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Engaging Health Care Users by Building

Patient- and Family-Centered-Care Systems

WHO WE ARE

How we care

Patricia K. Sodomka Patient-and Family-Centered Care

Patient-and Family-Centered Care

Involving patients and families in every aspect of their care from admissions to discharge. Developing relationships between healthcare providers, patients and families which create partnerships.

Patient-and Family-Centered Principles

People are treated with respect and dignity.

Health care providers communicate and share complete and unbiased information with patients and families in ways that are affirming and useful.

Individuals and families build on their strengths through participation in experiences that enhance control and independence.

Collaboration among patients, families, and providers occurs in policy and program development and professional education, as well as in the delivery of care.

History

• 1993 – Introduction to PFCC to MCG

• 1995 – Family Advisor Council (FAC)

• 1996 – KIDS Art

• 1998 – Opening of Children's Hospital

• 2002 – Health Partners Advisory Council

• 2004 – Neuroscience/MS Clinic implemented PFCC

• 2005 – SPEAK UP Campaign

• 2006 – Remaking American Medicine

• 2006/07 – Ambulatory Clinics implemented PFCC

• 2008 – AHRQ and Picker Grants

• 2010 – Medical Office Advisory (Ambulatory)

• 2012 – PFCC Proclamation

Partnering with Advisors to Build Better Centers for Care

Patient-Centered Medical Record

Bedfair 2007

Patient Advisor demos ePHR for

Dr. Ted Eytan

CMC Visioning Retreat - 1993

Neuroscience Planning

Partnering with Health System Patient/Family Advisors

R: 24 G: 60 B: 71

Patient Advisors Engaged Throughout the Entire Academic Medical Center

Levels of Involvement

• Essentials of Clinical Medicine (ECM)

• StartWise (New Employee Orientation)

• Creating and conducting classes

• Conferences/Learning labs

• Secret Shoppers/Rounding

• Hospital Committees

Accomplishments

• Medicine reconciliation procedure

• Billing redesign

• Research projects, interviewing and hiring process

• Creation of educational booklets and patient videos

• Creation of patient mentoring programs

• Creation of education booklets and videos

• Inclusion of websites and patient portals

“The way you teach Patient- and Family-Centered Care is

by bringing the patient into the room.”

-Patricia K. Sodomka

Questions?

Contact Information

T. Nicole Johnson-Boatwright, MBA, BBA, PMP

PFCC Program Coordinator

[email protected]

706-721-PFCC (7322)

706-721-9217

Christine Abbott

Patient Advisor

[email protected]

Kaiser Permanente’s Vision for Total Health American Hospital Association, March 20, 2013 Jed Weissberg, MD Senior Vice President, Hospitals, Quality and Care Delivery Excellence Kaiser Foundation Health Plan and Hospitals Kaiser Permanente

Agenda

Kaiser Permanente’s History

Total Health – Kaiser Permanente’s Strategic Vision and Performance

Factors Shaping Health and What We Need to Do

Next Wave – Hospital Patients

18 © 2013 Kaiser Foundation Health Plan, Inc.

Our Total Health Journey Begins

19

Kaiser Shipyard, Richmond. Noon-hour loudspeaker health

education program. Staff physician talking on the common cold.

© 2013 Kaiser Foundation Health Plan, Inc.

Pioneers in Health Care

Revolutionized ship–building industry

Global enterprises

Automobiles

Steel

Aluminum

Socially responsible business approach

Surgeon

Visionary

Trail blazed health care delivery


21 © 2013 Kaiser Foundation Health Plan, Inc..

Our Mission (since 1972)

Kaiser Permanente’s mission is to provide high-quality, affordable health care to our members and patients and to improve the health status of the communities we serve.

Targeting the Triple Aim (IHI, 2011)

Better Care

Better Health

Affordable Price

Our Mission for Generations

1960 – Building for Health


“Remember, good health is a way to get more out of your life – more energy, more enjoyment, more potential, more purpose, more life.”

– Sidney R. Garfield, MD

1987 – Total Health Care Project


2004 – Thrive!


25

From Health Advocates to Health Activists


For our employees

Total Health – Reaching out to Our Employees, Members and Communities

Total Health Assessment

Walking Promotion

Workplace Safety Healthy Schools

Employee Wellness

Health Education

Obesity Prevention

Community Benefit

26

For our members and communities

http://xnet.kp.org/newscenter/pressreleases/nat/2012/051412wotnhbo.html

http://healcitiescampaign.org/

Kaiser Permanente’s Strategic Vision

To be a Leader in Total Health by making lives better.


