Tanya Lord M.P.H., Ph.D. NYSPFP

Partnering for Safety: Developing and Enhancing Your Patient Engagement

Programs

Engaging Patient and Families for Safety

“The greatest asset we have underutilized is all the

assets of the patient” ~Maureen Bisognano, president and CEO of the Institute for Healthcare

Improvement.

(and Family)

Tanya Lord 2014

Tanya Lord 2014

Patient and Family engagement is not the latest buzzword.

It is an effective strategy to meet

patient safety, patient experience, and other goals.

Tanya Lord 2014

…patients, families, their representatives, and health professionals working in active

partnership at various levels across the health care system—direct care,

organizational design and governance, and policy making—to improve health

and health care. Source: Carman KL, Dardess P, Maurer M, Sofaer S, Adams K, Bechtel C, Sweeney J. 2013.Patient and family engagement: a framework for understanding the elements and developing interventions and

polices

Tanya Lord 2014

Patient and Family Engagement Defined. . .

"Health Policy Brief: Patient Engagement," Health Affairs, February 14, 2013. http://www.healthaffairs.org/healthpolicybriefs/

Tanya Lord 2014

Truly is patient and family-centered care Helps promote culture change toward patient- centered care Strengthens community relations Improves patient experience scores Improves patient health outcomes Provides different experience, insights and perspectives Involves motivated, passionate partners Improves quality and safety

Tanya Lord 2014

Benefits of Engaging Patients

Engaging patients can improve Medical histories Care transitions Readmission rates Discharge Treatment adherence Decision making Overall communication Many others

Tanya Lord 2014

Engaging Patients Direct Care/Clinical Relationship

Patients and families as advisors on Short-term projects

Patients and families as Advisory council members

Patients and families as members of Hospital committees

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Engaging Patient in Organizational Design

Participate in discussion groups to provide input on care practice or policy changes Review, revise, or help create educational and informational materials for patients and families Serve as faculty in education and trainings Serve as members of an improvement workgroup Share stories with hospital leadership, clinicians, and other staff

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Advisors on Short Term Projects

Patient and family advisory council members work together to: Identify and implement ways of improving the care experience

for all patients and families Discuss and plan changes to improve hospital quality and safety Identify ways of improving the care experience for all patients

and families Council members include patients, families, hospital staff, and

clinicians

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Patient/Family Advisory Councils

Patient Safety/Quality Patient Experience Improvement Facility planning Information technology Ethics Lean Projects And others

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Advisors as Members of Hospital Committees

“Facts bring us to knowledge, but stories bring us to wisdom.”

Rachel Naomi Remen, M.D. Kitchen Table Wisdom

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Patient and Family Story Tellers

If there was a culture of engaging patients and families?

What might have been different in Noah’s Story?

Three patient and family advisors are invited to join a patient safety team that is beginning an initiative to improve medication reconciliation An administrator invites patients and families to comment on the final plans for the facility’s upcoming renovation

Tanya Lord 2014

Patient Engagement or Not?

A multidisciplinary committee develops new educational materials about diabetes management and treatment for patients and their families

A surgeon asks family members who experienced complicated surgical procedure with their adult son to join the surgical residents’ noon conference to discuss what communication from physicians was helpful and what was not.

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More scenarios

I believe in the importance of patient and family participation in planning and decision making at the program and policy level I believe that the perspectives and opinions of patient and family advisors, staff, and clinicians are equally valid in planning and decision making at the program and policy level I believe that patients and family members bring a perspective to a project that no one else can provide I believe that patients, family members, staff, and clinicians can look beyond their own experiences and issues to come up with practical ideas and solutions Tanya Lord 2014

Are You Ready to Partner with Patients? Can you answer “yes” to these statements?

HIPAA Expensive suggestions We don’t need an ongoing committee We will have to do what they do Added risk of ligation Compromise the current culture Negative things being heard Not enough understanding of healthcare No Time No Money

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Perceived Barriers

Do one thing every day that scares you.

Eleanor Roosevelt

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Do you feel ready?

Patient and family engagement is a strategy to improve: Patient care Patient Safety Quality Patient experience Patient outcomes Employee satisfaction

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Key Takeaways

Choose a lead for Patient Engagement Patient Persistent Flexible Good listening skills Open to new ideas and ways of doing things Positive and proactive A sense of humor

Patient and Family advisors can be overseen by many departments, including: Nursing Quality and Safety Support Services Patient experience

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Getting Started is Simple

Decide to engage patients Pick a champion/lead for patient engagement Speak to leadership Consider patient engagement as part of the strategic plan

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What could you do tomorrow?

2006: Together we will provide safe, quality patient and family-centered care 2007-2008: We will provide safe, quality , patient and family-centered care 2009-2011: We will partner with patients and families in the delivery of safe, quality care

Tanya Lord 2014

Strategic Plan Examples

Engaging patients following an error or adverse event

It is never to late to do the right thing

Attending Surgeon Realized that there had been a miss-communication re: Noah having

obstructive sleep apnea

ED Nursing Did not communicate concerns effectively to the surgeon

ED Attending No one took “ownership” of Noah Discharge was not done to protocol

Social Service Did not know of Noah’s case because it went to Risk Management

and a referral was not made

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November, 2010

Noah Thomas Emory Lord 1/25/95-6/14/99

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Pam Dardess, Maureen Maurer, Shoshanna Sofaer, Karen Adams, Christine Bechtel, and Jennifer Sweeney Patient And Family Engagement: A Framework For Understanding The Elements And Developing Interventions And Policies Kristin L. Carman, Health Aff February 2013 32:2223-231

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References