IPFCC website Respect and dignity. Health care practitioners listen to and honor patient and family perspectives and choices. Patient and family knowledge, values, beliefs and cultural backgrounds are incorporated into the planning and delivery of care. Information Sharing. Health care practitioners communicate and share complete and unbiased information with patients and families in ways that are affirming and useful. Patients and families receive timely, complete, and accurate information in order to effectively participate in care and decision-making. Participation. Patients and families are encouraged and supported in participating in care and decision-making at the level they choose. Collaboration. Patients and families are also included on an institution-wide basis. Health care leaders collaborate with patients and families in policy and program development, implementation, and evaluation; in health care facility design; and in professional education, as well as in the delivery of care.
“ Viewing families as allies for quality and safety and supporting their presence and participation in care and decision-making requires change in hospital and unit policies and education and support for staff” IPFCC website
It is the shared responsibility between health care professionals and the patient/family Partnership in care
Adapted from the Lucile Packard Children’s Hospital presentation, October 16, 2011
** from the Lucile Packard Children’s Hospital presentation, October 16, 2011
**You need to understand how the hospital is organized and how it functions before it’s possible to change it ( from the Lucile Packard Children’s Hospital presentation, October 16, 2011 ) Time Unrecognized knowledge/expertise of patients and families Power differential Health care professionals uncomfortable with families present Cultural or gender issues? Trend —What is your institution ready for—often a champion will have a grandiose scheme—parents on the ethics board say—and most in the organization are saying you want parents/patients to do what? Goals and Institutional readiness match Function: once you have that information do you want folks to come in as advisors; work in partnership with you on committees or be more autonomous and develop programs on their own. Authority: Do what I say—or just here my perspective and consider it in your work Manages: is this parent/patient managed or HCP managed or a partnership Recruitment and Screening—Not all are ready to serve—not the right time—do you have a way to determine Training —for those you bring on—do you orient them to your institution—at the least how long change Accountability —how do you know it ’s working
Feedback from health care professionals too? Shaller
The Institute provides consultation, training, and technical assistance to hospitals, clinical practices, educational institutions, architecture firms, community organizations, and agencies at state, provincial, and federal levels.” (IPFCC, 2012)
Self-Assessment tools for evaluating Patient- And Family-Centred Care Practices Available through IPFCC (Johnson, 2000) Family-Centred Pediatric Care in Hospitals: A Self-Assessment Inventory Family-Centred Care in Adult Oncology: A Self-Assessment Inventory Moving Toward Patient- and Family-Centred Care in Geriatrics: Policies, Programs, and Practices: A Self-Assessment Inventory
References Institute for Patient- and Family-Centered Care. www.ipfcc.org Johnson, B. H. (2000). Family-centered care: Four decades of Progress. Families, Systems & Health, 18 (2), 137-156. Little, P., Everitt, H., Williamson, I., Warner, G., Moore, M., Gould, C., Ferrier, K., & Payne, S. (2001). Observational study of effect of patient centredness and positive approach on outcomes of general practice consultations. British Medical Journal , 323(7318), 908-911 . Lucile Packard Children’s Hospital presentation, October 16, 2011 Shaller, D. (2007). Patient-centered care: What does it take? The Commonwealth Fund . (publication number 1067) Stewart, M., Brown, J., Donner, A., McWhinney, I., Oates,J., Weston, W., & Jordan, J. (2000). The impact of patient-centered care on outcomes. The Journal of Family Practice , 49(9), 796-804.
How to measure fcc presentation
27 de abril de 2012
Enfª Profª Dra Nancy Moules Professora Titular Faculdade de EnfermagemUniversidade de Calgary-Canadá
“Patient-and family-centered care is an approach to the planning, delivery, and evaluation of health care that is grounded in mutually beneficial partnerships among health care providers, patients, and families. It redefines the relationships in health care.” IPFCC, 2010
Respect and Dignity Information Sharing Participation Collaboration
Evidence Based Research Supports Patient- and Family-Centered Care Benefits to: Patients & Families Health Care Providers Health Care Organizations Patient Safety IPFCC, 2012
“Viewing families as allies for quality and safety and supporting their presence and participation in care and decision-making requires change in hospital and unit policies and education and support for staff” IPFCC, 2012
Are the key concepts to achieving Success in Patient- and Family- Centered Care
Patient care will honour the central role of the family PatientCare will be conducted in partnership with the family PatientCare will strive to increase parental/ family self-efficacy to manage their child’s/loved one’s health care
Model of Levels of FCC Parent Participants Level I to Level III LEVEL III Increase in: Autonomy Oversee Level III FCC Visibility Programs Responsibility LEVEL II Consistency Hrs/ Time Commitment Advisory Council for Compensation FCC Dept Management Service LIne Lead Parent Actor/Staff Trainer Committee Member Conduct New Parent Family Ed Document Trainings Review LEVEL I Trainer for National Forums FCC Awareness Good-will Presentations Research & Program Presentations Evaluation Group Input Patient Safety Program Family Ed Document Dev Nat Conference Preceptor Level I & II FACs Participation Presentations Parents Parent Advisory Parent Partners Parent Leads Advisory + Advisory + Participation + Advisory Participation Management
Patient- Centeredness in GeneralSample: Practice Consultations3 General Practices.865 Consecutive Patients visiting thepractices.Measured:•Patients enablement.•Patient satisfaction.•Burden of symptoms.Outcomes:•Components of patientsperceptions can be measuredreliably, and predict differentoutcomes.•If doctors provide a positive, Adapted from the Alberta Health Services Patientpatient-centred approach, patients Engagement Team presentationwill be more satisfied, more Little, P., Everitt, H., Williamson, I., Warner, G., Moore, M.,enabled, and may have decreased Gould, C., Ferrier, K., & Payne, S. (2001). Observational study of effect of patient centredness and positive approach onsymptom burden and lower referral outcomes of general practice consultations. British Medicalrates. Journal, 323(7318), 908-911.
Sample: Patient-Centered Care39 Physicians.315 Randomly Selected Patients. on OutcomesMeasured:•Patient-Centredness of office visit.•Patient’s perception of finding“common ground” with physician.•Patient’s self-reported health.•Tests & interventions were tracked.Outcomes: (3 month follow-up)•Patient-centered practice improvedpatients’ health status and efficiency ofcare.•Patient –physician communicationinfluences patients’ health. • Patient feels as though they are a full participant in their health Adapted from the Alberta Health Services Patient Engagement Team presentation discussions. • Patient had better self-reported Stewart, M., Brown, J., Donner, A., McWhinney, I., health outcomes - with fewer Oates,J., Weston, W., & Jordan, J. (2000). The impact of patient-centered care on outcomes. The Journal of Family tests or interventions. Practice, 49(9), 796-804.
Multiplemethods to obtain feedback from patients and families: Patient/family surveys Post-discharge telephone calls Focus groups Community Surveys Shaller, D. (2007).
Isan “information resource center for patient and family leaders, clinicians, administrators, educators, researchers, and facility designers who are interested in advancing the practice of patient- and family-centered care.” www.ipfcc.org