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The Patient & Family Care Experience Program: Partnering with Our Future Providers to Build a Patient & Family-Centred Culture
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The Patient & Family Care Experience Program: Partnering with Our Future Providers to Build a Patient & Family-Centred Culture


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The Patient & Family Care Experience Program pairs first year medical and pharmacy students with patient / family advisors over a six month period. Students learn firsthand what it’s like for patients …

The Patient & Family Care Experience Program pairs first year medical and pharmacy students with patient / family advisors over a six month period. Students learn firsthand what it’s like for patients and families to journey through our system. In this unique program, students have the opportunity to understand the role that patient and family members have as valuable members of the health care team, and to gain insight into how their health challenges have altered their lives. Come hear about the program and how it’s shaping the patient and family-centred culture of our future care providers.

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  • Rena DeCoursey
    Petra Dolman, Jolly deGuzman, Jovan Hasmatali
  • Just for some context,
    Best practice for teaching patient- and family-centred care has not been established.
    Clinical experiences and interactions with health providers or patients and families may not model patient- and family-centered care despite health provider intent or organizational philosophy.

    Even though as an organization we have adopted a patient- and family-centered philosophy that alone may not ensure learners will acquire the knowledge and skills necessary to provide patient- and family-centered care. Current providers may not have the appropriate attitudes, knowledge or skills to teach or model patient- and family-centered care. And despite our best and continued efforts in organizational change that supports implementation of PFCC at the care delivery level, such as policy development, staff education and culture change - these things take time.

    Limitations - interpersonal or human factors, organizational
  • Through today’s presentation you will hear how, by partnering first year medical and pharmacy students with patient and family advisors we are promoting client - and family-centeredness. In fact, placing the medical student with the patient and family at the center of the medical system, rather than with health professionals, is a goal of this program
     You will hear from Dr. Krista Baerg who was instrumental in helping to design the program, and in coaching and mentoring students on PFCC principles, as well as Heather Thiessen, patient advisor, and Christie Kimber, a medical student who participated in the program on what it meant for them to be a part of this initiative.

  • Informed by medical students and a family advisor
    Developed and co-facilitated by team
    physician lead
    medical college liaison
    client and family care specialist
    Elective option, maximum 15 hours of credit
    Currently, first year medical students are required to complete 40 hours of service learning as part of their professional skills course

    Krista – 8 min
    First and second iteration – informed by students and family
  • Krista – 8 min
  • Krista – 8 min
    Medical student objectives
    Identify key concepts in patient and family centered care including respect/dignity, information sharing (communication), collaboration and participation
    Reflect on patient and family experience and identify medical practices to optimize patient/client family centered care.
  • YEAR 1:
    Advisors recruited from pediatrics, capacity for 10 students
    Brief orientation, participants meet and exchange information
    Student-advisor meetings, attendance at medical appointment mandatory
    Midpoint mentorship co-facilitated
    Wrap-up includes evaluation, time for sharing and good-byes
    YEAR 2:
    Expanded advisor involvement outside pediatrics, capacity 16 students, students matched in pairs
    Program intensified and expectations clarified
    Added reflective essay for students
    Removed requirement to attend a medical appointment, still encouraged
    Two mentorship options offered for students, groups balanced
    Added basic core curricula on patient- and family-centered care
    YEAR 3: only minor modifications took place
    Strategies implemented to address need for closure
    YEAR 4:
    Program expanded to include pharmacy students

  • (may want to cut this back since it’s included in the student part) *Added for program participants in year 2 of the 3 year pilot project. Note: Core curriculum on patient- and family-centered care also added for all first year medical students in year 2.
    1After a brief ice-breaker and introductory video, participant expectations and program requirements are reviewed. Students and families then exchange contact information and discuss options for subsequent meetings.
    3The students are encouraged to sign up with their partners for the midpoint mentorship meeting.Sessions are facilitated by the physician lead and the Client and Family Care Specialist. Students are instructed to come prepared to discuss 1. How was your patient/family affected by this disease/condition? How did it change his/her life? 2. Evaluate the interactions your patient/family had with the health care system. Make suggestions for improvement where warranted.
    4The Reflective Essay is due shortly before the wrap-up event and is submitted to the physician lead. Medical students are asked to briefly describe and reflect on the four main pillars of Family Centered Care as they pertain to the patient/family (maximum 1500 words).
    5The Wrap-up includes a brief gathering time and review of the evening agenda. Students and families are separated into two focus groups which are facilitated. The program facilitators do not observe or participate. Subsequently students and families come back together for information sharing and good-byes. Family advisors provide students with a certificate of participation.
  • 11
  • Heather – you can add your own notes here
    Suggested themes for Student and Family meetings are as follows, but not limited to: general life history and impact of illness on the family system; discuss the client/family experience with the health care system and seek to clarify what made the experiences positive or negative; clarify the family’s role in care coordination and information sharing between health professionals; consider shadowing a medical appointment and debriefing subsequently with family. Dates and times for family meetings are to be mutually agreed upon and a suggested duration is 1-1.5 hours. Students are expected to confirm attendance as soon as possible and at least 24 hours prior. When medical appointments are attended, students are asked to allow time for debriefing.
  • -Students were expected to engage the patient and/or family in a conversation about life, health and health care experiences, and seeking to understand the patient/client and family experience. Students will also explore the value of a patient- and family-centered approach and reflect on plans for future practice. A mentorship meeting for students is held at mid-point through the program. Students are required to submit a reflective essay at the end of the program, as well as completing a Family Centredness Attitude Scale. Through sharing their experiences with students, patient and family advisors have been able to demonstrate the critical role that they play as members of the health care team, and mentor students on how to practice in a more patient and family-centred way.
  • -Patients as people.
    O The first thing I learned about Heather is that she is a mother of two daughters, a wife, and very involved in her community. This was also the most important message I took away from the program, which was seeing patients as people first, and not as a disease. It wasn’t until later in our conversations I learned about Heather’s medical conditions, problems within the health care system, and challenges she faced individually and as a family unit. While all of these conversations are a vital part of the program, the most important lesson I took away was seeing each person as an individual.

