from patient to partner — engaging patients and families in care · 2019-11-18 · trends and/or...
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From Patient to Partner —Engaging Patients and Families in CareKaren CurtissPartnerHealth, LLC
Mary E. Foley, PhD, RN, FAANUCSF School of Nursing
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Presented by: Karen CurtissPartnerHealth
Mary Foley, PhD, RN, FAANClinical Professor, UCSF School of Nursing
From Patient to Partner: Engaging Patients and Families in Care
Making ConnectionsFeb 16-17CHA Center forPost-Acute Care
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A little background about Karen and Mary
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Co-Authors and Co-Presenters
Karen Curtiss
Mary Foley, PhD,RN, FAAN
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After our hour together, our goal is for you to leave with
Practical strategies to Activate patients and
families Prevent readmissions
and support patient safety
A plan to act on these strategies
The case for family engagement to prevent HACs and readmissions
Engagement vs. activation
How to activate families to help you prevent HACs and readmissions
Take the Bossy Pants Challenge
Objectives Agenda
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“ Bring someone with you.”
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Karen’s Family Story:7 Months
Successful lung transplant. PF cured!FallVAPMRSAC diffDVTPEMRSA … againC diff … againStage 4 Bed Sore all the while
Bill Aydt, married to Margaret, 51 years6 children, 9 grandchildren (Lily, age 3, shown)
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+ Best Intentions, No Information. Dad Paid the Price.
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Who are Your Nearest and Dearest?
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Why?
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+ It’s Complicated
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+ Patients Forget 80% of What You Tell Them
* Numerous studies in the U.S and U.K.
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+ 3 out of 4 patients, age 64+, leave the hospital with an incorrect prescription or no understanding of their medication regimen. (Yale New Haven study, December 2012)
Yale New Haven study by Dr. Leora Horwitz of patients aged 64+ with heart failure, acute coronary syndrome or pneumonia, December 2012.
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+ Preventable Round Trips 14
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“We have trained, hired and rewarded people to be cowboys, but it is pit crews that we need —pit crews for patients.”
- Atul Gawande, MD
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+We cannot solve our problems with the same thinking we used when we created them.
- Albert Einstein
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+Your Allies for Safe Care
No one is more patient-centered. No one knows
your patient better.
Informed and Activated Care Partners 17
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How to Engage Patients and Families in Care
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How to Engage Patients and Families in Care
Create Culture Inform Connect Activate
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How to Engage Patients and Families in Care
Create Culture Inform Connect Activate
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How to Engage Patients and Families in Care
Create Culture Inform Connect Activate
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How to Engage Patients and Families in Care
Create Culture Inform Connect Activate
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23Copyright © 2017, PartnerHealth
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How to Engage Patients & Families in Care
Start With Culture1. Listen to patients2. Create Vision3. Acknowledge the pain of change4. Put “pain” on the table — and pivot! 5. Be curious6. Look up!
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+ “I am the patient and I need to be heard!”
www.youtube.com/watch?v=iVt3eHAsdK4
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+ “I Just Want a Milkshake.” 26
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+Trends and/or RulesWhat are You Doing?
1. Provide planning checklists for patients and families who have scheduled admissions
2. Conduct shift change huddles and bedside reporting
3. Have a dedicated person or functional area for attending to patient and family engagement
4. Have an active PFAC (Patient and Family Advisory Council)
5. Have at least one patient/family member sit on your hospital’s Board of Trustees with full voting rights and privileges
6. Provide information and tools to patients and families to prevent HACs and readmissions. (from HEN 2.0)
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+ Try These Thinking Caps On for Size
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Why May NOT workWhy it WILL
Or CAN work
Feelings, Intuition
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+ Informed by All Needs, All Viewpoints
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FamiliesClerics
AidsPT, OT
LTC personnelQuality
MarketingPharmacists
Comm. RelationsDieticians
Any others
PatientsNursesDocsAdminsRegistrarsVolunteersParkingGift ShopEnvironmental StaffAdvocates
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StrengthsStrengths WeaknessesWeaknesses
OpportunitiesOpportunities ThreatsThreats
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Get in the Weeds 32
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How to Engage Patients & Families in Care
Activation Starts with Information
1. Use lay language, non-medical terms2. Speak, write in 6th grade literacy level or below3. Share simple checklists, 5-7 items4. Build trust. Be transparent. Talk about HACs,
build partnerships to prevent.
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Share Facts:Simple info in simple terms
Connect to Motivate:Fuel connection, “We’re in this together!” Reasons why
Provide "To Do" Tools:
Engage? Safe & Sound Activation Rubric
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35S a f e & S o u n d E n g a g e m e n t P r o c e s s Copyright to PartnerHealth, LLC, 2013
Essential: A Common Vocabulary35
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Bed Sore
Make funeral arrangements
Infection, bad germs
???
