1. [Hospital Name | Presenter name and title | Date of presentation]
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The Guide to Patient and Family Engagement in Hospital Quality and Safety: Engaging Patients and Families to Improve the Quality and Safety of Care We Provide
[Hospital Name | Presenter name and title | Date of presentation]
Handouts that accompany this presentation:
About the Guide to Patient and Family Engagement
How Patient and Family Engagement Benefits Your Hospital
Supporting Patient and Family Engagement: Best Practices for Hospital Leaders
You may also wish to have on hand:
Printouts of this PowerPoint presentation
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Guide to Patient and Family Engagement

2. Today’s presentation
Improving the care we provide through patient and family engagement
How the Guide to Patient and Family Engagement helps
Moving forward
We will begin today by talking about how engaging patients and family members helps us improve the quality and safety of care we provide.
Then we will talk about how the Guide to Patient and Family Engagement can help us partner with patients and family members.
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Guide to Patient and Family Engagement

3. Patient and family engagement: Improving the care we provide
To set the stage for our conversation, I’d like to talk about the importance of engaging patients and families as partners in improving the quality and safety of care that we provide.
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Guide to Patient and Family Engagement

4. What is patient and family engagement?
Creates an environment where patients, families, clinicians, and hospital staff work together as partners to improve the quality and safety of hospital care
Involves working with patients and family members as:
Members of the health care team
Advisors at the organizational level
Patient and family engagement is an area of increasing importance for hospitals. The ultimate goal of patient and family engagement is to create a set of conditions where patients, family members, clinicians, and hospital staff are all working together – as partners – to improve the quality and safety of care.
On one level, patient and family engagement means providing day-to-day care experiences that engage patients and family members as members of the health care team. For example, in our hospital, we provide opportunities for patients and family members to be involved in their care by: [Modify the examples below to indicate how your hospital provides opportunities for partnership and engagement during the hospital stay]
Making sure that we invite patients and family members to partner with their health care team throughout their stay.
Conducting nurse change of shift report at the bedside, where patients and families can participate.
Involving patients and families in discharge planning and plans for safe care at home.
Patient and family engagement also means that patients and family members are involved beyond their own care as organizational partners, or advisors – for example, working together with staff, clinicians, and leaders to improve policies, processes, programs, facility design, and education for hospital staff, clinicians and trainees in the health professions.
Patient and family engagement is not a new initiative. It is part of what we are already doing to improve quality and safety!
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Guide to Patient and Family Engagement

5. Patient- and family-centered care
Patient and family engagement is an important part of providing patient- and family-centered care
Core concepts of patient- and family-centered care:
Dignity and respect
Information sharing
Involvement
Collaboration
Patient and family engagement is an important part of providing patient- and family-centered care. According to the Institute for Patient- and Family-Centered Care, the core concepts of patient- and family- centered care are:
Dignity and respect, which means listening to and honoring patient and family ideas and choices and using patient and family knowledge, values, beliefs, and cultural backgrounds to improve care planning and delivery.
Information sharing, which means communicating and sharing complete and unbiased information with patients and families in useful ways. Patients and families receive timely, complete, and accurate details so they can take part in care and decision- making.
Involvement, which means encouraging and supporting patients and families in care and decision making at the level they choose.
Collaboration, which means inviting patients and family members to work together with health care staff to develop and evaluate policies and programs.
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6. Benefits of patient and family engagement
Improves multiple aspects of hospital performance
Overall improvements in quality and safety
Patients and families as allies in safe medication use, infection control initiatives, observing care processes, reporting complications
Reduction in preventable readmissions
Improved patient outcomes
Emotional health, symptom resolution, pain control, physiologic measures
Improved CAHPS® Hospital Survey scores
Patient-provider communication, pain management, medications, provision of discharge information
For more specific information, refer to the handout “How Patient and Family Engagement Benefits Your Hospital.”
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Guide to Patient and Family Engagement

7. Benefits of patient and family engagement
Better response to the Joint Commission standards or other accreditation
Improved financial performance
Decreased litigation and malpractice claims
Lower costs per case due to complications
Improved patient flow
Less waste associated with higher call volume, repetitive patient education efforts, diagnostic tests
Enhanced market share and competitiveness
Establishment of brand identify around patient and family engagement
Increased employee satisfaction and retention
For more specific information, refer to the handout “How Patient and Family Engagement Benefits Your Hospital.”
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Guide to Patient and Family Engagement

