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©2013 Children's Mercy. All Rights Reserved. 09/13 David Seastrom RN, BSN Trauma Injury Prevention, Outreach & Education Coordinator Patient & Family Centered.

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Presentation on theme: "©2013 Children's Mercy. All Rights Reserved. 09/13 David Seastrom RN, BSN Trauma Injury Prevention, Outreach & Education Coordinator Patient & Family Centered."— Presentation transcript:

1 ©2013 Children's Mercy. All Rights Reserved. 09/13 David Seastrom RN, BSN Trauma Injury Prevention, Outreach & Education Coordinator Patient & Family Centered Care

2 ©2013 Children's Mercy. All Rights Reserved. 09/13

3 Objectives Recognize and understand the 4 Core Concepts in Patient - Family-Centered Care Recognize and understand the 4 Core Concepts in Patient - Family-Centered Care Be able to define family presence Be able to define family presence Identify ways you can change your practice to be more patient and family centered Identify ways you can change your practice to be more patient and family centered

4 ©2013 Children's Mercy. All Rights Reserved. 09/13 History Began in 1962 Began in 1962 Congressional address from President Kennedy Congressional address from President Kennedy Right to safety Right to safety Right to be informed Right to be informed Right to choose Right to choose Right to be heard Right to be heard 1965 Head Start was legislated 1965 Head Start was legislated

5 ©2013 Children's Mercy. All Rights Reserved. 09/13 History Surgeon General C. Everett Koop Surgeon General C. Everett Koop 1991 – EMS-C National Resource Center 1991 – EMS-C National Resource Center Childrens National Medical Center Childrens National Medical Center 1992 – The Institute for Family Centered Care formed 1992 – The Institute for Family Centered Care formed 1993 – Family Preservation & Family Support Act 1993 – Family Preservation & Family Support Act 1994 – The Families of Children with Disabilities Act 1994 – The Families of Children with Disabilities Act

6 ©2013 Children's Mercy. All Rights Reserved. 09/13 History Why are these important? Why are these important? Led the way for family / collaborative programs Led the way for family / collaborative programs Women started to challenge Women started to challenge Family advocates voiced concerns Family advocates voiced concerns

7 ©2013 Children's Mercy. All Rights Reserved. 09/13 Core Values Respect & Dignity Respect & Dignity Information Sharing Information Sharing Participation Participation Collaboration Collaboration

8 ©2013 Children's Mercy. All Rights Reserved. 09/13 Respect & Dignity Listening to Listening to Honoring Honoring Planning & Deliver of Care Considerations Planning & Deliver of Care Considerations Knowledge Knowledge Values Values Beliefs Beliefs Cultural Background Cultural Background Family perspectives & choices

9 ©2013 Children's Mercy. All Rights Reserved. 09/13 Information Sharing Share complete & unbiased information Share complete & unbiased information Share in ways that are useful & affirming Share in ways that are useful & affirming Receiving info in a timely, accurate & complete form Receiving info in a timely, accurate & complete form So as to participate & make decisions So as to participate & make decisions

10 ©2013 Children's Mercy. All Rights Reserved. 09/13 Participation Encourage & Support in participating Encourage & Support in participating Care Care Decision Making Decision Making Level they choose Level they choose Non-judging / Opinion forming / etc. Non-judging / Opinion forming / etc.

11 ©2013 Children's Mercy. All Rights Reserved. 09/13 Collaboration Delivery of care Delivery of care Facility design Facility design Program development Program development Policy development Policy development Ped Emerg Form Ped Emerg Form

12 ©2013 Children's Mercy. All Rights Reserved. 09/13 Core Value Overview Listen to the patient & families Listen to the patient & families Communication is of the utmost importance Communication is of the utmost importance Participation at the families comfort level Participation at the families comfort level Working together we can accomplish more Working together we can accomplish more

13 ©2013 Children's Mercy. All Rights Reserved. 09/13 EMS

14 EMS & Family Presence Why do we separate families from their children? Why do we separate families from their children? Control Control Our ambulance Our ambulance Focus Focus Multi-tasking Multi-tasking Time Time Scene times, etc. Scene times, etc.

15 ©2013 Children's Mercy. All Rights Reserved. 09/13 Class Participation

16 EMS & Family Presence Who here with EMS has a Family Presence Guideline?

17 ©2013 Children's Mercy. All Rights Reserved. 09/13 EMS & Family Presence Who here with a hospital has a Family Presence Guideline?

18 ©2013 Children's Mercy. All Rights Reserved. 09/13 EMS & Family Presence Who here supports Family Presence during invasive procedures & resuscitation?

