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Steps To Success: Launching And Sustaining APatient Family Advisory Council
MD Anderson Cancer Center
Steps To Success: Launching And Sustaining A
Patient Family Advisory Council
April 2016
Amy HallPatient & Family Advisor
Kathy Denton, PhD., C.P.H.Q.Associate Director of Patient Experience
Debbie Schultz, M.Ed., L.P.A., C.P.H.Q.Associate Director Volunteer Services
Welcome
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Overview
MD Anderson OverviewHistory Organizational StructureRecruitment and OnboardingServing as an AdvisorSustainability
• PFAC /PFAP • Institutional level
QuestionsCopies of forms and documents
Introhttps://youtu.be/qeIXpb
gS0Jo
MD Anderson Cancer Center
April 13, 2016
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Patient Care Statistics
Education StatisticsMore than 6,600 trainees, including physicians, scientists, nurses and allied health professionals, took part in educational programs at MD Anderson in FY15.
Nearly 21,000 employees, including almost 1,700 faculty
906 on-site volunteers, who contributed 145,452 hours of service
2437 off-site volunteers and nine myCancerConnection programs making 125,002 total contacts
Our people • FY 2015
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Our LocationsIn addition to MD Anderson’s main campus in the Texas Medical Center and two research campuses in Bastrop County, Texas, the institution has developed a number of local, national and international locations.Houston-area care centersBay Area, Katy, West Houston (diagnostic imaging), Bellaire (diagnostic imaging), Sugar Land, The Woodlands, Memorial City (surgical clinic), The Woman’s Hospital of Texas (gynecologic oncology)MD Anderson is now the exclusive provider of breast radiology services for 15 of Memorial Hermann’s breast care centers in the Houston area. MD Anderson physicians provide cancer care to patients at Lyndon B. Johnson Hospital.
MD Anderson Cancer Network® Partner members: Banner MD Anderson Cancer Center (Gilbert, Arizona), MD Anderson Cancer Center at Cooper (Camden, New Jersey), Baptist MD Anderson Cancer Center (Jacksonville, Florida), and MD Anderson Cancer Center at Summit Medical Group (Berkeley Heights, New Jersey)Associate member: Hospital Israelita Albert Einstein (São Paulo, Brazil)Certified members: 14 hospitals and health systems in 12 states
MD Anderson affiliatesMD Anderson Cancer Center Madrid (Spain) MD Anderson Radiation Treatment Center at American Hospital (Istanbul) MD Anderson Radiation Treatment Center at Presbyterian Kaseman Hospital (Albuquerque, New Mexico)
Mission, Vision, and Values
MissionThe mission of The University of Texas MD Anderson Cancer Center is to eliminate cancer in Texas, the nation, and the world through outstanding programs that integrate patient care, research and prevention, and through education for undergraduate and graduate students, trainees, professionals, employees and the public.
VisionWe shall be the premier cancer center in the world, based on the excellence of our people, our research-driven patient care and our science. We are Making Cancer History™.
Core ValuesCaring – Discovery - Integrity
Defining the Patient Experience
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History
History
• Children’s Cancer Hospital:Family Advisory Council started in 2008
• Adult - Patient Family Advisory Council (PFAC) development committee established 2013
• May 2014 – first PFAC meeting• January 2016 – expanded program to
Patient & Family Advisor Program
Committee: Initiated October 2013 – Core Group attended IPFCC Training
Representatives from:Patient Education Patient & Family Engagement Volunteer Services
Patients (3) Global Network Inpatient Nursing
Outpatient Nursing Internal Communications Pediatric FAC Program
Initial implementation committee
Key success factor: ownership in patient experience by many divisions
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2008• MD Anderson
Children’s Cancer Hospital establishes Pediatric Parent-Family Advisory Council
March 2013• MDA employees attend
Institute of Patient and Family Centered Care PFAC training seminar
June 2013• Strategic Planning
Group endorses formation of Patient and Family Advisory Council
October 2013• Working group begins
project to plan a PFAC• Institutional Committee
established – attended IPFCC
April 2014• Invited 27
patients/family members and 12 MDA employees to join PFAC
May 2014• First PFAC meeting
and New Advisor Orientation
Sept 2014 – Aug 2015 • Patient and family
members and employees individually added throughout the year on a request basis
July 2015Moved from a Program in the Division of Nursing to a Department under the
Vice-President for Performance Improvement
September 2015Recruitment of new PFAC
MembersUpdated By-Laws.
