1. Patient- & Family-Centered Care

2. The Imperative for PFCC Quality – Patient safety Experience – Patient satisfaction – Physician / staff satisfaction Efficiency of care

3. Five Transforming Concepts to Improve Healthcare Safety Patients must become full partners in all aspects of healthcare The free, uninhibited sharing of information throughout all components of the healthcare system (transparency); The delivery of health care by multidisciplinary teams working in across all venues of healthcare – inpatient, outpatient, & residential; Healthcare workers must to find joy and meaning in their work; Medical education must be redesigned to prepare new physicians to function in this new environment L.Leape, D. Berwick, C. Clancy, et al. Transforming healthcare: a safety imperative. Qual Saf Health Care 2009;18:424-428

4. Definition PFCC is a system / strategy of healthcare in which patients and their families are essential and respected partners in their own care and in the design & execution of all aspects of healthcare. “Nothing about me without me” “If health is on the table, then the patient and family must be at the table, every table, now”

5. Who better to make recommendations to us regarding our care quality, safety, and efficiency, than those who watch our every move. Improve healthcare quality Enhance patient safety Improve patient satisfaction Improve efficiency of care PFCC is a powerful tool in which to……..

6. Improved physician / staff satisfaction 60% of physicians indicated they were considering leaving medical practice because they were discouraged – American College of Physician Executives “Physician Morale Survey”. J Med Management 2006;32:6 – 15. 33%of newly licensed registered nurses indicated that they might seek another job within the year – Kovener CT, Brewer CS, Fairchild S, et al. Newly licensed RN’s characteristics, attitudes, and intentions to work. Am J Nurs 2007; 107:58-70 If we don’t have our physicians, nurses and staff on board with us when this health care changes are implemented we will be in big trouble.

7. Some of the University Hospitals that have implemented PFCC Barnes-Jewish Hospital Baylor Health System Dallas Brigham & Women’s Hospital Dana-Farber Cancer Institute Emory University Medical College of Georgia Methodist Le Bonheur Healthcare University of Alabama University of Louisville University of Michigan University of Minnesota University of North Carolina University of Wisconsin University of Washington University of Pennsylvania – Childrens Hospital of Pennsylvania Vanderbilt University

8. PFCC Implementation Strategies Signage Family presence – …..not visitors Patient & family advisors – Not focus groups or surveys Vision / Values Facility design Patterns of care – Family centered rounds – Parenteral presence in PACU Information sharing Family support Charting & documentation – Nursing change of shift – Medication lists – Discharge planning documents PF Activated Response Team Public reporting of quality data

9. Patient & family centered care is working with patients and families, rather than just doing to or for them. Summary (1)

10. Summary (2) PFCC provides the framework & strategies to: – improve the experience of care Patients & families Physicians, nurses, & staff – enhance quality, safety, & efficiency of care

11. Summary (3): Current patient & family centered care processes Interdisciplinary rounding Bedside change of shift Patient & family advisory counsels – Cancer – Hospital – Medical Home – NICU Involvement of patients & families on hospital committees