19 ©2013 Children's Mercy. All Rights Reserved. 09/13 EMS & Family Presence Who here isnt exactly sure how they feel about Family Presence during invasive procedures & resuscitation?

20 ©2013 Children's Mercy. All Rights Reserved. 09/13 EMS & Family Presence EMS & Family Presence The healthcare field is evolving from a paradigm where the patient is expected to passively comply with diagnosis and treatment to one that emphasizes patient-provider collaboration Guidelines for Providing Family-Centered Prehospital Care (Consensus Panel from EMS-C, NAEMT & HRSA)

21 ©2013 Children's Mercy. All Rights Reserved. 09/13 Who Supports Family Presence?

22 ©2013 Children's Mercy. All Rights Reserved. 09/13 Family Presence Policy Family Advisory Board Members (parents) ED providers Social Workers Chaplain ICU providers Trauma providers Child life Critical Care Transport Family Care Coordinators Administration Code Blue Committee

23 ©2013 Children's Mercy. All Rights Reserved. 09/13 Are We Still Awake?

24 ©2013 Children's Mercy. All Rights Reserved. 09/13 24 ©2013 Children's Mercy. All Rights Reserved. 09/13 Are We Still Awake?

25

26 Family Presence Principles behind Guidelines Consistency of Practice Consistency of Practice –While we attempt to be fair in everything we do, we must admit that some families get to stay with their children and some dont Communication with Staff Communication with Staff –Attending staff have control over what happens, guidelines give others the right to talk openly about family presence

27 ©2013 Children's Mercy. All Rights Reserved. 09/13 Family Presence Principles behind Guidelines Evolution Evolution –Guidelines will create a guided evolution of the culture of interaction between staff & families Culture Culture –Once we make it part of our practice, families will expect it.

28 ©2013 Children's Mercy. All Rights Reserved. 09/13 Family Presence 2000 Clinical Group Recommendations 2000 Clinical Group Recommendations Family members should be involved in primary training for pre-hospital emergency medical responders at all levels. Family members should be involved in primary training for pre-hospital emergency medical responders at all levels. Family members should be given the option to be present and to participate in pre-hospital care, on scenes, during transport and during transfer of care to the receiving facility. Family members should be given the option to be present and to participate in pre-hospital care, on scenes, during transport and during transfer of care to the receiving facility.

29 ©2013 Children's Mercy. All Rights Reserved. 09/13 Family Presence Cont. So What Does the Research Say?

30 ©2013 Children's Mercy. All Rights Reserved. 09/13 Family Presence Cont. Dingeman, et al. – 2007 JAAP Dingeman, et al. – 2007 JAAP Growing trend of family members offered to be present are staying present Growing trend of family members offered to be present are staying present 87% Procedures 87% Procedures 83% Resuscitations 83% Resuscitations 86% Right 86% Right 94% Repeat Decision 94% Repeat Decision

31 ©2013 Children's Mercy. All Rights Reserved. 09/13 Family Presence Cont. Sacchetti, et al. – 2005 Anals Emerg Med Sacchetti, et al. – 2005 Anals Emerg Med 7% interfered with care 7% interfered with care None significantly alter patient management None significantly alter patient management

32 ©2013 Children's Mercy. All Rights Reserved. 09/13 Family Presence Cont. OConnell, et al. – 2007 JAAP OConnell, et al. – 2007 JAAP 136 Trauma Team Activations 136 Trauma Team Activations 197 Family Members Participated 197 Family Members Participated 7 asked to leave (various reasons) 7 asked to leave (various reasons) Evaluation/Procedure times not altered Evaluation/Procedure times not altered 97% FMP had none or positive effect on decision-making 97% FMP had none or positive effect on decision-making 92% Improved communication 92% Improved communication

33 ©2013 Children's Mercy. All Rights Reserved. 09/13 33 ©2013 Children's Mercy. All Rights Reserved. 09/13 Family Presence Cont. What can we do?

34 ©2013 Children's Mercy. All Rights Reserved. 09/13 Family Presence Overview While some choose NOT to be present, nearly all want to be given the option While some choose NOT to be present, nearly all want to be given the option The research is overwhelmingly in favor of family presence The research is overwhelmingly in favor of family presence VERY small percentage of families are disruptive VERY small percentage of families are disruptive If not present the option is what the families want If not present the option is what the families want

35 ©2013 Children's Mercy. All Rights Reserved. 09/13 Family Presence Overview Many families present use their observations to conclude everything was done Many families present use their observations to conclude everything was done Families who are present are less likely to litigate Families who are present are less likely to litigate Families cannot usually differentiate between an attending physician from a fellow or a resident Families cannot usually differentiate between an attending physician from a fellow or a resident

