involving patients and families in improvement work

Involving Patients and Families in Improvement Work

A Case Study and Practical Guide

Beryl ConferenceDallas, TX

April 10, 2015

© 2014 Virginia Mason Medical Center

Who We Are

• Kathy Leicester- Leadership & Communication Consultant, Patient-Family Partner since fall 2013

• Amy London- Lean Specialist and Experience-Based Design Faculty since 2007

• Ann Hagensen- Registered Nurse and Project Manager Patient-Family Partner Program since 2013


Session Objectives

• Distinguish important steps for applying tools for recruiting, orienting, and assessing applicants

• Identify common pitfalls during implementation of a patient-family partner program

• Develop the skills to listen to the “story behind the story”

• Hear about successful matching strategies

Culture of an Organization

Culture + Framework = Success


Virginia Mason


Virginia Mason Production System

Toyota Production System philosophies and

practices have given us an effective

management approach focused on

achieving:

• Customer first

• Highest quality

• Obsession with safety

• Highest staff engagement

• A successful economic enterprise


Time

Defects

Motion

Transportation

Inventory

Overproduction

Processing

Taiichi

Ohno’s

7 Wastes

Relentless Focus on Waste

Key Objective: Reduce the burden of work on the worker. That includes our patients, family and other customers!

Waste is any task or item that does not add value from the perspective of the customer.


Emotional Experiences Matter

Technical tools of VMPS are great• Measure time, flow, defects, etc.

• Tended to flow processes from our perspective

But what about the emotional experiences of our customers?

• How do negative experiences impact flow and quality?

• What does their process flow look like?

• How can we incorporate their stories and emotions?


Experience-Based Design Is . . .

A philosophy and set of methods focused

on an understanding of the experiences and emotions of those who are involved in

receiving and delivering healthcare services, striving to understand what people naturally

do and feel.

What really matters to our customers?


EBD Helps Bust Assumptions


Our Vision

14(Professor Paul Bate, UCL 2007)


Shifts in Thinking Under Way

From To

One patient on the team Half patients, half staff

Designing for patients and

families

Designing with patients and

families

Listening to voice of one or

few

Listening to voice of many

Convenient sampling Broader sampling

Conventional surveys More qualitative data

EBD data for events only Creating a habit of listening

to fuel kaizen plans


Patient-Family Partner Program

Gaining the “voice of the patient”

through surveys and random interviewing

Virginia Mason team members represent the patient voice

EBD formally began with development, testing of the emotion word list and implementation

RPIW created a patient

recruitment strategy

Innovation Event

PFP recruitment

and development

First Innovation Co-Design

Event

Kaizen Eventcreated

standards for preparing

teams

108 PFP and growing stronger!

Recruiting, Onboarding, and Implementation

An ongoing source of learning for our organization


Recruitment Step by Step

• Added a question to an existing patient survey

• Resulted in 500 responses in 3 months

• Held information sessions

• Developed an application process


Information Sessions


Recruitment Refinement

• Went electronic with survey responses

• Email message each week

• Link to an online application

• Created a readiness checklist


Onboarding Process Step by Step

Receive and review application via email

Call for phone interview

If unsure after phone interview, invite for an in-person interview

Invite to 2-hour orientation

Grant access to web-based volunteer management system


Interview Step by Step

Using the interview form, listen and take notes

• Basic complex thinking skills

• Strong communication skills

• Flexibility/Adaptability

Listening for the story behind the story

Digging into examples from application

22


Interview Practice

23


The Art of Matching

Right Opportunity

Experience

Readiness to Engage

Skills

24


Preparing Teams Step by Step

Normalize involvement of

Patient-Family Partners

Email introductions

between workshop leaders

and Patient-Family

Partners

Support by providing: name

badges, parking and meal

vouchers and escort to first

day


Opportunities for Involvement

Process Improvement Workshops

Speaking to the Board

Review & Provide

Feedback on Patient

Education Materials

Family Faculty

Attend VMPS Classes

Panelists on Professional Recognition

Events

Peer to Peer

26


2014 Snapshot of Involvement

Role # of participants

Content reviewers 72

Individual speakers 26

Panelists 22

On kaizen activities (kaizen events, RPIWs and

innovation events)

76

Total encounters 196


Products from Improvement Events


Patient Stories from 2014


Patient-Family Partners

• Insightful about what we do well and areas where changes may be needed

• Help us prioritize and make improvements based on patient- and family- identified needs

• Challenge our assumptions by coming up with new ideas and solutions


Lessons Learned

• Share the organizational commitment to partnerships with patients

• Coach patients/family members just like staff

• Prepare staff teams to work with patients/family members

• Use the same chain of command processfor barriers

• They want to work!

• We are better together!

32


Pitfalls During Implementation

• Set up is important

• Onboarding is labor intensive

• Trust your “scratch & sniff test”

• Address the mental health issues of potential partners

• Plan for communication logistics


Next Steps

• Make patient-family partner preparation less operator dependent

• Use volunteer matching web portal to simplify matching process

• Continue to remove fear and assumptions of working with patients and families

The Cycle of

Generosity

Connection

Purpose

the

foundation

for

Virginia Mason Staff

“The Insiders”

Patient-Family-Partner

“The Outsider”


Reflection

• Do you have a silver bullet for matching?

• What does patient-family engagement (PFE) look like at your organization?

• What is your biggest hurdle to PFE?

involving patients and families in improvement work

Documents