1. Patient- and Family-Centered Care for Adults with Chronic Conditions Web Event May 20, 2014 Follow this event on Twitter Hashtag: #AHRQIX 1

2. Using the Webcast Console and Submitting Questions Click the Q&A widget to get the Q&A box to appear To submit a question, type question here and hit submit. 2

3. Accessing Presentations Download slides from console ► Click on the “Download Slides” widget for a PDF version 3

4. What is the Health Care Innovations Exchange? Publicly accessible, searchable and downloadable database of health policy and service delivery innovations Searchable QualityTools Successes and attempts Innovators’ stories and lessons learned Expert commentaries Learning and networking opportunities New content posted to the Web site every two weeks Sign up at http://www.innovations.ahrq.gov under “Stay Connected”http://www.innovations.ahrq.gov 4

5. Innovations Exchange Web Event Series Archived Event Materials ► Available within two weeks under Events & Podcasts at http://www.innovations.ahrq.govhttp://www.innovations.ahrq.gov Next Event ► Tuesday, July 22, 2014 1-2:30 pm ET Patient- and Family-Centered Care for Children and Older Adults 5

6. Patient- and Family-Centered Care Implications for Adults with Chronic Conditions Beverley H. Johnson 6

7. Patient- and Family-Centered Core Concepts ▼ People are treated with respect and dignity ▼ Health care providers communicate and share complete and unbiased information with patients and families in ways that are affirming and useful ▼ Patients and families are encouraged and supported for participation in care and decision- making at the level they choose ▼ Collaboration among patients, families, and providers occurs in policy and program development and professional education, as well as in the delivery of care 7

8. Patient- and Family-Centered Core Concepts Patient- and family-centered care is working with patients and families, rather than to or for them 8

9. A Broad Definition of Family... ▼ In health care settings, patients are asked to define their families and how they will be involved in care and decision-making ▼ The American Academy of Family Physicians (2009) defines family as “a group of individuals with a continuing legal, genetic and/or emotional relationship” 9

10. Why Patient- AND Family-Centered Care and not just Patient-Centered Care? ▼ Individuals who are most dependent on health care are most dependent on families 10 ▼ Those with chronic conditions ▼ The very young ▼ The very old

11. Why Patient- AND Family-Centered Care and not just Patient-Centered Care? ▼ Families can be allies for quality and safety ▼ Families often are the constant support across settings and assist with transitions of care ▼ Families can participate in the development of a care plan and support the patient in following the plan 11

12. Triple Aim Patient- and Family-Centered Care "The most direct route to the Triple Aim is via patient- and family-centered care in its fullest form.” - Don Berwick (June 5, 2012) 12

13. Best Care at Lower Cost: The Path to Continuously Learning Health Care in America ▼ Institute of Medicine Recommendation: “Involve patients and families in decisions regarding health and health care, tailored to fit their preferences” (S-23) ▼ “In a learning health care system, patient needs and perspectives are factored into the design of health care processes, the creation and use of technologies, and the training of clinicians” (5-5) 13

14. Insights From an Institute of Medicine Working Group “In high-functioning health care teams, patients are members of the team; not simply objects of the team’s attention…” 14 Wynia, Matthew K., Isabelle Von Kohorn, and Pamela H. Mitchell. "Challenges at the intersection of team-based and patient-centered health care: insights from an IOM working group." JAMA 308.13 (2012): 1327-1328.

15. Redesign of Primary Care and the Management of Chronic Conditions http://www.chcf.org/topics/patient-self-management 15 Self-Management Support ▼ Information Sharing ▼ Goal Setting ▼ Action Plans ▼ Follow-Up Support

16. Open Notes 16 http://www.myopennotes.org

17. 17 Anne Arundel Medical Center Annapolis, MD Bedside Nurse Change of Shift Report WITH the Patient and Family

18. H. Lee Moffitt Cancer Center & Research Institute in Tampa, FL 18

19. 19 Patient and Family Advisors for Change, Improvement, and Health Care Redesign