8. Benefits of patient and family engagement
Patient and family engagement also:
Is consistent with our mission and vision [Insert mission statement as appropriate]
Helps us meet our strategic priorities [Insert relevant priorities from short- and long-term strategic plans]
Is the right thing to do [Share story from patient or family, or have them share their story]
Personalize this slide with information about how your hospitals can impact their mission, priorities.
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Guide to Patient and Family Engagement

9. The Guide to Patient and Family Engagement
What is it?
What do we want to do?
Personalize this slide with information about how your hospitals can impact their mission and priorities.
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Guide to Patient and Family Engagement

10. Guide to Patient and Family Engagement
Tested, evidence-based resource to help hospitals work as partners with patients and families to improve quality and safety
Includes strategies that reflect critical opportunities for patient and family engagement
Addresses real-world challenges
Contains detailed implementation guidance
Includes tools for hospital leaders, managers, clinicians, patients, and families
Refer to the handout “About the Guide to Patient and Family Engagement.”
The Guide was created and evaluated by a multidisciplinary team for the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services (DHHS).
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Guide to Patient and Family Engagement

11. Guide to Patient and Family Engagement
Includes four strategies to support engagement:
Working with Patients and Families as Advisors
Working with Patients and Families at the Bedside: Communicating to Improve Quality
Working with Patients and Families at the Bedside: Nurse Bedside Shift Report
Working with Patients and Families at the Bedside: Care Transitions from Hospital to Home: IDEAL Discharge Planning
Refer to the handout “About the Guide to Patient and Family Engagement.” Please note that the next four slides give a brief rationale for focusing on each strategy included in the Guide. Select the slides for the strategy or strategies that are most relevant to your hospital.
The Guide contains four specific strategies that represent critical opportunities for hospitals to improve patient and family engagement. Each strategy includes a detailed implementation handbook and a set of tools (brochures, training presentations, materials) that hospitals can use to support implementation.
Strategy 1: Working With Patients and Families as Advisors contains tools to help hospitals begin to work with patients and family members as organizational-level advisors, providing a mechanism for involving patients and family members in policymaking; facility design; and the planning, delivery, and evaluation of care.
Strategy 2: Working With Patients and Families at the Bedside: Communicating to Improve Quality contains tools to improve communication between patients, family members, and clinicians from the point of admission, including giving patients a clearer understanding of how to ask questions, who to go to for information or help, and how to participate in their care.
Strategy 3: Working With Patients and Families at the Bedside: Nurse Bedside Shift Report contains tools to support the safe handoff of care between nurses by involving the patient and family in the change of shift report for nurses.
Strategy 4: Working With Patients and Families at the Bedside: IDEAL Discharge Planning contains tools engage patients and family members in the transition from hospital to home, with the goal of reducing medication errors and preventable readmissions.
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Guide to Patient and Family Engagement

