Supporting Patient And Family Engagement: Best Practices .
Information to Help Hospitals Get StartedSupporting Patient and FamilyEngagement: Best Practicesfor Hospital LeadersKey TakeawaysHospital leaders have a criticalrole in creating and sustaining asupportive environment forpatient and familyengagement.Leaders make a commitmentto patient and familyengagement by: Modeling partnerships withpatients and families Reaching out to staff,clinicians, patients, andfamilies to identify andovercome barriers Providing resources andsupport Providing incentives thatencourage the adoption ofstaff behaviors to facilitatepatient and familyengagementThe Guide to Patient and Family Engagement in Hospital Quality and Safety is anevidence-based resource to help hospitals improve quality and safety by engagingpatients and family members. * Patient and family engagement creates anenvironment in which clinicians, hospital staff, patients, and families work togetheras partners to improve the quality and safety of care.Strong hospital leadership is essential for creating and sustaining a supportiveenvironment for patient and family engagement.(1-5) The ability of hospital leadersto advocate for and participate in change initiatives significantly increases ahospital’s ability to innovate and sustain change.(4, 6) Effective leaders: Communicate the hospital’s vision and values related to patient and familyengagement Serve as role models for partnering with patients and family members Provide the necessary infrastructure and resources Involve and support clinicians and hospital staff in patient and familyengagement initiatives Integrate patient and family engagement into personnel policies and practicesThroughout this document, we have included examples and real-world experiencesfrom hospitals that participated in a series of interviews. This document also containsinformation from three hospitals that implemented the Guide strategies in a yearlong pilot project: Advocate Trinity Hospital in Chicago, IL; Anne Arundel MedicalCenter in Annapolis, MD; and Patewood Memorial Hospital in Greenville, SC.*The Guide was developed for the U.S. Department of Health and Human Services’ Agency forHealthcare Research and Quality by a collaboration of partners with experience in and commitment topatient and family engagement, hospital quality, and safety. Led by the American Institutes forResearch, the team included the Institute for Patient and Family-Centered Care, ConsumersAdvancing Patient Safety, the Joint Commission, and the Health Research and Educational Trust.Other organizations contributing to the project included Planetree, the Maryland Patient SafetyCenter, Aurora Health Care, and Emory University Hospital.Guide to Patient and Family Engagement:: 1
Information to Help Hospitals Get StartedCommunicate the hospital’s vision and valuesrelated to patient and family engagementLeaders who explicitly communicate the vision for patient and family engagementhelp ensure that everyone recognizes the importance of patient and familyengagement for improving the safety and quality of hospital care.Align the hospital’s mission and vision statements to supportpatient and family engagementMission and vision statements are tangible representations to clinicians, staff,patients, and families of a hospital’s commitment to patient and familyengagement. They also help create a pathway for change by fostering a sharedsense of purpose and prioritizing critical elements.(7)Ideally, the hospital’s mission statement should: Articulate a clear commitment to patient and family engagement Reflect the perspectives and input of all involved parties, including clinicians,staff, patients, and family members(8) Articulate simple elements that can be easily repeated and embedded in routineactivities(9)Cooper University Hospital’s Vision StatementCooper University Health Care in Camden, NJ will be the health care leader inthe Delaware Valley providing exceptional medical care and service for everypatient, every day in a patient-centered, family-focused environment. A patient is an individual to becared for, not a medical conditionto be treated. Each patient is a unique person withdiverse needs. Each staff member is a caregiverwhose role is to meet the needs ofeach patient. Our patients are our partners andhave knowledge that is essential totheir care. Our patients’ family and friends arealso our partners in our patients’well-being, and we welcome theirinvolvement. Access to understandable healthinformation is essential to empowerpatients to participate in their care,and it is our responsibility toprovide access to that information. The opportunity to make decisionsis essential to the well-being of ourpatients. It is our responsibility tomaximize patients’ opportunities forchoices and to respect thosechoices. Our patients’ well-being can beenhanced by an optimal healingenvironment. In order to effectively care for ourpatients, we must also care for eachother. Patient-and family-centered care isthe core of a high-quality health caresystem and a necessary foundationfor safe, effective, timely, andequitable care.Guide to Patient and Family Engagement:: 2
