewer preference-sensitive heart surgeries

wwwplanetreeorg

All-Cause 30-day Readmission Rates Fall as Patient ndash Family Engagement in Discharge Planning Increases

bull Shared Teaching Tool utilizing 4th grade literacy

bull ldquoTeach Backrdquo by patients

bull Follow-up MD appointments made before discharge

bull HF protocol included in discharge packet for next provider

bull Scales provided for home care patients

bull Follow-up phone calls to patients amp families

Medicare amp Medicaid Research Review 2013 Vol 3 No 2 Centers for Medicare amp Medicaid Services Office of Information Products amp Data Analytics

wwwplanetreeorg

All-Cause 30-day Readmissions 2007-2014

US Department of Health amp Human Services May 7 2014 ldquoNew HHS Data Shows Major Strides Made in Patient Safety Leading to Improved Care and Savingsrdquo

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Shared Decision-Making

wwwplanetreeorg

The ultimate patient-engagement tool Shared decision making (SDM) A 2013 study published in the February issue of Health Affairs found bull providing shared decision making-based health coaching for patients

with conditions that frequently require major treatment decisions reduces the overall costs of care hospitalizations and surgeries significantly

bull patients who received enhanced support had 53 lower overall medical costs than patients who received the usual level of support

bull patients receiving enhanced support had 125 fewer hospital admissions than the usual support group and 99 fewer preference-sensitive surgeries including 209 fewer preference-sensitive heart surgeries

wwwplanetreeorg

All-Cause 30-day Readmissions 2007-2014

US Department of Health amp Human Services May 7 2014 ldquoNew HHS Data Shows Major Strides Made in Patient Safety Leading to Improved Care and Savingsrdquo

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Shared Decision-Making

wwwplanetreeorg

The ultimate patient-engagement tool Shared decision making (SDM) A 2013 study published in the February issue of Health Affairs found bull providing shared decision making-based health coaching for patients

with conditions that frequently require major treatment decisions reduces the overall costs of care hospitalizations and surgeries significantly

bull patients who received enhanced support had 53 lower overall medical costs than patients who received the usual level of support

bull patients receiving enhanced support had 125 fewer hospital admissions than the usual support group and 99 fewer preference-sensitive surgeries including 209 fewer preference-sensitive heart surgeries

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndash Shared Decision-Making

wwwplanetreeorg

The ultimate patient-engagement tool Shared decision making (SDM) A 2013 study published in the February issue of Health Affairs found bull providing shared decision making-based health coaching for patients

with conditions that frequently require major treatment decisions reduces the overall costs of care hospitalizations and surgeries significantly

bull patients who received enhanced support had 53 lower overall medical costs than patients who received the usual level of support

bull patients receiving enhanced support had 125 fewer hospital admissions than the usual support group and 99 fewer preference-sensitive surgeries including 209 fewer preference-sensitive heart surgeries

wwwplanetreeorg

The ultimate patient-engagement tool Shared decision making (SDM) A 2013 study published in the February issue of Health Affairs found bull providing shared decision making-based health coaching for patients

with conditions that frequently require major treatment decisions reduces the overall costs of care hospitalizations and surgeries significantly

bull patients who received enhanced support had 53 lower overall medical costs than patients who received the usual level of support

bull patients receiving enhanced support had 125 fewer hospital admissions than the usual support group and 99 fewer preference-sensitive surgeries including 209 fewer preference-sensitive heart surgeries

wwwplanetreeorg

Engaging patients begins with understanding of their preferences

Lee CN Hulsman CS Sepucha K Ann Plastic Surg201064563-6

Wagner E et a l Med Care199533765-70 Covinsky KE et a l J Am Geriatr Soc 200048SupplS187-S193

Only 41 of Medicare patients believe that their treatment reflected their preference for palliative care over more aggressive interventions

40

Doctors believe 71 of patients with breast cancer rate keeping their breast as top priority The figure reported by patients is just 7

Once patients are informed about the risks of surgery for benign prostate disease 40 fewer prefer surgery

wwwplanetreeorg

Six Steps to a Shared Decision 1 Invite patient to participate

2 Present options

3 Provide information on benefits and risks

4 Elicit patient goals and preferences

5 Facilitate deliberation and decision making

6 Assist with implementation

Invite Options Benefits and Risks

Patient Preferences

Deliberate and Decide

Implementation

Credits R Wexler IMDF and K Clay Center for Shared Decision Making Dartmouth-Hitchcock Medical Center

wwwplanetreeorg

Ottawa Personal Decision Guide

bull Generic tool

bull Clinicians or trained students can use to guide patients through decisions

bull Also good for training in concepts of Shared Decision Making

httpsdecisionaidohricadecguidehtml

wwwplanetreeorg

Decision-Making Session

1 In pairs decide who will be the lsquodecision-makerrsquo and who will be the lsquodecision coachrsquo

2 Decision-maker identifies an example of a decision they are facing in their life currently

3 Using the Ottawa Personal Decision Guide the coach poses each of the questions on the form to the lsquodecision-makerrsquo and helps them to explore aspects of the decision process

wwwplanetreeorg

Developing Certified Decision Aid Standards

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndashBedside Shift Report

82

84

86

88

90

92

94

96

Nurses treat you with

courtesyrespect

Nurses attitude

toward requests

Attention to

specialpersonalneeds

Nurses kept you

infromed

Staff include you in

decision re treatment

Staff worked together

to care for you

6 months prior to implementation of bedside report 6 months after implmentation of bedside report

Spirit and Intent of Hourly Rounding bull More frequent touch-points bull Security to patients bull Moves from reactive to proactive bull 4 Prsquos- Pain Personal Needs Positioning Placement

Bedside shift report as a time saver bull Sharp decline in the number of call lights bull Nurses have reported a better ability to prioritize cases bull Overall decrease in staff time post-implementation

wwwplanetreeorg

Barriers to Engagement

TOP Concerns of Patients

1 Dismissal trivialization of the patient voice

2 Absence of caring attitudes from providers

3 Lack of continuity in care

Based on 6000+ focus groups amp interviews with more than 50000 patients families and caregivers across the care continuum

wwwplanetreeorg

Joint Commission Online October 21 2010

80

ldquohellipan estimated 80 of serious medical errors involve

miscommunication between caregivers when patients are

transferred or handed-offhellip communications breakdowns

continue to be a leading contributing factor in many different

kinds of sentinel eventshelliprdquo

wwwplanetreeorg

PRACTICES that promote better communications ndash Open Medical RecordOpen Notes

Shared medical record Refers to the patientsrsquo ability to access their real-time in-progress personal health information during a care episode eg during a hospitalization andor treatment

wwwplanetreeorg

A 2013 survey of 1000 US patients found

Accenture Survey on Patient Engagement - Research Recap

United States Sept 2013

Shared Medical Records

82 say access their medical records is important

41 would consider switching doctors to gain

access to their medical records

wwwplanetreeorg

ldquoI donrsquot have time to sit down and review the record and Irsquom not sure they [the patients] would even want tordquo

ldquoWhat if yoursquove written something that offends them Lawsuitrdquo

ldquoItrsquos too complex and I donrsquot think most of the time theyrsquod understand what was writtenrdquo

ldquoPrivacy regulations wonrsquot let us do that without a signature and that takes timerdquo

Concerns related to patients reading their medical record

of doctors reported longer visits when they opened their notes to patients Delbanco T et al 2012 Annals of Internal Medicine

wwwplanetreeorg

Impact of Shared Medical Record

Def

init

ely

wo

uld

rec

om

men

d th

is

ho

spit

al t

o o

ther

s

50

60

70

80

90

100

Yes No

Patients who are told they can read their medical chart are more likely to recommend the hospital to others

Were you told that you could read your medical chart

wwwplanetreeorg

Of patients who reviewed their doctorsrsquo notes report feeling more in control of their care

Delbanco T et al 2012 Annals of Internal Medicine

71 Of consumers think they should be able to update their electronic health records

wwwplanetreeorg

Patients work with clinicians to co-design research on outcomes they define as important

MISSION hellipproducing and promoting high-integrity evidence-based information that comes from research guided by patients caregivers and the broader healthcare community

hellipthe meaningful involvement of patients caregivers clinicians and other healthcare stakeholders throughout the research processmdashfrom topic selection through design

and conduct of research to dissemination of results

PRACTICES that engage patientsfamilies in research activities

wwwplanetreeorg

Funding 2010- $10 million

2011- $50 million 2012-2019- $150 million per year

13 Areas of Funding Focus including o Engagement Awards o Communication-Dissemination Research o Assessment of Prevention Diagnosis and Treatment Options

PCORI Funding Levels and Opportunities

wwwplanetreeorg

Engaging Moms in Comparative Research

PICC line supplies

wwwplanetreeorg

Ron Keren MD MPH The Childrens Hospital of Philadelphia

Philadelphia PA

Engagement

Patient advisory council involved in formulating the research question defining essential characteristics of the comparators and outcomes monitored study progress and developed strategies to disseminate and implement the research findings

Potential Impact

No studies had been done to compare the impact of these two treatment options on the quality of life of the children and their caregivers

Compares effectiveness of oral vs intravenous antibiotics in children who require at least one week of home antibiotic therapy following hospitalization for a serious bacterial infection Spends 18 months surveying at least 1000 patients (and their caregivers) who are discharged from four large childrenrsquos hospitals

Assessment of Prevention Diagnosis and Treatment Options awarded December 2012

Comparative Effectiveness of Intravenous vs Oral Antibiotic Therapy for Serious Bacterial Infections

wwwplanetreeorg

Conclusions and Relevance Given the magnitude and seriousness of PICC complications clinicians should reconsider the practice of treating otherwise healthy children with acute osteomyelitis with prolonged intravenous antibiotics after hospital discharge when an equally effective oral alternative exists

wwwplanetreeorg

Every PCORI research publication must include a 500-word lay language description

Patient amp family engagement begins to influence medical research values amp practices

Majority of patient engagement research is qualitative or mixed method with a focus on practices

wwwplanetreeorg

Logic Model for PFE Care Culture

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

Intermediate benefits

bull Patient activation

bull Increased health literacy

bull Increased family presence

bull Improved care coordination

bull Less psychological stress for patients families and staff

bull Improved sleep for patients

bull Improved communication

bull Decreased utilization

bull Fewer malpractice claims

bull Increased trust

bull Improved operational efficiency

bull Culture of safety

wwwplanetreeorg

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

wwwplanetreeorg

What research says about patient access to satisfaction and patient experience

Huppertz JW and Carlson JP Consumers Use of HCAHPS Ratings and Word-of-Mouth in Hospital Choice Health Serv Res 2010 Dec 45(6 Pt 1) 1602ndash1613 doi 101111j1475-6773201001153x

bull A study examined results of exposing 309 consumers to hospital patient satisfaction results and anecdotal email stories about the scores

bull Patient intention to choose a hospital was most positively affected when both the scores and stories were positive

bull There was less of an effect if scores were positive but the story was not

bull Patient testimonials and positive stories may be very influential on consumer decision-making in addition to scores

wwwplanetreeorg

Six Steps to a Shared Decision 1 Invite patient to participate

2 Present options

3 Provide information on benefits and risks

4 Elicit patient goals and preferences

5 Facilitate deliberation and decision making

6 Assist with implementation

Invite Options Benefits and Risks

Patient Preferences

Deliberate and Decide

Implementation

Credits R Wexler IMDF and K Clay Center for Shared Decision Making Dartmouth-Hitchcock Medical Center

wwwplanetreeorg

Ottawa Personal Decision Guide

bull Generic tool

bull Clinicians or trained students can use to guide patients through decisions

bull Also good for training in concepts of Shared Decision Making

httpsdecisionaidohricadecguidehtml

wwwplanetreeorg

Decision-Making Session

1 In pairs decide who will be the lsquodecision-makerrsquo and who will be the lsquodecision coachrsquo

2 Decision-maker identifies an example of a decision they are facing in their life currently

3 Using the Ottawa Personal Decision Guide the coach poses each of the questions on the form to the lsquodecision-makerrsquo and helps them to explore aspects of the decision process

wwwplanetreeorg

Developing Certified Decision Aid Standards

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndashBedside Shift Report

82

84

86

88

90

92

94

96

Nurses treat you with

courtesyrespect

Nurses attitude

toward requests

Attention to

specialpersonalneeds

Nurses kept you

infromed

Staff include you in

decision re treatment

Staff worked together

to care for you

6 months prior to implementation of bedside report 6 months after implmentation of bedside report

