We Are All in This Together: The Journey Toward Collaboration with Patient and Family Members in Today’s Healthcare Environment  Mary Ann Peugeot, CPA, Volunteer Past Chair, Vanderbilt Patient and Family Advisory Council, Nashville, TN TCPS Regional Meetings August, 2014

Rx For The ‘Blockbuster Drug’ Of Patient Engagement “Even in an age of hype, calling something “the blockbuster drug of the century” grabs our attention. In this case, the “drug” is actually a concept— patient activation and engagement—that should have formed the heart of health care all along.” Susan Dentzer, Editor-in-Chief, Health Affairs

“Anyone who is involved in the problem should be involved in developing the solution.” Chris Hart

Levels of Patient- and Family-Centered Care Environment Community Groups Public Health Campaigns OrganizationPatient Experience Surveys Patient and Family Councils Resource Centers Micro systemParents, Advisors and Councils Family Participation in Rounding Individual ExperienceAccess to Patient Record Shared Care Planning Achieving an Exceptional Patient and Family Experience of Inpatient Hospital Care

Interaction between the Healthcare Facility and the Council  Engagement  Education  Involvement  Collaboration  Empowerment “The sense of urgency will never work unless it is felt at the top.”

“An actively engaged patient and family are the most underutilized members of the healthcare team.” Dr. Jim Jirjis, former Vanderbilt physician

Reasons to Involve Patients and Families in Collaborative Efforts Advancing the Practices of Patient- and Family-Centered Care.

Patient & Family Advisors  Authenticity  Empowerment  Respect  Inspiration  Honest Feedback  Partner  Educator  Speaker  Listener  Advocate  Collaborator  Leader  Cheer Leader What They Provide Roles They Fill

Selection of Patients and Families for Collaboration Advancing the Practices of Patient- and Family-Centered Care.

Other Attributes  People with experience with your organization  Representative of the population you serve  Distanced from Diagnosis or Experience  People with constructive criticism skills  People with a desire to improve care for others  People who can be a representative voice  Solution focused  Teachable From Libby Hoy, President of Patient & Family Centered Care Partners

Where Do We Find Them? SELF REFERRAL Newsletters Blasts Outpatient clinics Website Physician Referral Coffee Carts Open House Recruitment posters Community  Resource Events Direct Mailers STAFF REFERRAL Support Groups/Disease specific meetings Lobby Surfing Customer Service Grievance Committee Executive Rounds Unit Staff Community Mailers From Libby Hoy, President of Patient & Family Centered Care Partners

Take a moment to discuss:  If you had a Patient and Family Advisory Council, list some of the potential topics you might bring to the council for collaboration.

Sample Agenda Items at Vanderbilt:  Operating systems, such as clinic redesign and billing  Patient safety  Quality initiatives  Health literacy/patient education  Facility planning  Feedback for electronic patient portal

Collaboration on PFCC Website

Patient Portal During a serious disease, the chance to be engaged is a huge mood booster. Users see health information on My Health at Vanderbilt home pages based on age, gender and diagnoses from the past year.

Signage Before After L A M P

New Patient Handbook

Surgical Consents Before After

The Vanderbilt Promise

Just a few more actual examples:  Focus group for patient/family perspective for VMG Leadership Planning  Design of and furniture for Critical Care Tower  Surgical Experience from initial news of needing surgery to the follow-up clinic visit  Safe Visit website  Patient safety posters  Participation in Care Transition Workshop with hospital leadership

Vanderbilt Hospital Committees with Council Representation Patient Education Council Patient Experience and Service Improvement Council HCAHPS Improvement work group Food Service Advisory Committee Quality and Safety Council My Health at Vanderbilt (Patient Portal) Facility Design Group Strategic planning design shops PCORI research grant steering committees

Challenges in Establishing a PFAC Challenges  Finding diverse members  Modeling partnership  Finding people passionate about improvement  Finding experienced people who relate to the experiences to others  Finding diverse team personalities  Developing a shared mental model about what we’ll do  Ensuring security, privacy, immunizations Approach  Broad solicitation  Recruit both care users & staff  Application essay question & interview  Application brochure/cover letter, interview & training  Standard volunteer processes for security check, HIPPA & shots From Victoria Nahum, Co-Founder of H2Pi, The Healthcare and Patient Partnership Institute

Using a PFAC charter to proactively prepare for likely challenges Challenge  Developing shared mental model of purpose/mission  Modeling partnership  Organizational support  Attendance  Leadership and teamwork  Leadership turnover  Finding the right fit Approach  Statement of purpose  Co-leadership  Executive +/or Board reporting  Attendance requirements  Covenant (rules)  One year co-lead terms, annual elections & succession planning From Victoria Nahum, Co-Founder of H2Pi, The Healthcare and Patient Partnership Institute

Other Resources for Patient- and Family- Centered Care Information  Achieving an Exceptional Patient and Family Experience of Inpatient Hospital Care - Institute for Healthcare Improvement (IHI)  Advancing the Practice of Patient- and Family Centered Care in Hospitals: How to Get Started - Institute for Patient- and Family- Centered Care (IPFCC)  Advancing the Practice of Patient- and Family Centered Care in Primary Care and Other Ambulatory Settings: How to Get Started - Institute for Patient- and Family-Centered Care (IPFCC)  Healthcare Communities/Partnership for Patients  Tennessee Hospital Association Website

Do Your Homework!  Talk to people who have been involved in advisory councils at other hospitals.  Consider ways that you might involve patient, family, or resident advisors at your organization. (Hint: Think of any process or project that is undergoing planning or review that touches the people you serve directly.)  Consider developing a patient and family work group as a precursor to a more formal council.  Identify staff champions. From Lisa Morrise, Patient Co-Lead, Patient and Family Affinity Group; National Partnership for Patients

Keys to Successful Collaboration  Align goals  Create a continuing process  Foster an atmosphere of mutual respect  Encourage open exchange  Provide patients and families with the tools to support their roles  Communicate!!!