Information to Help Hospitals Get StartedIncorporate patient and family engagement intothe hospital’s strategic planA hospital’s strategic plan can help lay out how patient and family engagement fitsinto organizational processes on a daily, operational basis. For example, as part of aprocess to integrate various entities under a common organizational umbrella, theUniversity of Wisconsin Health system in Madison, WI, added “service excellence”as a formal strategic pillar. In defining service excellence, the strategic planemphasized the organization’s focus on patient-and family-centered care andpatient and family engagement. The strategic focus on service excellence led toseveral specific initiatives, including allowing family members on hospital units 24hours a day, creating patient and family advisory councils, and including patientsand families on various quality and safety committees.(10) At Patewood MemorialHospital, the strategic pillar of “service” includes an explicit recognition of the focuson patients and families. This is also reflected in the Philosophy of ProfessionalNursing, which is based on patient- and family-centered care and the Planetreemodel of patient-centered care. Anne Arundel Medical Center formallyincorporates patient- and family-centered care into their organizational goals andstrategic plans. For example, in fiscal year 2012, implementing bedside shift reporthospital-wide was an organizational goal in the strategic plan. Anne ArundelMedical Center’s written policies and procedures also reflect the value placed onpatient- and family-centered care, acknowledging the importance of informationsharing, participation, and collaboration between staff, patients, and families.Repeatedly communicate the organization’s mission, vision,and commitment to patient and family engagementAnother essential role for senior leadership is disseminating clear and consistentmessages about the importance of patient and family engagement. In doing this, itis important for leaders to find ways to communicate with staff on a regular basis.For example, the chief executive officer of the University of Wisconsin Health sendsout a weekly one-page communication to all staff members that focuses on theorganization’s key strategic priorities, including patient and family engagement.(10)Likewise, the chief executive officer and other senior leaders at Enloe MedicalCenter in Chico, CA, send out weekly messages about patient and familyengagement-related issues that can be accessed on a dedicated employee phoneline. Emails encourage staff to listen to the messages which are also posted in hardcopy in areas where employees and physicians congregate.(1) As noted by theformer chief executive officer of Cincinnati Children’s Hospital in Cincinnati, OH,this type of frequent communication also needs to be accompanied by clearexpectations for clinicians and staff (e.g., providing the message that patient andfamily engagement is an expectation, not a choice).(11)Guide to Patient and Family Engagement:: 3
Information to Help Hospitals Get StartedIncorporate patient and family stories whenever possibleAnother strategy for conveying the importance of patient and family engagementis using patient and family stories to describe the type of care your hospital isstriving to provide. This means telling patients’ stories, not just sharing statistics,when discussing successes and failures. Some organizations have created a policywhereby every meeting begins with a “mission moment” during which a staffmember shares a story about a particular patient or reads a patient letter. Thepatient story establishes the tone for the meeting and reminds attendees to discussissues with patients and families in mind.(1)Share outcomes related to patient and family engagementLeaders not only put systems into place to measure the outcomes of patient andfamily engagement but also share collected data and outcomes with clinicians andstaff.(12) By sharing quality and safety data about the organization, leaders helpcreate a culture of transparency and improvement. Sharing data also helps staffidentify areas for improvement and allows them to see what the hospital is doingwell. Sharing positive experiences can be particularly important in helping staff tocelebrate successes and build on areas of strength. At Advocate Trinity Hospital,the implementation of Strategies 2, 3, and 4 from the Guide on a medical-surgicalunit resulted in improved CAHPS Hospital Survey scores. Hospital leadershipmade a point of recognizing these outstanding scores throughout the hospital.Serve as role models for engaging in partnershipswith patients and family membersBy “talking the talk” and “walking the walk,” hospital leaders emphasize theimportance of patient and family engagement and model how to engage in bestpractices daily.(13)Helpful LinkFor more information aboutconducting leadershiprounds:Patient Safety LeadershipWalkRoundsAvailable tSafetyLeadershipWalkRounds.aspxConduct leadership rounds with staff, patients,and family membersRounding connects senior leaders and board members with patients and familiesand signals to staff that leadership is committed to patient and family engagement.At Alegent Health at Midlands in Papillion, NE, for example, the chief operatingofficer regularly conducts leadership rounds, often taking pictures of things he findsinspiring and sharing the photos in presentations and newsletters to reinforcepatient- and family-centered practices.(1) At Advocate Trinity Hospital, leadersconducted rounds with patients to ensure that nurse change-of-shift reports werehappening at the bedside as planned and to obtain patients’ perspectives. Includingpatients and family members in leadership rounding teams can send an evenstronger message about the importance of patient and family input and insight.Guide to Patient and Family Engagement:: 4