Spirit and Intent of Hourly Rounding bull More frequent touch-points bull Security to patients bull Moves from reactive to proactive bull 4 Prsquos- Pain Personal Needs Positioning Placement

Bedside shift report as a time saver bull Sharp decline in the number of call lights bull Nurses have reported a better ability to prioritize cases bull Overall decrease in staff time post-implementation

wwwplanetreeorg

Barriers to Engagement

TOP Concerns of Patients

1 Dismissal trivialization of the patient voice

2 Absence of caring attitudes from providers

3 Lack of continuity in care

Based on 6000+ focus groups amp interviews with more than 50000 patients families and caregivers across the care continuum

wwwplanetreeorg

Joint Commission Online October 21 2010

80

ldquohellipan estimated 80 of serious medical errors involve

miscommunication between caregivers when patients are

transferred or handed-offhellip communications breakdowns

continue to be a leading contributing factor in many different

kinds of sentinel eventshelliprdquo

wwwplanetreeorg

PRACTICES that promote better communications ndash Open Medical RecordOpen Notes

Shared medical record Refers to the patientsrsquo ability to access their real-time in-progress personal health information during a care episode eg during a hospitalization andor treatment

wwwplanetreeorg

A 2013 survey of 1000 US patients found

Accenture Survey on Patient Engagement - Research Recap

United States Sept 2013

Shared Medical Records

82 say access their medical records is important

41 would consider switching doctors to gain

access to their medical records

wwwplanetreeorg

ldquoI donrsquot have time to sit down and review the record and Irsquom not sure they [the patients] would even want tordquo

ldquoWhat if yoursquove written something that offends them Lawsuitrdquo

ldquoItrsquos too complex and I donrsquot think most of the time theyrsquod understand what was writtenrdquo

ldquoPrivacy regulations wonrsquot let us do that without a signature and that takes timerdquo

Concerns related to patients reading their medical record

of doctors reported longer visits when they opened their notes to patients Delbanco T et al 2012 Annals of Internal Medicine

wwwplanetreeorg

Impact of Shared Medical Record

Def

init

ely

wo

uld

rec

om

men

d th

is

ho

spit

al t

o o

ther

s

50

60

70

80

90

100

Yes No

Patients who are told they can read their medical chart are more likely to recommend the hospital to others

Were you told that you could read your medical chart

wwwplanetreeorg

Of patients who reviewed their doctorsrsquo notes report feeling more in control of their care

Delbanco T et al 2012 Annals of Internal Medicine

71 Of consumers think they should be able to update their electronic health records

wwwplanetreeorg

Patients work with clinicians to co-design research on outcomes they define as important

MISSION hellipproducing and promoting high-integrity evidence-based information that comes from research guided by patients caregivers and the broader healthcare community

hellipthe meaningful involvement of patients caregivers clinicians and other healthcare stakeholders throughout the research processmdashfrom topic selection through design

and conduct of research to dissemination of results

PRACTICES that engage patientsfamilies in research activities

wwwplanetreeorg

Funding 2010- $10 million

2011- $50 million 2012-2019- $150 million per year

13 Areas of Funding Focus including o Engagement Awards o Communication-Dissemination Research o Assessment of Prevention Diagnosis and Treatment Options

PCORI Funding Levels and Opportunities

wwwplanetreeorg

Engaging Moms in Comparative Research

PICC line supplies

wwwplanetreeorg

Ron Keren MD MPH The Childrens Hospital of Philadelphia

Philadelphia PA

Engagement

Patient advisory council involved in formulating the research question defining essential characteristics of the comparators and outcomes monitored study progress and developed strategies to disseminate and implement the research findings

Potential Impact

No studies had been done to compare the impact of these two treatment options on the quality of life of the children and their caregivers

Compares effectiveness of oral vs intravenous antibiotics in children who require at least one week of home antibiotic therapy following hospitalization for a serious bacterial infection Spends 18 months surveying at least 1000 patients (and their caregivers) who are discharged from four large childrenrsquos hospitals

Assessment of Prevention Diagnosis and Treatment Options awarded December 2012

Comparative Effectiveness of Intravenous vs Oral Antibiotic Therapy for Serious Bacterial Infections

wwwplanetreeorg

Conclusions and Relevance Given the magnitude and seriousness of PICC complications clinicians should reconsider the practice of treating otherwise healthy children with acute osteomyelitis with prolonged intravenous antibiotics after hospital discharge when an equally effective oral alternative exists

wwwplanetreeorg

Every PCORI research publication must include a 500-word lay language description

Patient amp family engagement begins to influence medical research values amp practices

Majority of patient engagement research is qualitative or mixed method with a focus on practices

wwwplanetreeorg

Logic Model for PFE Care Culture

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

Intermediate benefits

bull Patient activation

bull Increased health literacy

bull Increased family presence

bull Improved care coordination

bull Less psychological stress for patients families and staff

bull Improved sleep for patients

bull Improved communication

bull Decreased utilization

bull Fewer malpractice claims

bull Increased trust

bull Improved operational efficiency

bull Culture of safety

wwwplanetreeorg

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

wwwplanetreeorg

What research says about patient access to satisfaction and patient experience

Huppertz JW and Carlson JP Consumers Use of HCAHPS Ratings and Word-of-Mouth in Hospital Choice Health Serv Res 2010 Dec 45(6 Pt 1) 1602ndash1613 doi 101111j1475-6773201001153x

bull A study examined results of exposing 309 consumers to hospital patient satisfaction results and anecdotal email stories about the scores

bull Patient intention to choose a hospital was most positively affected when both the scores and stories were positive

bull There was less of an effect if scores were positive but the story was not

bull Patient testimonials and positive stories may be very influential on consumer decision-making in addition to scores

wwwplanetreeorg

Ottawa Personal Decision Guide

bull Generic tool

bull Clinicians or trained students can use to guide patients through decisions

bull Also good for training in concepts of Shared Decision Making

httpsdecisionaidohricadecguidehtml

wwwplanetreeorg

Decision-Making Session

1 In pairs decide who will be the lsquodecision-makerrsquo and who will be the lsquodecision coachrsquo

2 Decision-maker identifies an example of a decision they are facing in their life currently

3 Using the Ottawa Personal Decision Guide the coach poses each of the questions on the form to the lsquodecision-makerrsquo and helps them to explore aspects of the decision process

wwwplanetreeorg

Developing Certified Decision Aid Standards

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndashBedside Shift Report

82

84

86

88

90

92

94

96

Nurses treat you with

courtesyrespect

Nurses attitude

toward requests

Attention to

specialpersonalneeds

Nurses kept you

infromed

Staff include you in

decision re treatment

Staff worked together

to care for you

6 months prior to implementation of bedside report 6 months after implmentation of bedside report

Spirit and Intent of Hourly Rounding bull More frequent touch-points bull Security to patients bull Moves from reactive to proactive bull 4 Prsquos- Pain Personal Needs Positioning Placement

Bedside shift report as a time saver bull Sharp decline in the number of call lights bull Nurses have reported a better ability to prioritize cases bull Overall decrease in staff time post-implementation

wwwplanetreeorg

Barriers to Engagement

TOP Concerns of Patients

1 Dismissal trivialization of the patient voice

2 Absence of caring attitudes from providers

3 Lack of continuity in care

Based on 6000+ focus groups amp interviews with more than 50000 patients families and caregivers across the care continuum

wwwplanetreeorg

Joint Commission Online October 21 2010

80

ldquohellipan estimated 80 of serious medical errors involve

miscommunication between caregivers when patients are

transferred or handed-offhellip communications breakdowns

continue to be a leading contributing factor in many different

kinds of sentinel eventshelliprdquo

wwwplanetreeorg

PRACTICES that promote better communications ndash Open Medical RecordOpen Notes

Shared medical record Refers to the patientsrsquo ability to access their real-time in-progress personal health information during a care episode eg during a hospitalization andor treatment

wwwplanetreeorg

A 2013 survey of 1000 US patients found

Accenture Survey on Patient Engagement - Research Recap

United States Sept 2013

Shared Medical Records

82 say access their medical records is important

41 would consider switching doctors to gain

access to their medical records

wwwplanetreeorg

ldquoI donrsquot have time to sit down and review the record and Irsquom not sure they [the patients] would even want tordquo

ldquoWhat if yoursquove written something that offends them Lawsuitrdquo

ldquoItrsquos too complex and I donrsquot think most of the time theyrsquod understand what was writtenrdquo

ldquoPrivacy regulations wonrsquot let us do that without a signature and that takes timerdquo

Concerns related to patients reading their medical record

of doctors reported longer visits when they opened their notes to patients Delbanco T et al 2012 Annals of Internal Medicine

wwwplanetreeorg

Impact of Shared Medical Record

Def

init

ely

wo

uld

rec

om

men

d th

is

ho

spit

al t

o o

ther

s

50

60

70

80

90

100

Yes No

Patients who are told they can read their medical chart are more likely to recommend the hospital to others

Were you told that you could read your medical chart

wwwplanetreeorg

Of patients who reviewed their doctorsrsquo notes report feeling more in control of their care

Delbanco T et al 2012 Annals of Internal Medicine

71 Of consumers think they should be able to update their electronic health records

wwwplanetreeorg

Patients work with clinicians to co-design research on outcomes they define as important

MISSION hellipproducing and promoting high-integrity evidence-based information that comes from research guided by patients caregivers and the broader healthcare community

hellipthe meaningful involvement of patients caregivers clinicians and other healthcare stakeholders throughout the research processmdashfrom topic selection through design

and conduct of research to dissemination of results

PRACTICES that engage patientsfamilies in research activities

wwwplanetreeorg

Funding 2010- $10 million

2011- $50 million 2012-2019- $150 million per year

13 Areas of Funding Focus including o Engagement Awards o Communication-Dissemination Research o Assessment of Prevention Diagnosis and Treatment Options

PCORI Funding Levels and Opportunities

wwwplanetreeorg

Engaging Moms in Comparative Research

PICC line supplies

wwwplanetreeorg

Ron Keren MD MPH The Childrens Hospital of Philadelphia

Philadelphia PA

Engagement

Patient advisory council involved in formulating the research question defining essential characteristics of the comparators and outcomes monitored study progress and developed strategies to disseminate and implement the research findings

