Project PARIS- Parents and Residents in Session –Teaching family-centered care in a training

programChristine Low, L.C.S.W.1, 2, Rachel A. Annunziato, Ph.D.1,4, Melissa Rubes, B.A.4, Eyal Shemesh,

M.D.1, Dana Wyles, B.S.N., M.L.S.3, Joel Forman, M.D.1

Mount Sinai Medical Center, New York, Departments of Pediatrics1, Social Work Services2, and Child Life and Creative Arts Therapy3, and Fordham University, Department of Psychology4

The aims of this research were to (1) improve the knowledge and attitudes of medical trainees regarding the practice of patient and family centered care (PFCC), and (2) to ascertain if there is an ideal time to offer PFCC education to medical trainees for maximal impact.

•8 family faculty volunteer to use their own family's healthcare experiences to highlight core tenets of family centered care to medical trainees. •Hospital staff write a manual outlining the session content.•The patient and family centered care coordinator trains family faculty participants for 2 hours regarding the purpose of the study and the session content. •Family faculty discuss 10 standardized topics related to family centered care, using the manualized approach, in one hour meetings with the trainees. •Pre and Post session questionnaires are given to participant trainees.•Trainees’ acceptance of patient centered care is evaluated via a Likert scale with 6 questions, with a range of scores of 6-30. • Pre and post evaluations scale scores compared using T tests.•Family faculty experience is also captured using a 9 item questionnaire designed for the study.

AIM:

CHANGES MADE:

STRATEGY for CHANGE:

Accreditation bodies (including The Joint Commission, the Accreditation Council for Graduate Medical Education , Magnet and the American Academy of Pediatrics) have embraced the need to incorporate patient and family centered principles into training methodologies and hospital operations. Patient and family centered care has also has become a training requirement for pediatric residency programs in the United States. The Department of Pediatrics at Mount Sinai School of Medicine has embarked on a multi-year strategic effort to improve the provision of family centered care in inpatient and outpatient settings. The Parents and Residents in Session (PARIS) initiative was launched as part of this effort in October 2010 with input from physicians, psychologists , nursing, social work, and child life. Project PARIS calls for a supervised meeting between a family member of a previously hospitalized child and a medical trainee. The meeting addresses the perspective of the family during the child’s hospital stay and encourages communication between family members and physicians when making healthcare decisions.

In phase 1 (2010-2011) 29 pediatric residents participated in training sessions with 7 family faculty members. Mean scores on the Attitudes measure given to the residents showed significant improvement after the session . Similarly, Knowledge scores also significantly improved.

In phase 2 (2011-2012) 52 medical students participated in training sessions with 5 family faculty members. Mean scores on the Attitudes measure given to the medical students showed significant improvement after the session but there was no significant improvement in the knowledge scores for this group.

RESULTS:

MEASUREMENT of IMPROVEMENT:

Trainee’s knowledge of family centered care principlesTrainee’s attitude regarding family centered care practicesFamily faculty experience of participation in teaching efforts

LESSONS LEARNED:

As patient and family centered care has been embraced as a preferred method of practice and as a requirement in pediatric training programs project PARIS seems to be a feasible and highly promising way to incorporate patient and family centered care practices into training curricula. This training methodology requires investment in the recruitment, training and coordination of family faculty but then can be easily incorporated into existing training rotations.

32.5%35.7%

52.4%

38.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Residents Students

Knowledge Score: % Correct

Pre

Post

P - Value = .026 (Significant)

P - Value = .699 (Not Significant)

22.71

20.26

25.84

22.15

0

5

10

15

20

25

30

Residents Students

Attitude Mean Score

Pre Post

P - Value < .01 (Significant)

P - Value < .01 (Significant)