Patient and Family Engagement E-Letter
Patient & Family Engagement at BIDMC
Our quarterly e-letter tells the stories behind patient and family engagement, featuring the perspectives of patient and family advisors and BIDMC staff who have worked with advisors.
Issue 7, Winter 2013
Primary care, patient roles, and a physician's perspective - Part 2
Dr. Amy Ship from BIDMC's primary care practice Healthcare Associates sat down with Erica Dente, ICU Patient & Family Advisory Council member, to talk about the current landscape of primary care. In the second segment of this three-part interview, Dr. Ship shares how patients can help make doctor's appointments informative and productive.
How should a patient prepare for an appointment?
All patients must know what they hope to get out of the appointment. A lot of women’s magazines advocate bringing lists, but it doesn’t have to be a list. It is just important to know what you want to get out of the visit. What is the most frustrating thing for the physician is when you have your hand on the door, ready to leave and the patient says, “But what I really wanted to ask you is…” and it is something that warrants a lot of time. That’s why as a clinician I try to organize the meeting, so even if the patient doesn’t have a list I say, “What do you want to talk about today?” Knowing what you hope to get out of the visit, knowing what your medicines are, and having information on any new medicines or health updates is the best way to prepare for appointments.
Sometimes patients are scheduled for a follow-up visit, but don’t know why they are coming in. Is it possible for patients to prepare in those situations?
That is absolutely true, and I think that is a failing on our behalf; and when I say “our” I mean doctors. Most of the time, when I ask for a follow up appointment it is so I can make sure the interventions I put in place are effective and there are not any difficulties. I follow up to see if there is change. If a patient is trying to make behavioral change, I like to check in to see if there are any changes, like if a patient is trying to lose weight or quit smoking, it won’t be helpful to see them in a year. And as a patient, if you have access to your note, you can check it out and see what your physician’s plan is. (Read about how BIDMC is using OpenNotes.)
For folks that are well, how often do you see them?
Most doctors and insurance agencies recommend going every year. If people are genuinely healthy without any issues, two years is probably okay. I think it is helpful to have an annual visit to make sure all the things we can do to keep people healthy are being done. I ask, “Have you seen a dentist, have you seen an eye doctor, have you had a mammogram?” so it is like a routine check-in. I think it is helpful for most adults, particularly over 35, to go to the doctor once a year. Patients with chronic issues must be seen much more frequently.
How should a patient best prepare when they have requested the appointment?
Those patients are usually extremely well prepared because they are driving the meeting. They come in and say, “This is how I feel, this is what is wrong.” So, in some ways those meetings are the easiest. The better you are able to tell the story of what is going on, what you are most worried about, you can make sure the doctor checks for that.
Advisors assist in development of service excellence training
With a mission to provide extraordinary care, where the patient comes first, supported by world-class education and research, patient care is a clear priority at BIDMC. The healthcare providers on Farr 2 are focusing on this mission with a service excellence training, We C.A.R.E.
“The purpose of We C.A.R.E. is to improve the patient experience, our communication to patients and families and to one another,” explains Denise Corbett-Carbonneau, Nurse Manager of Farr 2. We C.A.R.E. teaches the multi-disciplinary staff on Farr 2 to practice mindfulness in order to be present when treating a patient. This training is also designed to educate the staff on how to communicate in times of conflict: Clarify and listen, Acknowledge and Apologize, Respond and deliver, Empower to problem solve.
What is unique and most effective about this training is that it uses testimonies from advisors to illustrate the importance of improved patient experience and communication. Randy Gonchar, Andrea Howley and Mal Malme were filmed sharing their experiences as patients and family members at BIDMC. This video is a part of all We C.A.R.E. trainings to provide the attendees with a special perspective on the patient experience.
We asked Kate Orsillo, a Farr 2 staff nurse, for her perspective on the training, and two advisors, Randy and Mal, how it felt to be a part of the planning process.
What did you take away from the We C.A.R.E. training?
The interviews with the patients and family members were poignant, and that is what stuck out in my mind the most from the training.
How was has this training impacted your work?