Potential Impact

No studies had been done to compare the impact of these two treatment options on the quality of life of the children and their caregivers

Compares effectiveness of oral vs intravenous antibiotics in children who require at least one week of home antibiotic therapy following hospitalization for a serious bacterial infection Spends 18 months surveying at least 1000 patients (and their caregivers) who are discharged from four large childrenrsquos hospitals

Assessment of Prevention Diagnosis and Treatment Options awarded December 2012

Comparative Effectiveness of Intravenous vs Oral Antibiotic Therapy for Serious Bacterial Infections

wwwplanetreeorg

Conclusions and Relevance Given the magnitude and seriousness of PICC complications clinicians should reconsider the practice of treating otherwise healthy children with acute osteomyelitis with prolonged intravenous antibiotics after hospital discharge when an equally effective oral alternative exists

wwwplanetreeorg

Every PCORI research publication must include a 500-word lay language description

Patient amp family engagement begins to influence medical research values amp practices

Majority of patient engagement research is qualitative or mixed method with a focus on practices

wwwplanetreeorg

Logic Model for PFE Care Culture

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

Intermediate benefits

bull Patient activation

bull Increased health literacy

bull Increased family presence

bull Improved care coordination

bull Less psychological stress for patients families and staff

bull Improved sleep for patients

bull Improved communication

bull Decreased utilization

bull Fewer malpractice claims

bull Increased trust

bull Improved operational efficiency

bull Culture of safety

wwwplanetreeorg

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

wwwplanetreeorg

What research says about patient access to satisfaction and patient experience

Huppertz JW and Carlson JP Consumers Use of HCAHPS Ratings and Word-of-Mouth in Hospital Choice Health Serv Res 2010 Dec 45(6 Pt 1) 1602ndash1613 doi 101111j1475-6773201001153x

bull A study examined results of exposing 309 consumers to hospital patient satisfaction results and anecdotal email stories about the scores

bull Patient intention to choose a hospital was most positively affected when both the scores and stories were positive

bull There was less of an effect if scores were positive but the story was not

bull Patient testimonials and positive stories may be very influential on consumer decision-making in addition to scores

wwwplanetreeorg

Decision-Making Session

1 In pairs decide who will be the lsquodecision-makerrsquo and who will be the lsquodecision coachrsquo

2 Decision-maker identifies an example of a decision they are facing in their life currently

3 Using the Ottawa Personal Decision Guide the coach poses each of the questions on the form to the lsquodecision-makerrsquo and helps them to explore aspects of the decision process

wwwplanetreeorg

Developing Certified Decision Aid Standards

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndashBedside Shift Report

82

84

86

88

90

92

94

96

Nurses treat you with

courtesyrespect

Nurses attitude

toward requests

Attention to

specialpersonalneeds

Nurses kept you

infromed

Staff include you in

decision re treatment

Staff worked together

to care for you

6 months prior to implementation of bedside report 6 months after implmentation of bedside report

Spirit and Intent of Hourly Rounding bull More frequent touch-points bull Security to patients bull Moves from reactive to proactive bull 4 Prsquos- Pain Personal Needs Positioning Placement

Bedside shift report as a time saver bull Sharp decline in the number of call lights bull Nurses have reported a better ability to prioritize cases bull Overall decrease in staff time post-implementation

wwwplanetreeorg

Barriers to Engagement

TOP Concerns of Patients

1 Dismissal trivialization of the patient voice

2 Absence of caring attitudes from providers

3 Lack of continuity in care

Based on 6000+ focus groups amp interviews with more than 50000 patients families and caregivers across the care continuum

wwwplanetreeorg

Joint Commission Online October 21 2010

80

ldquohellipan estimated 80 of serious medical errors involve

miscommunication between caregivers when patients are

transferred or handed-offhellip communications breakdowns

continue to be a leading contributing factor in many different

kinds of sentinel eventshelliprdquo

wwwplanetreeorg

PRACTICES that promote better communications ndash Open Medical RecordOpen Notes

Shared medical record Refers to the patientsrsquo ability to access their real-time in-progress personal health information during a care episode eg during a hospitalization andor treatment

wwwplanetreeorg

A 2013 survey of 1000 US patients found

Accenture Survey on Patient Engagement - Research Recap

United States Sept 2013

Shared Medical Records

82 say access their medical records is important

41 would consider switching doctors to gain

access to their medical records

wwwplanetreeorg

ldquoI donrsquot have time to sit down and review the record and Irsquom not sure they [the patients] would even want tordquo

ldquoWhat if yoursquove written something that offends them Lawsuitrdquo

ldquoItrsquos too complex and I donrsquot think most of the time theyrsquod understand what was writtenrdquo

ldquoPrivacy regulations wonrsquot let us do that without a signature and that takes timerdquo

Concerns related to patients reading their medical record

of doctors reported longer visits when they opened their notes to patients Delbanco T et al 2012 Annals of Internal Medicine

wwwplanetreeorg

Impact of Shared Medical Record

Def

init

ely

wo

uld

rec

om

men

d th

is

ho

spit

al t

o o

ther

s

50

60

70

80

90

100

Yes No

Patients who are told they can read their medical chart are more likely to recommend the hospital to others

Were you told that you could read your medical chart

wwwplanetreeorg

Of patients who reviewed their doctorsrsquo notes report feeling more in control of their care

Delbanco T et al 2012 Annals of Internal Medicine

71 Of consumers think they should be able to update their electronic health records

wwwplanetreeorg

Patients work with clinicians to co-design research on outcomes they define as important

MISSION hellipproducing and promoting high-integrity evidence-based information that comes from research guided by patients caregivers and the broader healthcare community

hellipthe meaningful involvement of patients caregivers clinicians and other healthcare stakeholders throughout the research processmdashfrom topic selection through design

and conduct of research to dissemination of results

PRACTICES that engage patientsfamilies in research activities

wwwplanetreeorg

Funding 2010- $10 million

2011- $50 million 2012-2019- $150 million per year

13 Areas of Funding Focus including o Engagement Awards o Communication-Dissemination Research o Assessment of Prevention Diagnosis and Treatment Options

PCORI Funding Levels and Opportunities

wwwplanetreeorg

Engaging Moms in Comparative Research

PICC line supplies

wwwplanetreeorg

Ron Keren MD MPH The Childrens Hospital of Philadelphia

Philadelphia PA

Engagement

Patient advisory council involved in formulating the research question defining essential characteristics of the comparators and outcomes monitored study progress and developed strategies to disseminate and implement the research findings

Potential Impact

No studies had been done to compare the impact of these two treatment options on the quality of life of the children and their caregivers

Compares effectiveness of oral vs intravenous antibiotics in children who require at least one week of home antibiotic therapy following hospitalization for a serious bacterial infection Spends 18 months surveying at least 1000 patients (and their caregivers) who are discharged from four large childrenrsquos hospitals

Assessment of Prevention Diagnosis and Treatment Options awarded December 2012

Comparative Effectiveness of Intravenous vs Oral Antibiotic Therapy for Serious Bacterial Infections

wwwplanetreeorg

Conclusions and Relevance Given the magnitude and seriousness of PICC complications clinicians should reconsider the practice of treating otherwise healthy children with acute osteomyelitis with prolonged intravenous antibiotics after hospital discharge when an equally effective oral alternative exists

wwwplanetreeorg

Every PCORI research publication must include a 500-word lay language description

Patient amp family engagement begins to influence medical research values amp practices

Majority of patient engagement research is qualitative or mixed method with a focus on practices

wwwplanetreeorg

Logic Model for PFE Care Culture

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

Intermediate benefits

bull Patient activation

bull Increased health literacy

bull Increased family presence

bull Improved care coordination

bull Less psychological stress for patients families and staff

bull Improved sleep for patients

bull Improved communication

bull Decreased utilization

bull Fewer malpractice claims

bull Increased trust

bull Improved operational efficiency

bull Culture of safety

wwwplanetreeorg

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

wwwplanetreeorg

What research says about patient access to satisfaction and patient experience

Huppertz JW and Carlson JP Consumers Use of HCAHPS Ratings and Word-of-Mouth in Hospital Choice Health Serv Res 2010 Dec 45(6 Pt 1) 1602ndash1613 doi 101111j1475-6773201001153x

bull A study examined results of exposing 309 consumers to hospital patient satisfaction results and anecdotal email stories about the scores

bull Patient intention to choose a hospital was most positively affected when both the scores and stories were positive

bull There was less of an effect if scores were positive but the story was not

bull Patient testimonials and positive stories may be very influential on consumer decision-making in addition to scores

wwwplanetreeorg

Developing Certified Decision Aid Standards

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndashBedside Shift Report

82

84

86

88

90

92

94

96

Nurses treat you with

courtesyrespect

Nurses attitude

toward requests

Attention to

specialpersonalneeds

Nurses kept you

infromed

Staff include you in

decision re treatment

Staff worked together

to care for you

6 months prior to implementation of bedside report 6 months after implmentation of bedside report

Spirit and Intent of Hourly Rounding bull More frequent touch-points bull Security to patients bull Moves from reactive to proactive bull 4 Prsquos- Pain Personal Needs Positioning Placement

Bedside shift report as a time saver bull Sharp decline in the number of call lights bull Nurses have reported a better ability to prioritize cases bull Overall decrease in staff time post-implementation

wwwplanetreeorg

Barriers to Engagement

TOP Concerns of Patients

1 Dismissal trivialization of the patient voice

2 Absence of caring attitudes from providers

3 Lack of continuity in care

Based on 6000+ focus groups amp interviews with more than 50000 patients families and caregivers across the care continuum

wwwplanetreeorg

Joint Commission Online October 21 2010

80

ldquohellipan estimated 80 of serious medical errors involve

miscommunication between caregivers when patients are

transferred or handed-offhellip communications breakdowns

continue to be a leading contributing factor in many different

kinds of sentinel eventshelliprdquo

wwwplanetreeorg

PRACTICES that promote better communications ndash Open Medical RecordOpen Notes

Shared medical record Refers to the patientsrsquo ability to access their real-time in-progress personal health information during a care episode eg during a hospitalization andor treatment

wwwplanetreeorg

A 2013 survey of 1000 US patients found

Accenture Survey on Patient Engagement - Research Recap

United States Sept 2013

Shared Medical Records

82 say access their medical records is important

41 would consider switching doctors to gain

access to their medical records

wwwplanetreeorg

ldquoI donrsquot have time to sit down and review the record and Irsquom not sure they [the patients] would even want tordquo

ldquoWhat if yoursquove written something that offends them Lawsuitrdquo

ldquoItrsquos too complex and I donrsquot think most of the time theyrsquod understand what was writtenrdquo

ldquoPrivacy regulations wonrsquot let us do that without a signature and that takes timerdquo

Concerns related to patients reading their medical record

of doctors reported longer visits when they opened their notes to patients Delbanco T et al 2012 Annals of Internal Medicine

wwwplanetreeorg

Impact of Shared Medical Record

Def

init

ely

wo

uld

rec

om

men

d th

is

ho

spit

al t

o o

ther

s

50

60

70

80

90

100

Yes No

Patients who are told they can read their medical chart are more likely to recommend the hospital to others

Were you told that you could read your medical chart

wwwplanetreeorg

Of patients who reviewed their doctorsrsquo notes report feeling more in control of their care

