massachusetts patient and family advisory councils pfac call #4 june 15, 2010 1

Massachusetts Patient and Family Advisory Councils

PFAC Call #4

June 15, 2010

www.macoalition.org

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Patient and Family Advisory Councils Regulatory Overview

• Regulations adopted by the Public Health Council May 13, 2009• Regulations effective June 12, 2009

• Printed in the Massachusetts Register July 24, 2009

• Requirement of all hospitals licensed under 105 CMR 130.000• Applies to acute care, pediatric, rehabilitation and long term care hospitals.  • Requirement does not apply to public hospitals and mental health hospitals. 

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Patient and Family Advisory Councils Regulatory Requirements

• PFAC hospital work plans publically available September 30, 2009 • Established PFAC by October 1, 2010

• Annual reports publically available beginning October 1, 2010

• PFAC must meet at least quarterly

• Minutes transmitted to the hospital’s governing body

• Fifty percent of PFAC members must be current or former patients or family members and representative of the hospital community

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Patient and Family Advisory CouncilsCoalition Goals

Support hospitals in establishing PFACs by 10/1/10.

Support hospitals in moving from being “patient and family focused” to providing “patient and family centered care”

In focused care, interventions are done to and for patients and families rather than with them

In centered care, patients and family members are active participantsMa Coalition for the Prevention of Medical Errors

Institute for Family Centered Care

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Patient and Family Advisory CouncilsProgram Committee

Susan Abookire, MD, MPH, Mount Auburn Hospital

Effie Pappas Brickman, MPA/H, MA Coalition for the Prevention of Medical Errors

Linda Burgess, Consumer Health Quality Council, Health Care for All

Maureen Connor, MPH, RN, Claremont Consulting and previously at Dana Farber Cancer Institute

Christine Combs, MA, RN, Emerson Hospital

Patricia Crombie, MSN, RN, Cambridge Health Alliance

Elizabeth Daake, MBA, MPH, MA Department of Public Health

Ken Farbstein, MPP, Consumer Health Quality Council, Health Care for All

Anuj Goel, JD, Massachusetts Hospital Association

Paula Griswold, MS, MA Coalition for the Prevention of Medical Errors

Deborah Hoffman, MSW, LCSW, Dana Farber Cancer Institute

Pamela Mann, Kenneth Schwartz Center

Cynthia Medeiros, previously at Dana Farber Cancer Institute

Karen Nelson, MPA, RN, Massachusetts Hospital Association

Lynnie Reid, Children’s Hospital

Terry Sievers, RN, Northeast Health Systems

Nicola Truppin, JD, Consumer Health Quality Council, Health Care for All

Deborah Wachenheim, Health Care for All

Susan Shaw, Children’s Hospital

Alec Ziss, Consumer Health Quality Council, Health Care for All

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Patient and Family Advisory CouncilsAudio Conference Series

Audio Conferences Offered to MA Hospitals

Call #1 - July 21, 2009 Call #2 - September 18, 2009 Call #3 - March 9, 2010 Call #4 - June 15, 2010

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Patient and Family Advisory CouncilsCall #4 Agenda

Introduction Paula Griswold

Maureen Connor

Including PFAC Members in Your Daily Work Kristine White

     Including patients and families in a very comprehensive

manner to improve their daily work throughout the healthcare

system. Working on discharges, transitions, avoidable

readmissions, rapid response teams, medication safety,

cancer survivor network, building expansion, medical school

education on PFACs                                                            

Q & A Time Marlene Fondrick

Responses to questions received through call registration All

site will be provided

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Call #4 Faculty

Kristine White, MBA, BSN, RN, Vice President, Innovation and Patient Affairs, Spectrum Health System, MI

Marlene Fondrick, MSN, RN, Program Associate, Institute for Family-Centered Care

Paula Griswold, MS, Executive Director, Massachusetts Coalition for the Prevention of Medical Errors

Maureen Connor, MPH, RN, Claremont Consulting Partners and previously at Dana Farber Cancer Institute

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Patient Family Advisory Councils-Creating Lasting ImpactKris White, MBA, BSN, RN

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Welcome to Spectrum Health…where exceptional people create an

exceptional experience for patients and families.

Spectrum Health Overview

•Integrated health system

•Spectrum Health Hospital Group

•Spectrum Health Medical Group

•Continuing Care Division - home care, hospice, LTACH, sub-acute, VNA, and long term care

•Priority Health

•Areas largest employer

•Strong Value Proposition

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Spectrum Health

Mission

To improve the health of the communities we serve.

VisionBy 2020, Spectrum Health will be the national leader for health.

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Patient Family Advisory Councils-

Councils formed in 2006

Today there are 10 PFAC’s in Place

Intentional support and growth of the councils

Leadership engagement and support is essential

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Ortho/NeuroPatient and Family Advisory Council

United Hospital Patient and Family

Advisory Council

Reed City Patient and FamilyAdvisory Council

Patient and Family Advisory Councils

Spectrum Health Executive

Patient and Family Advisory Council

Outpatient ServicesPatient and FamilyAdvisory Council

Cancer ProgramPatient and Family Advisory Council

Fred & Lena Meijer Heart Center

Patient and Family Advisory Council

Helen DeVos Children’s Hospital

Family Centered CareAdvisory Council

Women and Infant Services

Patient and FamilyAdvisory Council

Helen DeVosChildren’s Hospital

Neonatal Family Advisory Council

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The Strategy

Strategically and intentional integrate the experience of care as seen through the eyes

of patients and families

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Patient Family Centered Care Model

Family is defined by the patient

Patient and family are essential part of the healthcare team.