After this training, I was able to effectively communicate with a family member who was dissatisfied with an aspect of her mother's care. Acting as resource at that time, I was able to prepare myself prior to speaking with this family member through the model of We C.A.R.E. communication. By following these four steps, both parties were able to come to an agreement that not only left the patient satisfied, but the family member as well.
What was your impression of the advisor video?
The video reiterated that we do need to be present in the moment. As staff at a busy medical center, sometimes it is easy to overlook things that we are used to seeing every day, but it may be a patient's first experience in a hospital. It was nice to see the feedback from family members. It reinforces the fact that we all need to remember that we are humans first and we need to sympathize with each other.
Was there something about your experience that made you interested in being involved in this particular project?
I want to give health care providers, especially those that have had the good fortune of not having to experience an inpatient stay, information about the psychological issues that patients and their families encounter. As a frequent flyer, I have experienced many issues and the emotions that travel with them and I believe that if I can convey these issues to providers, they may become empathetic to their patients.
What do you hope you contributed as an advisor to the development of the training?
I hope that the providers take away that as a patient, we are psychologically vulnerable and often scared, and that they must be aware of that as they implement their treatment plan. Communication with the patient/family is the core element of this training.
How do you see this training improving patient care?
I hope that providers may have a better understanding of a patient’s emotional and physical needs. Communication between all parties is critical to alleviating the patient/family concerns and will allow for the development and implementation of a successful care plan.
Was there something about your experience that made you interested in being involved in this particular project?
I was encouraged to get involved by our PFAC coordinator as she knows I enjoy contributing to projects like this. I also feel that in my experience as a patient and as a family member, I had several perspectives I could share that might be helpful.
As an advisor on this project, did you feel your voice was heard? If so, in what way? If not, what do you believe the barriers to be?
This was my second opportunity to be involved in making a video as a PFAC member and both times, the experience has been truly great and well-organized. I felt encouraged and supported by the audio-visual staff as well as the project managers. I would definitely participate in other projects like this if another opportunity arises, and I would also encourage other PFAC members to become involved as well.
How do you see this training improving patient care?
I hope that as staff and others watch this video, they will know that we aren’t “actors” saying our lines, we are people who are patients and/or caregivers and we are committed to ensuring that all patients, family members and caregivers are treated with humanity and respect, no matter what their illness or condition may be. And that we are committed to BIDMC and making sure that the great care we received and continue to receive only gets better.
Advisors appreciated at annual event
November 13 marked the 3rd Annual Patient and Family Advisor Appreciation Event. Advisors caught up with one another, talked about the projects they’ve worked on, and listened to a keynote address from Dr. Sigall Bell.
“The best part of this event was seeing so many advisors and staff in the room, said Barbara Sarnoff Lee, Senior Director of Social Work and Patient and Family Engagement and co-chair of the Hospital Wide and ICU Patient and Family Advisory Councils. “This really speaks to the spirit of collaboration and partnership between the staff and the advisors.”
The event also gave advisors and staff a chance to talk in a less formal, and more fun, setting, said Elana Premack Sandler, Patient and Family Engagement Project Manager and Sarah O’Neill, Director of Care Connection and Special Projects and co-chair of the Universal Access Advisory Council.
O’Neill continued, “It felt very nice to have time that is not part of the council or related to council work. All those I spoke with really seemed to enjoy the event – they felt appreciated and I think impressed that their voice was pretty powerful – almost an element of surprise here, and they love connecting with one another.”
Dr. Sigall Bell, in her keynote address, highlighted the importance of patient engagement and expressed the deepest gratitude to all the advisor volunteers.
“Her presentation was informative, engaging, entertaining, and so heartfelt, said Joan Simpkins, who partners with Patient and Family Engagement in her role as an Organizational Development specialist. “She conveyed extremely well the gratitude that she - and likely others at BIDMC - feels toward patients and families who give their time and get involved with BIDMC in this way.”
Dr. Bell did an inspiring job of explaining why she was so thankful for the work of advisors, specifically noting their work has changed her practice. She now thinks with two heads, by asking herself how the patients would feel; “dares to dream big” and creatively about the future of healthcare, reassured by the support of the advisors; and understanding the “true north” is the patient experience and is thankful for the new insight into her practice. Lastly, Dr. Bell noted that the greatest way advisors have impacted her practice is by creating a new family, with unconditional respect for one another.
