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Planetree 2012
INTERNATIONAL ACTIVITIES
ADVANCED PATIENT-CENTERED PRACTICES
Hello from Planetree International Staff!
INTERNATIONAL ACTIVITIES
Planetree Partner Activities
• Planetree Netherlands- The largest patient-centered member community outside of the U.S.
• Annual member day event with over 570 participants!
• High quality, innovative members, including some of the first Planetree Designated sites
Netherlands
First Hospitals in Europe Awarded Planetree Designation, and First LTC Sites in the World
Gemini Hospital,
The Netherlands
LTC SITES DESGINATED IN 2010/2011
• De Merlinge
• Judith Leysterhof
• The Toonladder
Newest Designated Dutch LTC Communities…
Het Gasthuis
Molenhoek (Rivas Zorggroep)
Tiendwaert (Rivas Zorggroep)
De Vijverhof (Rivas Zorggroep)
Pantein Care Center Op’t Hoogveld
Pantein Care Center Huize Loôn
De Wieken (Rivas Zorggroep)
Planetree Quebec:
19 healthcare organizations
1 manufacturing company
Potential New Planetree Partners
• Brazil – In active discussion
– Possible structure as a part of an existing or a new subsidiary of Hospital Israelita Albert Einstein
• Australia – Preliminary discussions
– Collaborative involving two parties, Health Consumers Alliance of South Australia and regional Ministry of Health
New Collaboration Opportunities
• Joint Commission International (JCI)
• Denmark-Unit of Patient-Perceived Quality, The Capital Region of Denmark Copenhagen
• Singapore-Ministry of Health
• Malaysia-International Medical University
2012 Planned International Engagements
• Brazil: Latin American Hospitality Congress-March
• France: IHI/BMJ International Forum-April
• Singapore: Patient-Centered Care Workshop-April
• Quebec: Coordinator day and Board meeting-June
• Scotland: NHS Lothian University PCC Symposium- June
• Kenya: USAID African Leadership Workshop- June
• Japan: Japanese Society Quality Assurance-September
• Australia: Health Consumers Association- September
• Switzerland: ISQua Conference-October
One patient’s experience ignited a global movement
“…the ideal hospital would
combine the best of modern
medicine, with the best
possible patient care
experience to become a truly
healing environment, where
just being there is healing .”
Angelica Thieriot
1978
A simple message to all healthcare providers:
“How do you want to be remembered?”
-Laura Gilpin, RN
Our challenge: to listen to the patient and include them as members of the health care team
Personalize Humanize Demystify
Our challenge: to share information and decision-making with the patient
Project Puts Records in the Patients’ Hands By RONI CARYN RABIN
Published: January 9, 2012
“The medical record is information that really belongs to the patient, but it’s treated like a classified document,” said Susan B. Frampton, president of Planetree, a nonprofit organization based in Derby, Conn., that promotes patient-centered approaches to health care.
DEFINING, MEASURING AND RECOGNIZING EXCELLENCE IN PATIENT-CENTERED CARE
PLANETREE DESIGNATION
Planetree Designation Program
28 Planetree Designated Sites Worldwide
14 sites in the U.S.
