PATIENTS AND FAMILY AS FULL PARTNERSOF THE HEALTHCARE TEAM

LES PATIENTS/LA FAMILLE, PARTENAIRES À PART ENTIÈRE DE L’ÉQUIPE DE SOINS

Thursday, March 24 2015Jeudi, 24 Mars 2015

Your Hosts & PresentersVos hôtes et présentateurs

Bruce Harries, Collaborative Director

Leanne Couves, Improvement Advisor

Shari Watson, Guest Speaker

Heather Thiessen, Guest Speaker

Hélène Riverin, French Language Support, CPSI

Ardis Eliason, Technical Host

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Interacting in WebEx: Today’s ToolsInteragir dans Webex : outils à utiliser

Be prepared to use:- Pointer - Raise hand- CHAT

Have you used WebEx before?Avez-vous déjà utilisé WebEx? YES / OUI NO / NON

Soyez prêts à utiliser les outils :

- le pointeur - lever la main- clavardage Type your

message & click ‘send’

Select ‘send to’

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Who’s Online? Qui est en ligne?

POINTER

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What professions are represented?Quelles professions sont représentées?

Nurse MD

Educator / Quality Improvement Professional

Infection Control

Administrator / Senior Leader

Other

POINTER

Respiratory or Physio

Therapist

Patient/Family Member

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Name of your institution One thing you’d like to learn more about

in this session

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Use “Chat”

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Shari Watson and Heather Thiessen

PATIENTS AND FAMILY AS FULL PARTNERSOF THE HEALTHCARE TEAM

LES PATIENTS/LA FAMILLE, PARTENAIRES À PART ENTIÈRE DE L’ÉQUIPE DE SOINS

Patient & Families:

Full partners on the healthcare team

How are we doing across Canada?

1. How many units have patients and families participate in multidisciplinary rounds?

2. Every day?3. Invite them to attend?4. Coordinate the time to accommodate the

patient/family?

Objectives

1. Creating a culture that is open to family2. Family presence on multidisciplinary rounds3. Taking the fear out of working with patients

and families4. Patient/family advisory council

What impression does family have when they arrive

at your door?

Welcoming

Open door policy

Access to care team

Rules- Intimidating/formal- Put you in your place- THEIR domain - Added family stress

Examples- Strict rules- Strict visiting hours - DO NOT CALL sign- Poor information sources

People are treated with respect and dignity.

Health care providers communicate and sharecomplete and unbiased information with patientsand families in ways that are affirming and useful.

Individuals and families build on their strengthsthrough participation in experiences that enhance

control and independence.

Collaboration among patients, families, andproviders occurs in policy and program developmentand professional education, as well as in the delivery

of care.

Patient and Family centered core concepts

SurveyHow do you know if you are patient/family centered?1. Do you feel welcome when you come into

the unit?2. Do you feel the staff is willing to answer your

questions?3. Did we give you information in a way you

understood?4. Were you or your family able to contribute

when making decisions about the patients care?

Admission to the ICU

1. Greet the family within 10 minutes 2. Welcome package that includes the

welcome booklet, a journal , contact info.3. Once in the unit, get a brief orientation to

the unit and invitation to rounds- we give info on what to expect, info about the App

4. Invite them to come back in anytime, info on the closed curtain, phoning if preferred.

5. Education on hand hygiene, privacy

First Steps

Creating the Environment

What was the first step?1. Staff education about PFCC

-Really important to hear peoples concerns2. Information on Privacy- at all times,

-remembering that people hear info all daylong not just during rounds

3. Education on the safety aspects- Allergies, correct history and previousexperience

Creating a welcoming environment

Multidisciplinary rounds

1. The team moves close to the patient, introduces themselves- usually to the family as patient often not awake

2. The team reviews the patients, each member covering their area. - The nurse will prepare the family as this conversation is held in

medical terms and often teaching is done3. Main physician summarizes the content in layman’s terms to the

family or patient and asks if they have any questionsObservations: family most commonly comments on how they hadn’t realized so many people where involved. It provides comfort and they know that they can ask questions of the nurse or the RRT . **** It is important to offer time for a separate family conference at a later time for difficult or complex conversations** we do notice that family conferences are reduced as families feel much more informed

Heather’s Story

~2000. there is a newspaper on the bed as Heather had to prove to the insurance company that she really was ill.