Delbanco T et al 2012 Annals of Internal Medicine

71 Of consumers think they should be able to update their electronic health records

wwwplanetreeorg

Patients work with clinicians to co-design research on outcomes they define as important

MISSION hellipproducing and promoting high-integrity evidence-based information that comes from research guided by patients caregivers and the broader healthcare community

hellipthe meaningful involvement of patients caregivers clinicians and other healthcare stakeholders throughout the research processmdashfrom topic selection through design

and conduct of research to dissemination of results

PRACTICES that engage patientsfamilies in research activities

wwwplanetreeorg

Funding 2010- $10 million

2011- $50 million 2012-2019- $150 million per year

13 Areas of Funding Focus including o Engagement Awards o Communication-Dissemination Research o Assessment of Prevention Diagnosis and Treatment Options

PCORI Funding Levels and Opportunities

wwwplanetreeorg

Engaging Moms in Comparative Research

PICC line supplies

wwwplanetreeorg

Ron Keren MD MPH The Childrens Hospital of Philadelphia

Philadelphia PA

Engagement

Patient advisory council involved in formulating the research question defining essential characteristics of the comparators and outcomes monitored study progress and developed strategies to disseminate and implement the research findings

Potential Impact

No studies had been done to compare the impact of these two treatment options on the quality of life of the children and their caregivers

Compares effectiveness of oral vs intravenous antibiotics in children who require at least one week of home antibiotic therapy following hospitalization for a serious bacterial infection Spends 18 months surveying at least 1000 patients (and their caregivers) who are discharged from four large childrenrsquos hospitals

Assessment of Prevention Diagnosis and Treatment Options awarded December 2012

Comparative Effectiveness of Intravenous vs Oral Antibiotic Therapy for Serious Bacterial Infections

wwwplanetreeorg

Conclusions and Relevance Given the magnitude and seriousness of PICC complications clinicians should reconsider the practice of treating otherwise healthy children with acute osteomyelitis with prolonged intravenous antibiotics after hospital discharge when an equally effective oral alternative exists

wwwplanetreeorg

Every PCORI research publication must include a 500-word lay language description

Patient amp family engagement begins to influence medical research values amp practices

Majority of patient engagement research is qualitative or mixed method with a focus on practices

wwwplanetreeorg

Logic Model for PFE Care Culture

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

Intermediate benefits

bull Patient activation

bull Increased health literacy

bull Increased family presence

bull Improved care coordination

bull Less psychological stress for patients families and staff

bull Improved sleep for patients

bull Improved communication

bull Decreased utilization

bull Fewer malpractice claims

bull Increased trust

bull Improved operational efficiency

bull Culture of safety

wwwplanetreeorg

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

wwwplanetreeorg

What research says about patient access to satisfaction and patient experience

Huppertz JW and Carlson JP Consumers Use of HCAHPS Ratings and Word-of-Mouth in Hospital Choice Health Serv Res 2010 Dec 45(6 Pt 1) 1602ndash1613 doi 101111j1475-6773201001153x

bull A study examined results of exposing 309 consumers to hospital patient satisfaction results and anecdotal email stories about the scores

bull Patient intention to choose a hospital was most positively affected when both the scores and stories were positive

bull There was less of an effect if scores were positive but the story was not

bull Patient testimonials and positive stories may be very influential on consumer decision-making in addition to scores

wwwplanetreeorg

PRACTICES that promote patient and family engagement ndashBedside Shift Report

82

84

86

88

90

92

94

96

Nurses treat you with

courtesyrespect

Nurses attitude

toward requests

Attention to

specialpersonalneeds

Nurses kept you

infromed

Staff include you in

decision re treatment

Staff worked together

to care for you

6 months prior to implementation of bedside report 6 months after implmentation of bedside report

Spirit and Intent of Hourly Rounding bull More frequent touch-points bull Security to patients bull Moves from reactive to proactive bull 4 Prsquos- Pain Personal Needs Positioning Placement

Bedside shift report as a time saver bull Sharp decline in the number of call lights bull Nurses have reported a better ability to prioritize cases bull Overall decrease in staff time post-implementation

wwwplanetreeorg

Barriers to Engagement

TOP Concerns of Patients

1 Dismissal trivialization of the patient voice

2 Absence of caring attitudes from providers

3 Lack of continuity in care

Based on 6000+ focus groups amp interviews with more than 50000 patients families and caregivers across the care continuum

wwwplanetreeorg

Joint Commission Online October 21 2010

80

ldquohellipan estimated 80 of serious medical errors involve

miscommunication between caregivers when patients are

transferred or handed-offhellip communications breakdowns

continue to be a leading contributing factor in many different

kinds of sentinel eventshelliprdquo

wwwplanetreeorg

PRACTICES that promote better communications ndash Open Medical RecordOpen Notes

Shared medical record Refers to the patientsrsquo ability to access their real-time in-progress personal health information during a care episode eg during a hospitalization andor treatment

wwwplanetreeorg

A 2013 survey of 1000 US patients found

Accenture Survey on Patient Engagement - Research Recap

United States Sept 2013

Shared Medical Records

82 say access their medical records is important

41 would consider switching doctors to gain

access to their medical records

wwwplanetreeorg

ldquoI donrsquot have time to sit down and review the record and Irsquom not sure they [the patients] would even want tordquo

ldquoWhat if yoursquove written something that offends them Lawsuitrdquo

ldquoItrsquos too complex and I donrsquot think most of the time theyrsquod understand what was writtenrdquo

ldquoPrivacy regulations wonrsquot let us do that without a signature and that takes timerdquo

Concerns related to patients reading their medical record

of doctors reported longer visits when they opened their notes to patients Delbanco T et al 2012 Annals of Internal Medicine

wwwplanetreeorg

Impact of Shared Medical Record

Def

init

ely

wo

uld

rec

om

men

d th

is

ho

spit

al t

o o

ther

s

50

60

70

80

90

100

Yes No

Patients who are told they can read their medical chart are more likely to recommend the hospital to others

Were you told that you could read your medical chart

wwwplanetreeorg

Of patients who reviewed their doctorsrsquo notes report feeling more in control of their care

Delbanco T et al 2012 Annals of Internal Medicine

71 Of consumers think they should be able to update their electronic health records

wwwplanetreeorg

Patients work with clinicians to co-design research on outcomes they define as important

MISSION hellipproducing and promoting high-integrity evidence-based information that comes from research guided by patients caregivers and the broader healthcare community

hellipthe meaningful involvement of patients caregivers clinicians and other healthcare stakeholders throughout the research processmdashfrom topic selection through design

and conduct of research to dissemination of results

PRACTICES that engage patientsfamilies in research activities

wwwplanetreeorg

Funding 2010- $10 million

2011- $50 million 2012-2019- $150 million per year

13 Areas of Funding Focus including o Engagement Awards o Communication-Dissemination Research o Assessment of Prevention Diagnosis and Treatment Options

PCORI Funding Levels and Opportunities

wwwplanetreeorg

Engaging Moms in Comparative Research

PICC line supplies

wwwplanetreeorg

Ron Keren MD MPH The Childrens Hospital of Philadelphia

Philadelphia PA

Engagement

Patient advisory council involved in formulating the research question defining essential characteristics of the comparators and outcomes monitored study progress and developed strategies to disseminate and implement the research findings

Potential Impact

No studies had been done to compare the impact of these two treatment options on the quality of life of the children and their caregivers

Compares effectiveness of oral vs intravenous antibiotics in children who require at least one week of home antibiotic therapy following hospitalization for a serious bacterial infection Spends 18 months surveying at least 1000 patients (and their caregivers) who are discharged from four large childrenrsquos hospitals

Assessment of Prevention Diagnosis and Treatment Options awarded December 2012

Comparative Effectiveness of Intravenous vs Oral Antibiotic Therapy for Serious Bacterial Infections

wwwplanetreeorg

Conclusions and Relevance Given the magnitude and seriousness of PICC complications clinicians should reconsider the practice of treating otherwise healthy children with acute osteomyelitis with prolonged intravenous antibiotics after hospital discharge when an equally effective oral alternative exists

wwwplanetreeorg

Every PCORI research publication must include a 500-word lay language description

Patient amp family engagement begins to influence medical research values amp practices

Majority of patient engagement research is qualitative or mixed method with a focus on practices

wwwplanetreeorg

Logic Model for PFE Care Culture

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

Intermediate benefits

bull Patient activation

bull Increased health literacy

bull Increased family presence

bull Improved care coordination

bull Less psychological stress for patients families and staff

bull Improved sleep for patients

bull Improved communication

bull Decreased utilization

bull Fewer malpractice claims

bull Increased trust

bull Improved operational efficiency

bull Culture of safety

wwwplanetreeorg

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

wwwplanetreeorg

What research says about patient access to satisfaction and patient experience

Huppertz JW and Carlson JP Consumers Use of HCAHPS Ratings and Word-of-Mouth in Hospital Choice Health Serv Res 2010 Dec 45(6 Pt 1) 1602ndash1613 doi 101111j1475-6773201001153x

bull A study examined results of exposing 309 consumers to hospital patient satisfaction results and anecdotal email stories about the scores

bull Patient intention to choose a hospital was most positively affected when both the scores and stories were positive

bull There was less of an effect if scores were positive but the story was not

bull Patient testimonials and positive stories may be very influential on consumer decision-making in addition to scores

wwwplanetreeorg

Barriers to Engagement

TOP Concerns of Patients

1 Dismissal trivialization of the patient voice

2 Absence of caring attitudes from providers

3 Lack of continuity in care

Based on 6000+ focus groups amp interviews with more than 50000 patients families and caregivers across the care continuum

wwwplanetreeorg

Joint Commission Online October 21 2010

80

ldquohellipan estimated 80 of serious medical errors involve

miscommunication between caregivers when patients are

transferred or handed-offhellip communications breakdowns

continue to be a leading contributing factor in many different

kinds of sentinel eventshelliprdquo

wwwplanetreeorg

PRACTICES that promote better communications ndash Open Medical RecordOpen Notes

Shared medical record Refers to the patientsrsquo ability to access their real-time in-progress personal health information during a care episode eg during a hospitalization andor treatment

wwwplanetreeorg

A 2013 survey of 1000 US patients found

Accenture Survey on Patient Engagement - Research Recap

United States Sept 2013

Shared Medical Records

82 say access their medical records is important

41 would consider switching doctors to gain

access to their medical records

wwwplanetreeorg

ldquoI donrsquot have time to sit down and review the record and Irsquom not sure they [the patients] would even want tordquo

ldquoWhat if yoursquove written something that offends them Lawsuitrdquo

ldquoItrsquos too complex and I donrsquot think most of the time theyrsquod understand what was writtenrdquo

ldquoPrivacy regulations wonrsquot let us do that without a signature and that takes timerdquo

Concerns related to patients reading their medical record

of doctors reported longer visits when they opened their notes to patients Delbanco T et al 2012 Annals of Internal Medicine

wwwplanetreeorg

Impact of Shared Medical Record

Def

init

ely

wo

uld

rec

om

men

d th

is

ho

spit

al t

o o

ther

s

50

60

70

80

90

100

Yes No

Patients who are told they can read their medical chart are more likely to recommend the hospital to others

Were you told that you could read your medical chart

wwwplanetreeorg

Of patients who reviewed their doctorsrsquo notes report feeling more in control of their care