Information to Help Hospitals Get StartedEstablish channels for direct communication withpatients and family membersSenior leaders can communicate and interact directly with patients and familymembers in ways that publicly emphasize two-way communication. For example,the former chief executive officer of the University of Colorado Hospital in Aurora,CO, started a program whereby patients and family members could send himfeedback about their experiences via email. He responded to each email personallyand often forwarded relevant messages to appropriate staff so that they could seethe feedback, whether positive or negative.(2) This program sent a strong signal tothe entire organization on the importance of listening to patients and families.Involve patients and families in the development ofpolicies and proceduresGuide ResourcesStrategy 1: Working WithPatients and Families asAdvisors containsinformation and tools tohelp hospitals begin to workwith patients and families asorganizational-leveladvisors.Leaders can also involve patients and family members as hospital-level advisorsand enforce the authentic involvement of these advisors in the planning,development, implementation, and evaluation of hospital policies and procedures.This can involve, for example, requiring that any planning initiative include patientsand family members as part of the team before the initiative can move forward.Attend meetings of Patient and Family Advisory Councilsto discuss hospital priorities and seek input fromcouncil membersAt hospitals within University of Wisconsin Health, the chief executive officer, chiefmedical officer, and senior vice president for patient care services periodicallyattend meetings of the patient and family advisory councils.(10) At Duke UniversityHealth system in Durham, NC, the chancellor of the health system, senior leadersfrom the system’s hospitals, the system-level patient safety officer, and chiefnursing officer regularly attend meetings of Duke’s Patient Advocacy Council toreceive feedback and reinforce leadership commitment to patient- and familycentered care.(14) At Anne Arundel Medical Center, the chief nursing officerregularly attends meetings of their patient and family advisory council.Provide the necessary infrastructure and resourcesAlthough hospitals do not need to make major investments to effectivelyimplement patient and family engagement strategies, moving forward doesrequire resources to create and maintain opportunities for patient and familyengagement.Guide to Patient and Family Engagement:: 5
Information to Help Hospitals Get StartedCreate an organizational structure with a place forpatient and family engagementCreating an organizational structure with a place for patient and familyengagement helps ensure responsibility and accountability for progress. Thespecific organizational structure for patient and family engagement and patientand family-centered care will vary from organization to organization.For example, Cincinnati Children’s Hospital created a core corporate function,housing patient- and family-centered care under the senior vice president forquality and transformation. Other organizations elect to set up a small, dedicatedoffice or department to support patient- and family-centered care.(2) Still otherorganizations have created a steering committee for patient- and family-centeredcare or a patient experience team with responsibility for these functions.Provide resources for staff positions to supportpatient and family engagementGuide ResourcesStrategy 1: Working WithPatients and Families asAdvisors contains additionalinformation about the roleof the staff liaison.Staff will need time to develop, implement, integrate, and coordinate variousinitiatives, such as recruiting, selecting, and training patient and family advisors orestablishing patient and family advisory councils. If hiring new staff is not feasible,existing staff should be allocated time for patient-and family-centered careactivities. Important roles may include an executive sponsor for patient- and familycentered care, patient- and family-centered care coordinators, staff liaisons tofacilitate the process of developing partnerships with patient and family advisors,and unit coordinators to assist with patient-and family-centered care initiatives onthe clinical unit.(12) These key staff members at the operational level help translatethe hospital leaders’ vision into practical programs and procedures. Frequently,these individuals are existing clinical staff, such as nurse leaders, who are wellrespected and who have institutional memory and the necessary connections atboth the administrative and clinical levels to get things done.(2) Although eachhospital will choose to assign resources differently, patient and family engagementactivities can take up a meaningful portion of time. For example, at SUNY Upstatein Syracuse, NY, the staff champion for patient- and family-centered care spendsroughly three-quarters of her time on activities related to patient- and familycentered care, including integrating such activities throughout the organization.(2)Guide to Patient and Family Engagement:: 6