With all the accomplishments from the work of this year’s advisors, it is exciting to think about the future for patient engagement. “As BIDMC grows, we will need the help, advice and wisdom of our advisors to provide high quality, seamless care across the network,” said Sarnoff Lee.
Similarly, O’Neill is looking forward to the growing presence of patient advisors at BIDMC. “My hope is to find ways to leverage these voices and reach more staff with the power of stories. We are breaking down a long-standing attitude that providers of care know best.” As said Simpkins, “I hope that we can expand the program by finding new ways to involve and engage patients/families. This might be in new parts of the medical center and even with areas that don’t provide direct patient care.”
Premack Sandler hopes that “patients and family members will come along for the ride with us as we navigate the changes in healthcare. Now it feels even more important to hear the voices of patients and family members as part of any planning or decision-making process.”
With such supportive and aspirational leadership at the helm, patient and family advisors will continue to make a mark on the BIDMC community and pave the way for patient engagement across the country.
“It’s through the ideas and vision of staff and the thoughtful contributions of advisors that we’re able to continue to grow our patient and family engagement efforts,” explains Premack Sandler, illustrating the importance of the work of advisors. BIDMC truly appreciates how advisors shine a light on the patient experience.
Issue 6, Fall 2013
Primary care, patient roles, and a physician's perspective
Dr. Amy Ship from BIDMC's primary care practice Healthcare Associates sat down with Erica Dente, ICU Patient & Family Advisory Council member, to talk about the current landscape of primary care. In the first segment of this three-part interview, Dr. Ship tells us about how got into medicine and how she continues to remain positive as healthcare and primary care change. Look forward to reading about how patients can best prepare for appointments and how to develop the patient/physician relationship.
What turned you on to medicine? And particularly primary care?
My dad, who is now a retired surgeon, was passionate about medicine; he was inspiring. I actually went to medical school “late,” at age 28; I decided I wanted what my dad had, so I changed my path.
Do you feel in primary care you have the same passion that your dad had?
I think there is a big difference between being an internist and a surgeon. As a surgeon you get to fix things, you get to cut things out, and in primary care you don’t get to do that - you have to adapt to a different set of expectations. I became a physician, like many others, to fix things, and in primary care most of the time that’s not possible. But there is still a lot of joy in caring for patients. In my old life, working in an art gallery, I would watch the clock ticking and think, “time moves so slowly.” In this job, I look up at the clock and I’m surprised to find that time has passed so quickly.
How do you remain positive as primary care physician and continue to care for your patients?
It’s a challenge. It is hard to have so much time pressure on every single visit, to fulfill so many expectations and measures. And all these expectations and measures can get in the way of caring for people. If you were to go into every visit thinking “I need to check all these things off,” you wouldn’t be able to and you wouldn’t be a good doctor. You just have to make decisions about what to prioritize in that moment.
Issue 5, Summer 2013
Helping BIDMC get Conversation Ready
Patient/family advisor Erica Dente interviewed Jennie Greene, project manager, and Dr. Lauge Sokol-Hessner, project director for BIDMC's Conversation Ready initiative, about the work the hospital is undertaking. Conversation Ready is a component of the Conversation Project, created by the Institute for Healthcare Improvement (IHI) to ensure that everyone's goals for end-of-life care are expressed, recorded, and respected.
Can you briefly describe the Conversation Project?
The Conversation Project is a national effort to help people talk about their wishes and preferences around end-of-life care. The project was launched in 2010 when Boston Globe columnist Ellen Goodman and a group of colleagues and concerned media, clergy, and medical professionals gathered to share stories of “good deaths” and “bad deaths” within their own circle of loved ones. Their sense was that too many people are dying in a way they wouldn’t choose, and too many of their loved ones are left feeling bereaved, guilty, and uncertain. In a survey conducted by the California Health Foundation, 60% of Californians said that making sure their family is not burdened by tough end-of-life decisions is “extremely important.” Yet, less than half of those surveyed had communicated their wishes to anyone. The Conversation Project, which is partnering with ABC News, provides information and tools to encourage people to talk about what they want so that more people can make the plans that allow for their wishes and preferences to be respected.