36 ©2013 Children's Mercy. All Rights Reserved. 09/13 Family Presence Overview Families who are given the option of family presence have a more positive bereavement outcome Families who are given the option of family presence have a more positive bereavement outcome Families who are given the option feel as though they have more control of their situation Families who are given the option feel as though they have more control of their situation

37 ©2013 Children's Mercy. All Rights Reserved. 09/13 37 ©2013 Children's Mercy. All Rights Reserved. 09/13 Childrens Mercy Kansas City

38 ©2013 Children's Mercy. All Rights Reserved. 09/13 Level I Pediatric Trauma Center Level I Pediatric Trauma Center Center for Excellence in Pediatric Resuscitation Center for Excellence in Pediatric Resuscitation Leading Cardiac Surgery Program Leading Cardiac Surgery Program Leading Hemophilia Treatment Center Leading Hemophilia Treatment Center Leading Sickle Cell Disease Program Leading Sickle Cell Disease Program International Consortium of Blood & Bone Marrow Transplant International Consortium of Blood & Bone Marrow Transplant

39 ©2013 Children's Mercy. All Rights Reserved. 09/13 One of a few national comprehensive liver treatment & research centers One of a few national comprehensive liver treatment & research centers National Leader in Specialty Critical Care Transport National Leader in Specialty Critical Care Transport Ped. Critical Care Fellowship Ped. Critical Care Fellowship Ped. Emergency Medicine Fellowship Ped. Emergency Medicine Fellowship Ped. Surgery Fellowship Ped. Surgery Fellowship 2007 Designated one of the top five Ped. Emergency Departments in the country 2007 Designated one of the top five Ped. Emergency Departments in the country Extensive Research Activities Extensive Research Activities

40 ©2013 Children's Mercy. All Rights Reserved. 09/13 40 ©2013 Children's Mercy. All Rights Reserved. 09/13 Family Centered Care Coordinators Sheryl Chadwick DeeJo Miller Parents on Staff - NOT MEDICAL PROVIDERS – –Provide opportunities for families to connect with other families

41 ©2013 Children's Mercy. All Rights Reserved. 09/13 Childrens Mercy Family Centered Care Coordinators –Empower families to use the resources CMH provides –Serve as a family voice on committees in the hospital –Provide opportunities for families to connect with other families

42 ©2013 Children's Mercy. All Rights Reserved. 09/13 42 ©2013 Children's Mercy. All Rights Reserved. 09/13 Childrens Mercy Family Advisory Board

43 ©2013 Children's Mercy. All Rights Reserved. 09/13 43 ©2013 Children's Mercy. All Rights Reserved. 09/13 Teen Advisory Board Consejo de Familias Latinas/Hispanas

44 ©2013 Children's Mercy. All Rights Reserved. 09/13 44 ©2013 Children's Mercy. All Rights Reserved. 09/13 Death & Dying Workshop Parents and family members come in and talk with staff physicians, nurses, RT, residents, etc and communicate what was helpful and what was hurtful during their experience of loss. We then allow the staff to ask questions dealing with their experience

45 ©2013 Children's Mercy. All Rights Reserved. 09/13 45 ©2013 Children's Mercy. All Rights Reserved. 09/13 Childrens Mercy POPS POPS – –Parents Offering Parents Support Primarily phone mentoring 1 on 1 Easy to do Location not an issue

46 ©2013 Children's Mercy. All Rights Reserved. 09/13 Childrens Mercy New Journeys New Journeys Guide for Families Guide for Families From Families From Families Services Guide Services Guide Layout Layout Paperwork Guide Paperwork Guide Coping Tips Coping Tips Hospital Guidelines Hospital Guidelines

47 ©2013 Children's Mercy. All Rights Reserved. 09/13 Childrens Mercy Family Time Family Time Open house on the floor so families can get away from the bedside & connect with other families Open house on the floor so families can get away from the bedside & connect with other families

48 ©2013 Children's Mercy. All Rights Reserved. 09/13 Family as Faculty – 13 Families currently – Focus on Resident Education PGY1 – Dinner with FAB PGY1 – Dinner with FAB PGY2 – Meet Family in their home PGY2 – Meet Family in their home PGY3 – Clinic visit with family PGY3 – Clinic visit with family –GN Education –Child Life & Music Therapy Interns –Hem/Onc Residents

49 ©2013 Children's Mercy. All Rights Reserved. 09/13 49 ©2013 Children's Mercy. All Rights Reserved. 09/13 YOU are a piece of the puzzle! Child Life EMS Volunteers Social Work Medical Team Patient Family Chaplaincy

50 ©2013 Children's Mercy. All Rights Reserved. 09/13 THE END(s)…


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