1. FIRST IMPRESSIONS BY KEVIN BLACKMAN RN BSCN
Healthcare Leadership Course: Patient and Family Centered Care PowerPoint
FIRST IMPRESSIONS
BY KEVIN BLACKMAN RN BSCN

2. Highlights After completing this lesson, you will be able to:
After completing this lesson, you will be able to:
Explain why making a good first impression is an important part of patient- and family-centered care (PFCC).
2. Describe the link between PFCC and patient outcomes.
List at least three specific behaviors providers should practice when they first
meet patients and their families, in order to treat them with dignity and respect.

3. SECTION 1: A GOOD FIRST IMPRESSION
Lauren’s List -
Treating your patients with dignity and respect starts from the moment you first meet them. When Lauren Sampson was only seven years old, she had already been hospitalized more than 50 times. With her mother, Sally, by her side, she had spent a large part of her life with health care professionals. The two watched teams of physicians barge into Lauren’s hospital room and pat her stomach because they were curious about her pancreatitis. They watched nurses deliver shots and say “This won’t hurt” when, in fact, it did. They watched all kinds of caregivers explain what was going to happen, but not explain who they were. 
Even though she was just a kid, Lauren decided she had some advice for them.  1) Please knock on my door
2) Please introduce yourself
3) Please explain why you are here
4) Please tell me if something might hurt
Frustrated with her care and the loss of control she experienced with each hospitalization, Lauren taped to the door of her hospital room a piece of paper that listed some requests for any caregiver who came to see her. In time, Lauren, Sally, and the hospital’s Child Life Specialist refined the original list and changed the way those health care providers interacted with their patients. Sally shares Lauren’s story, the creation of “Lauren’s List”: 
Ultimately, with guidance from Sally who helped to build on those important rules the hospital adopted Lauren’s idea to be used for all patients. The added points included:
1) Acknowledge the patient and family; make eye contact, ideally at the level of the patient and family.
2) Introduce yourself to the patient and family by the name you prefer to be called. Make sure your introduction includes your title and a description of your role. Avoid using medical jargon or titles that do not have value or meaning for patients and families.
3) Ask family members how they would like to be addressed and ask the patient or family if there are designated family members with whom the staff should communicate about the plan of care. Don’t make assumptions about the role of friends or family members and their access to information.
4) If possible, partner with the patient and family to decide the best time for a meeting, procedure, or discussion.
5) Be open, nonjudgmental, and accepting when patients and family members share their points of view.
Today, the simple, yet innovative list has been used on nearly every patient’s door in the hospital. If you were a patient, what would be on your list? Take a moment to write down the top three or four things on your list. 

4. Section 2: Link Between PFCC and Patient Outcomes
From your very first meeting with a patient and family, you can practice some basic behaviors that show respect. These behaviors include knocking before entering, making eye contact, introducing yourself, sharing information about what you are doing, and listening openly. All this may require that you spend a little more time with each patient than you otherwise would. But failing to practice patient- and family-centered care has consequences, too, both for health professionals and their patients. If a patient feels you don’t really care, she may disregard your advice or perhaps find another caregiver with whom she feels more at ease. Thus, the costs of cutting corners and not making care, patient centered, will have devastating effects.
Here is a list of the negative outcomes that occur when patient centered care is not offered: Care plans are not followed, medicines are not taken appropriately, patient satisfaction goes down, trusting relationships decrease, caregiver turnover increases (due to patients believing other doctors to be more satisfying), doctors spend more time and money finding new patients (time to register, develop new relationships and rapport), and continuity of care decreases.
Therefore, practicing patient- and family-centered care from the moment you meet a patient is not just the right thing to do, it’s also the practical thing to do.
(Institute of Healthcare Improvement, 2014)

5. WATCH AND REFLECT ON VIDEO:
VIDEO LINK-
After watching the video, what have we learned regarding the benefits of providing Patient and Family Centered Care? What are the negatives behind not providing Patient and Family Centered Care?
A Wild (and Costly) Goose Chase
Learning Objectives: At the end of this activity, you will be able to: 
Recognize how a lack of communication among providers can disrupt the continuum of care and lead to frustration for patients. 
 Summarize how clinician bias can influence a diagnosis and affect a patient’s care experience. 
Discuss how unnecessary tests and incorrect diagnoses can add significant costs to the health care system. 
Description: In a new patient story, you’ll hear from Rani, a patient who visits several different health care providers in search of a diagnosis. As you follow Rani’s story, you’ll be prompted to stop along the way to consider a number of questions about miscommunication, cost, and the patient perspective. When you get to the end of the story, you’ll hear from Rani as she looks back on the experience seven years later.

6. Section 2: LINK BETWEEN PFCC AND PATIENT OUTCOMES
READ, WATCH VIDEO, AND ANSWER QUESTIONS PROVIDED IN LINK:
VIDEO LINK:

7. Section 3: What Should Providers Do When They First Meet Patients
Let us review the list of basic behaviors that providers need to demonstrate to ensure dignity and respect of their clients:
1) Knock before entering an inpatient or outpatient room.
2) Acknowledge the patient and family; make eye contact, ideally at the level of the patient and family.
3) Introduce yourself to the patient and family by the name you prefer to be called. Make sure your introduction includes your title and a description of your role. Avoid using medical jargon or titles that do not have value or meaning for patients and families.
4)Describe why you have entered the patient’s room and talk about what you are doing while you are interacting with or around the patient. Before you leave, let the patient know what will happen next, and if and when you will return.
5) Practice good safety precautions in front of the family and describe what you are doing so patients and families are informed about good infection control measures and best safety practices.
6) Be pleasant. If appropriate, smile and let your compassion and kindness show.
7) Ask the patient how he or she would like to be addressed. Perhaps the patient has a nickname or prefers his or her given name. In some cultures, the use of “Mr.” or “Miss” is expected as a sign of respect.
8) Ask family members how they would like to be addressed and ask the patient or family if there are designated family members with whom the staff should communicate about the plan of care. Don’t make assumptions about the role of friends or family members and their access to information.
9) If possible, partner with the patient and family to decide the best time for a meeting, procedure, or discussion.
10) Listen attentively when a patient or family member is talking or sharing observations.
11) Show the same respect for fellow staff and team members as you do for patients and families.
12) Let the patient and family know that you value their input, observations, questions, and concerns.
13) Be open, nonjudgmental, and accepting when patients and family members share their points and concerns.
(Institute of Healthcare Improvement, 2014)

8. References
Bergeson SC, Dean JD. A systems approach to patient-centered care. JAMA Dec 20;296(23):   Berwick D. Escape Fire: Lessons for the Future of Health Care. New York: The Commonwealth Fund; Available online at  Children’s Hospital of Philadelphia. Family-Centered Care Curriculum.  Institute of Healthcare Improvement. (2014). First Impressions. Retrieved From:
Sadler BL, Joseph A, Keller A, Rostenberg B. Using Evidence-Based Environmental Design to Enhance Safety and Quality. IHI Innovation Series white paper. Cambridge, MA: Institute for Healthcare Improvement; Available online at