CEO Webinar
Leadership for
Patient-Family Engagement Initiatives
Sue Collier, MSN, RN, FABC
Performance Improvement Specialist
Patient-Family Engagement
August 15, 2013
Objectives
•
Review the 2013 Patient Safety Goal for Patient
-Family* Engagement and the CEO Pledge
•
Review PFE principles and practices
•
Discuss the role of leaders in PFE
•
Review suggestions on how to select and support staff
responsible for guiding a hospital or healthcare system
PFE initiatives
•
Review NCQC’s commitment to educating and
supporting PFE initiatives in NC hospitals
NCHA Board 2013 Patient Safety Goal:
Patient-Family Engagement
NC Hospitals Pledge to
ü
Have a dedicated person or func-onal area that
is responsible for planning, implemen-ng, and
evalua-ng pa-ent and family engagement
ini-a-ves
ü
Engage Pa-ent-‐Family Advisors in this work
ü
Report progress on this goal to the NC Quality
Center for inclusion in the NCHA Board
Dashboard.
CEO Webinar
Pa-ent-‐Family Engagement Pledge 08.15.13
Drivers for PFE
Cost Restructuring
Coordinated Care
Fragmented Care
Pa-ent Centered
Provider Centered
Payment for Value
Payment for Volume
Care Systems Focused
Facili-es Focused
Care Team Accountability
Physician Accountability
Longitudinal, Mul--‐Site Care Models
Episodic, Hospital-‐Based Care Models
Efficient, Evidence Based Care
Inconsistent, Variable Methods
Electronic
Paper
FUTURE
TODAY
Health Care Senior Leader
Priorities Check List
Reduce harmful events
Improve patient experience
Reduce hospital readmissions
Manage transitions of care
Lower costs
Improve health outcomes
Develop workforce
CEO Webinar
Pa-ent-‐Family Engagement Pledge 08.15.13
Definition of Quality
Care that is…
•
Safe
•
Timely
•
Efficient
•
Effective
•
Equitable
•
Patient Centered
Institute of Medicine, 2000
The Cascade Effect of
Shared Decision Making
Informed pa-ents oUen prefer lower-‐
cost and less intensive treatments
Pa-ent-‐centered care hinges on shared decisions
Shared decision processes support informed pa-ents
Informed pa-ents make beVer choices and communicate
more effec-vely to providers
Open communica-on promotes efficiency,
reduces waste, supports evidence-‐based care
î
î
î
î
CEO Webinar
Patient-Family Engagement Pledge 08.15.13
Principles of
Patient-Family Centered Care (PFCC)
Dignity and Respect
–
listen and honor choices
Information Sharing
–
communicate and share
accurate, unbiased and timely knowledge with
patients and families at all levels
Participation
–
encourage shared decision making
in all planning, delivery, and evaluation of health care
services and programs
Collaboration
–
partners in all aspects of care at all
Levels of Patient Engagement
Individual (skills & knowledge)
Adhering to mutually agreed upon treatment plan
Active participation
Healthcare Team (shared understanding)
Bedside shift report
Teach-back
Access to medical records and decision aids
Organization (integrate perspectives)
Patient-family advisors and advisor councils
Family presence (open visitation)
Community (population health)
Health education and literacy programs
Local, state, and national policy changes
CEO Webinar
Pa-ent-‐Family Engagement Pledge 08.15.13
PFCC Best Practices
Ø
Bedside rounds and shift report
Ø
Shared decision making tools and aides
Ø
Teach back, motivational interviewing
Ø
Family presence
Ø
Patient stories in meetings
Ø
Strategic plans, HR policies and leadership expectations
reflect PFCC as a priority
Ø
Patient-family advisor roles and councils
Ø
Program planning with patients & families as faculty
Ø
Advisors on leadership teams and patient safety and
quality performance improvement teams
Ø
Patients on facility and IT design teams
Ø
Patients co-design physician office practices
Ø
Advisors serve on boards and hospital leadership
Pa-ent-‐Family Engagement: Shared Decision Making
From the Bedside to the Boardroom
CEO Webinar
Pa-ent-‐Family Engagement Pledge 08.15.13
The Bottom Line
PFE Strategies support:
Reduced harmful events
Improved patient experience
Reduced hospital readmissions
Improved
transitions of care
Lower costs
Improved health outcomes
Barriers to PFE
Lack of:
A clear vision
Accurate assessment of current state
Understanding of principles and practices
Unified approach to improvement
Skills, knowledge and confidence
Discipline in priority setting and measurement (i.e. a plan)
