Adopt a definition and core concepts 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 patients, families, and health care providers. It is founded on the understanding that the family plays a vital role in ensuring the health and well-being of patients of all ages. In patient- and family-centered care, patients and families define their “family” and determine how they will participate in care and decision-making. (Institute for Patient and Family Centered Care)Core Concepts:Dignity and respect - Health care providers listen to and honor patient and family perspectives and choices. Patient and family knowledge, values, beliefs and cultural backgrounds are incorporated into care planning and decision-making.Information Sharing - Health care providers communicate and share complete and unbiased information with patients and families in ways that are affirming and useful. Patients and families receive timely, complete, 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, families, and providers collaborate in policy and program development, implementation, and assessment; in health care facility design; and in professional education, as well as in the delivery of care.2. Develop and Implement a workshop for facilitators to help Patients/Families tell their stories and identify a group of Story Facilitators in each Region/Organization. 3. Develop an Education Plan including: Board, SLT, Directors and Unit Managers, Health Care Providers, Support Staff and Patients and Families.4. Develop a Patient- and Family-Centered Care Steering Committee for your organization/Region.
5. Do an organizational assessment of the current state of PFCC in the organization down to the unit level. (See Appendix A: List of tools).6. Develop an action plan (strategies about how) to Advance PFCC at Individual, Unit/Specialty, and Organizational Levels, that you could begin now or based on the assessment in 5 above. (See Appendix B: List of Strategies).7. Explore options to optimize and integrate PFCC into current initiatives and strategies so as not to overwhelm staff (Releasing Time to Care™ - See document “Alignment of Releasing Time to Care™ with Patient- and Family-Centered Care Strategy in Saskatchewan: Opportunities and Challenges” – Appendix C).8. Identify currently collected outcome measures. Evaluation statements: • We treat patients and families with dignity and respect.• We provide clear, comprehensive information in ways that are useful and empowering.• We create opportunities for patients and families to participate in ways that enhance their control and delivery of care.• We ensure that collaboration is inherent in our policies, programs, education and delivery of care.Simplified consistent outcome measure such as “Did you (patient/family) get and give the information that you needed or wanted when you needed or wanted it?”
Personal Level:• NOD (Name, Occupation, Duty).• Knock.• Wash hands and other patient safety initiatives.• Include pts families in shift and other handovers.• Include pts families in ward rounds.• Support initiatives that eliminate families as visitors.• Encourage the patient to define who are family members.• Ask the patient/family “What is the most important thing you want to accomplish today?”Unit Level:• Include pt and families in Unit meetingso About process,o About procedures,o About vision and mission.• Remove all signs that indicate that families are visitors (http://www.ipfcc.org/visiting.pdf). • Create family spaces close to patients and not just for those “We” perceive need it.• Reward patient- and family-centered care initiatives.• Start the conversation – are we patient- and family-centered – see questions and develop and post/share stories of successful patient- and family-centered care.• Support and augment the current emphasis on PFCC in RTC™ program.• Identify and enlist PFCC champions on each unit.• Promote truly listening to patients and families, rather than assuming we know what they want.• Be open to getting rid of “sacred cows” or old techniques or process in our practice.• Start conversations related to PFCC and listen to success stories.• Provide opportunities to discuss how PFCC is different from Patient focused or Family focused care.• Share experiences and journeys at provincial (and national?) organizational meetings including: April Quality Summit, Professional Association Meetings, specialty meetings and others.Organizational Level:• Implement patient and family policy and processes that support patient and family participation and collaboration• Add patients and families to all clinical committees:o Safetyo Quality• Implement a framework for, and hire patient and family advisors• Ensure PF are involved in facility design from the concept stage forward and get final signoff on projects.• Develop a Patient- and Family-Centered Care Steering Committee.• Develop a hiring policy based on the principles of PFCC.• Implement and plan to include PFCC in Orientation Programs.• Start with education and a common understanding of key concepts.• Identify PFCC facilitators and champions within the organization.• Provide coaching, facilitating and appreciative inquiry education for facilitators and champions.• Do not begin a new program where current initiatives RTC, Lean, QBS, customer service, shared decision making or other processes/strategies are currently being trialed or implemented (try to incorporate PFCC core concepts into the initiative).• Support and encourage the use of patient and family stories in all that is being done.• Consider the use of and contributing to provincially developed patient panel opportunities.• Use Recruitment and Retention teams from SUN/Govt partnership to support pilot projects related to PFCC.• Share experiences and journeys at provincial (and national?) organizational meetings including: April Quality Summit, Professional Association Meetings and others.• Share experiences through road shows, conference, symposiums, websites and PNC website. • Identify resource person to facilitate the conversations and reflect to make changes in individuals and support system change• Leadership training and leadership support at multiple levels.• Shared services to assist in developing training/education guidelines, development of strategies and repository of PFCC successful initiatives, etc• Team building workshops that involve patients and families as multidisciplinary professionals.PNC Activities:• Encourage making PFCC a professional continuing competency, standard, etc• Describe criteria indicating that units/organizations are ready for culture change such as PFCC.• Encourage and support curriculum changes to enhance PFCC.• Advocate for specific resources which may be needed to enhance PFCC.o Point persons to guide the initiative.• Advocate for leader professional development related to culture change and PFCC.• Coordinate a shared message about PFCC through current venues (professional newsletters, websites, etc)