Expansion of Patient and Family Advisor Program .
December 2016New Advisors selected ……………………………………………………
………
January 2016• New Advisor
Orientation
Timeline
Key success factor: leadership focus on patient experience at an institutional level
Organizational Structure
Patient and Family Advisor Program
Department of Patient Experience
Office of Performance Improvement
John BinghamVice President of
Performance Improvement
Quality & Safety Subcommittee
Executive Clinical Operations Team (ECOT)
OPIPress GaneySurvey
Contract
DI Patient Experience Committee
Family Advisory Council
Pediatrics
Organizational Structure
Key success factors: Patient voice linked to safety and quality
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Recruitment and Onboarding
Communication:• mymdanderson.org announcement (patient portal)
• Information flyers in Volunteer Services and Hospitality Centers
• Story in This Week an Internal Communications patient focused flyer
Selection:• 30 day application window
• Application submitted to Director of Patient and Family Engagement
• Face-face interview with at least 1 committee member (30-45 minutes)
• Standard interview evaluation criteria and form
• Range 20-25 members (22 selected)
• Committee review meeting to select council members
• ranked top 3
• discussed selection criteria
Initial PFAC recruitment - March 2014
Communication:• mymdanderson.org announcement (patient portal)
• Information flyers in Volunteer Services and Hospitality Centers and PIKNIC
• Story in This Week an Internal Communications patient focused flyer
Selection:• 30 day application window (October) - Over 80 applications
• Application submitted through Patient Experience email or mailed to Director
• Face-face interview preference with 2 committee members
• Standard interview evaluation criteria and form
QUICKLY REALIZED NEED TO CHANGE – expanded to PFAP…
PROGRAM EXPANDED after first day of interviews.
PFAC-PFAP recruitment – October 2015
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.
OnboardingInitial March/May 2014 Onboarding• Completed during first PFAC meeting
• Role of advisor and example opportunities
• All paperwork completed individually outside of meeting
Second Onboarding January 2016• Orientation session
• 2 ½ hours
• Roles and responsibilities of advisors
• Opportunities
• Required forms and education
Serving as an advisor
Roles and responsibilities Be observant of what is going on around you
Please do not expect to be treated any differently or to receive special
favors as a patient and family advisor
Please represent all patients and families, not just your personal issues
Serving on a committee: Represent all patients and families
Ask the staff members to help you understand the committee’s purpose,
goals, and any words or language unique to the committee
Seek to offer constructive input of storytelling and limit complaining
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Patient and Family Advisor (PFA)Definition:Patient and Family Advisor role will enable patients and families to have direct input and influence on the policies, programs, and practices that affect the care and services individuals and families receive at MD Anderson Cancer Center.
Purpose: The patient and their family are at the center of the care and services at MD Anderson Cancer Center. Therefore, involvement of Patient and Family Advisors will enhance communication and improve patient satisfaction, quality of care, and safety in a collaborative effort.
Role: The Patient and Family Advisor offers input into patient care and organization processes, and advocates Patient and Family needs from a broad perspective.
Advisor Program Purpose Statement
While supporting the mission and vision of MD Anderson Cancer Center, we will strive to continually improve the experience of care for patients and families.
Keeping dignity and respect at the forefront, our goals are to:1. Educate stakeholders on the philosophy and core concepts of
Patient-and-Family-Centered Care2. Develop, implement and evaluate policies, programs and services
through the collaboration of patients, families, faculty, staff and community.
3. Create a partnership with patients, families, faculty and staff that promotes advocacy and involvement
To promote a better understanding of the principles of patient and
family-centered health care among patients and the MD Anderson
community.
To channel information, needs and concerns to the MD Anderson
Cancer Center administration and staff.
To be active consultants with regard to decisions and plans that
affect MD Anderson Cancer Center patients and families.
To assist in promoting positive relationships between MD Anderson
Cancer Center and members of the community.
Patient and Family Advisor Responsibilities
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Activity Ground Rules/Tips Arrive on time
Major decisions are made by consensus
Discussions should be held in open and honest atmosphere
Allow others to complete their comments before beginning yours
Contribute to discussion but monitor your talking time to assure that
others have the opportunity to participate
Actively listen to what individuals have to say and verify perceptions
No side conversations
Follow through with commitments
Stay focused on the topic at hand
Seek balanced participation
Ground Rules/Tips Continued:
Address disagreements directly
No hidden agendas
Communicate with co-facilitators or the staff liaison, if unable to
attend meetings
Refrain from using hospital jargon
All ideas are valuable
Be aware of confidentiality issues and guidelines
Communication Tips Use “I” statements to describe how you feel instead of blaming or
accusing
Share the time with other team members and listen. Seek first to
understand, then to be understood
Try to be non-judgmental in sharing and listening
TEAM – Together, Everyone, Achieves, More
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Serving as an Advisor
• Why I am an advisor?
