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2 Presenters Kris Green Supervisor, Family support services Ted Hawley Family Action Council

3 Today’s objective As a hospital within a hospital: Demonstrate successful strategies to overcome the reluctance of ancillary service areas. Suggest strategies to increase family-centered care practices in a forbidden zone Share successes gained and challenges still ahead.

4 Key Elements of FCC process The family is the constant in the child’s life Information exchange is unbiased Recognize and respects different methods of coping Encourages and facilitates family to family support Found not only in program or at the bedside, but incorporates POLICY

5 Family Centered Care Principles The family is the constant in the child’s life Information exchange is unbiased Recognize and respects different methods of coping Encourages and facilitates family to family support Found not only in program or at the bedside, but incorporates POLICY

6 Remote Alaska.... Photo removed

7 Alaska’s Geographic & Diversity Challenges (scale)

8 Hospital within Hospital: Providence Alaska Medical Center 360 Bed Campus Beds are the Children’s Hospital and Women’s Center - 26 bed pediatric center - 37 licensed bed NICU (45+) - 32 post-partum - 7 LDR Outpatient subspecialty clinics

9 Lofty goals : Bringing change to an 75 yr. old hospital The journey of many steps, is worth the reward Photo removed

10 Family Action Council Initiative Involve parent and family in the care delivery of the surgery center (FAC goal in 2003/4) Build a foundation of family-support services to house FCC initiatives Use the nationally recognized discipline of child life to create a voice for both the child and family Impact the design and program delivery, reducing both the patient and family’s fear of the surgery process

11 Family Support Services Purpose Compassionately provide therapeutic family-centered care by collaborating to support those in need as they navigate the healthcare system.

12 FCC and surgery center goals To improve the care delivery by including parents and families in decision making, bringing families back to recover room or allowing families to stay with their child until they were asleep

13 Selling the idea Seized the opening: medication error in child for post-op pain Used JCAHO standards and recommendations Research other hospital and use physician to physician examples Got CMN funding for.5 position

14 Family support services

15 Change Team WHO: Child Life Specialists Parents and patients RN’s Anesthesiologists Physicians and Surgeons Technicians.

16 Standards and goals Timely reunification of parent and child, valuing parents presence Pre-surgery physician of child life medical play and surgery preparation Assisting families with special considerations Scheduling and comfort Parents having the option to be with their child should be a viable choice

17 Reaching the goal…. Photo removed

18 Change Team WHEN 1 Year ago:  Meet with managers to discuss needs  Funding and selling services  Family Focus  Job description and guidelines  Individually meet with MD’s  Data gathering  Beginning stages of patient interaction  Developing information cards

19 Change Team WHEN 6 months ago:  Tours with medical play explanations and visits to both surgery center and pediatrics  Agree to guidelines for parent presence in PACU  Education for staff in all areas  Communication with all disciplines  Design of new area and where families will be incorporated

20 Change Team WHEN 1 month ago:  Calling families from out of town  Distraction toys  Communication  Future planning

21 Challenges Time & Communication Work load Mindset Protocol Until proven it doesn’t work

22 Successful strategies Talk with management and a representative from each area Discuss and listen and incorporate concerns into solutions Set clear boundaries and expectations Make staff job’s easier Giveaways that promote your mission Sit in the backseat first, then take the wheel Take time to breathe, then react Know that change is hard and you are the element of change for them Document!!!

23 Keeping momentum going Keep statistics, advertise success, and publicly praise collaboration Keep advocating for what is best for patients and families Reciprocate your allies Keep committees connected Go on vacation… then they know how much you really do!

24 The start….. Photo removed

25 With Child life’s influence…… Photo removed

26 What’s working Pre-arranged tours Support to staff Distraction& environment Staff tolerance Parents’ perceptions Anesthesia & Surgeons Photo removed

27 Care delivery using.5 position of Child life staff Annual pediatric “day surgeries” : 1200 Annual pediatric surgery center: 500 Patient’s Served January 2007-June30, %

28 Future plans  Survey for children to complete  DVD/Web Video  Benefited FT position  Coloring books and distraction tools  Pediatric trained anesthesiologists  Protocols for IV starts  Induction room with parent’s present during induction  Improved pediatric pain assessment skills and tools

29 The Children’s Hospital at Providence 3200 Providence Drive POB Anchorage, AK Kris Green (Phone)