20. Patient- and Family-Centered Best Practices ▼ Senior leaders believe in the possibility and potential of patient and family partnerships ▼ There is an executive champion for patient- and family- centered care ▼ A designated staff liaison for collaborative endeavors facilitates the process ▼ Orientation and preparation for collaboration are provided to patients, families, staff, clinicians, and leaders ▼ Patient and family involvement from the beginning of a project makes a difference. 20

21. Additional Resources 21 http://www.ipfcc.org/tools/downloads-tools.html http://www.ipfcc.org/index.html

22. Partnering with Patients and Families As Advisors 22 Bernard Roberson, MSM, BA, HSC

23. Frontline Innovators on Providing Patient- and Family-Centered Care 23

24. Patients and Families As Advisors Begins With… Recruitment Referred by faculty, administrators, staff, students and other patient and family members Must be utilizing health system services ► Patients and families – satisfied or dissatisfied with services and come with positive recommendations for change ► Highly recommended by faculty, staff, students and others 24

25. Patients and Families As Advisors Begins With… Qualities advisor should possess Positive attitude Willingness to assist with positive change in patient care, education, research and Patient- and Family-Centered Care initiatives Ability to share their experience and insight in a balanced and objective way Ability to listen to and reflect on differing points of view Ability to keep information confidential Willingness to look beyond their own personal issues Willingness to work with others as an active member of the team 25

26. When to Partner with Patients and Families as Advisors Brainstorming sessions Planning new services Developing new policies, procedures Implementing new policies and procedures Interviewing leadership candidates Educating staff, students, other personnel Changing clinically relevant processes 26

27. Partnering is a Factor in all Aspects of the Health System Strategic planning Management Operations 27

28. Patients and Families are Involved in the Following: Patient Satisfaction Electronic Personal Health Record (EPHR) Family Faculty – Personal Healthcare Stories ► University and Staff Educational Programs and Trainings ► Conferences 28

29. Patients and Families are Involved in the Following: Quality and Safety Committees ► Ethics ► Performance Improvement ► Joint Commission Leadership ► Safety and Security ► Medication Error and Prevention ► Discharge Education and Planning ► Quality Unit Council Committees 29

30. Patients and Families are Involved in the Following: Community Coalitions and Outreach Initiatives Renovations and New Construction Projects Research: Sub-Investigators Board Level Committee Human Resources ► New Employee Orientation ► Employee Interviews Administrative Committees ► Billing 30

31. Involving Patients and Families in EVERY Aspect of Operations 31

32. Examples of Partnership 32

33. Improving Patient and Family Centered Care Rounds Research 33

34. Improving Patient and Family Centered Care Rounds Research 34

35. Improving Patient- and Family- Centered Care Rounds Research 35

36. Improving Patient and Family Centered Care Rounds Research 36

37. Collaborating with Shock Trauma Unit and Medical Illustration 37

38. Breast Health Center Redesign Renovation Workflow 38

39. Improving Hand Washing throughout the Organization ► Working on Campaign ► Auditing the Faculty and Staff ► Confronting the Faculty and Staff ► Rewarding the Faculty and Staff o Buttons 39 Hand Washing Initiative

40. Neurosciences Center of Excellence Results Patient Satisfaction ► 10th → 95th percentile ► 75th to 90th percentile Staff vacancy rate ► 7.5% → 0% ► Have waiting list Discharges increased 15.5% 62% decrease in medication errors 40

41. Questions? Click me to get Q&A box to appear

42. Additional Resources Guide to Patient and Family Engagement in Hospital Quality and Safety Patient Centered Medical Home (PCMH) Resource Center ► Engaging Patients and Families in the Medical Home ► Strategies to Put Patients at the Center of Primary Care 42

43. The Innovations Exchange Visit our Web site ► http://www.innovations.ahrq.gov/ http://www.innovations.ahrq.gov/ ► Frontline Innovators on Providing Patient- and Family- Centered Care Videos Frontline Innovators on Providing Patient- and Family- Centered Care Videos Follow us on Twitter: #AHRQIX Send us email: info@innovations.ahrq.gov 43