Can you explain the Conversation Ready project and how you see BIDMC becoming Conversation Ready?
Part of the Conversation Project, the Conversation Ready initiative is focused on how health care institutions, like BIDMC, can address some of the gaps between what people say they want in terms of end-of-life care and what actually happens. For instance, 70% of people say they prefer to die at home, but 70% die in a hospital, nursing home, or long-term care facility. Eighty percent of people say that if seriously ill, they would want to talk to their doctor about end-of-life care, but only 7% report having had an end-of-life conversation with their doctor. And, one study found that about 70% of physicians whose patients had a written document detailing their wishes and preferences were not aware that it existed. To address this, BIDMC and nine other health care organizations across the country are working with the Institute for Healthcare Improvement on what we’ve come to refer to as the “Four R’s”: reaching patients and families in thinking about and talking about their wishes and preferences; recording their wishes in our health record systems; retrieving those documented wishes when the time comes and, thereby, respecting patients’ wishes.
How do you suggest families discuss their wishes with loved ones and at what point would you recommend that this occur?
The Conversation Project has developed a "Conversation Starter Kit" to help guide you through the process of thinking about your wishes for care and then talking with family and other loved ones about those wishes. While the project and the kit are focused on end-of-life care primarily, we encourage you to think and talk about this when you’re healthy, before a crisis. In particular, we recommend that everyone, regardless of age or health status: 1) identify a Health Care Proxy, or surrogate decision maker, who would make decisions should you become unable to 2) talk to that person about what you’d want should you become unable to make medical decisions for yourself and 3) complete a Massachusetts health care proxy form and bring a copy of it to your next doctor’s appointment.
Are there ways providers can help families coming from different places have conversations?
Through Conversation Ready, we’re hoping to better prepare providers to approach these conversations with patients and families from diverse cultural, ethnic, and religious backgrounds. It may be that some patients simply do not want to talk about end-of-life care or death, and providers need to respect that. The conversation will be different with each patient, but it’s our responsibility as an institution and as individual providers to try to understand our patients’ goals and wishes at all points in our patients’ lives, but especially when they’ve had serious illness(es) or are of an advanced age.
At what point/stage would you recommend patients and families bring their wishes to their providers?
As noted above, we encourage everyone – regardless of age or health status - to complete a health care proxy form and bring it to your health care provider(s). That way, in the event of an accident or illness, we will know who to contact should you become unable to make medical decisions for yourself. In addition to giving your providers a copy of the proxy form, we encourage you to speak with your doctor, nurse or social worker about your goals or preferences, particularly around end-of-life care. The Conversation Project has developed a guide titled “How to Talk to Your Doctor” to help prepare you to discuss your wishes with your doctors and other health care providers. We encourage everyone to use this tool, or others like it, to ensure that your health care team understands your personal preferences and goals of care.
Dr. Sokol-Hessner, as a hospitalist (a doctor caring for acutely ill hospitalized patients), can you share your experience when you have to initiate these conversations vs. when the conversations have already taken place prior to an admission?
Talking with a patient and their health care proxy or family members about their wishes, preferences and goals of care can be challenging, especially if it's when they're admitted to the hospital for a serious illness. If the patient has already had a conversation, whether with their proxy, family or their outpatient providers, it is much more likely that we'll be able to understand and respect their wishes right from the start. Patients also prefer to have these conversations with health care providers they know well and who know them well - like their primary care doctors or specialists they've been seeing for years. That said, as a hospitalist (a hospital-based general physician), I often have these conversations after a person is admitted, even though I may just have met him/her and the family. Regardless of whether or not the person has had a conversation before, these conversations have to be approached carefully, with preparation and a clear idea of what we're hoping to achieve. The principles of respect and "Ask, Tell, Ask" always apply. With patients that aren't critically ill, I often start the conversation by asking: "Have you ever thought about what you'd like to have happen if you got really sick someday?" If they have, then it's usually quite easy for them to tell me what they've thought about; and as a result, it's easier for me to factor their wishes into clinical recommendations. If they haven't thought about this before, then we're starting from scratch, and we'll do our best to identify their wishes, but it might take us longer to get there.
