leading quality improvement -...
TRANSCRIPT
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Leading Quality Improvement
Essentials for ManagersLesson 5: Partner with Patients and Families
March 21, 2017
These presenters have
nothing to disclose
Janet Porter, PhDDave Munch, MDKathy Duncan, RN
Today’s Host2
Rebecca Goldberg, Project Coordinator, Institute for
Healthcare Improvement (IHI), coordinates multiple
projects focused on increasing value in health care by
improving quality and reducing costs. Currently,
Rebecca’s primary responsibility is coordinating and
hosting IHI’s Expeditions, monthly virtual support
programs focused on specific topic areas. Rebecca is a
recent graduate of Georgetown University in
Washington, D.C., where she obtained her Bachelor of
Science degree in human science with a minor in public
health.
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Phone Connection (Preferred)3
To join by phone:
1) Click on the “Participants”
and “Chat” icon in the top,
right hand side of your
screen to open the
necessary panels
2) Click the button on
the right hand side of the
screen.
3) A pop-up box will appear
with the option “I will call
in.” Click that option.
4) Please dial the phone
number, the event
number and your attendee
ID to connect correctly .
WebEx Quick Reference
• Please use chat to
“All Participants”
for questions
• For technology
issues only, please
chat to “Host”
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Enter Text
Select Chat recipient
Raise your hand
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5
Chat
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Name and the Organization you represent
Example: Sam Jones, Midwest Health
Please send your message to All Participants
LQI Structure
9 Lessons in the program
– Each lesson is composed of:
1. Preparation work on the Learning Management System (videos,
articles, case studies, and an assignment)
2. A coaching call for that Lesson (WebEx call with faculty)
– Lesson preparation work opens two weeks before the lesson’s
coaching call (Lesson 6 pre-work will open after this call)
– While you complete your preparation activities, please feel free
to email the listserv, [email protected], or the Lesson faculty
with questions
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LQI Objectives
At the end of the program, participants will be able to:
Describe the skills, tools, and resources needed by
a middle manager to lead quality improvement
efforts in their local settings
Demonstrate how to link department-level
improvement activities to the organization’s goals
and overall strategic plan
List at least three ways middle managers can be
successful in partnering with front-line staff in quality
improvement activities
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LQI Lessons
Lesson 1 – Know Yourself, Janet Porter
Lesson 2 – Managing Time and Attention, Dave Munch
Lesson 3 – Practice Improvement Essentials, Kathy Duncan
Lesson 4 – Coach Your Team, Dave Munch
Lesson 5 – Partner with Patients and Families, Marnie Carnie and
Janet Porter
Lesson 6 – Problem Solving in a Culture of Safety, Dave Munch
Lesson 7 – Managing Systems and Connections, Dave Munch
Lesson 8 – Identify and Spread Successful Improvement, Kathy
Duncan
Lesson 9 – Empower Teams to Engage in Improvement, Janet Porter
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Today’s Faculty• Cancer Survivor
• Patient Advocate for over 20 years• Founding Chair of Dana-Farber/Brigham
and Women’s Cancer Center Patient and Family Advisory Council (1997)
• Current Co-Chair of Brigham and Women’s Patient and Family Advisory Council
• Chief Operating Office at Nationwide Children’s Hospital
• Associate Dean at University of North Carolina School of Public Health
• Chief Operating Officer at Dana-Farber Cancer Institute
• Principal, Stroudwater Associates• Board of Directors, AARP
Martie [email protected]
Janet [email protected]
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At the end of this program I will be able to implement
plans to engage patients and family members by July 1,
2017
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Brigham and Women’s ED case11
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Chat
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What are the barriers to
patients and family
members being
involved in the design
and delivery of care?
Please send your message to All Participants
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Chat
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What are the barriers to
patients and family
members being
involved in the design
and delivery of care?
How can managers help
to reduce these
barriers?
Please send your message to All Participants
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Chat
14 Please send your message to All Participants
One mechanism for
involving patients and
family members is the
creation of a Patient and
Family Advisory Council.
What are some other
means that can be used
to include them and to
hear their voice?
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Patient Engagement Framework
Patient Engagement in Their Own Care“Shared Decision-Making”
• Portals for Patient Access to Information• Educational Tools and Provider Training
Patient Engagement in Clinical Quality Improvement and Safety• Process Improvement (Lean: Kaizens, Workouts)
• Disease-Specific Protocols
Patient Engagement in Patient Experience Improvement• Patient Satisfaction Committees
• HCAHPS
Patient Engagement in Organizational Decision-Making• Patient and Family Advisory Committees
• Governing Board Roles
Specific to Patient (Individual)
Specific to Disease(Dept/Unit)
Specific to Quality(Organizational)
General(Organizational)
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Chat
16 Please send your message to All Participants
What policies or
processes need to be in
place to ensure patients
and/or family members
are a constructive force?
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Chat
17 Please send your message to All Participants
How is culture shaped in
an organization? What
could ED leadership do to
change the culture about
family member inclusion
– in addition to revising
the policy?
