Blank cell Use this tool to Description and formatting Inform patient and family advisors Blank cell Blank cell Tool 5 Patient and Family Advisor Information Session Conduct an information session for people who are interested in becoming advisors This presentation gives information on who patient and family advisors are, what they do, and how they help the hospital and provides tips from other advisors. Format: PowerPoint presentation with talking points Tool 6 Am I Ready to Become an Advisor? Help people who are interested in becoming advisors self-assess their readiness This handout is to be given and completed during the advisor information session. Format: 1-page handout Tool 7 Sharing My Story: A Planning Worksheet Help potential patient and family advisors plan how to talk about their experiences This handout is distributed during the advisor information session. Format: 1-page handout Tool 8 My Participation Interests Identify the specific interests of potential patient and family advisors This form is completed at the end of the advisor information session. Format: 1-page form Train patient and family advisors Blank cell Blank cell Tool 9 Patient and Family Advisor Orientation Manual Orient patients and family members who have been selected to serve as advisors This manual provides information on hospital safety and quality and on what patient and family advisors do and how they help the hospital, and provides tips about being a patient and family advisor. Format: Manual
Patient and family advisors can offer: Insights about a hospital’s strengths and areas where changes may be needed Feedback on practices and policies that patients and families find meaningful and useful in helping them be active partners in their care Timely feedback and a fuller picture of the care experience than standard patient and family satisfaction surveys provide The benefits of working with advisors include improvements in overall systems and processes of care. This can lead to longer-term benefits including: Better health outcomes for patients Reduced errors and adverse events Increased patient loyalty Reduced risk of malpractice Increased employee satisfaction Improved financial performance Implementing Working With Patients and Families as Advisors The Working With Patients and Families as Advisors strategy is designed to be flexible and adaptable to each hospital’s environment and culture. The five steps outlined in this implementation handbook can help your hospital start the process of working with advisors or move further along with your current efforts. Step 1: Identify a staff liaison The staff liaison works with hospital leaders to put in place the infrastructure necessary for advisor engagement; prepares staff and clinicians to work with patient and family advisors; and recruits, trains, and supports advisors. >> Learn more: (on page 8) Step 2: Identify opportunities for involving patient and family advisors Hospitals that have little prior experience with advisors may want to start by working with advisors on short-term projects or consultations. Or, hospitals can create a more formal structure by forming a patient and family advisory council. Hospitals that have more extensive experience may be ready to incorporate advisors as members of quality and safety committees. >> Learn more: (on page 10) Step 3: Prepare hospital leadership, clinicians, and staff to work with advisors The engagement of hospital leadership, clinicians, and staff helps develop and sustain meaningful partnerships with patient and family advisors. >> Learn more: (on page 12)
Use advisors to help you plan and implement the other strategies in the Guide (Communicating to Improve Quality, Nurse Bedside Shift Report, and the IDEAL Discharge Planning). Anne Arundel Medical Center worked with patient and family advisors in creating their own training video on bedside shift report. Advisors helped by playing patients in the video. Watch the video they developed: Step 2: Identify Opportunities for Working With Patient and Family Advisors This section contains information and guidance to help staff liaisons think about opportunities for working with patient and family advisors. These opportunities are neither mutually exclusive nor do they represent the only ways of working with patient and family advisors. Plans for short-term activities should fit within a longer term vision of the role patient and family advisors will play in your organization. For more detailed information about implementing the opportunities in this section, refer to the appendixes of this handbook. Advisors on short-term projects Hospitals that have little prior experience working with advisors may wish to start by working with advisors on short-term projects or one-time consultations (e.g., working with advisors to implement the other strategies included in this Guide). Other examples of ways to work with advisors include: Invite two or three patient and family advisors to a hospital staff or committee meeting to discuss their hospital stay. Advisors can share what went well, what could have been done better, and any ideas they have for changes and improvements. Work with advisors to develop or revise written and audiovisual materials, such as patient and family handbooks, informational videos, or care instructions. To get the most of advisor input, be sure to bring in patient and family advisors early in the project when their ideas and input can have the biggest impact. Invite advisors to present at staff orientations and in-service programs to share their perspectives of care and the impact of illness or hospitalization on patients and families. >> Learn more: (on page 31) Patient and family advisory councils A patient and family advisory council is a formal group that meets regularly for active collaboration between clinicians, hospital staff, and patients and family members on policy and program decisions. It is not a support group, grievance committee, staff meeting, or presentation forum. Advisory councils can identify opportunities for improving the patient and family experience, advise on policies and practices to support patient and family engagement, and recommend how to better measure, quantify, and evaluate patient and family engagement. Specific roles of council members may include serving as a sounding board for new initiatives; generating ideas; sharing best
Including displays and information about projects that have involved patient and family advisors at hospital staff educational programs. Ask for an advisor to be part of the presentation. Seek opportunities to improve communication and collaboration across disciplines. It is difficult to collaborate with patients and families if the organization does not strongly encourage interdisciplinary collaboration and consistently communicate the expectation that high-performing teams actively involve and build respect for all members. Explore how other hospitals have achieved successful partnerships with patient and family advisors. Hold a conference call or virtual meeting with other hospitals and include hospital administration, clinicians, staff, and patient and family advisors. The team may also wish to conduct a site visit if possible. Building a foundation for success: Tips for successful meetings and interactions When patients and family members join committees or project workgroups, the first interactions and experiences are critical in establishing a foundation for success. Following are some tips to help promote positive experiences. Getting started Encourage existing committee or workgroup members to participate in the orientation of new patient and family advisor members. This helps patient and family advisors feel welcome and facilitates their understanding of the purpose of and goals for the committee or project. For the first few meetings that new patient and family advisors are present, include time on the agenda for introductions. It is also helpful to distribute rosters and use name tent cards to help with name recognition. Encourage the committee or workgroup to build in agenda time for sharing stories or ice-breaker activities that help members build trust and establish a good working relationship. Ask the committee or workgroup chair to recruit experienced members to mentor a new patient or family advisor. Mentors can contact the advisor after each meeting to answer questions and make sure the advisor remains confident with his or her participation. This commitment does not need to be longstanding. It is likely only needed for the first three to four meetings. The staff liaison can check in with each advisor at the end of the first 3 or 4 months to determine if he or she needs the mentorship to continue.