Child poverty is high in th edouble digitsDecresed by 28,000Bc reports the highest provicial child poverty rateOntario has 324, 000 low income children or 43% of all children Albert is lower because of their $400 paymentsNew plan to be released by December 2008
Lone parent – usually women – high burden One out of every three live in povertySole provider and have to find adequate child care and housing – at increased ratesBalance education or trainingFamily burdenWomen ear about 71% of what men earn for full time year round workInsufficitent time and money to provide what they know Children are a visible minority – new Canadians and aboriginal familiesDisabilities - increased riskPersistent social and economic inequalityThreatens social cohesion in a country that prides itself on being inclusinveUnfair practices in workplace – systemic discrimination, inequalities in pay and practices – fail to recognize foreigh credentials and work experience of many newcomers
additional public investments in the social security of Canadian families. Strong economic growth and prosperity did not, in and of themselves, lift many children from poverty. Times of economic crisis will only deepen the hardship, as occurred in the early 1990s, if there is no intervention from our nation’s leaders.Now more than ever is the time for Parliament to adopt a poverty reduction strategy for Canada that includes an aggressive first step to protect children and families from falling into poverty.making public investments during economically tough times, particularly to support the nation’s most vulnerable.5 Social investments help stabilize markets andprotect families from further hardship. Canadian consumers power 57% of the economy. Investments in low income families are particularly strategic because they use their money inlocal communities to pay rent, purchase food and other necessities in contrast to more affluent families that often spend or invest funds outside of Canada.Social investment is not only an effective poverty reduction strategy, it is an astute economic one too. Repeating the “belt-tightening” methods of the 1990s will not only deepen the inequalities within Canada but will cost Canadian taxpayers more in the future through increased health care costs, emergency housing resources, thecriminal justice system, and through losses in skilled labour market productivity and lifetime earnings.The CCTB (including the National Child Benefit supplement for low and modest income families) has played a major role in preventing and reducing child and family poverty. This jointfederal, provincial and territorial initiative was launched in 1998 and reached its maximum cash transfer of $3,271 for the first child in 2007.8 The NCB can take the credit for preventing an estimated 59,000 families with 125,000 children from living in poverty.9 That’s a 12% decrease in the number of families living in poverty during 2004. The NCB, which provides additional disposable income to low and modest income families, also helped to reduce the depth of poverty by 18% among those families who remained in low income.
Learning outcome 6 narrated - part i - presentation
NRSG 246 – Learning outcome 6 &7<br />Describe family vulnerabilities<br />Discuss mental health literacy for families<br />
Provincial Nursing councilsteps and stragtegies for advancing patient and family centered care<br /><ul><li>Met on January 5th to explore patient and family centered care
Review strategies and ensure progress was obtained from members
What follows are some of suggestions of the council</li></li></ul><li>Adopt a definition and core concepts<br /><ul><li>Core concepts:</li></ul>* dignity and respect<br />* information sharing<br />* participation<br />* collaboration<br />2. Develop and implement a workshop<br />3. Develop an education plan<br />4. Develop a patient and family centered care steering committee<br />Steps and concepts<br />
5. Do an organizational assessment<br />6. Develop an action plan<br />7. Explore option to optimize and integrate initiatives and strategies<br />8. Identify currently collected outcome measures<br />* evaluation statements<br />Steps and concepts<br />
Advancing the Practice of Patient- and Family-Centered Care How to Get Started… http://www.ipfcc.org/pdf/getting_started.pdf<br />Strategies for Leadership: Patient- and Family-Centered Care – A Hospital Self-Assessment Inventory. http://www.aha.org/aha/content/2005/pdf/assessment.pdf<br />Advancing the Practice of Patient- and Family-Centered Care in Primary Care and Other<br />Ambulatory Settings How to Get Started… http://www.ipfcc.org/pdf/GettingStarted-AmbulatoryCare.pdf<br />Assessment tools<br />
Personal level<br />Unit level<br />Organizational level<br />PNC activities (Provincial Nursing Council)<br />Implementation strategies – a beginning<br />
Learning Outcome 6<br />Describe family vulnerabilities<br />Learning Steps<br />Discuss situations that protract vulnerabilities in families.<br />Discuss the effects of poverty on families<br />Readings <br />National Report Card<br />Stuart – chapter 10 and 32 – covered in other learning outcomes<br />Potter and Perry – Chapter 20 – self study<br />Learning Outcome 7 – self study as they are only 4 pages total<br />Learning Outcome 6<br />
Overall Stats <br /><ul><li>760,000 children – 1 child out of every 9 – lives in poverty