MyStory, A Multifaceted Initiative to Capture Each Pediatric Patient’s Story
Cheristi Cognetta-Rieke, DNP, RN; University of Minnesota Amplatz Children’s Hospital, Minneapolis, MN
Methodology•BuildaninterventionwithpatientsandfamiliesthatwillbeanAlwaysEvent™ whencaringforchildren—MyStory.
o MyStory as an Always Event™ is an interprofessional effort to capture each patient’s“story.”
o Documentthe“story”inaconvenient toolwithintheelectronichealthrecord.
o Usethepatient’s“story”topersonalizethecareweprovidetopatients,andtoinvolvethemincareplanningand decisionmaking.
•Personalizethecareforallpediatricpatientsbylearningtheirstoryandengagingthemincareplanninganddecisionmaking.
Tools and Implementation •TheMyStorytoolisbuiltintotheelectronichealthrecord.
•WehavealsodevelopedaMyStory tooltobeusedintheoutpatient areas:
o SurgerywaitingroomoPediatricEmergencyDepartment o Pediatric Hemodialysis Department
Outcomes TheMyStoryprojectoutcomesaremeasuredbyanumberofmetricsthathavebeenputintoadashboardthatisformattedtomatchtheorganizationsclinicalqualityandsafetydashboard(s).•NRCPickersurvey:o “Wastheinformationabouthis/her
conditiondiscussedwithyourchild inawayhe/shecouldunderstand”– 57.6%pre-implementationto 96.4%post-implementation.
•FromtheChildren’sSatisfactionSurvey:o “Findwaystomakethehospitalfeellike
home”–58.3%pre-implementationto64.8%post-implementation.
o “Likehowtheytookcareofyou”–83.3%pre-implementationto 87.5%post-implementation.
Lessons Learned •Patientandfamilyinvolvementinthecreationandimplementationofthistypeofinitiativeisinvaluable.
•Theinnovativenatureofachild’smind.•Thesharedvalueofgrassrootsinitiatives.•Thestrengthofinterprofessionalcollaboration.•Theabilitiesoftransformationalleadership.•Thepowerofanindividual’spersonal“story”.
MyStory is being funded by the Picker Institute as an Always Event ™.
Data Source MetricMeasurement Time Period
Pre - MyStory
DataPrevious
MeasurementCurrent
Measurement Target
Long-Term
Target TrendStatus vs.
Target
"Hospital workers talk to you?" 1Q 12 96.1% 85.7% 100% 100% m
"Listen when you told them something?" 1Q 12 85.0% 78.6% 93% 100% m
"Let you make choices?" 1Q 12 70.0% 67.9% 85% 100% m
"Find ways to make hosp feel like home?" 1Q 12 58.3% 64.8% 79% 100% k
"When hurting, help you feel better?" 1Q 12 80.0% 83.9% 90% 100% k
"Like how they took care of you?" 1Q 12 83.3% 87.5% 92% 100% k
"Did the Doctors pay enough attention to your experiences and suggestions in caring for your child?" 4Q 11 62.6% 96.9% 86.4% 100% k
"Did the Nurses pay enough attention to you experiences and suggestion in caring for your child?" 4Q 11 63.6% 94.9% 88.0% 100% k
"Would you have liked more involvement in making the decisions about your child's hospital care?" 4Q 11 67.3% 90.8% 77.3% 100% k
"How much did you participate in your child's care, such as feeding or bathing?" 4Q 11 93.9% - 95.2% 100%
"Was the information about his or her condition discussed with your child in a way he or she could understand?" 4Q 11 57.6% 96.4% 81.3% 100% k
"Did someone explain to your child the tests that were being done in a way he or she could understand?" 4Q 11 64.5% 94.8% 83.3% 100% k
Do My Caregivers Know My Favorite Things? Jan 12 - Feb 12 41% 53% 60% 75% k
Do My Caregivers Know Things I Don't Like? Jan 12 - Feb 12 30% 9% 60% 75% mGet
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ell
Net
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University of Minnesota Amplatz Children's Hospital - MyStory Dashboard
Chi
ldre
n's
Satis
fact
ion
Surv
eyN
RC
Pic
ker P
aren
t Sat
isfa
ctio
n
Arrow Up = Performance ImprovingArrow Straight = Performance SameArrow Down = Performance Declining
Green = Going WellYellow = Monitor
Red = Requires Mgmt Attention
Arrow Up = Performance Improving Arrow Straight = Performance Same Arrow Down = Performance Declining
Key:Green = Going Well Yellow = Monitor Red = Requires Mgmt Attention
* Questions taken from Children’s perceptions survey© Lindeke,L., Fulkerson, J., Chesney, M., Johnson, L., Savik, K. (2009). Children’s perceptions of healthcare survey. Nursing Administration Quarterly, 33(1), p. 26-31.