Ask patients and families to join staff when they meet with funders and community groups Invite patients and families to present at staff orientation and in-service programs Ask patients or families to offer a clinician trainee the opportunity to spend a day with them to observe how patients manage their care in their daily life Invite patients and families to assist in creating or revising a patient and family satisfaction survey and involve them in developing strategies to respond to concerns and problems reported via the survey Convene focus groups of patients and families as specific issues arise, and ask a patient or family member to co-facilitate the group Three initial activities to conduct with patient and family advisors The following activities — sharing personal and professional experiences, patient and family stories, and conducting a walkabout from the patient and family perspective — are activities that health care organizations have found effective in the early stages of partnering with patient and family advisors. Activity 1: Sharing personal and professional experiences This activity increases staff awareness of how care is experienced as a patient or family member. It can be conducted during a training and orientation session, committee meeting, or in-service program. Purpose. This exercise is intended to help clinicians, hospital staff, and patient and family advisors share experiences about developing and working in partnerships with each other. Introduce the exercise. The facilitator should spend 5 to 10 minutes reviewing the core concepts of patient- and family-centered care. Ask each participant (patients, families, hospital staff, and clinicians) to share a personal or professional example of a direct care experience that illustrates partnership. Encourage participants to share examples — positive or negative — that had a profound effect on them. Although clinicians and staff can describe a professional work experience, the activity is more meaningful when participants share a personal experience with the health care system. Remind participants that all experiences shared are considered private and confidential. Sometimes it is helpful for the facilitator to share a story to serve as a model. Suggest that people be fairly brief and take no more than 2 to 3 minutes to tell their story. Encourage everyone to participate but be prepared that some might decline. During the exercise. Be prepared to be a timekeeper and provide reminders of the 2- to 3-minute time limit. Listen to the stories and include your observations of how the stories illustrate one or more of the core concepts of patient- and care and, as appropriate, point out how these stories illustrate important qualities of the partnership between patients and their families and staff. Core Concepts of Patient- and Family-Centered Care
Advisory councils may also establish bylaws to guide how the council functions and outline council members’ responsibilities. Bylaw development and approval can take time because the bylaws should be established i with agreement from all members of the council. A new advisory council may want to generate a few guiding principles or norms and then wait until a subcommittee can be formed to develop more formal bylaws. Advisory council bylaws typically address functional issues such as: Eligibility for membership Expectations for how long a member serves on the council Meeting schedule Specific council member roles and responsibilities Optional issues that may be addressed include: Required training and orientation for new council members Expectations for attendance at meetings Reimbursement for expenses Annual or other review processes Advisory council goals and activities For newly formed advisory councils, all members should be actively involved in the development of the council structure and processes. During the first few months that the advisory council meets, all members of the council will have the chance to suggest, discuss, and choose specific goals and activities to work on over the year. Until more formal goals are established, general goals can be to: Provide feedback and advice for changes to hospital policies, care practices, and materials Help create materials and strategies for improving health care quality and safety for all patients Help hospital staff carry out changes to improve hospital safety and quality As an initial step, advisory councils may wish to undertake the activities described in Appendix A: Working With Patient and Family Advisors on Short-Term Projects. These activities include conducting walkabouts and sharing personal and professional experiences and stories. Budget considerations Hospitals may want to reimburse patients and families for expenses (e.g., parking, transportation, child care) incurred during their work on the advisory council. Some programs also offer stipends or honoraria for participation in meetings. Many councils celebrate accomplishments or a membership term with small acknowledgements, such as gift cards. Other budget line items for the advisory council may include: refreshments or meals for council meetings, printing expenses, communication expenses (mail and phone), and expenses for supplies. Think creatively about whether and how you will secure funding for these expenses. Some hospitals use an administration discretionary fund, some use general operating funds, some have guilds or service leagues that provide earmarked dollars specifically for this support, and some write grants to community organizations or foundations. Strategies for successful advisory council meetings
Area Description 1 Description 2 Description 3 Senior leadership support for patient and family involvement Senior leaders do not consider patient and family involvement in improvement a top priority. Senior leaders are aware of and communicate support for patient and family involvement in improvement. Senior leaders provide resources necessary to involve patient and family advisors in improvement. Experience with patient and family involvement Beyond patient satisfaction surveys or focus groups, our organization does not have a formal method for patient and family feedback. We have patient and family advisors and/or a patient and family advisory council. Patient and families are members of standing committees and make decisions at the program and policy level. Collaboration and teamwork Staff in this organization occasionally work in multidisciplinary teams to provide care. Staff in this organization work effectively across disciplines to provide care to patients. Staff are effective at working collaboratively in multidisciplinary teams that include patients and families as valued members of the care team. What supports the idea of involving patient and family advisors? What are your current challenges? How confident are you about successfully involving patient and family advisors in your improvement work (on a 1–10 scale with 1 = not confident at all and 10 = extremely confident)?