2

Northern California

Southern California

Colorado

Georgia

Hawaii

Mid Atlantic2

Northwest3

Ohio

Kaiser Permanente Medicare State Ranking

1

1

1

1

1

1

4

24

We’re #1 for Medicare in the States We Serve NCQA ranking of 341 Medicare health plans in the US (2011)

KEY:

1\ Medicare ranking out of 341 ranked health plans

2\ Mid Atlantic ranked #1 for Medicare in VA, DC, and MD

3\ Northwest ranked #1 in OR and WA

4\ Second only to the other KP plan in California

1


But Our Communities are NOT #1...Yet!

Source: University of Wisconsin Population Health Institute in collaboration with the Robert Wood Johnson Foundation.

Environmental and lifestyle choices result in 2-3 times higher rates of premature death.

See how healthy your county is:

www.countyhealthrankings.org


http://www.countyhealthrankings.org/

Many Factors Shape Health

30

Environmental

and Social

Factors

20%

Family History and Genetics

30%

Personal Behaviors

40%

Source: Determinants of Health and Their Contribution to Premature Death, JAMA 1993

Medical

Care

10%

© 2013 Kaiser Foundation Health Plan, Inc.

Leading Contributors to Death in the U.S. – 1990

Source: Data are from McGinnis and Foege. Percentages are for all deaths.


Actual cases Number of deaths Percentage of deaths

Tobacco 400,000 19%

Poor diet and physical inactivity 300,000 14%

Alcohol consumption 100,000 5%

Microbial agents 90,000 4%

Toxic agents 60,000 3%

Motor vehicles 25,000 1%

Firearms 35,000 2%

Sexual behavior 30,000 1%

Illicit drug use 20,000 <1%

Total 1,060,00 50%

We Have to Disrupt Current Defaults…


...With Positive, Healthy Defaults


What We’re up Against


Cardiovascular

disease

Chronic respiratory

disease

Diabetes Cancer

Integrated Approach to Diseases and Risk Factors* 4 Diseases,

*Aligns with World Health Organization’s framework for monitoring non-communicable diseases


Cardiovascular

disease

Chronic respiratory

disease

Diabetes Cancer




Risk Factors

Unhealthy diet

Inactivity

Tobacco

Harmful use of alcohol

4 Risk Factors,

Cardiovascular

disease

Chronic respiratory

disease

Diabetes Cancer




Risk Factors

Unhealthy diet

Inactivity

Tobacco


Economic factors

4 Risk Factors, In Context

Cardiovascular

disease

Chronic respiratory

disease

Diabetes Cancer

Integrated Approach to Diseases and Risk Factors*

Support Individuals Encourage Groups

Change Communities Track Outcomes

4 Diseases,



Risk Factors

Unhealthy diet

Inactivity

Tobacco


Economic factors

4 Kaiser Permanente Actions 4 Risk Factors, In Context

Kaiser Permanente’s Total Health Framework


Deploying Kaiser Permanente’s Assets for Total Health

COMMUNITY

VIRTUAL

CLINIC

WORKPLACE

SCHOOL

HOME

NEIGHBORHOOD

SOCIETY

Physical, Mental and Social Well Being

Individual / Family

Behavior Change Touch Points

CLINICAL EXECUTION

Effective delivery system interventions to

screen, advise, assist, and refer

ONLINE ENGAGEMENT

Optimal use of online resources, health coaching,

mobile apps, social media, etc.

ENVIRONMENTAL AND COMMUNITY

STRATEGIES

Support healthy choices


Next Wave of Total Health – Hospital Patients


Post-Hospital Syndrome – 30-day period of risk

Causes:

Sleep deprivation

Poor nourishment

Pain and discomfort

Stress

Mentally challenging situations

Medications

Inactivity

Need to pay attention to:

Sleep

Nutrition

Activity/strength

Symptom management during hospitalization


Patient Activity Tracking Project Dr. Robert Sallis, Kaiser Permanente Southern California

Tractivity system tested on 7 elderly patients – sensor placed in ankle band

Tractivity data correlated with manual tracking system data

Tractivity value confirmed:

Highly accurate

Effective in the hospital and after discharge

Useful in assessing recovery progress and making discharge decisions


From the Individual to Society…

44

Total Health – Making Lives Better

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