Delbanco T et al 2012 Annals of Internal Medicine

71 Of consumers think they should be able to update their electronic health records

wwwplanetreeorg

Patients work with clinicians to co-design research on outcomes they define as important

MISSION hellipproducing and promoting high-integrity evidence-based information that comes from research guided by patients caregivers and the broader healthcare community

hellipthe meaningful involvement of patients caregivers clinicians and other healthcare stakeholders throughout the research processmdashfrom topic selection through design

and conduct of research to dissemination of results

PRACTICES that engage patientsfamilies in research activities

wwwplanetreeorg

Funding 2010- $10 million

2011- $50 million 2012-2019- $150 million per year

13 Areas of Funding Focus including o Engagement Awards o Communication-Dissemination Research o Assessment of Prevention Diagnosis and Treatment Options

PCORI Funding Levels and Opportunities

wwwplanetreeorg

Engaging Moms in Comparative Research

PICC line supplies

wwwplanetreeorg

Ron Keren MD MPH The Childrens Hospital of Philadelphia

Philadelphia PA

Engagement

Patient advisory council involved in formulating the research question defining essential characteristics of the comparators and outcomes monitored study progress and developed strategies to disseminate and implement the research findings

Potential Impact

No studies had been done to compare the impact of these two treatment options on the quality of life of the children and their caregivers

Compares effectiveness of oral vs intravenous antibiotics in children who require at least one week of home antibiotic therapy following hospitalization for a serious bacterial infection Spends 18 months surveying at least 1000 patients (and their caregivers) who are discharged from four large childrenrsquos hospitals

Assessment of Prevention Diagnosis and Treatment Options awarded December 2012

Comparative Effectiveness of Intravenous vs Oral Antibiotic Therapy for Serious Bacterial Infections

wwwplanetreeorg

Conclusions and Relevance Given the magnitude and seriousness of PICC complications clinicians should reconsider the practice of treating otherwise healthy children with acute osteomyelitis with prolonged intravenous antibiotics after hospital discharge when an equally effective oral alternative exists

wwwplanetreeorg

Every PCORI research publication must include a 500-word lay language description

Patient amp family engagement begins to influence medical research values amp practices

Majority of patient engagement research is qualitative or mixed method with a focus on practices

wwwplanetreeorg

Logic Model for PFE Care Culture

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

Intermediate benefits

bull Patient activation

bull Increased health literacy

bull Increased family presence

bull Improved care coordination

bull Less psychological stress for patients families and staff

bull Improved sleep for patients

bull Improved communication

bull Decreased utilization

bull Fewer malpractice claims

bull Increased trust

bull Improved operational efficiency

bull Culture of safety

wwwplanetreeorg

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

wwwplanetreeorg

What research says about patient access to satisfaction and patient experience

Huppertz JW and Carlson JP Consumers Use of HCAHPS Ratings and Word-of-Mouth in Hospital Choice Health Serv Res 2010 Dec 45(6 Pt 1) 1602ndash1613 doi 101111j1475-6773201001153x

bull A study examined results of exposing 309 consumers to hospital patient satisfaction results and anecdotal email stories about the scores

bull Patient intention to choose a hospital was most positively affected when both the scores and stories were positive

bull There was less of an effect if scores were positive but the story was not

bull Patient testimonials and positive stories may be very influential on consumer decision-making in addition to scores

wwwplanetreeorg

Joint Commission Online October 21 2010

80

ldquohellipan estimated 80 of serious medical errors involve

miscommunication between caregivers when patients are

transferred or handed-offhellip communications breakdowns

continue to be a leading contributing factor in many different

kinds of sentinel eventshelliprdquo

wwwplanetreeorg

PRACTICES that promote better communications ndash Open Medical RecordOpen Notes

Shared medical record Refers to the patientsrsquo ability to access their real-time in-progress personal health information during a care episode eg during a hospitalization andor treatment

wwwplanetreeorg

A 2013 survey of 1000 US patients found

Accenture Survey on Patient Engagement - Research Recap

United States Sept 2013

Shared Medical Records

82 say access their medical records is important

41 would consider switching doctors to gain

access to their medical records

wwwplanetreeorg

ldquoI donrsquot have time to sit down and review the record and Irsquom not sure they [the patients] would even want tordquo

ldquoWhat if yoursquove written something that offends them Lawsuitrdquo

ldquoItrsquos too complex and I donrsquot think most of the time theyrsquod understand what was writtenrdquo

ldquoPrivacy regulations wonrsquot let us do that without a signature and that takes timerdquo

Concerns related to patients reading their medical record

of doctors reported longer visits when they opened their notes to patients Delbanco T et al 2012 Annals of Internal Medicine

wwwplanetreeorg

Impact of Shared Medical Record

Def

init

ely

wo

uld

rec

om

men

d th

is

ho

spit

al t

o o

ther

s

50

60

70

80

90

100

Yes No

Patients who are told they can read their medical chart are more likely to recommend the hospital to others

Were you told that you could read your medical chart

wwwplanetreeorg

Of patients who reviewed their doctorsrsquo notes report feeling more in control of their care

Delbanco T et al 2012 Annals of Internal Medicine

71 Of consumers think they should be able to update their electronic health records

wwwplanetreeorg

Patients work with clinicians to co-design research on outcomes they define as important

MISSION hellipproducing and promoting high-integrity evidence-based information that comes from research guided by patients caregivers and the broader healthcare community

hellipthe meaningful involvement of patients caregivers clinicians and other healthcare stakeholders throughout the research processmdashfrom topic selection through design

and conduct of research to dissemination of results

PRACTICES that engage patientsfamilies in research activities

wwwplanetreeorg

Funding 2010- $10 million

2011- $50 million 2012-2019- $150 million per year

13 Areas of Funding Focus including o Engagement Awards o Communication-Dissemination Research o Assessment of Prevention Diagnosis and Treatment Options

PCORI Funding Levels and Opportunities

wwwplanetreeorg

Engaging Moms in Comparative Research

PICC line supplies

wwwplanetreeorg

Ron Keren MD MPH The Childrens Hospital of Philadelphia

Philadelphia PA

Engagement

Patient advisory council involved in formulating the research question defining essential characteristics of the comparators and outcomes monitored study progress and developed strategies to disseminate and implement the research findings

Potential Impact

No studies had been done to compare the impact of these two treatment options on the quality of life of the children and their caregivers

Compares effectiveness of oral vs intravenous antibiotics in children who require at least one week of home antibiotic therapy following hospitalization for a serious bacterial infection Spends 18 months surveying at least 1000 patients (and their caregivers) who are discharged from four large childrenrsquos hospitals

Assessment of Prevention Diagnosis and Treatment Options awarded December 2012

Comparative Effectiveness of Intravenous vs Oral Antibiotic Therapy for Serious Bacterial Infections

wwwplanetreeorg

Conclusions and Relevance Given the magnitude and seriousness of PICC complications clinicians should reconsider the practice of treating otherwise healthy children with acute osteomyelitis with prolonged intravenous antibiotics after hospital discharge when an equally effective oral alternative exists

wwwplanetreeorg

Every PCORI research publication must include a 500-word lay language description

Patient amp family engagement begins to influence medical research values amp practices

Majority of patient engagement research is qualitative or mixed method with a focus on practices

wwwplanetreeorg

Logic Model for PFE Care Culture

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

Intermediate benefits

bull Patient activation

bull Increased health literacy

bull Increased family presence

bull Improved care coordination

bull Less psychological stress for patients families and staff

bull Improved sleep for patients

bull Improved communication

bull Decreased utilization

bull Fewer malpractice claims

bull Increased trust

bull Improved operational efficiency

bull Culture of safety

wwwplanetreeorg

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

wwwplanetreeorg

What research says about patient access to satisfaction and patient experience

Huppertz JW and Carlson JP Consumers Use of HCAHPS Ratings and Word-of-Mouth in Hospital Choice Health Serv Res 2010 Dec 45(6 Pt 1) 1602ndash1613 doi 101111j1475-6773201001153x

bull A study examined results of exposing 309 consumers to hospital patient satisfaction results and anecdotal email stories about the scores

bull Patient intention to choose a hospital was most positively affected when both the scores and stories were positive

bull There was less of an effect if scores were positive but the story was not

bull Patient testimonials and positive stories may be very influential on consumer decision-making in addition to scores

wwwplanetreeorg

PRACTICES that promote better communications ndash Open Medical RecordOpen Notes

Shared medical record Refers to the patientsrsquo ability to access their real-time in-progress personal health information during a care episode eg during a hospitalization andor treatment

wwwplanetreeorg

A 2013 survey of 1000 US patients found

Accenture Survey on Patient Engagement - Research Recap

United States Sept 2013

Shared Medical Records

82 say access their medical records is important

41 would consider switching doctors to gain

access to their medical records

wwwplanetreeorg

ldquoI donrsquot have time to sit down and review the record and Irsquom not sure they [the patients] would even want tordquo

ldquoWhat if yoursquove written something that offends them Lawsuitrdquo

ldquoItrsquos too complex and I donrsquot think most of the time theyrsquod understand what was writtenrdquo

ldquoPrivacy regulations wonrsquot let us do that without a signature and that takes timerdquo

Concerns related to patients reading their medical record

of doctors reported longer visits when they opened their notes to patients Delbanco T et al 2012 Annals of Internal Medicine

wwwplanetreeorg

Impact of Shared Medical Record

Def

init

ely

wo

uld

rec

om

men

d th

is

ho

spit

al t

o o

ther

s

50

60

70

80

90

100

Yes No

Patients who are told they can read their medical chart are more likely to recommend the hospital to others

Were you told that you could read your medical chart

wwwplanetreeorg

Of patients who reviewed their doctorsrsquo notes report feeling more in control of their care

Delbanco T et al 2012 Annals of Internal Medicine

71 Of consumers think they should be able to update their electronic health records

wwwplanetreeorg

Patients work with clinicians to co-design research on outcomes they define as important

MISSION hellipproducing and promoting high-integrity evidence-based information that comes from research guided by patients caregivers and the broader healthcare community

hellipthe meaningful involvement of patients caregivers clinicians and other healthcare stakeholders throughout the research processmdashfrom topic selection through design

and conduct of research to dissemination of results

PRACTICES that engage patientsfamilies in research activities

wwwplanetreeorg

Funding 2010- $10 million

2011- $50 million 2012-2019- $150 million per year

13 Areas of Funding Focus including o Engagement Awards o Communication-Dissemination Research o Assessment of Prevention Diagnosis and Treatment Options

PCORI Funding Levels and Opportunities

wwwplanetreeorg

Engaging Moms in Comparative Research

PICC line supplies

wwwplanetreeorg

Ron Keren MD MPH The Childrens Hospital of Philadelphia

Philadelphia PA

Engagement

Patient advisory council involved in formulating the research question defining essential characteristics of the comparators and outcomes monitored study progress and developed strategies to disseminate and implement the research findings

Potential Impact

No studies had been done to compare the impact of these two treatment options on the quality of life of the children and their caregivers

Compares effectiveness of oral vs intravenous antibiotics in children who require at least one week of home antibiotic therapy following hospitalization for a serious bacterial infection Spends 18 months surveying at least 1000 patients (and their caregivers) who are discharged from four large childrenrsquos hospitals