• How I make a difference.
• What I would change if I could.
• My advice as you start a Patient and Family Advisory Council
Patient and Family Advisor Opportunities
HAL Advising
Story Telling
Speakers
Committees
Patient Education and Internal
Communications SimulationsOn-line Advisor
Short Term Projects
Council
Patient Shadowing
Quality & Safety
Rounding
Social Media Tips
Remember that what you say on social media stays on social media
Be smart about how you talk about the Advisor Program and MD
Anderson Cancer Center on social media
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PFAC Sustainability:• MD Anderson Partnering with Advisors• Orientation • Annual education • PFAC meeting structure• Annual advisor evaluation • Annual program evaluation-SWAT analysis
What you can expect – sustainability
To be accompanied by an employee to the first Advisor activity and to
have a de-briefing before and after the first activity.
Can request to have a de-briefing before and after any activity.
Can expect to have processes and terminology explained as needed.
Will be given the name and contact information for the lead of the activity.
Will be listened to and respected for personal insight and suggestions.
Can expect a safe environment to discuss concerns.
May be invited to attend educational sessions.
Key component to success
Communication
Follow HIPAA guidelines for confidentiality
Committees, advisor meetings, and other sharing opportunities should
be a safe place to talk about experience. Everyone should be
comfortable knowing the other members are not telling those they know
at home, school, or social media what we hear
Please do not identify doctors, nurses, or other staff members by name
when sharing a story that includes that person
We want to focus on the issue, not the person
Use personal experience to illustrate a point
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Standards – sustainability
The Patient Family Advisor will maintain confidentiality of patient and organizational sensitive information.
The Patient Family Advisor will attend required Advisor meetings and provide input through identified activities.
Participation is voluntary and may be withdrawn at any time with notice, by either party.
The Advisor position is a one year position, with an annual review providing renewal for an additional year. Renewal may be provided for up to three years.
The Patient Family Advisor will complete the PFA orientation and all required forms including but not limited to: HIPPA training, a confidentiality statement and a Code of Conduct statement.
What is Protected Health Information What is Protected Health Information (“PHI”)?
PHI is any individually identifiable health information that relates to
a person’s health care. For example, PHI includes health
information paired with any of the following: name, address, Social
Security number, recognizable photos, dates of service, date of
birth, contact information, and medical record numbers. PHI may
be electronic, paper, or spoken word. See “Confidentiality Policy”
(Policy # ADM0264). Even the simple fact that someone is an MD
Anderson patient constitutes PHI.
Health Information includesPHI is health information paired with identifying information. • Treatment;• Diagnosis;• Genetics; and• Patient status.Identifying information includes:• Name (incl. initials);• Date of birth;• Medical Record Number (MRN);• Treatment dates;• Contact information (address, fax, e-mail, phone);• Photos;• Account numbers; and• Social Security Numbers.
PHI is found almost everywhere; in medical records, billing records, appointment reminders, advertisements, publications, research databases, etc. HIPAA dictates how we use, disclosure, and protect PHI.
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New Advisor Signature FormsWrite your name on the manila folder tab
1. Protecting Patient Privacy Form
2. Confidentiality, Conflict of Interest & Non-Disclosure Agreement Form
3. Information Resources User Rights and Responsibilities Acknowledgement Form
4. Non-Employee Vetting Form
5. Patient and Family Advisory Program Orientation Acknowledgement Form
6. Patient and Family Advisor Program Preference Form
Work with the employees at your table to answer questions, complete and hand-in the
forms listed above in the manila folder: Last Name, First Name.