12. Why work with patients and families as advisors?
Patient and family advisors help us provide care and services based on patient- and family-identified needs rather than our assumptions
Patient and family advisors offer
Insight on our strengths and areas where changes may be needed
Feedback on practices and policies that can help patients and families be active partners in their care
Feedback that is timely and gives a fuller picture of the care experience than standard patient and family satisfaction surveys
We are interested in focusing on Strategy 1: Working with Patients and Families as Advisors.
Working with patient and family advisors can help us improve the quality and safety of care we provide by building a shared agreement around quality and safety priorities.
In addition to the improvements in hospital performance already discussed, working with patients and families at an organizational level has benefits [read slide].
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13. Why focus on communication?
It’s the foundation of all interactions with patients and families
Research shows patient-centered communication can improve:
Patient safety
More than 70% of adverse events caused by breakdowns in communication
Patient outcomes, including emotional health, functioning, and pain control
Patient experiences of care
[Insert hospital goal / data related to communication]
We are interested in focusing on Strategy 2: Working with Patients and Families at the Bedside: Communicating to Improve Quality.
Various studies indicate that the effects of engaging patients and families translate into measurable improvements in quality and safety:
Improved patient safety. Better communication, realized through patient and family engagement, has a direct impact on patient safety. For example, one study found that more than 70% of adverse events are caused by breakdowns in communication among caregivers and between caregivers and patients.1 In addition, studies show that patients who are informed and engaged can help improve safety through “informed choices, safe medication use, infection control initiatives, observing care processes, reporting complications, and practicing self-management.”2 When patients and families are engaged in their care, an extra set of eyes and ears is available to help catch and prevent safety issues.
Improved patient outcomes. Adopting patient-centered care strategies and engaging patients actively in their health also has the potential to improve health outcomes. In a review of the literature, Roter found that patient-centered care, realized through effective communication, had a positive effect on patient outcomes – specifically, emotional health, symptom resolution, functioning, pain control, and physiologic measures such as blood pressure and blood sugar levels.3
Improved scores on public reports of patient experiences of care. The Centers for Medicare & Medicaid Services (CMS) publishes hospitals’ patient experience scores on its public Web site ( The scores are based on a standardized survey known as the CAHPS® Hospital Survey. Many of the measures from the CAHPS Hospital Survey—particularly those related to patient-provider communication, pain management, and the provision of discharge information—reflect key elements of patient and family engagement. Hospitals that have implemented strategies to improve patient engagement and the patient-centeredness of care have seen subsequent improvements in patients’ ratings of care.4
References:
Sentinel event root cause and trend data. Improving America’s hospitals: the Joint Commission’s annual report on quality and safety Available at Accessed July 23, 2010.
Coulter A, Ellins J. Analysis: effectiveness of strategies for informing, educating, and involving patients. BMJ 2007;335(7609):24-27.
Roter D. Which facets of communication have strong effects on outcome: a meta-analysis. In: Steward M., Roter D. eds. Communicating with medical patients. Newbury Park, CA: Sage; 1989.
Iacono S. Planetree Philosophy: a study on the relationship of patient satisfaction and utilization of a Planetree model in care delivery. PlaneTalk; 2001.
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Guide to Patient and Family Engagement