Assessment of Prevention Diagnosis and Treatment Options awarded December 2012

Comparative Effectiveness of Intravenous vs Oral Antibiotic Therapy for Serious Bacterial Infections

wwwplanetreeorg

Conclusions and Relevance Given the magnitude and seriousness of PICC complications clinicians should reconsider the practice of treating otherwise healthy children with acute osteomyelitis with prolonged intravenous antibiotics after hospital discharge when an equally effective oral alternative exists

wwwplanetreeorg

Every PCORI research publication must include a 500-word lay language description

Patient amp family engagement begins to influence medical research values amp practices

Majority of patient engagement research is qualitative or mixed method with a focus on practices

wwwplanetreeorg

Logic Model for PFE Care Culture

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

Intermediate benefits

bull Patient activation

bull Increased health literacy

bull Increased family presence

bull Improved care coordination

bull Less psychological stress for patients families and staff

bull Improved sleep for patients

bull Improved communication

bull Decreased utilization

bull Fewer malpractice claims

bull Increased trust

bull Improved operational efficiency

bull Culture of safety

wwwplanetreeorg

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

wwwplanetreeorg

What research says about patient access to satisfaction and patient experience

Huppertz JW and Carlson JP Consumers Use of HCAHPS Ratings and Word-of-Mouth in Hospital Choice Health Serv Res 2010 Dec 45(6 Pt 1) 1602ndash1613 doi 101111j1475-6773201001153x

bull A study examined results of exposing 309 consumers to hospital patient satisfaction results and anecdotal email stories about the scores

bull Patient intention to choose a hospital was most positively affected when both the scores and stories were positive

bull There was less of an effect if scores were positive but the story was not

bull Patient testimonials and positive stories may be very influential on consumer decision-making in addition to scores

wwwplanetreeorg

A 2013 survey of 1000 US patients found

Accenture Survey on Patient Engagement - Research Recap

United States Sept 2013

Shared Medical Records

82 say access their medical records is important

41 would consider switching doctors to gain

access to their medical records

wwwplanetreeorg

ldquoI donrsquot have time to sit down and review the record and Irsquom not sure they [the patients] would even want tordquo

ldquoWhat if yoursquove written something that offends them Lawsuitrdquo

ldquoItrsquos too complex and I donrsquot think most of the time theyrsquod understand what was writtenrdquo

ldquoPrivacy regulations wonrsquot let us do that without a signature and that takes timerdquo

Concerns related to patients reading their medical record

of doctors reported longer visits when they opened their notes to patients Delbanco T et al 2012 Annals of Internal Medicine

wwwplanetreeorg

Impact of Shared Medical Record

Def

init

ely

wo

uld

rec

om

men

d th

is

ho

spit

al t

o o

ther

s

50

60

70

80

90

100

Yes No

Patients who are told they can read their medical chart are more likely to recommend the hospital to others

Were you told that you could read your medical chart

wwwplanetreeorg

Of patients who reviewed their doctorsrsquo notes report feeling more in control of their care

Delbanco T et al 2012 Annals of Internal Medicine

71 Of consumers think they should be able to update their electronic health records

wwwplanetreeorg

Patients work with clinicians to co-design research on outcomes they define as important

MISSION hellipproducing and promoting high-integrity evidence-based information that comes from research guided by patients caregivers and the broader healthcare community

hellipthe meaningful involvement of patients caregivers clinicians and other healthcare stakeholders throughout the research processmdashfrom topic selection through design

and conduct of research to dissemination of results

PRACTICES that engage patientsfamilies in research activities

wwwplanetreeorg

Funding 2010- $10 million

2011- $50 million 2012-2019- $150 million per year

13 Areas of Funding Focus including o Engagement Awards o Communication-Dissemination Research o Assessment of Prevention Diagnosis and Treatment Options

PCORI Funding Levels and Opportunities

wwwplanetreeorg

Engaging Moms in Comparative Research

PICC line supplies

wwwplanetreeorg

Ron Keren MD MPH The Childrens Hospital of Philadelphia

Philadelphia PA

Engagement

Patient advisory council involved in formulating the research question defining essential characteristics of the comparators and outcomes monitored study progress and developed strategies to disseminate and implement the research findings

Potential Impact

No studies had been done to compare the impact of these two treatment options on the quality of life of the children and their caregivers

Compares effectiveness of oral vs intravenous antibiotics in children who require at least one week of home antibiotic therapy following hospitalization for a serious bacterial infection Spends 18 months surveying at least 1000 patients (and their caregivers) who are discharged from four large childrenrsquos hospitals

Assessment of Prevention Diagnosis and Treatment Options awarded December 2012

Comparative Effectiveness of Intravenous vs Oral Antibiotic Therapy for Serious Bacterial Infections

wwwplanetreeorg

Conclusions and Relevance Given the magnitude and seriousness of PICC complications clinicians should reconsider the practice of treating otherwise healthy children with acute osteomyelitis with prolonged intravenous antibiotics after hospital discharge when an equally effective oral alternative exists

wwwplanetreeorg

Every PCORI research publication must include a 500-word lay language description

Patient amp family engagement begins to influence medical research values amp practices

Majority of patient engagement research is qualitative or mixed method with a focus on practices

wwwplanetreeorg

Logic Model for PFE Care Culture

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

Intermediate benefits

bull Patient activation

bull Increased health literacy

bull Increased family presence

bull Improved care coordination

bull Less psychological stress for patients families and staff

bull Improved sleep for patients

bull Improved communication

bull Decreased utilization

bull Fewer malpractice claims

bull Increased trust

bull Improved operational efficiency

bull Culture of safety

wwwplanetreeorg

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

wwwplanetreeorg

What research says about patient access to satisfaction and patient experience

Huppertz JW and Carlson JP Consumers Use of HCAHPS Ratings and Word-of-Mouth in Hospital Choice Health Serv Res 2010 Dec 45(6 Pt 1) 1602ndash1613 doi 101111j1475-6773201001153x

bull A study examined results of exposing 309 consumers to hospital patient satisfaction results and anecdotal email stories about the scores

bull Patient intention to choose a hospital was most positively affected when both the scores and stories were positive

bull There was less of an effect if scores were positive but the story was not

bull Patient testimonials and positive stories may be very influential on consumer decision-making in addition to scores

wwwplanetreeorg

ldquoI donrsquot have time to sit down and review the record and Irsquom not sure they [the patients] would even want tordquo

ldquoWhat if yoursquove written something that offends them Lawsuitrdquo

ldquoItrsquos too complex and I donrsquot think most of the time theyrsquod understand what was writtenrdquo

ldquoPrivacy regulations wonrsquot let us do that without a signature and that takes timerdquo

Concerns related to patients reading their medical record

of doctors reported longer visits when they opened their notes to patients Delbanco T et al 2012 Annals of Internal Medicine

wwwplanetreeorg

Impact of Shared Medical Record

Def

init

ely

wo

uld

rec

om

men

d th

is

ho

spit

al t

o o

ther

s

50

60

70

80

90

100

Yes No

Patients who are told they can read their medical chart are more likely to recommend the hospital to others

Were you told that you could read your medical chart

wwwplanetreeorg

Of patients who reviewed their doctorsrsquo notes report feeling more in control of their care

Delbanco T et al 2012 Annals of Internal Medicine

71 Of consumers think they should be able to update their electronic health records

wwwplanetreeorg

Patients work with clinicians to co-design research on outcomes they define as important

MISSION hellipproducing and promoting high-integrity evidence-based information that comes from research guided by patients caregivers and the broader healthcare community

hellipthe meaningful involvement of patients caregivers clinicians and other healthcare stakeholders throughout the research processmdashfrom topic selection through design

and conduct of research to dissemination of results

PRACTICES that engage patientsfamilies in research activities

wwwplanetreeorg

Funding 2010- $10 million

2011- $50 million 2012-2019- $150 million per year

13 Areas of Funding Focus including o Engagement Awards o Communication-Dissemination Research o Assessment of Prevention Diagnosis and Treatment Options

PCORI Funding Levels and Opportunities

wwwplanetreeorg

Engaging Moms in Comparative Research

PICC line supplies

wwwplanetreeorg

Ron Keren MD MPH The Childrens Hospital of Philadelphia

Philadelphia PA

Engagement

Patient advisory council involved in formulating the research question defining essential characteristics of the comparators and outcomes monitored study progress and developed strategies to disseminate and implement the research findings

Potential Impact

No studies had been done to compare the impact of these two treatment options on the quality of life of the children and their caregivers

Compares effectiveness of oral vs intravenous antibiotics in children who require at least one week of home antibiotic therapy following hospitalization for a serious bacterial infection Spends 18 months surveying at least 1000 patients (and their caregivers) who are discharged from four large childrenrsquos hospitals

Assessment of Prevention Diagnosis and Treatment Options awarded December 2012

Comparative Effectiveness of Intravenous vs Oral Antibiotic Therapy for Serious Bacterial Infections

wwwplanetreeorg

Conclusions and Relevance Given the magnitude and seriousness of PICC complications clinicians should reconsider the practice of treating otherwise healthy children with acute osteomyelitis with prolonged intravenous antibiotics after hospital discharge when an equally effective oral alternative exists

wwwplanetreeorg

Every PCORI research publication must include a 500-word lay language description

Patient amp family engagement begins to influence medical research values amp practices

Majority of patient engagement research is qualitative or mixed method with a focus on practices

wwwplanetreeorg

Logic Model for PFE Care Culture

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

Intermediate benefits

bull Patient activation

bull Increased health literacy

bull Increased family presence

bull Improved care coordination

bull Less psychological stress for patients families and staff

bull Improved sleep for patients

bull Improved communication

bull Decreased utilization

bull Fewer malpractice claims

bull Increased trust

bull Improved operational efficiency

bull Culture of safety

wwwplanetreeorg

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

wwwplanetreeorg

What research says about patient access to satisfaction and patient experience

Huppertz JW and Carlson JP Consumers Use of HCAHPS Ratings and Word-of-Mouth in Hospital Choice Health Serv Res 2010 Dec 45(6 Pt 1) 1602ndash1613 doi 101111j1475-6773201001153x

bull A study examined results of exposing 309 consumers to hospital patient satisfaction results and anecdotal email stories about the scores

bull Patient intention to choose a hospital was most positively affected when both the scores and stories were positive

bull There was less of an effect if scores were positive but the story was not

bull Patient testimonials and positive stories may be very influential on consumer decision-making in addition to scores

wwwplanetreeorg

Impact of Shared Medical Record

Def

init

ely

wo

uld

rec

om

men

d th

is

ho

spit

al t

o o

ther

s

50

60

70

80

90

100

Yes No

Patients who are told they can read their medical chart are more likely to recommend the hospital to others

Were you told that you could read your medical chart

wwwplanetreeorg

Of patients who reviewed their doctorsrsquo notes report feeling more in control of their care

Delbanco T et al 2012 Annals of Internal Medicine

71 Of consumers think they should be able to update their electronic health records

wwwplanetreeorg

Patients work with clinicians to co-design research on outcomes they define as important

MISSION hellipproducing and promoting high-integrity evidence-based information that comes from research guided by patients caregivers and the broader healthcare community

hellipthe meaningful involvement of patients caregivers clinicians and other healthcare stakeholders throughout the research processmdashfrom topic selection through design

and conduct of research to dissemination of results

PRACTICES that engage patientsfamilies in research activities

wwwplanetreeorg

Funding 2010- $10 million

2011- $50 million 2012-2019- $150 million per year

13 Areas of Funding Focus including o Engagement Awards o Communication-Dissemination Research o Assessment of Prevention Diagnosis and Treatment Options