Yellow
Drink more water
Main doctor (or … angel dust, a street drug)
What you say … What everyone else says/thinks Decubitus Ulcer
Heart failure
MRSA
Isolation precautions
Jaundice
Up fluids
PCP
Translation Please!
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+ Checklists: Simple Info Can Help Solve Complex Problems
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Enlist Families with Checklists to Help Prevent …
Falls
Hospital Infections
Blood Clots
VAP
Bed Sores
Readmissions
Plan Ahead for Care Post-Discharge
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Virtually eliminated CLABSIs in ICU’s in University of Michigan hospitals
Reduced mortality rate overall by 10%
“Safety Checklist Use Yields 10 Percent Drop in Hospital Deaths”,John Hopkins, Release Date Of 02/14.
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Why?Checklists Work!
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+ A Good Example
P LE A S E
Wash Hands!
AboutBloodst reamInfect ions:Germs can invade thebody through cuts orbreaks in the skin,resulting in seriousinfection that’scarried through thebody in thebloodstream.
Risk Fact ors: Use of a tube andbag system calledan “IV” or a “centralline” to deliverfluids because theskin has to bebroken for theselines to be inserted.
Use this Checklist to Help Prevent Bloodstream Infect ion
When a central line is inserted, ask: “Are you using acentral line bundle?"
Watch to make sure that nurses and doctors always:
I Wash their hands thoroughly before touching yourloved one
I Use sterile instruments and suppliesI Sterilize the skinI Choose the safest spot
Ask, “Why?” if groin is chosenI Use a clean sheet to drape your loved one's bodyI Wear a maskI Cover the area with a sterile pad
Make sure any openings in the skin are kept covered atall times.
xxx
xxx
xxx
Central line
IV lines often go here (but not always)
Central line can go inthe groin, but it’s not
the safest place
xxxshows example surgery sites
P LE A S E
Wash Hands!
AboutBloodst reamInfect ions:Germs can invade thebody through cuts orbreaks in the skin,resulting in seriousinfection that’scarried through thebody in thebloodstream.
Risk Fact ors: Use of a tube andbag system calledan “IV” or a “centralline” to deliverfluids because theskin has to bebroken for theselines to be inserted.
Use this Checklist to Help Prevent Bloodstream Infect ion
When a central line is inserted, ask: “Are you using acentral line bundle?"
Watch to make sure that nurses and doctors always:
I Wash their hands thoroughly before touching yourloved one
I Use sterile instruments and suppliesI Sterilize the skinI Choose the safest spot
Ask, “Why?” if groin is chosenI Use a clean sheet to drape your loved one's bodyI Wear a maskI Cover the area with a sterile pad
Make sure any openings in the skin are kept covered atall times.
xxx
xxx
xxx
Central line
IV lines often go here (but not always)
Central line can go inthe groin, but it’s not
the safest place
xxxshows example surgery sites
Quick information
6th grade literacy level
Active voice
Icons and pictures
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+ Checklists Put Everyone on the Same Page for Patient Safety
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Reactions: “Peace of Mind” is Common
*See more at: http://www.amazon.com/Safe-Sound-Hospital-Must-Have-Checklists/
“Since my husband and I are both in our middle 80's, probably one of us will be in the hospital sometime.
I carefully went through the checklists … these records would be very helpful!!
It will bring comfort and peace .” - Joanne Cerling
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How to Engage Patients & Families in Care
Connect
Invite families to partner with you with empathy and grace
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+ The Power of Empathy
www.youtube.com/watch?v=1Evwgu369Jw
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S a f e & S o u n d E n g a g e m e n t P r o c e s s Copyright to PartnerHealth, LLC, 2013
Alternative approach:
To do’s linked to safety and preventing readmission
Reasons why (motivation)
Empathy/Grace notes (art, heart, tone)
6th grade reading level
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How to Engage Patients & Families in Care
Activate
Share Tools with To Do’s
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+ Example: Prevent VAP for Pennies
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+ Checklists in Many Forms47
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Infection? Not on My Watch!
Catherine: 42 Days
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S a f e & S o u n d E n g a g e m e n t P r o c e s s Copyright to PartnerHealth, LLC, 2013
Take the Bossypants Challenge
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+Quality ImprovementsWhat Will You Do Next?
1. Provide planning checklists for patients and families who have scheduled admissions
2. Conduct shift change huddles and bedside reporting
3. Have a dedicated person or functional area for attending to patient and family engagement
4. Have an active PFAC (Patient and Family Advisory Council)
5. Have at least one patient/family member sit on your hospital’s Board of Trustees with full voting rights and privileges
6. Provide information and tools to patients and families to prevent HACs and readmissions.
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Be the Change You Want to See
For your familyFor your patients
For your peace of mind
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+ Keep Us Posted: We’re Here to HelpKaren Curtiss [email protected] PH:847.208.6074
Mary Foley [email protected]
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Questions?