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“We want to feel heard and feel valued.”Collaborative Goal Setting with Families
Alda Antunes Silvestre, RN, MSN Program Manager Acute Rehabilitation ProgramRita Janke, RN, MSNQuality, Patient Safety LeaderSunny Hill Health Centre for Children
Family-centered care is neither a destination nor
something that one instantly becomes.
It is a continual pursuit of being responsive to the priorities and choices of
families.- Bissell
Hearing from Families
“Listen to parents, they know their child.”
“We want to be heard and feel valued.”
“Care is not always tailored to us”.
Provide parents with control and choice whenever possible.”
Engage child and parents in decision making.”
Why Goal Setting?Effective means of understanding and changing human behavior. Clear and functional goals enhance motivation, leading to improved outcomes (Oien et al., 2010; Eccles & Wigfield, 2002; Locke & Latham, 2002; Mastos et al., 2007).
Implementing a family centered approach within a goal setting framework emphasizes parental involvement in decision-making, collaboration, and partnership, acceptance of the family’s choices, and empowerment (Law et al. 2003, 2005) Oien et al., 2010); Wiart et al., 2010).
Key Principles for Collaborative Goal Setting
Family identified needsShared responsibility Family empowermentInterprofessional PracticeSpecific tools and processes are needed
to facilitate family collaboration in goal setting.
Value Stream MapFamily Integrated Care
Unified and Integrated Team
Optimizing child participation, motivation, and function
Holding families and each other as capable, resourceful, and whole
Child-centered care
Inspiration from Mike (our family representative)
“The concept of rehab is not just for the child but is a family process…
Emphasizing to the family that they have a key role on the rehab team [because] they will be the teams eyes and ears for
the extended parts of the day”
Current State: Problem and Aim Statements
There is no documented, consistent collaborative goal setting process for children and families
receiving Acute Rehabilitation services.
100% of children will have goals set using a validated goal setting tool.
100% of families will be satisfied with their participation in their child’s rehabilitation
journey.
Intro to TeamThe Winning Team: With Family!
Alda Antunes Silvestre, Tanya St. John, Sandy Tatla, Kim Magnus, Patricia Bastante, Daniel Budgell, Sarah Small, Tamara Zagustin, Michael McCormick, Rita Janke, Kristen Barnes
The Task! By the end of the week….
Choose/develop a goal setting tool
Establish outcome &
process measures
Develop a “scale up”
and sustainment
plan
Develop a goal setting
process which involves families
Begin testing.
I feel the team plans with me so that we are working in the same direction.
1 2 3 4 5 6 7 8 9 100%
10%
20%
30%
40%
50%
60%
70%
0% 0% 0% 0% 0%4% 4%
12%16%
64%n= 25
I have been treated as an equal member of the team.
1 2 3 4 5 6 7 8 9 100%
10%
20%
30%
40%
50%
60%
70%
0% 0% 0%4%
0% 0% 0% 0%
28%
68%
n= 25
The information that the team gave me was consistent from
person to person.
1 2 3 4 5 6 7 8 9 100%
10%
20%
30%
40%
50%
60%
0% 0% 0% 0% 0% 0%
12%
20%
12%
56%n= 25
I know how I can support my child's rehabilitation goals.
1 2 3 4 5 6 7 8 9 100%
5%
10%
15%
20%
25%
30%
35%
40%
0%4%
0% 0% 0%4%
12%
20%24%
36%
Chart Title n= 25
What families are saying…“As my child has changed so quickly the information provided has given me the information we will require to integrate back into our home.”
“Team supported us in our top priorities around feeding and toileting”
“Again, I was included and able to assist in providing my child's care.”
“Consistency prevailed throughout our experience with therapists and nursing.”
“Staff is respectful of me and asking to have my input.”
“Everyone seems to be on the same page.”
Lessons Learned: Our Ongoing Journey
Sustainment
Team Involvement Family
Daily Managem
ent
Coaching
Discussion
PDSAs
Domino Effect
Visual Cues