PCORI Funding Levels and Opportunities

wwwplanetreeorg

Engaging Moms in Comparative Research

PICC line supplies

wwwplanetreeorg

Ron Keren MD MPH The Childrens Hospital of Philadelphia

Philadelphia PA

Engagement

Patient advisory council involved in formulating the research question defining essential characteristics of the comparators and outcomes monitored study progress and developed strategies to disseminate and implement the research findings

Potential Impact

No studies had been done to compare the impact of these two treatment options on the quality of life of the children and their caregivers

Compares effectiveness of oral vs intravenous antibiotics in children who require at least one week of home antibiotic therapy following hospitalization for a serious bacterial infection Spends 18 months surveying at least 1000 patients (and their caregivers) who are discharged from four large childrenrsquos hospitals

Assessment of Prevention Diagnosis and Treatment Options awarded December 2012

Comparative Effectiveness of Intravenous vs Oral Antibiotic Therapy for Serious Bacterial Infections

wwwplanetreeorg

Conclusions and Relevance Given the magnitude and seriousness of PICC complications clinicians should reconsider the practice of treating otherwise healthy children with acute osteomyelitis with prolonged intravenous antibiotics after hospital discharge when an equally effective oral alternative exists

wwwplanetreeorg

Every PCORI research publication must include a 500-word lay language description

Patient amp family engagement begins to influence medical research values amp practices

Majority of patient engagement research is qualitative or mixed method with a focus on practices

wwwplanetreeorg

Logic Model for PFE Care Culture

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

Intermediate benefits

bull Patient activation

bull Increased health literacy

bull Increased family presence

bull Improved care coordination

bull Less psychological stress for patients families and staff

bull Improved sleep for patients

bull Improved communication

bull Decreased utilization

bull Fewer malpractice claims

bull Increased trust

bull Improved operational efficiency

bull Culture of safety

wwwplanetreeorg

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

wwwplanetreeorg

What research says about patient access to satisfaction and patient experience

Huppertz JW and Carlson JP Consumers Use of HCAHPS Ratings and Word-of-Mouth in Hospital Choice Health Serv Res 2010 Dec 45(6 Pt 1) 1602ndash1613 doi 101111j1475-6773201001153x

bull A study examined results of exposing 309 consumers to hospital patient satisfaction results and anecdotal email stories about the scores

bull Patient intention to choose a hospital was most positively affected when both the scores and stories were positive

bull There was less of an effect if scores were positive but the story was not

bull Patient testimonials and positive stories may be very influential on consumer decision-making in addition to scores

wwwplanetreeorg

Of patients who reviewed their doctorsrsquo notes report feeling more in control of their care

Delbanco T et al 2012 Annals of Internal Medicine

71 Of consumers think they should be able to update their electronic health records

wwwplanetreeorg

Patients work with clinicians to co-design research on outcomes they define as important

MISSION hellipproducing and promoting high-integrity evidence-based information that comes from research guided by patients caregivers and the broader healthcare community

hellipthe meaningful involvement of patients caregivers clinicians and other healthcare stakeholders throughout the research processmdashfrom topic selection through design

and conduct of research to dissemination of results

PRACTICES that engage patientsfamilies in research activities

wwwplanetreeorg

Funding 2010- $10 million

2011- $50 million 2012-2019- $150 million per year

13 Areas of Funding Focus including o Engagement Awards o Communication-Dissemination Research o Assessment of Prevention Diagnosis and Treatment Options

PCORI Funding Levels and Opportunities

wwwplanetreeorg

Engaging Moms in Comparative Research

PICC line supplies

wwwplanetreeorg

Ron Keren MD MPH The Childrens Hospital of Philadelphia

Philadelphia PA

Engagement

Patient advisory council involved in formulating the research question defining essential characteristics of the comparators and outcomes monitored study progress and developed strategies to disseminate and implement the research findings

Potential Impact

No studies had been done to compare the impact of these two treatment options on the quality of life of the children and their caregivers

Compares effectiveness of oral vs intravenous antibiotics in children who require at least one week of home antibiotic therapy following hospitalization for a serious bacterial infection Spends 18 months surveying at least 1000 patients (and their caregivers) who are discharged from four large childrenrsquos hospitals

Assessment of Prevention Diagnosis and Treatment Options awarded December 2012

Comparative Effectiveness of Intravenous vs Oral Antibiotic Therapy for Serious Bacterial Infections

wwwplanetreeorg

Conclusions and Relevance Given the magnitude and seriousness of PICC complications clinicians should reconsider the practice of treating otherwise healthy children with acute osteomyelitis with prolonged intravenous antibiotics after hospital discharge when an equally effective oral alternative exists

wwwplanetreeorg

Every PCORI research publication must include a 500-word lay language description

Patient amp family engagement begins to influence medical research values amp practices

Majority of patient engagement research is qualitative or mixed method with a focus on practices

wwwplanetreeorg

Logic Model for PFE Care Culture

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

Intermediate benefits

bull Patient activation

bull Increased health literacy

bull Increased family presence

bull Improved care coordination

bull Less psychological stress for patients families and staff

bull Improved sleep for patients

bull Improved communication

bull Decreased utilization

bull Fewer malpractice claims

bull Increased trust

bull Improved operational efficiency

bull Culture of safety

wwwplanetreeorg

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

wwwplanetreeorg

What research says about patient access to satisfaction and patient experience

Huppertz JW and Carlson JP Consumers Use of HCAHPS Ratings and Word-of-Mouth in Hospital Choice Health Serv Res 2010 Dec 45(6 Pt 1) 1602ndash1613 doi 101111j1475-6773201001153x

bull A study examined results of exposing 309 consumers to hospital patient satisfaction results and anecdotal email stories about the scores

bull Patient intention to choose a hospital was most positively affected when both the scores and stories were positive

bull There was less of an effect if scores were positive but the story was not

bull Patient testimonials and positive stories may be very influential on consumer decision-making in addition to scores

wwwplanetreeorg

Patients work with clinicians to co-design research on outcomes they define as important

MISSION hellipproducing and promoting high-integrity evidence-based information that comes from research guided by patients caregivers and the broader healthcare community

hellipthe meaningful involvement of patients caregivers clinicians and other healthcare stakeholders throughout the research processmdashfrom topic selection through design

and conduct of research to dissemination of results

PRACTICES that engage patientsfamilies in research activities

wwwplanetreeorg

Funding 2010- $10 million

2011- $50 million 2012-2019- $150 million per year

13 Areas of Funding Focus including o Engagement Awards o Communication-Dissemination Research o Assessment of Prevention Diagnosis and Treatment Options

PCORI Funding Levels and Opportunities

wwwplanetreeorg

Engaging Moms in Comparative Research

PICC line supplies

wwwplanetreeorg

Ron Keren MD MPH The Childrens Hospital of Philadelphia

Philadelphia PA

Engagement

Patient advisory council involved in formulating the research question defining essential characteristics of the comparators and outcomes monitored study progress and developed strategies to disseminate and implement the research findings

Potential Impact

No studies had been done to compare the impact of these two treatment options on the quality of life of the children and their caregivers

Compares effectiveness of oral vs intravenous antibiotics in children who require at least one week of home antibiotic therapy following hospitalization for a serious bacterial infection Spends 18 months surveying at least 1000 patients (and their caregivers) who are discharged from four large childrenrsquos hospitals

Assessment of Prevention Diagnosis and Treatment Options awarded December 2012

Comparative Effectiveness of Intravenous vs Oral Antibiotic Therapy for Serious Bacterial Infections

wwwplanetreeorg

Conclusions and Relevance Given the magnitude and seriousness of PICC complications clinicians should reconsider the practice of treating otherwise healthy children with acute osteomyelitis with prolonged intravenous antibiotics after hospital discharge when an equally effective oral alternative exists

wwwplanetreeorg

Every PCORI research publication must include a 500-word lay language description

Patient amp family engagement begins to influence medical research values amp practices

Majority of patient engagement research is qualitative or mixed method with a focus on practices

wwwplanetreeorg

Logic Model for PFE Care Culture

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

Intermediate benefits

bull Patient activation

bull Increased health literacy

bull Increased family presence

bull Improved care coordination

bull Less psychological stress for patients families and staff

bull Improved sleep for patients

bull Improved communication

bull Decreased utilization

bull Fewer malpractice claims

bull Increased trust

bull Improved operational efficiency

bull Culture of safety

wwwplanetreeorg

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

wwwplanetreeorg

What research says about patient access to satisfaction and patient experience

Huppertz JW and Carlson JP Consumers Use of HCAHPS Ratings and Word-of-Mouth in Hospital Choice Health Serv Res 2010 Dec 45(6 Pt 1) 1602ndash1613 doi 101111j1475-6773201001153x

bull A study examined results of exposing 309 consumers to hospital patient satisfaction results and anecdotal email stories about the scores

bull Patient intention to choose a hospital was most positively affected when both the scores and stories were positive

bull There was less of an effect if scores were positive but the story was not

bull Patient testimonials and positive stories may be very influential on consumer decision-making in addition to scores

wwwplanetreeorg

Funding 2010- $10 million

2011- $50 million 2012-2019- $150 million per year

13 Areas of Funding Focus including o Engagement Awards o Communication-Dissemination Research o Assessment of Prevention Diagnosis and Treatment Options

PCORI Funding Levels and Opportunities

wwwplanetreeorg

Engaging Moms in Comparative Research

PICC line supplies

wwwplanetreeorg

Ron Keren MD MPH The Childrens Hospital of Philadelphia

Philadelphia PA

Engagement

Patient advisory council involved in formulating the research question defining essential characteristics of the comparators and outcomes monitored study progress and developed strategies to disseminate and implement the research findings

Potential Impact

No studies had been done to compare the impact of these two treatment options on the quality of life of the children and their caregivers

Compares effectiveness of oral vs intravenous antibiotics in children who require at least one week of home antibiotic therapy following hospitalization for a serious bacterial infection Spends 18 months surveying at least 1000 patients (and their caregivers) who are discharged from four large childrenrsquos hospitals

Assessment of Prevention Diagnosis and Treatment Options awarded December 2012

Comparative Effectiveness of Intravenous vs Oral Antibiotic Therapy for Serious Bacterial Infections

wwwplanetreeorg

Conclusions and Relevance Given the magnitude and seriousness of PICC complications clinicians should reconsider the practice of treating otherwise healthy children with acute osteomyelitis with prolonged intravenous antibiotics after hospital discharge when an equally effective oral alternative exists

wwwplanetreeorg

Every PCORI research publication must include a 500-word lay language description

Patient amp family engagement begins to influence medical research values amp practices