PFAC meetings – sustainability Monthly – 3rd Tuesday of the month 5:30 – 8:00
Dinner included
Standard agenda:
• Patient Story
• 2 presentations/projects 5 minutes each
• 2 small group breakouts – simultaneously
• Break
• Large group project or update for feedback – most recently EPIC feedback
• Committee report-outs
Institutional sustainability • Vice-President of Performance Improvement attends all
PFAC meetings
• President spoke at first annual celebration
• SAFTEY COMMITTEE - first Committee to have a PFAC member
• Internal Communications -partner
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Next Steps: Institutional sustainability
• Invite a different Executive leaders to speak at and attend a PFAC meeting
• Increase PFAC membership on institutional committees
• Internal Communications about PFAC/PFAP to employees and faculty
Innovation committee Communication of death policy and procedureUpdated visitor policyWhite boards updated to include daily patient goalNew thermostats in patient roomsNew mattresses in patient roomsCommit-to-sitBedside shift reportAccent modification class Safety Committee MemberNew Nurse Simulation labsFocus Groups for research surveys and education pieces Facilitated Facilities Inpatient room survey with patientsNew signage Patient education materials
Partial list of PFAC involvement results
At MD Anderson, everything we do
revolves around our patients and placing
patients and their families first.
So what does it mean to put them first?
It’s delivering on our promise of safe,
timely, effective, efficient, equitable, and
patient-centered care every day.
Patients story at top of a meetings
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Expected Outcomes of thePatient & Family Advisory Council
Improved communication
Improved provider-patient relationships
Improved quality of care/patient safety
Improved patient experiences of receiving/participating in care
More efficient use of resources
Improved provider satisfaction with providing care
Improved patient/health outcomes.
Agency for Healthcare Research and Quality (2012) Guide to Patient and Family Engagement
Patient and Family Advisor Program
0
10
20
30
40
50
60
70
80
Hours
Patient and Family Advisor Total
Volunteer Hours
0
20
40
60
80
100
2014 2015 2016
Number of Advisors
Founding PFAC Advisors
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Next…
Poster Session Presentations
4:00-5:00 PM
Foyer
Off Site Networking Reception & Dinner
6:00-9:00
Busses will transport attendees to Winspear Opera House
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Patient and Family Advisory Council
TOOL BOX RESOURCES
Patient and Family Advisory Council Interview Guide
Candidate Name: ______________________________Date:__________________
Why would you like to participate in the Patient and Family Advisory Council?
Tell me about a positive experience you’ve had at the hospital.Can you recall a challenging or problem situation that you have encountered here and describe how you managed it?How have you handled a situation in the past when someone’s background or values were different than your own?What are two or three personal strengths you have when working in groups?The PFAC meetings will be held once a month on a weeknight. Are there any days of the week that would NOT work for …..you?Have you ever received services at one of our regional locations? If so, how frequently?
Reminders:We will be doing background checksIf a person isn’t selected, it isn’t because they aren’t “good” enough, but it is because diversity of the group is so importantDiversity = background, diagnosis, experience at MDA, gender, race, family type, socioeconomic status, educational background, age, etc.We will keep applicants in mind for potential opportunities for projects outside of the PFAC business meetings
Interviewer:_________________________________
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Table of Contents
Welcome LetterBeing a Patient and Family AdvisorThe Department of Patient Experience Structure: The Patient and Family Advisory ProgramPatient and Family Advisory Program OverviewPatient and Family Advisory Program Purpose StatementPatient & Family Family Advisor positon description Patient and Family Advisory Program Ground RulesWhat It Means to Be a Patient and Family AdvisorTips For How To Be An Effective Patient of Family Advisor: A Beginning List Communication Tool BoxPatient and Family Advisors - January 2016 Do the Right ThingVision, Mission and ValuesInstitutional Code of ConductPrivacy, Confidentiality, and Security Work EnvironmentYour Rights and ResponsibilitiesProtecting Patient Privacy (your copy)Confidentiality, Conflict of Interest & Non-Disclosure Agreement (your copy)Information Resources User Rights and Responsibilities Acknowledgement Contractor (your copy)Patient and Family Advisor Position DescriptionPFAC By-LawsPFAC Co-Chair Position DescriptionStrategic Plan Overview
Forms to sign and turn inProtecting Patient PrivacyConfidentiality, Conflict of Interest & Non-Disclosure AgreementInformation Resources User Rights and Responsibilities Acknowledgement Non-Employee Vetting FormPatient and Family Advisor Program Preference FormPatient and Family Advisory Program Orientation Acknowledgement Form
Patient and Family Advisory Council (Program) Orientation
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Welcome Letter
PFAC Meeting Agenda Template -Example
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PFAC By-laws
PFAC By-laws continued
PFAC Co-Chair Position Description
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Patient and Family Advisor Position Description
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Request A Patient and Family Advisor Form
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First Assignment Check-off Form
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Letter to team lead when Patient Advisor added to team
Internal Communications