The Journey toPatient Family Centered Care

PFCC 1

“Nothing about me without me”

Patient and Family Centered Care

Objectives:

• What is PFCC?

• Why PFCC?

• What stays the same?

• What will be different?

• What will be better for our patients/families?

• Why is this better for me?

2

What is PFCC?

• Patient and Family Centered Care is a process of working WITH patients and families, rather than TO or FOR them.

• The patient and family are full partners in the healthcare team including:

–Providing Information–Developing the plan of care–Participating in decision making

3

The PFCC Philosophy

• Our patients are our partners and have knowledge and experience that is essential to their care.

• Our patients’ family and friends are also our partners and we welcome their involvement

• Patients’ want and need to be involved in healthcare decisions/choices.

4

Principles of PFCC

• Information Sharing: Healthcare providers and patients / families share complete and unbiased information with each other.

• Participation: Patients / families build strength with experiences that enhance control and independence.

• Collaboration: Includes policy and program development as well as the delivery of care.

• Dignity and Respect: All people are treated with respect and dignity.

5

Why PFCC?

Experience demonstrates that PFCC:

• Increases:–Quality of care–Patient / Family Satisfaction–Staff Satisfaction

• Decreases:–Patient / Family Stress–Staff / Faculty Stress–Medical Errors and claims–Costs

6

What Stays the Same?

CVC CORE VALUES:• Respect & Compassion

• We honor and care for one another as individuals.

• Collaboration

• We honor the synergy of team and build on trust.

• Innovation

• We honor individual and collective creativity.

• Commitment to Excellence

• We honor the intrinsic desire to be "Leaders and Best".

7

What Stays the Same?

Collaboration:• Mutual respect for skills and knowledge

• Communication that is honest and clear

• Listen with empathy to the patient for understanding

• Mutually agreed upon goals

• Shared decision-making

• Open sharing of information

• Accessibility and responsiveness

• Absence of labeling and blaming

8

What Stays the Same?

Collaboration:• Treat the patient, not just the diagnosis

• Provide information in ways that patients prefer and find useful and affirming

• Work together on setting and achieving daily goals

• Encourage families to actively participate and share observations, ideas, and suggestions for the plan of care

• Acknowledge the experience of the patients and families

9

What will Change?

• Who participates in health care decisions

• How information is shared

• How discussions are conducted

• How decisions are made

10

PFCC Survey Results

• Overall

–We believe PFCC is important–We want to learn more about PFCC–Many work areas encourage PFCC–Many staff and faculty want to learn more–Patient and family participation is encouraged–Many believe that the patient drives their care–Many view patients and families as a unit 11

Barriers

• Staff and faculty “buy in”

• Time to provide PFCC

• Lack of understanding–“I do everything for my patient”–“I already give great customer service”

• Collaborative communication

• Competing interests

• Misperceptions of patient and families 12

How Information is Shared

• From the patients and their families to the cardiovascular center staff

• From the cardiovascular center staff to patients and their families–FAMILY is defined as the individual or group that patients designate as being significant in their life and their care (e.g., biological relative, friend, significant other, etc.)

13

Information from the Patient

• Patient’s will Share:

• History: Social, family medical and personal

• Patient’s personality, preferences and fears

• Description of family dynamics and personalities

14

Get To Know Me . . . Things that cheer me up: Things that stress me out:

Achievements of which I am proud: Other things I’d like you to know (e.g. job, career…):

I understand information best when:

Name:

I liked to be called:

Important People (Family & Friends)

FAVORITES:

(TV/movies, books, music, sports, interests/hobbies …)

Foods

Pets too!

AT HOME I USE:

[ ]Glasses [ ]Dentures [ ]Other:

[ ]Contact Lenses [ ]Wheelchair/Walker:

[ ]Hearing Aid [ ] CPAP

©MGH Collaborative Governance, EICP Committee 2003. Adapted with permission, 2010.

Endorsed by the CVC Patient Family Advisory Committee, July, 2010

Information from the Staff

Staff will Share:• Clear, unbiased information 

• What to expect day to day

• How and why tests and procedures are done

• How treatment is progressing

• Pain management, diagnosis and treatment options including benefits, risks and recommendations

• Prognosis 15

PFCC Information Sharing

Transparency is sharing truthful, unbiased and complete information.

Shared Information:

• Supports the patient and family participation, learning, and accountability for their own care.

• Allows the patient and family more choices to support their care and education from healthcare workers

• Supports collaboration of care across the continuum

16

Transparency

• The University of Michigan has historically and culturally been committed to transparency.

• Our Disclosure of Unanticipated Outcomes Policy states: –“It is the policy of the University of Michigan that patients be treated with openness and honesty at all times… In general, patients should be informed about all aspects of their care and treatments, including unanticipated outcomes.”

17

Who Participates in Healthcare?

• The Patient (Driver of Care)

• And at the request of the Patient:

–Family–Friends–Clergy / Spiritual Advisors

• The CVC Staff and faculty

• Consulting Physicians 18

How Discussions will Occur

Discussions are made as a “team”

• Healthcare providers, patient and family members are all treated with respect as equal members of the team determining about what is best for the patient

• Rounds are conducted at the bedside with the patient

19

How Decisions will be Made 

Decisions are made:

• Legally – the patient must consent to care (if competent)

• With consensus of all members of the patient team being heard

• After all thoughts and feelings are discussed with transparency

• The family or designee is the advocate when the patients can not speak for themselves

20

What Will Patients Gain?

• Patients receive more information

• Patients become more empowered

• Improved patient satisfaction and safety

• Improved outcomes

• Better transition to home

21

What Will Physicians Gain?

• More information to make the best treatment decisions

• Higher patient satisfaction: patients come back and refer others

• Transparency decreases lawsuits because it builds trust between you and the patient

• Collaboration with other care providers at the bedside promotes confidence in the entire team!

22

What Will Nurses Gain?

• PFCC promotes confidence in the care plan which:

–Increases the patient sharing information–Reduces stress patients, families and caregivers–Promotes safety–Reduces concerns–Reduces call lights 23

Metrics

• Press Ganey has added questions

• Staff satisfaction

• Turnover of staff

• Current Press Ganey measure regarding pain, listening, and treatment of visitors

• Change in length of stay (LOS)

• Change in readmissions

• Change in recommending UHMS 24

Results We Anticipate

• Better transition back home

• Increased family participation

• Increased patient satisfaction

• Increased staff satisfaction

• Decrease LOS

• Increased recommendation (technical and emotional needs cared for)

25

Remember:

• Patient and Family Centered Care is not just being nice. It is a direct and intentional effort to unequivocally communicate to patients that they are viewed as distinct and valuable individuals with a family and place in the community. -Hospitals moving forward with patient and family centered care seminar 2006

• Celebrate what you do!!

26

UMHS Future State

“The patient or as appropriate the family or designee, will be the ultimate decision maker or source of control related to their care within medically appropriate options. This includes a free flow of information about the disease or illness; an assessment of the patients' options clearly articulated in a manner that they can understand; and the trusted clinician’s expert advice. The patient will make the decisions for their care to the degree they are most comfortable. “

Source: UMHS – Ideal Patient Care Experience 27

THAT IS THE

MICHIGAN DIFFERENCE!

28

Presenters

• Call with questions –Joan McNeice CVC5 Clinical Nurse Manager 232-5083/7201

–Michele Derheim CPU Director Clinical Operations 615-8107/31856

–Raul Perdomo – Patient and Family Centered Advisory Committee Member

–Bonnie Davis - Patient and Family Centered Advisory Committee Member