12 sites in the Netherlands (10 continuing care sites; 2 hospitals)
1 site in Quebec, Canada
1 site in Brazil
Designated Hospitals
Carolinas Medical Center-Mercy (NC)
Centre de réadaptation Estrie, Quebec
Delnor Hospital (IL)
Fauquier Hospital (VA)
Flevoziekenhuis, The Netherlands
Gemini Ziekenhuis, The Netherlands
Griffin Hospital (CT)
Hospital Israelita Albert Einstein (Brazil)
Kadlec Regional Medical Center (WA)
Longmont United Hospital (CO)
Mid-Columbia Medical Center (OR)
New York Presbyterian Hospital/
Westchester Division (NY)
Northern Westchester Hospital (NY)
Sharp Coronado Hospital (CA)
Valley View Hospital (CO)
Waverly Health Center (IA)
Windber Medical Center (PA)
Dutch Resident-Centered Communities
Care Center, Huize Loôn
OUTCOMES SUPPORTING PLANETREE MODEL OF CARE
Perc
ent
(%)
Planetree Designated hospitals are more highly recommended
Patients Would Definitely Recommend This Hospital to Friends and Family
Perc
ent
(%)
Planetree hospitals are more highly recommended
Patients Would Definitely Recommend This Hospital to Friends and Family
Perc
ent
(%)
Planetree hospitals are more highly recommended
Patients recommend Planetree designated hospitals significantly
more than peers (9%+)
Patients Would Definitely Recommend This Hospital to Friends and Family
Patients are more satisfied at Planetree hospitals
% of Patients Highly Satisfied (Scored a 9 or 10)
Perc
ent
(%)
Patients are more satisfied at Planetree hospitals
% of Patients Highly Satisfied (Scored a 9 or 10)
Perc
ent
(%)
Patients are more satisfied at Planetree hospitals
% of Patients Highly Satisfied (Scored a 9 or 10)
Perc
ent
(%) Patients at Planetree
designated hospitals are significantly more
satisfied than at other hospitals (8%+)
ADVANCED PRACTICES IN PATIENT CENTERED CARE
ALBERT EINSTEIN HOSPITAL BRAZIL
• The hospital was built in 1971 by Jewish Benevolent Albert Einstein Brazilian Society.
• Reputation for cutting edge technology, humanized care and a commitment to social responsibility, teaching and research.
Why Planetree?
“Planetree complements the Society’s mission, and
guides the humanization of the hospital, with well-structured strategies and strong impact on
the results of customer satisfaction.”
Facilitators of Humanization
OA • Staff education and training in humanization
PA
• Engaging leadership—doctors, managers, and supervisors—to model humanization
• Humanizing the environment (e.g., quiet)
DA • Empowering patients with information
• Actively engaging volunteers
Humanization is Increasingly Evident across HIAE
• “Each sector improving its care, humanizing, it’s becoming more humanized, and this has been a strong point for Einstein.” (Employee)
• “Once the Planetree training is done with all employees… I think the humanization, the focus on the patient, will improve a lot…. If there’s more focus on patients… this will improve care because the organization, what it does for patients, is excellent. Humanization as Planetree will make this even better...”(Employee)
Certain patients in certain units
More units and also families and staff
Entire hospital, and also physicians
Findings: Improved staff empathy and compassion as measured by patient compliments vs. complaints
4,63
10,01
36,3
0
5
10
15
20
25
30
35
40
Indicador
2009 2010 2011
Período
Indicador de Humanização
CMC MERCY HOSPITAL U.S.A.
Fast Track to Designation
• Focused on Staff Engagement, Medical Staff Engagement, Communication, Measurement
Identified Leaders and Engaged Staff
• Identified and engaged top performers to participate on the steering committee and in work groups
• 94 percent of staff attended retreats in the first two years (2008-2009)
• Staff now attending second level retreats (2010-2012)
Focus on Medical Staff Engagement
• Dr. Waxman co-chaired Planetree steering committee that led to creation of his role: – Medical Director, Patient-Centered
Care
• Medical Executive Committee Involvement
• New Physician Orientation • Physician Well-being Talks • Schwartz Center Rounds
Dashboard Measures Outcomes, Tracks Progress
• Mercy Experience Dashboard measures outcomes and tracks progress
– Inpatient “excellent” scores for nurse communication soared from 43.4% to 87.7%
– Likelihood to recommend increased from 61% to 80.8%
– Workforce commitment indicator score rose to 89th percentile
Patient Safety: Outperforming in every domain
SHARP HEALTHCARE SYSTEM U.S.A.
Ailing Hospital Seeks a Cure
2000: Sharp Coronado Hospital failing: eroding market share, negative operating margins, an aging medical staff and difficulty recruiting
2002: Planetree affiliation: The focus of Planetree
implementation was on engaging staff and physicians, changing attitudes, and listening to the voice of patients and families.