*
** Questions taken from NRC Picker Patient Satisfaction Survey©
**
Transforming the care we provide to children
Evidence-based
Interprofessional Collaboration
Patient and Family Involvement
MyStoryPersonalizing
Pediatric Care
Inspiration for the MyStory ProjectMyStorywasdesignedtopersonalizethecareweprovidetopediatricpatientsandtransformthehospitalexperienceforthepatientsandfamiliesweserveattheUniversityofMinnesotaAmplatzChildren’sHospital.
Background and Significance•Americanshad36millionhospitalstaysin2000.oApproximately18%ofthesestayswereforchildrenandadolescents17yearsandyounger.oThisaccountsforabout13%ofalldaysinthehospital,andabout9%oftotalhospitalcharges(AHRQ,2000).•Thereisresoundingevidencedisplayingtheimportanceofcapturingthepsychosocialaspectsofachildbeingadmittedto anacutecarehospitalsetting.
o Incorporatingthepsychosocialneedsofpediatricpatientscreatesindividualized,patientcenteredcarethatengagesthechildindecision-making.
(Kelsey,Abelson-Mitchell&Skirton,2006,Prilleltensky,2010,Prilleltensky,Nelson&Peirson,2001,Reed,Smith,Fletcher&Bradding,2003,Sartain,Clarke&Heyman,2000)
•Despitethegrowingbodyofliteraturethatemphasizestheneedtotalkdirectlytothechildandstressestheimportance ofobtainingthechild’sview,thisisrarelydoneinpractice.
•Sadly,childrenareoftensilentconsumersofhealthcare;children’svoicesremaingenerallyexcludedfromdecisionmaking andcareplanninginacutecarehospitalsettings(Coyne,2006).
My name is: You can call me: Age:
My caregiver(s) name(s) are:
I am from:
My friends are:
My favorite toys or things to do are:
I am good at:
When I grow up, I want to be:
Draw a picture of what you want to be when you grow up:
My Story:(School Age)
� is is to be used as a template only! Give to health care team to enter in EPIC.
uofmchildrenshospital.org
My name is: You can call me: Age:
My caregiver(s) name(s) are:
I am from:
My friends are:
My favorite hobbies/activities are:
I am good at:
In the future, I want to:
My past experience with being sick or coming to the hospital:
Before a procedure, I need to know:
My Story:(Teen)
uofmchildrenshospital.org
MyStory is a navigator/button
on the left
My name is: You can call me: Age:
My caregiver(s) name(s) are:
I am from:
Special parent requests:
My favorite toys are:
I become upset or cry when:
Things that comfort me are:
You can distract me with:
My past experience being sick or coming to the hospital:
My Story:(Infant and Toddler)
� is is to be used as a template only! Give to health care team to enter in EPIC.
uofmchildrenshospital.org
Implications for Policy and Practice •Involvingpatientsandfamilyininitiativesfromthe pointofinceptiontosustainabilityisvitalforsuccess.
•Emphasisandrigorcanandshouldbeappliedto patient/familycenteredcareinitiativestomeasure theimpact(s)ofhowcareisdelivered.
•Innovationandoptimizationoftheelectronichealth recordtocreatehighreliabilityandconsistencyofthe patient’scareexperienceacrosscontinuumsofcare.