Setting the Stage for
Patient Engagement
Connect with the Director of Volunteers
Identify champions of patient engagement
Discuss at a staff meeting the concept of engaging
patients and family members
Brainstorm ways patients might be involved in providing
feedback
Tell a story of listening to patients with a positive outcome
Explain this is a pilot, experiment
Identify departmental patient liaison
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Establishing the
Patient Liaison Role
Not a full-time job but an assignment for someone in
current role
Advocate for inclusion of patients and families
Informal leader within department
Point person for patient and family involvement
Recruit, selects, orients patient and family members
Structures patient engagement experiences
Provides feedback to patient and family members
Serves as interface between staff and patients
Desired Qualities and Skills of
Patient and Family Volunteers
The ability to share personal experiences in ways that
others can learn from then
The ability to see the big picture
Broader interest in many issues (does not have a
specific agenda based upon their own agenda)
Listening skills and appreciation for others viewpoint
Ability to connect with people
A sense of humor
Patience
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Recruiting Patient
and Family Members
Staff identify patients and family members who have expressed constructive suggestions, gratitude and interest in giving back
Background check with other care providers
Telephone the patient/family member to discuss role, commitment
If interested, invite in for interview
Formalize invite with welcome letter and orientation materials and expectations and support (free parking, business cards, etc)
Specify time commitment and time frame (term)
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Patient/Family Member
Interview Guide
Describe your patient care experience here.
What would you like us to improve?
What contribution do you think you can make?
What would others say are your strengths?
Have you volunteered in any hospitals or other health
facilities? Tell us about that.
Do you have any questions or concerns?
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Orientation Check-List
Set expectation that patient is a candidate – not official until
through orientation
Application completed with contact information
Hospital volunteer orientation (flu shots, etc) completed –
hospital overview and mission, confidentiality
Occupational health visit
Received ID badge, parking pass
Orientation to specific role
Mentor assigned
Shadowing of mentor and by mentor
Coaching/feedback – Candidate becomes official volunteer
Brigham and Women’s ED
Patient Satisfaction
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Brigham and Women’s ED Update
New Nursing Director hired and oriented to patient/family
policies of inclusion in ED
Thirty new staff oriented to ED inclusion policies
ED being renovated and expanded to double in size –
PFAC voice instrumental in design from the beginning
PFAC members working with staff on sexual
orientation/gender preference policies
PFAC working with nursing and medical staff on end-of-
life conversations and referrals back to primary care
MD/oncologist
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Next Steps to Hear the
Patient and Family Voice
Look at your quality improvement initiatives for 2017. Ask yourself, “How might we engage patients and family members in this initiative?”
Ask staff to identify patients or family members who might be interested in serving in a focus group or on a task force.
Follow the steps outlined regarding notifying volunteer services, interviewing, orienting your patient/family members
Debrief afterwards as what went well, lessons learned with staff, with patients and staff
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Resources
Institute for Patient and Family Centered Care
(www.ifpcc.org)
IHI (http://www.ihi.org/explore/PFCC/Pages/default.aspx)
American Hospital Association
(http://www.aha.org/advocacy-issues/quality/strategies-
patientcentered.shtml)
Dana-Farber Cancer Institute
(http://www.dana-farber.org/Pediatric-Care/New-Patient-
Guide/Patient-and-Family-Advisory-Council/Establishing-
Patient-and-Family-Centered-Care.aspx
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Additional Resources
Institute for Patient and Family Centered Care (ipfcc.org)
IPFCC Toolkit (http://www.ipfcc.org/tools/Patient-Safety-Toolkit-04.pdf)
Arnold P. Gold Foundation (humanizingmedicine.org)
Anna Quindlen Address (http://humanizingmedicine.org/anna-quindlen-advises-physicians/
Agency for Healthcare Research and Quality (http://www.ahrq.gov/research/findings/final-reports/ptfamilyscan/index.html
American Hospital Association (http://www.aha.org/advocacy-issues/communicatingpts/pt-family-centered-care.shtml)
Institute for Healthcare Improvement (http://www.ihi.org/offerings/Initiatives/PatientFamilyCenteredCare/Pages/default.aspx)
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to access the IHI Open School: http://app.ihi.org/lms/home.aspx/EssentialsForManagers
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Questions?
Please chat in or, if you are connected by
phone, raise your hand to be unmuted!
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Closing Poll
How useful was this lesson on a scale from 1-5?
Given today's topic, what would you like to learn more
about?
Any other comments on today's lesson?
30
1 2 3 4 5
Not Useful Somewhat Useful
Very Useful
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LQI Communications
All sessions are recorded
– Recording and materials sent in post-call email and uploaded to
your MyIHI account
Pre-work materials are located in LMS
Listserv address for session communications:
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Lesson 632
Tuesday, April 4, 1 PM ET
Problem Solving in a Culture of Safety
Dave Munch, MDSenior Vice President & Chief Clinical Officer
Healthcare Performance Partners
Gallatin, TN
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Thank You!33
Rebecca Goldberg
Please let us know if you have any questions or
feedback following today’s LQI Coaching Call.