2. Enfª Profª Dra Nancy Moules
Professora Titular
Faculdade de Enfermagem
Universidade de Calgary-Canadá
3. “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
4. Respect and Dignity
Information Sharing
Participation
Collaboration
5. Evidence Based Research Supports Patient-
and Family-Centered Care
Benefits to:
Patients & Families
Health Care Providers
Health Care Organizations
Patient Safety
IPFCC, 2012
6. “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
7.
8. Are the key concepts to achieving
Success in Patient- and Family-
Centered Care
9. 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
10. 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
11.
12.
13.
14. Patient- Centeredness in General
Sample: Practice Consultations
3 General Practices.
865 Consecutive Patients visiting the
practices.
Measured:
•Patients' enablement.
•Patient satisfaction.
•Burden of symptoms.
Outcomes:
•Components of patients'
perceptions can be measured
reliably, and predict different
outcomes.
•If doctors provide a positive, Adapted from the Alberta Health Services Patient
patient-centred approach, patients Engagement Team presentation
will 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 on
symptom burden and lower referral outcomes of general practice consultations. British Medical
rates. Journal, 323(7318), 908-911.
15. Sample: Patient-Centered Care
39 Physicians.
315 Randomly Selected Patients. on Outcomes
Measured:
•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 improved
patients’ health status and efficiency of
care.
•Patient –physician communication
influences 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.
16. Multiplemethods to obtain feedback from
patients and families:
Patient/family surveys
Post-discharge telephone calls
Focus groups
Community Surveys
Shaller, D. (2007).
17. 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
Editor's Notes
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.
