True Patient/Family Centered Care?

From the boardroom to home health, everyone must share in the principles of patient-centered care: making patients and the community a part of the ongoing conversation about what works, and what doesn’t, in improving the health of our communities.

Six steps are outline in this overview by Molly Gamble (from May 20, 2013, Beckers Hospital I have added some thoughts on each of their six strategies that Molly gleaned from an interview with Towers Watson consulting.

1)  Transform hospital governance to support the patient experience, with patient/family advisory councils, making patients a part of the hospital board and patient safety and quality committees.  Rate your hospital or ACO in terms of inclusion of patient/family focus in governance structures.

2) Include patient champions (and patients)  throughout the continuum:  Towers Watson lists patient navigators, and I would add that RN roles such as patient advocates,  CNLs, care or case managers.

3) Ensure that everyone understands the role in patient/family centered care:  In RROHC training, we make sure that all disciplines use the 4 Ps as a common language:  The purpose, picture, plan, and part for each patient/family unit must be clear to all, including both short and long term goals.

4) Treat patient/family focus like a core measure:  Emphasizing the importance of HCAHPS and VBP measures as a part of board and executive level discussions is important, but bringing the understanding of VBP to the level of staff is essential. The culture of the organization changes as everyone sees that fulfilling the mission is more than a slogan,  and ranks up there linked with financial performance. We often witness unit staff conversant with their unit’s latest HCAHPS measures and what they are doing to be sure patients understand their medications and that patients are included in their plan-of-care decision-making.

5) Checklists and Scripts : Use checklists for safety, but also be sure that scripts do not replace authenticity in patient-provider relationships.  We teach RNs and MDs to sit at eye level, including patients in the conversation, and how to use active listening.

6) Rewards:  Including patient-family centered goals in compensation from the executive level to all staff, makes a real difference in the team’s functioning.  They are more apt to call our positive (or negative) behaviors and teach and mentor each other as the organization improves their processes to create a more humane workplace as well as real healing.

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