Information to Help Hospitals Get StartedProvide opportunities for ongoing education and trainingHospital leaders have a critical role in providing training and support foradministrative leaders, clinicians, and staff on how to collaborate and partnereffectively with patients and families. Investing in staff development related topatient and family engagement helps staff partner meaningfully with patients andfamilies not only in direct patient care but also in quality and safety initiatives,educational endeavors, evaluation, and research.(12)For some organizations, investing in temporary or permanent coaches helps withthe transition to patient and family engagement. For example, the University ofWashington Medical Center’s Office of Medical Affairs in Seattle, WA, employs anurse who serves as “MD Coach.” The coach observes residents as they conductpatient interviews and assessments and then provides feedback on residents’ skillsin communicating with and engaging patients and family members.(1) Otherorganizations provide opportunities for formal education, training sessions, orretreats. For example, Georgia Health Sciences Health System in Augusta, GA, helda series of 4-hour offsite retreats to focus on patient- and family-centered careafter which staff were required to develop an action plan tailored to their sites.(2)Mid-Columbia Medical Center in The Dalles, OR hosted a 5-day cultural orientationprocess for all employees featuring an “experience center” that allowed staff to actas patients.Build in longer-term resources for the expansion of activitiesIn the long-term, it may be necessary to invest in new resources or the upgrading ofexisting resources to further your organization’s commitment to patient and familyengagement.(15) For example, hospitals may wish to invest in informationtechnology and create patient portals and Web sites that let patients and familymembers access vital information about the hospital and their care (e.g., aboutfacilities and services or clinical information), communicate with physicians, makeappointments, view personal health information, or retrieve test results. As anotherexample, hospitals may wish to invest in the physical environment. Because thequality of the physical environment in which care is provided represents a criticallyimportant component of patient- and family-centered care, hospitals may make aninvestment in physically altering patient rooms or common spaces in accordancewith patient- and family-identified needs.(9)Involve and support clinicians and hospital staffin patient and family engagement initiativesCreating a culture of patient and family engagement will be more likely to succeedif senior leaders include hospital staff in the change process from the beginning,listen to and address their concerns, and support them throughout the process.Guide to Patient and Family Engagement:: 7
Information to Help Hospitals Get StartedOffer a range of opportunities for staff involvement in planning,implementation, and evaluationInvolving staff in all phases of initiatives helps address staff concerns and createsbuy-in for patient and family engagement. For example, leaders can involve staff indeveloping statements of core values and new practices, ask nurses to help revisejob expectations, or invite frontline staff to participate in the planning process fornew patient and family engagement initiatives. Also, giving autonomy to mid-levelleaders, such as nurse managers, to implement day-to-day activities helps ensureefforts are implemented in a way that works best for the staff and patients on theunit. These opportunities should complement the availability and schedule ofclinicians and hosp
on patients and families. This is also reflected in the Philosophy of Professional Nursing, which is based on patient- and family-centered care and the Planetree model of patient-centered care. Anne Arundel Medical Center formally incorpor
Patient and Family Centred Care (or person/people centred care) is the philosophy of care, Patient Engagement is an approach to Patient and Family Centred Care and Patient Experience is an outcome. Patient engagement is the act of involving the patient and their family in decision-making, design, planning,
This is the work of patient and family engagement— bringing patient and family voices to decisions about care, to healthcare organizational design and governance, and to public policy. The evidence on the benefits of doing this is compelling, so much so that patient and family engagement has been called the "blockbuster drug of the century."
As the Family Engagement Coalition members articulated their definition of family engagement, they realized some aspects of partnerships need ongoing attention and support to be effective. Effective family engagement practices are characterized by six components. Effective family engagement in children's/youth's growth and learning is: 1.
4 Patient and Family Engagement Resource Compendium exeCuTive summary By partnering with patients, their families and other caregivers, hospitals can improve the quality and safety of health care, 1,2 reduce costs,3 increase employee satisfaction4,5 and improve the patient experience.6 Carmen et al.7 define patient and family engagement as “patients, families, their
1. Discharge planning checklist discussed prior to admission 2. Shift change huddles/bedside shift reporting Policy & Protocol: 3. Dedicated functional area for patient and family engagement 4. Active patient and family engagement committee or patient advisor
2. Implementing customer engagement 12 Effective customer engagement is a dialogue 12 Effective customer engagement aims to build mutual trust 13 Effective customer engagement is strategic and planned 13 Effective customer engagement recognises a scale of participation 16 Effective customer engagement is conducted responsibly 17 Case Study 2 18 3.
Engagement Report 2021 Credit Suisse Rockefeller SM Ocean Engagement Fund. Engagement für eine Blue Economy. 2/22. Engagement Report 2021 3/22 Inhaltsverzeichnis 04 Vorwort 06 Engagement-Indikatoren 07 Rückblick auf 2020 08 Schlüsselereignisse, die 2020 die Agenda für einen nachhaltigen Ozean
the unparalleled patient, family and employee experience Language of Caring Employee Engagement: Key to the Exceptional Patient Experience INSIDE THIS ISSUE 1 EmployEE EngagEmEnt 2 Staff mEEting activity 3 nEwSbytE 4 QuotEworthy 5 cElEbrating nurSE caring 6 wEbinar-thE rEturn on invEStmEnt (roi) for improving thE patiEnt ExpEriEncE 7 frEE .