Resources
(time, people, money)
Willingness to participate
(patient, staff, physicians, leadership)
Commitment over time
CEO WebinarPa-ent-‐Family Engagement Pledge 08.15.13
The Role of CEOs/Senior Leaders
Number 1:
Set a clear vision and
communicate that PFE is a
priority for your organization
The Role of CEOs/Senior Leaders
Number 2:
Make an explicit commitment to infrastructure and
processes that support PFE
o
Ensure a purposeful approach to advance PFE
o
Designate leaders and staff liaisons to guide the work
o
Provide resources to support the work (people, time, money)
o
Conduct an
realistic self-assessment
o
Develop a strategy to
recruit, select, orient and engage patient-family advisors
o
Provide opportunities for advisors to be partners
o
Provide (and attend) training on PFE principles and practices, performance
improvement methods
o
Provide guidance to teams in priority setting and hold leaders accountable for using
proven performance improvement methods (discipline to FOCUS & EXECUTE)
o
Communicate how bedside, healthcare team, and hospital-level PFE strategies and
concepts are connected
o
Invest in leaders and staff who can facilitate or lead councils, teams, and projects
o
Measure and track performance
o
Lead by example
– strong visible support is a key driver of success
CEO Webinar
Pa-ent-‐Family Engagement Pledge 08.15.13
Guidelines to Selecting PFE Leaders
q
There is no one department that “owns” patient experience
and PFE work
q
PFE leaders can be any role, any area that is ready, willing
and able to commit to the vision and expectations
q
Commitment to the vision and expectations is mandatory
q
Variation in individual and team readiness, skills and
knowledge is normal and expected
q
Designated resources can be new positions, existing staff
with related focus, and/or redesigned roles
q
Individuals leading the work must be capable and willing to
role model the principles and lead by example
q
Leaders who guide must also inspire and be able to hold
Innovation Adoption Curve
Executing best practices requires discipline, time, and will
Spreading best practices requires discipline, time and will
Sustaining best practices requires leadership
CEO Webinar
Pa-ent-‐Family Engagement Pledge 08.15.13
The Leadership Imperative
q
Start with yourself (words, actions,
expectations)
q
Sustain relentless focus (every patient,
every place, every time)
q
Prioritize and plan
q
Practice transparency (performance data
and open communication)
q
Support champions, celebrate successes
Lessons Learned
ü
It takes time to change culture – never
underestimate the time necessary to effect
change
ü
Get all leaders involved and committed early
ü
Knowledge is power – encourage power!
ü
Build on existing work – don’t reinvent the
wheel
ü
Words matter
ü
Go Nike --
do something
!
CEO Webinar
Pa-ent-‐Family Engagement Pledge 08.15.13
NCQC Mission, Vision & Values
NCQC Mission
Partner with providers and communities on their
improvement journey to provide safe, quality healthcare
NCQC Vision
NC delivers the best healthcare
NCQC Values
Leadership, collaboration, integrity, transparency,
Advancing PFE in NC:
The Role of NCQC
1.
PFE Learning Network: The “WHAT” and “HOW TO”
o
Education, tools & resources to execute best practices
o
Networking opportunities for best performers to share and
everyone to learn
o
Recruiting begins October 2013
o
Builds on existing work (beginner to advanced)
2.
Support for setting priorities and developing action plans
3.
Integrate PFE principles and practices across all initiatives
4.
Engage patient-family advisors to design, implement and
evaluate programs
CEO Webinar
Pa-ent-‐Family Engagement Pledge 08.15.13
NCHA Board 2013 Patient Safety Goal:
Patient-Family Engagement
NC Hospitals Pledge to
ü
Have a dedicated person or func-onal area that
is responsible for planning, implemen-ng, and
evalua-ng pa-ent and family engagement
ini-a-ves
ü
Engage Pa-ent-‐Family Advisors in this work
ü
Report progress on this goal to the NC Quality
Center for inclusion in the NCHA Board
Dashboard.
“
Any executive who wants
to change things should be
guided by a point of view
about what’s going on in the
world, and (then) you invest
around that point of view.”
Jeff Immelt, CEO of GE
New York Times, 12/4/2010
CEO Webinar
Pa-ent-‐Family Engagement Pledge 08.15.13