14. Why focus on bedside shift report?
Transitions in care have potential for medical errors
Research shows bedside shift report can improve:
Patient safety and quality
Improved communication
Decrease in hospital-acquired complications
Patient experiences of care
Time management among and accountability between nurses
Decrease in time needed for shift report
Decrease in overshift time
[Include specific goals / data for hospital]
We are interested in focusing on Strategy 3: Working with Patients and Families at the Bedside: Nurse Bedside Shift Report.
Patient safety and quality. Bedside shift report is an opportunity to make sure there is effective communication between patients and families and nursing staff. One study found that more than 70 percent of adverse events are caused by breakdowns in communication among caregivers and between caregivers and patients.1 Studies have shown that bedside shift report improves patient safety and service delivery.2,3 For example, one study showed a decrease in patient falls during change of shift, dropping from one to two patient falls per month to one patient fall in six months.4
Improved communication during shift report can help catch potential medical errors in blood incompatibility, catheter-associated urinary tract infections, and air embolism, all of which are on the Centers for Medicare and Medicaid Services’ (CMS) list of hospital-acquired complications “never events.”
Patient experience of care. After implementing bedside shift report, hospitals reported an increase in patient satisfaction scores and improvements in the nurse-patient relationship.5,6 Also, one study noted a sharp decline in the average number of call lights on by the end of shift change.4
Time management and accountability between nurses. After implementing bedside shift report, nurses have reported better ability to prioritize their work or cases during their shift and an overall decrease in staff time.4,6 One study noted a decrease in overshift time by 100 hours in the first two pay periods on a 32-bed general surgical unit.6 In another study on a 34-bed progressive care unit, a 2-month review of overtime data demonstrated an $8,000 reduction directly associated with the decrease in time for shift report.4
[Include hospital specific goals or data]
References
Sentinel event root cause and trend data. Improving America’s hospitals: the Joint Commission’s annual report on quality and safety; Available at Accessed July 23, 2010.
Athwal P, Fields W, Wagnell E. Standardization of change-of-shift report. J Nurs Care Qual 2009;24(2):143–7.
Chaboyer W, McMurray A, Johnson J, et al. Bedside handover: quality improvement strategy to ‘transform care at the bedside.’ J Nurs Care Qual 2009;24(2):136–42.
Chaboyer W, McMurray A, Wallis M. Bedside nursing handover: a case study. Int J Nurs Pract 2010;16(1):27–34.
Anderson CD, Mangino RR. Nurse shift report: who says you can’t talk in front of the patient? Nurs Adm Q 2006;30(2):112–22. 
Kelly M. Change from an office-based to a walk-around handover system. Nurs Times 2005;101(10):34–5.
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15. Why focus on discharge planning?
Nearly 20% of patients experience an adverse event within a month of discharge, of which ¾ could be prevented
Common complications post-discharge are adverse drug events, healthcare-associated infections, and procedural complications
Many complications can be attributed to problems with discharge planning
Changes in medicines before and after discharge
Inadequate preparation for patients and families
Disconnect between information giving and patient understanding
Discontinuity between in-patient and out-patient providers
[Add hospital data / goals related to discharge]
We are interested in focusing on Strategy 4: Working With Patients and Families at the Bedside: Care Transitions from Hospital to Home: IDEAL Discharge Planning.
Nearly 20 percent of patients experience an adverse event within 30 days of discharge.1,2 Research shows that nearly three-quarters of these events could have been prevented or ameliorated.1
Common post-discharge complications include adverse drug events, healthcare-associated infections, and procedural complications. Many of these complications can be attributed to discharge planning problems, including medication changes before and after discharge; inadequate preparation for patient and family related to medications, danger signs, or lifestyle changes; a disconnect between clinician information-giving and patient understanding; and discontinuity between inpatient and outpatient providers.3-5
Involving patients and families in discharge planning can help improve patient outcomes, such as reducing unplanned readmissions and increasing patient satisfaction.6-7
References
Forster AJ, Murff HJ, Peterson JF, et al. The incidence and severity of adverse events affecting patients after discharge from the hospital. Ann Intern Med 2003;138(3):161–7.
Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med 2009;360(14):1418–28.
Kripalani S, Jackson AT, Schnipper JL, et al. Promoting effective transitions of care at hospital discharge: a review of key issues for hospitalists. J Hosp Med 2007;2(5):314–23.
Popejoy LL, Moylan K, Galambos C. A review of discharge planning research of older adults West J Nurs Res 2009;31(7):923–47.
Anthony MK, Hudson-Barr D. A patient-centered model of care for hospital discharge. Clin Nurs Res 2004;13(2):117–36.
Bauer M, Fitzgerald L, Haesler E, et al. Hospital discharge planning for frail older people and their family. Are we delivering best practice? A review of the evidence. J Clin Nurs 2009;18(18):2539–46.
Shepperd S, McClaran J, Phillips CO, et al. Discharge planning from hospital to home. Cochrane Database Syst Rev 2010;20(1):CD
As for our hospital,
[Add your own hospital data/goals related to discharge]
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Guide to Patient and Family Engagement

16. Moving forward What do we need from you?
Finally, we would like to talk about the support we are requesting to move forward.
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Guide to Patient and Family Engagement

17. What do we need from you? Staff time to [implement strategy] OR
Staff time to form a multi-disciplinary team to assess our hospital’s needs and decide which strategy to implement
[Note: Be specific of what support you need and who will be responsible for the initiative]
Adapt this slide as needed based on your hospital’s circumstances and available resources.
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Guide to Patient and Family Engagement

18. Other ways to support patient and family engagement
Communicate the hospital’s vision and values related to patient and family engagement.
Serve as role models for engaging in partnerships with patients and family members.
Provide the necessary infrastructure and resources.
Involve and support clinicians and hospital staff in patient and family engagement initiatives.
Integrate patient and family engagement into personnel policies and practices.
Patient and family engagement can be a way to improve quality and safety at our hospital. But, sustained change does not happen without a clear mandate and ongoing support from leadership – you. There are different ways you can show support for patient and family engagement.
Note to presenter: For more information, see the handout “Supporting Patient and Family Engagement: Best Practices for Hospital Leaders.”
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Guide to Patient and Family Engagement

19. Ways to end presentation
[Note: you may wish to end the presentation in one of the following ways:
Download and show the AHA Video: Patient-and Family-Centered Care: Partnerships for Quality and Safety
Ask a patient or family member to speak to leadership about his or her experiences receiving care at your hospital]
Link to the AHA video:
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Guide to Patient and Family Engagement

20. Thank you! For questions or more information:
[Insert contact name and information]
Thank you for your time today. If you would like additional information after this presentation, please feel free to contact me at any time.
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Guide to Patient and Family Engagement