The real challenge is when patients are so sick that they are confused or delirious, or can't speak for themselves. Then the best we can do is to ask their health care proxy, family or outpatient providers about their wishes, preferences and goals. If the patient hasn't had a conversation with any of these people prior to admission, it can be really difficult for all involved to feel confident that they’re making decisions in keeping with the person’s wishes. On the other hand, if we're lucky, the person will have previously expressed her preferences to her proxy, family and health care providers and perhaps has even have completed an advance health care directive, or a living will, such as Five Wishes. The more information patients have relayed about what they would want - verbally or in writing - the better able we are to provide care consistent with their wishes.
Issue 4, Spring 2013
Transformation of patient engagement at BIDMC
Erica Dente, ICU Patient & Family Advisory Council
I have been an ICU Patient & Family Advisory Council member since 2010 and an ICU patient/family representative on the Critical Care Experience Task Force Committee since 2011. Additionally, I have taken part in numerous projects, committees, working groups and outside activities as a BIDMC patient and family representative. It has been an unforeseen gift to witness the evolution of how BIDMC engages patients and families in a multitude of areas throughout the hospital.
When I first started taking part in these activities, although I always felt welcomed, having patients and family members sitting at the table was uncharted territory and the trepidation was palpable. I understood it was going to take time for everyone, myself included, to feel at ease. But, the fact that BIDMC was doing so was enough for me to weather my own discomfort.
Over time, more and more patients and family members have become “embedded” in groups. It seems that staff have not only realized that it is critical to have patients and family members present, but just like health care providers and administrators, we want to improve quality, safety and the overall experience for all. As patients and families, we bring a unique expertise and critical element to the table that no one else can provide. We’re able to do so from our own experiences, but also looking beyond our own experiences.
In my recent committee work with folks across the continuum of care, what has been so striking is that the only apprehension I felt was my own. I have been treated as an equal partner. My experiences, thoughts, and insights are equally valued.
It has been inspiring and hopeful to see health care professionals across all disciplines and in all care environments now request patient and family involvement before moving forward with projects, education material, changes within a unit and the like. I believe they have seen that involving patients and families at the front line makes health care better for everyone. I recall an ICU manager from a neighboring institution attending our ICU PFAC meeting in hopes he could learn from us how he might be able to develop an ICU PFAC. It was clear to me and everyone in attendance BIDMC is a shining example of working in earnest to be patient and family centered. In fact, his words were: “BIDMC is light years ahead”.
I personally have seen a shift in how care is provided across the institution as a whole. The paternalistic model of care is fading. I’ve observed that staff – from those working directly on patient engagement to staff throughout the organization – at their core truly believe engaging patients and families is not only the right thing to do, but have confidence that the voice of patients and families is essential in order to truly be a patient-centered institution. BIDMC has embraced the patient- and family- centered model of care by making patients and families an equal partner.
Family members advise on care transitions
Peter Gatsoulis, Hospital-Wide Patient & Family Advisory Council
My father, now at 91, has had three extended stays at Hebrew Senior Life in Roslindale in last few years, as well as a few more stays at another rehabilitation stay following other periods of hospitalization. My family and I, as his care provider, were very involved in the selection process and ensuing rehabilitation and stay at each facility.
These experiences informed my perspective when I recently participated in a quality improvement retreat aimed at re-engineering the process of transitioning care of patients from BIDMC to Hebrew Senior Life.
The five-day retreat was organized by the Department of Medicine. Though the time I was able to participate in the retreat was brief – two mornings of the five days – it was extremely beneficial from a personal education perspective. I was able to see the behind-the-scenes process of how my elderly parents are assigned and then “processed” by the human and information systems currently in place.
I participated in the retreat along with a fellow Hospital-Wide Patient & Family Advisory Council member. It was clear that our input as family members was desired. We shared that intake – when our family member is accepted to a rehabilitation facility – is the “end-game” for us. That’s when our victory dance happens.