Patient/Family Advisory council

PFAC

1. Creation of the patient/family advisory2. White boards3. All about me poster4. Bringing patient voice to our department

- hiring, education days5. Development of an APP for families

ICU physician speaking with the patient and her daughterat the bedside during rounds

Ensuring patients have a way to communicate.

Information, Participation, collaboration

Partners in Care

Creating a plan WITH the patient.What time works best to do a SBT?

Embracing technology

Exploring APP’s that have beencreated.• Trach tools (Passy Muir)• HandySpeech

• The Saskatoon Health Region ICU developed an APP for the ICU family guide

Skype and Facetime

Bringing family/home to the environment

“All about me “ poster• We encourage family to

complete to help with Delirium

• Post photos to show the patient is a person first

Gemba Walk

Gemba Walk:The advisory council spends 15 minutes

before each meeting and asks patient and families questions. No script. Might ask- how has your stay been? Do you have any questions?Manager questions:

Any ideas for improvement? What’s going well?Top 3 concerns

Critical Care Week, Celebrating the team

team

No one plans to be a patient.

Have you ever been a patient?

How could your unit create a welcoming environment?How could you incorporate patient and families into rounds?How could you incorporate patient and families the ICU environment?How could your unit work with MD’s re: acceptance of family involvement?How could your unit create positive patient and family EXPERIENCES?How could your unit use technology (e.g. cell phones, facetime, Skype) to connect with patients and families? Social media?What has been your biggest “bomb” when in comes to incorporating patients and families into rounds? What did you learn from those situations?

Discussion Questions

QUESTIONS?

RAISE YOUR HAND / LEVEZ LA MAIN

OR/OU

CHAT TO “ALL PARTICIPANTS”

“Taking the Pulse” Poll

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Instructions to download certificate

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Canadian ICU Collaborative FacultyMembres de la faculté

Paule Bernier, P.Dt., Msc, Présidente, Ordre professionnel des diététistes du Québec; Sir MB David Jewish General Hospital (McGill University)

Paul Boiteau MD, Department Head, Critical Care Medicine, Alberta Health Services; Professor of Medicine, University of Calgary

Leanne Couves, Improvement Advisor, Improvement Associates Ltd.

Vinay Dhingra MD, Vancouver General Hospital; Clinical Associate Professor, UBC

Bruce Harries, Collaborative Director, Improvement Associates Ltd.

Roy Ilan MD, MSC (Clinical Epidemiology), Kingston General Hospital, Assistant Professor, Queen’s University

Gordon Krahn, RRT, Research and Quality Initiatives Coordinator, BC Children’s Hospital

Denny Laporta MD, Intensivist, Department of Adult Critical Care, Jewish General Hospital; Faculty of Medicine, McGill University

Claudio Martin MD, Intensivist, London Health Sciences Centre, Critical Care Trauma Centre; Professor of Medicine and Physiology, Universityof Western Ontario; Chair/Chief of Critical Care Western

Cathy Mawdsley, RN, MScN, CNCC; Clinical Nurse Specialist – Critical Care, London Health Sciences Centre

John Muscedere MD, Assistant Professor of Medicine, Queens University; Intensivist, Kingston General Hospital

Peter Skippen MD, BC Children’s Hospital; Clinical Investigator, CFRI; Clinical Associate Professor, UBC

Yoanna Skrobik MD, MSc (Pharm), Intensivist, Department of Medicine, McGill University, Expert Panel for the new Pain, Sedation and Delirium Guidelines, Society of Critical Care Medline (SCCM)

Kristine Thibault, Quality & Safety Leader PICU, BC Children’s Hospital

Carla Williams, Patient Safety Improvement Lead, CPSI3603/24/16

RemindersRappels

Call is recorded Slides and links to

recordings will be available on Safer Healthcare Now! Communities of Practice

Additional resources are available on the SHNWebsite and Communities of Practice

L'appel est enregistré Les diapositives et liens

vers les enregistrements seront disponibles sur Des soins de santé plus sécuritaires maintenant!Communautés de pratique

Des ressources supplémentaires sont disponibles sur le site Web SSPSM et Communautés de Pratique

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THANK YOU MERCI

This National Call is hosted by:

Supported by:

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