Majority of patient engagement research is qualitative or mixed method with a focus on practices

wwwplanetreeorg

Logic Model for PFE Care Culture

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

Intermediate benefits

bull Patient activation

bull Increased health literacy

bull Increased family presence

bull Improved care coordination

bull Less psychological stress for patients families and staff

bull Improved sleep for patients

bull Improved communication

bull Decreased utilization

bull Fewer malpractice claims

bull Increased trust

bull Improved operational efficiency

bull Culture of safety

wwwplanetreeorg

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

wwwplanetreeorg

What research says about patient access to satisfaction and patient experience

Huppertz JW and Carlson JP Consumers Use of HCAHPS Ratings and Word-of-Mouth in Hospital Choice Health Serv Res 2010 Dec 45(6 Pt 1) 1602ndash1613 doi 101111j1475-6773201001153x

bull A study examined results of exposing 309 consumers to hospital patient satisfaction results and anecdotal email stories about the scores

bull Patient intention to choose a hospital was most positively affected when both the scores and stories were positive

bull There was less of an effect if scores were positive but the story was not

bull Patient testimonials and positive stories may be very influential on consumer decision-making in addition to scores

wwwplanetreeorg

Engaging Moms in Comparative Research

PICC line supplies

wwwplanetreeorg

Ron Keren MD MPH The Childrens Hospital of Philadelphia

Philadelphia PA

Engagement

Patient advisory council involved in formulating the research question defining essential characteristics of the comparators and outcomes monitored study progress and developed strategies to disseminate and implement the research findings

Potential Impact

No studies had been done to compare the impact of these two treatment options on the quality of life of the children and their caregivers

Compares effectiveness of oral vs intravenous antibiotics in children who require at least one week of home antibiotic therapy following hospitalization for a serious bacterial infection Spends 18 months surveying at least 1000 patients (and their caregivers) who are discharged from four large childrenrsquos hospitals

Assessment of Prevention Diagnosis and Treatment Options awarded December 2012

Comparative Effectiveness of Intravenous vs Oral Antibiotic Therapy for Serious Bacterial Infections

wwwplanetreeorg

Conclusions and Relevance Given the magnitude and seriousness of PICC complications clinicians should reconsider the practice of treating otherwise healthy children with acute osteomyelitis with prolonged intravenous antibiotics after hospital discharge when an equally effective oral alternative exists

wwwplanetreeorg

Every PCORI research publication must include a 500-word lay language description

Patient amp family engagement begins to influence medical research values amp practices

Majority of patient engagement research is qualitative or mixed method with a focus on practices

wwwplanetreeorg

Logic Model for PFE Care Culture

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

Intermediate benefits

bull Patient activation

bull Increased health literacy

bull Increased family presence

bull Improved care coordination

bull Less psychological stress for patients families and staff

bull Improved sleep for patients

bull Improved communication

bull Decreased utilization

bull Fewer malpractice claims

bull Increased trust

bull Improved operational efficiency

bull Culture of safety

wwwplanetreeorg

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

wwwplanetreeorg

What research says about patient access to satisfaction and patient experience

Huppertz JW and Carlson JP Consumers Use of HCAHPS Ratings and Word-of-Mouth in Hospital Choice Health Serv Res 2010 Dec 45(6 Pt 1) 1602ndash1613 doi 101111j1475-6773201001153x

bull A study examined results of exposing 309 consumers to hospital patient satisfaction results and anecdotal email stories about the scores

bull Patient intention to choose a hospital was most positively affected when both the scores and stories were positive

bull There was less of an effect if scores were positive but the story was not

bull Patient testimonials and positive stories may be very influential on consumer decision-making in addition to scores

wwwplanetreeorg

Ron Keren MD MPH The Childrens Hospital of Philadelphia

Philadelphia PA

Engagement

Patient advisory council involved in formulating the research question defining essential characteristics of the comparators and outcomes monitored study progress and developed strategies to disseminate and implement the research findings

Potential Impact

No studies had been done to compare the impact of these two treatment options on the quality of life of the children and their caregivers

Compares effectiveness of oral vs intravenous antibiotics in children who require at least one week of home antibiotic therapy following hospitalization for a serious bacterial infection Spends 18 months surveying at least 1000 patients (and their caregivers) who are discharged from four large childrenrsquos hospitals

Assessment of Prevention Diagnosis and Treatment Options awarded December 2012

Comparative Effectiveness of Intravenous vs Oral Antibiotic Therapy for Serious Bacterial Infections

wwwplanetreeorg

Conclusions and Relevance Given the magnitude and seriousness of PICC complications clinicians should reconsider the practice of treating otherwise healthy children with acute osteomyelitis with prolonged intravenous antibiotics after hospital discharge when an equally effective oral alternative exists

wwwplanetreeorg

Every PCORI research publication must include a 500-word lay language description

Patient amp family engagement begins to influence medical research values amp practices

Majority of patient engagement research is qualitative or mixed method with a focus on practices

wwwplanetreeorg

Logic Model for PFE Care Culture

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

Intermediate benefits

bull Patient activation

bull Increased health literacy

bull Increased family presence

bull Improved care coordination

bull Less psychological stress for patients families and staff

bull Improved sleep for patients

bull Improved communication

bull Decreased utilization

bull Fewer malpractice claims

bull Increased trust

bull Improved operational efficiency

bull Culture of safety

wwwplanetreeorg

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

wwwplanetreeorg

What research says about patient access to satisfaction and patient experience

Huppertz JW and Carlson JP Consumers Use of HCAHPS Ratings and Word-of-Mouth in Hospital Choice Health Serv Res 2010 Dec 45(6 Pt 1) 1602ndash1613 doi 101111j1475-6773201001153x

bull A study examined results of exposing 309 consumers to hospital patient satisfaction results and anecdotal email stories about the scores

bull Patient intention to choose a hospital was most positively affected when both the scores and stories were positive

bull There was less of an effect if scores were positive but the story was not

bull Patient testimonials and positive stories may be very influential on consumer decision-making in addition to scores

wwwplanetreeorg

Conclusions and Relevance Given the magnitude and seriousness of PICC complications clinicians should reconsider the practice of treating otherwise healthy children with acute osteomyelitis with prolonged intravenous antibiotics after hospital discharge when an equally effective oral alternative exists

wwwplanetreeorg

Every PCORI research publication must include a 500-word lay language description

Patient amp family engagement begins to influence medical research values amp practices

Majority of patient engagement research is qualitative or mixed method with a focus on practices

wwwplanetreeorg

Logic Model for PFE Care Culture

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

Intermediate benefits

bull Patient activation

bull Increased health literacy

bull Increased family presence

bull Improved care coordination

bull Less psychological stress for patients families and staff

bull Improved sleep for patients

bull Improved communication

bull Decreased utilization

bull Fewer malpractice claims

bull Increased trust

bull Improved operational efficiency

bull Culture of safety

wwwplanetreeorg

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

wwwplanetreeorg

What research says about patient access to satisfaction and patient experience

Huppertz JW and Carlson JP Consumers Use of HCAHPS Ratings and Word-of-Mouth in Hospital Choice Health Serv Res 2010 Dec 45(6 Pt 1) 1602ndash1613 doi 101111j1475-6773201001153x

bull A study examined results of exposing 309 consumers to hospital patient satisfaction results and anecdotal email stories about the scores

bull Patient intention to choose a hospital was most positively affected when both the scores and stories were positive

bull There was less of an effect if scores were positive but the story was not

bull Patient testimonials and positive stories may be very influential on consumer decision-making in addition to scores

wwwplanetreeorg

Every PCORI research publication must include a 500-word lay language description

Patient amp family engagement begins to influence medical research values amp practices

Majority of patient engagement research is qualitative or mixed method with a focus on practices

wwwplanetreeorg

Logic Model for PFE Care Culture

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

Intermediate benefits

bull Patient activation

bull Increased health literacy

bull Increased family presence

bull Improved care coordination

bull Less psychological stress for patients families and staff

bull Improved sleep for patients

bull Improved communication

bull Decreased utilization

bull Fewer malpractice claims

bull Increased trust

bull Improved operational efficiency

bull Culture of safety

wwwplanetreeorg

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

wwwplanetreeorg

What research says about patient access to satisfaction and patient experience

Huppertz JW and Carlson JP Consumers Use of HCAHPS Ratings and Word-of-Mouth in Hospital Choice Health Serv Res 2010 Dec 45(6 Pt 1) 1602ndash1613 doi 101111j1475-6773201001153x

bull A study examined results of exposing 309 consumers to hospital patient satisfaction results and anecdotal email stories about the scores

bull Patient intention to choose a hospital was most positively affected when both the scores and stories were positive

bull There was less of an effect if scores were positive but the story was not

bull Patient testimonials and positive stories may be very influential on consumer decision-making in addition to scores

wwwplanetreeorg

Logic Model for PFE Care Culture

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

Intermediate benefits

bull Patient activation

bull Increased health literacy

bull Increased family presence

bull Improved care coordination

bull Less psychological stress for patients families and staff

bull Improved sleep for patients

bull Improved communication

bull Decreased utilization

bull Fewer malpractice claims

bull Increased trust

bull Improved operational efficiency

bull Culture of safety

wwwplanetreeorg

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

wwwplanetreeorg

What research says about patient access to satisfaction and patient experience

Huppertz JW and Carlson JP Consumers Use of HCAHPS Ratings and Word-of-Mouth in Hospital Choice Health Serv Res 2010 Dec 45(6 Pt 1) 1602ndash1613 doi 101111j1475-6773201001153x

bull A study examined results of exposing 309 consumers to hospital patient satisfaction results and anecdotal email stories about the scores

bull Patient intention to choose a hospital was most positively affected when both the scores and stories were positive

bull There was less of an effect if scores were positive but the story was not

bull Patient testimonials and positive stories may be very influential on consumer decision-making in addition to scores

wwwplanetreeorg

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

wwwplanetreeorg

What research says about patient access to satisfaction and patient experience

Huppertz JW and Carlson JP Consumers Use of HCAHPS Ratings and Word-of-Mouth in Hospital Choice Health Serv Res 2010 Dec 45(6 Pt 1) 1602ndash1613 doi 101111j1475-6773201001153x

bull A study examined results of exposing 309 consumers to hospital patient satisfaction results and anecdotal email stories about the scores

bull Patient intention to choose a hospital was most positively affected when both the scores and stories were positive

bull There was less of an effect if scores were positive but the story was not

bull Patient testimonials and positive stories may be very influential on consumer decision-making in addition to scores

wwwplanetreeorg

What research says about patient access to satisfaction and patient experience

Huppertz JW and Carlson JP Consumers Use of HCAHPS Ratings and Word-of-Mouth in Hospital Choice Health Serv Res 2010 Dec 45(6 Pt 1) 1602ndash1613 doi 101111j1475-6773201001153x

bull A study examined results of exposing 309 consumers to hospital patient satisfaction results and anecdotal email stories about the scores

bull Patient intention to choose a hospital was most positively affected when both the scores and stories were positive

bull There was less of an effect if scores were positive but the story was not

bull Patient testimonials and positive stories may be very influential on consumer decision-making in addition to scores

wwwplanetreeorg

PRACTICES bull Practices that promote

patient and family engagement

bull Practices that attend to the emotional social and spiritual needs of patients families

bull Practices that attend to the emotional social and spiritual needs of healthcare professionals

bull Practices that engage patientsfamilies in research activities

bull Learning opportunities at every patient touchpoint

wwwplanetreeorg

Starting tomorrow I will ___________ to move patient-centered care forward

wwwplanetreeorg

Alan Manning amanningplanetreeorg

PlanetreeAlan

Susan Frampton sframptonplanetreeorg Planetree

wwwplanetreeorg

Starting tomorrow I will ___________ to move patient-centered care forward

wwwplanetreeorg

Alan Manning amanningplanetreeorg

PlanetreeAlan

Susan Frampton sframptonplanetreeorg Planetree

wwwplanetreeorg

Alan Manning amanningplanetreeorg

PlanetreeAlan

Susan Frampton sframptonplanetreeorg Planetree