It’s what happens before that point that was more mysterious to us, and where our input was particularly valuable. As a group, we walked through the whole process, using process maps, to share our concerns. We were thanked and re-thanked for bringing and sharing our perspective, which challenged and changed some of the key considerations being redesigned.
One of the key contributions, we have been told, is the proposed creation of a formalized patient-advocate role that would enhance, and in some cases substitute for, the family's involvement in the selection process and then formalization of a patient entering the post hospital care facility. Particularly for patients who do not have family members who can be as actively involved as we have been, this role will serve patients well.
Issue 3, Winter 2012
Issue 2, Fall 2012
Patients take the lead
For almost 10 years, BIDMC's Ethics Advisory Committee (EAC) has been reviewing and providing consultative support to the work of the Ethics Support Service and Ethics Liaisons, two BIDMC programs that aim to help patients, families, and staff navigate ethical issues involved in medical care.
This year, the EAC is breaking new ground. For the first time, the committee will be co-chaired by a hospital staff member, Dr. Alex Carbo, BIDMC hospitalist, and a patient, Nicola Truppin.
"The EAC is one of the more interesting committees with which I am involved as a patient advisor," says Truppin "I am honored to be working with thoughtful and compassionate committee members who feel strongly that ethics is an inextricable part of patient care at BIDMC."
What is Truppin looking forward to in her new term? "The EAC has been engaged in a project to prepare and train a larger group of people to conduct ethics consultations in the hospital and I am excited to be a part of this undertaking. Also, I am thrilled to be Co-Chair with Dr. Alex Carbo, who manages the committee's multi-faceted work with skill, humor, and modesty."
Truppin has been serving as a patient advisor on the EAC for several years. A second patient advisor, Betsy Lowe, joined Truppin about a year and a half ago.
As a patient advisor, Lowe says, "I find myself doing more outside reading to gain a better understanding of the topics we discuss, but I also feel like an integral part of the group and that the patient perspective is valued."
What is Lowe looking forward to in EAC's future? The development of a brochure to promote the Ethics Support Service "that explains the service to patients and families who may need extra support during a hospitalization," and "hearing the outcome of a project in patient and family bedside communication."
Says chair Carbo: "The EAC has representatives from across the medical center. Nicola and Betsy have been instrumental in providing the patient's voice in our discussions. We are lucky to have them on the committee and are grateful for all of their input."
Patients on board-level committees
Two patient/family advisors sit on BIDMC's Board-level Patient Care Committee (PCC). The work of the PCC is to look big-picture at BIDMC's approach to patient care.
Says Terri Payne Butler, one of the PCC advisors who also serves on BIDMC's Hospital-Wide Patient and Family Advisory Council (PFAC):
"When I joined the Patient Care Committee, a board-level group with two patient/family representatives among its fifty varied and dynamic members, I was used to the "in the trenches" focus of the PFAC. At PCC meetings, I learned almost immediately that I had to ratchet up that focus.
While patient care was clearly the committee's mandate, I came to understand that other factors - budget restrictions, governmental and insurance regulations, Press Ganey evaluations - all impinged on or enabled the committee's goals to make specific changes and improvements.
To use a Red Sox metaphor, I discovered I could no longer sit in the dugout alongside Terry Francona to respond to a single game's unfolding. I had to join John Henry in the owner's box as he (or the PCC) took both a short and long-range view of the shifting field of health care and how best to work within it to make effective change that would benefit BIDMC patients and staff.
This year the PCC will continue to explore the experience of illness through six domains: inconvenience, uncertainty, discomfort, grief and loss, loss of control and loss of dignity. I am looking forward to bringing the "voice of the patient," to these discussions, imparting what I've learned from my own health care experiences at BIDMC and from the experiences of other members of the PFAC."
Advisors tell their stories to improve check-in
When Sherry Calderon and her colleagues in Ambulatory Services wanted to re-create their Customer Service 101 training, they aimed to make it interactive. The ideal training would be online and would include a mix of information, self-testing, and video clips to bring home key messages.