Patients and families unique traditions, values and styles of communication are honored and respected.

Families represent the continuum of care for patients.

Families play a vital role in ensuring the well-being of the patient

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Purpose

Engaging patients and families in partnership with healthcare leaders, physicians, and staff to shape policies, program development, and decision making. The Patient and Family Advisory Council members act as consultants to the organization.

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Structure

PFAC Members are:

• Volunteers that are focused in unique purpose

• Partnered with Spectrum Health Leadership (Executive or Director)

• Representative of the communities we serve

• Representing diverse experiences

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Infrastructure is Essential

• “Status” of Patient/Family Advisors

• Screening and Hiring

• Participation Expectations

• Terms

• Responsibility/Accountability

• Define Partnership

• Set and Measure Goals20

Structure

PFAC members commit to:

• Teamwork

• Respect

• Communication

• Compassion

• Confidentiality

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PFAC Activities and Impact

• National and State initiatives and awards

• Mystery Shopping

• Evaluation of different service lines strengths and opportunities for improvement

• Partnering with teams to develop Experience Maps and Emotional Mapping to enhance patient and family experience

• Improve patient and family experience (Press Ganey Success Story 2009 Women Infant Services)

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PFAC Activities and Impact

• Serve on system committees- Safety, Ethics, Quality, and Communications

• Develop processes that changed care model such as Discharge Phone Calls, surgical approach, Discharge instructions, Valet Parking, Way-finding

• Evaluating renovations and building projects to ensure that they are patient and family centered in their approach and function.

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PFAC Activities and Impact

• Physician, resident, nursing, and ancillary staff education provided on the patient and family perspective through local and state universities.

• Patient panels to further engage staff and physicians with the Patient and Family Experience

• Interviews for key roles, ranging from Manager to Chief Operating Officer.

• Involvement in leadership retreats, staff celebrations, acceptance of national awards, and system wide addresses.

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Outcomes

• Impact of driving patient satisfaction from the 50th percentile to the 90th percentile

• Changes in process to increase efficiency and safety for registration

• Impact outcomes of committees ensuring patient is engaged in solutions

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Creating Exceptional Experiences

We will not achieve our vision without an intentional, strategic focus on the

experience of care through the eyes of our patients and their families

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Summary

Each member of our Patient and Family Advisory Councils are invaluable to Spectrum Health. They challenge us to drive towards success and keep us vigilant in providing patient and family centered care. We are honored to have them engaged as partners in this work.

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Questions?

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Patient and Family Advisory CouncilsNext Steps

List Serve Is available to hospitals participating in the PFAC Calls. Allows

hospitals to consult with colleagues on this work.

Implementation Underway for Hospitals for October 1, 2010

Involvement in statewide Transitions work

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Patient and Family Advisory CouncilsNext Steps

Key Recommendation of State Strategic Plan on Transitions includes:o Patient and Family Engagement

Using PFACs to improve care transitions is an immediate strategy for the State:o Provides opportunity to:

obtain feedback on proposed process changes, forms, strategies for improvement on a variety of activities affecting discharges and transitions.

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Strategic Plan: Principles and Key Recommendations

1. Timely feedback and feed forward of information

Standardized, minimum datasetCross-continuum teamsEnhanced early post-acute care follow up

2. Communication Infrastructure Contact information providedLiving databaseMedication tracking

3. Patient and Family Engagement Patient and/or advocacy group representation

4. Accountability for care remains with the sending set of providers

Handoff responsibilityIdentifiable provider

5. Provider and Practice Engagement Education/Best PracticesMentors

6. Standardized process and outcome measures, based on nationally endorsed measures

Collaboration with Expert Panel on Performance Measurement

7. Payment reform Incentive alignmentData transparency

Principles Key Recommendations

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A Model for Better Outcomes Across the Continuum of Care

Implement the Strategic Plan to Improve Transitions

Collaboratives Payment Reform Government Action

Improved Health Status & Patient Experience

Complications FunctionAdverse Events

Patient Satisfaction

Patient Understanding

Appropriate UtilizationER Visits Readmissions Preventable

AdmissionsUnnecessary Tests

Procedures

Achieve the IHI Triple Aim of optimizing: 1) Patient Experience, 2) Health of Defined Populations, and 3) Per Capita Cost 33

Patient and Family Advisory CouncilsNext Steps

Engaging Patients and Families in Improving Transition of Care:o Local work of hospital to continue from patients and families related to how

the hospital discharge may be improved. Obtain support from hospitals to have Transitions be an on-going PFAC meeting agenda item

o MA Coalition continue to support shared local learning among Massachusetts hospitals working with their PFACs on this topic

o MA Coalition continue to provide opportunities to learn from other hospitals nationally

Other Ideas?? Are there hospitals focusing on this now? Seeking hospitals’ input on statewide Transition strategy to be proposed

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Massachusetts Patient and Family Advisory Councils

Questions and/or Feedback?

Effie Pappas Brickman

Director, Patient and Family Advisory Councils

ebrickman@macoalition.org

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