    -Pioneers for change.
    oAlthough the idea of Patient and Family Centered Care is not new, cultural change is slow. We hope this program will help with the implementation of this concept, as well as foster new leaders in this area.
    oThis program promotes the belief that the perspectives and opinions of patients, families, and providers are equally valid in planning and decision-making at the program and policy level.
    Implementing this program in first year is most beneficial because as new students we are eager to learn and are easily influenced by what is presented to us. This program bypasses the need for controlled settings within the health care system to model and teach patient- and family-centeredness – away from the hospital setting.
  • -Implementing patient centered care in clerkship.
    oPatient’s name – I always make an effort to learn my patients’ name and call them as such when referring to them. This reminds me to think of the patient in a holistic way, rather than just as their disease.
    oRespect - In every story Heather told of her experience in the health care system, good or bad, respect was at the base of the story. If she felt others respected and included her in the process, her healthcare experience was a positive one, regardless of her own personal health outcome. When she was not respected or included in the decisions of her care was when her experiences were the worst.
    oHeather gave me numerous examples of how a patient and/or their family knows themselves best, and not to overlook that when considering severity of illness and treatment options. The patient is the most important member of your team.
    oDeveloped a more natural relationship outside of a hospital setting, which fosters an empathy I hope to carry with me into my practice.
  • (Lisa)
    Recruitment of patients, families, and students is significant. Lessons learned include realizing that expectations needed to be more clearly laid out for advisors regarding the student time commitment and that we needed to develop a process to identify concerns with advisors and/or students at midpoint. We found that parting at the end of the program for some advisors and students was also more difficult than anticipated. These issues are addressed through enhanced communication efforts with participants. Closure strategies: Common feelings related to closure were discussed with the group at orientation and wrap-up, with students at the midpoint mentorship meeting, with families during the mid-point check-in

    Enhancements to next year’s program include more balanced representation of med and pharmacy students (12 of both)
    At wrap-up, the focus group evaluation was moved earlier in the evening to allow more time for sharing
  • The pilot program was highly rated by students and was satisfactory to families
    Program participation was associated with changed perception of patient and family perspectives and expertise
  • Transcript

    • 1. Patient & Family Care Experience Program: Partnering with our Future Providers to Build a Patient- & Family- centred Culture Lisa Clatney, Family Care Specialist, Saskatoon Health Region Heather Thiessen, Patient Advisor, Saskatoon Health Region Christie Kimber, 3rd Year Medical Student, University of Saskatchewan Dr. Krista Baerg, Associate Professor, Pediatrics, University of Saskatchewan
    • 2. Acknowledgements • Dr. K. Baerg, Pediatrics • Dr. M. D’Eon, College of Medicine • M. Keller and L. Clatney, Saskatoon Health Region • R. DeCoursey, Family Representative, Saskatoon Health Region • P. Dolman, J. deGuzman, J. Hasmatali, Medical Students, Pediatric Interest Group • K. Trinder, Educational Support and Development, College of Medicine • Participating Patient- Family Advisors • Participating medical and pharmacy students
    • 3. Background • Health care professionals who practice patient and family centred care recognize the critical role that patients and families play in improving health outcomes and patient experience, and providing expertise as a member of the health care team
    • 4.
    • 5.
    • 6.
    • 7. Program Development • Implemented over three academic years, from 2010 to 2013 • Extension to inter-disciplinary involvement in current year • Revised annually based on feedback • survey and focus group evaluation • student and patient/family advisor participants • provided by Educational Support and Development, College of Medicine
    • 8.
    • 9. Evolution of Program
    • 10.
    • 11. Program Evaluation This program allowed me to view the healthcare system from a different (and very important) perspective. I went in expecting to gain a greater appreciation for patients and I have gain that through this program (student) I enjoyed the students very much. They are so young and full of potential (advisor)
    • 12. Patient Perspective
    • 13.
    • 14.
    • 15. Student Perspective
    • 16.
    • 17.
    • 18.
    • 19. Conclusions • Program viewed positively by both students and advisors • Program is associated with changed perception of patient and family perspectives and expertise
    • 20. Questions? Contact Me: Lisa Clatney Saskatoon Health Region #QS14