So when they needed to hear the voice of real patients to bring the customer service experience to life, they turned to patient and family advisors.
Three advisors were filmed for the training video, which will be used in 2013. The advisors share their perspectives on what could have been done differently or better at check-in to improve their experience as a BIDMC "customer."
What did they say?
- Ask "how are you today?" and mean it - it makes a big difference.
- Take a pause to recognize a patient as a person, not just another person checking in.
- Have an attitude that "says yes" - it's a way to recognize patients' humanity.
Says Calderon, it's good to remind staff that even if they are not in direct patient care roles, "the whole point of this is the patients."
Patients teaching providers
Last fall, Dr. Sigall Bell and David Browning came to the Hospital-Wide Patient and Family Advisory Council to get feedback on a program they were developing.
Patient Teachers in Patient Safety Education (Patient TIPS) uses patients and family members as educators of health care professionals, specifically to think together about communication when things go wrong - adverse events - and communication to prevent problems like medical errors from occurring.
This summer, the program launched, with the first workshop at Cambridge Health Alliance's Cambridge Hospital.
Says Bell: "The TIPS experience has been remarkable. It's exciting to see what can happen when you challenge traditional boundaries. Based on the feedback to date, the patients, family members, and clinicians who have participated find this to be a novel, valuable model for education. Bringing inter-professional clinicians together with patients and family members fosters mutual respect, enhanced perspective, creativity, and 'hopefulness,' as one patient participant told us. Patient safety very much needs more robust partnerships between clinicians and patients, and it's rewarding to see how hungry both groups are to forge a new path together.
By carefully designing a structure for learning in which clinicians, patients and family members can collaborate on patient safety, we hope to enact in the learning environment the changes we want to see in the clinical setting, and then help clinicians and patients to carry these forward into their own practice and health care experiences."
Sandy Novack has been involved with Patient TIPS in addition to her work on the Universal Access Advisory Council. Says Novack, "I'm a very frequent user of medical services, and I've experienced medical errors myself. It's been empowering to participate in Patient TIPS. As a patient, I can be on equal footing with medical professionals who are also grappling with medical errors. By partnering in this project, you get to hear what the other person, the other side, is thinking. One of the things patients most want to hear after an adverse event is an apology. I'm looking forward to helping work toward an understanding of how an apology can be freeing to both the patient and the physician."
Patients and families advise Inpatient Psychiatry
A priority of the Hospital-Wide Patient and Family Advisory Council since its inception, making BIDMC's Inpatient Psychiatry unit more patient- and family-centered has been a work in progress.
Over the past several months, three patient and family advisors have joined staff from the unit on an Inpatient Psychiatry Patient and Family Advisory Council (PFAC). The group meets once a month and has already taken on improvement projects including developing a patient handbook, recommending changes to the physical plant to make the unit more welcoming to families and healing for patients, and discussing the ideal patient admission experience. The group has also met the unit's new Patient Rights Clinician.
Kathy Moriarty's interest in helping Inpatient Psychiatry improve the patient and family experience stems from her brother's time spent on the unit. Kathy is also a member of the Hospital-Wide PFAC.
Says Moriarty: "I am really encouraged by the work accomplished by the group so far and the staff's willingness to listen to and act on the family members' and patients' thoughts and suggestions. I think this is such a vulnerable population who may not always be able to speak for themselves. The Inpatient Psychiatry PFAC is hoping to address issues that will make the experience of being a patient/ family member more pleasant. I hope that our involvement will result in a more cohesive, understandable patient stay which will ultimately result in better outcomes post-hospitalization."
How has working with patient and family advisors been viewed by unit staff? Says nurse manager and group co-chair Tina Gosselin, "I have been blessed with the opportunity to work with a talented and committed group of employees and advisors dedicated to improving the quality of patient care and treatment. Each advisor in the group has shared his or her ideas about improving the patient care experience with sensitivity and a focus on problem-solving."
The group will continue to meet bi-monthly, as Gosselin says, "in the spirit of continuous quality improvement."
Issue 1, Summer 2012
Patient and Family Engagement E Letter - Archive