2005: “Planetree Unit Designation” process engaged
the team
Planetree Pathway to Health and Wellness
• Steering committee, a multi-disciplinary hospital-wide workgroup
• Patient and family advisory council, staff training, Physician Forums
• Within just a few years, implemented: – patients unrestricted access to their
medical records,
– development of a Care Partner program,
– and introduction of a variety of integrative healing modalities
Exemplary Service, Quality and Safety
• 2007 Malcolm Baldrige National Quality Award (Sharp Healthcare System)
• Press Ganey: for sustaining the highest level of excellence in patient satisfaction for both inpatient care and ED
• “Best Place to Practice” award in 2009 for two consecutive years of physician satisfaction greater than the 95th percentile
• Ranked among the “Top Ten California Hospitals” for clinical quality outcomes.
• This past year Sharp Coronado earned an “Outstanding Patient Experience” Award for HCAHPS scores and its physician satisfaction and engagement ranked at the 99th percentile.
Sharp System Adopts Planetree
• These compelling results helped drive the entire Sharp HealthCare system to adopt the Planetree model in 2010
• In 2011, the 368-bed Sharp Memorial Hospital was named a Designated Planetree Patient-Centered Hospital.
• Co-hosts for the 2012 Planetree Annual Conference in Palm Desert, California on September 30th
INNOVATIONS IN PATIENT-CENTERED PRACTICES
Innovations in Partnering with Patients & Families
Patient Rx
• Developed by Good Samaritan Hospital (Kearney, NE)
• Preferences around visitation
• Cultural/language requests
• Option to request visit from clergy, animal, clown
• Option to review medical record
• Option to designate care partner
• Option to request massage
• Option to request aromatherapy
• Option to purchase guest tray
• Option to request newspaper, videos, games and more
“I had experience running departments in my working career and was eager to share my knowledge and expertise on this project (a Work Team focusing on Job Descriptions and Performance Evaluation). This gave me the opportunity to collaborate, create and implement a project from beginning to completion. I helped the community to have a committed and happy workforce which results in a partnership with residents and a positive atmosphere.”
Engaging Patients and Residents in Hiring Staff
Helen, Resident, Middlewoods of Farmington
Innovations in Partnering with Patients & Families
Innovations in Access to Information
First Quarter 2010: • 15 appointments made through eTalk • 95 questions answered • 1,400+ unique visitors to archived Q&As
Innovations in Embracing the Role of Family
Hackensack University Medical Center’s ED Take A Break Program
Innovations in the Healing Environment: A Patient-Centered Quiet Campaign
A Patient-Centered Quiet Campaign: Outcomes
50
55
60
65
70
% A
lway
s Q
uie
t at
Nig
ht
Designated Hospital National Average
Coming in 2013:
Putting Patients First: The International Field Guide to Patient-Centered Care
2003 2008
Patient-Centered LeanSM
PC LeanSM Objectives:
• Improve identified process outcomes and metrics
• Improve the patient, family and caregiver experiences with care by improving Planetree components within the identified value streams
Strategic
Cultural
Tactical
© PC Lean℠ 2011-2012
PC LeanSM Case Study: Carson Valley Medical Center
Opportunity Statement:
An opportunity exists to improve pharmacy services specifically related to problems with accurately capturing charges, medication access, and inventory waste which results in loss of revenue and decreased patient
and staff satisfaction.
Pharmacy Kaizen Event Activities
• Creation of a Spaghetti Chart Diagram: an analysis of movements made in the workplace for specific processes
• Process breakdown for filling dispensing machines with medications each day
• Workflow of medication administration on Med/Surg Nursing floor.
Improved flow cell reduce travel distance and time (95% improvement)
Allows pharmacist to spend additional 30 min./ day on average at patient bedside.
Process Medication Order:
PC LeanSM Case Study: Outcomes
$180,000 in annualized savings due to reduced process lead times
$20,000 - $40,000 in expired medication refunds (depending on volumes)
$86,000 a year in freed up RN time to be used for patient education
A patient medication self management tool