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Component 2:
Organizational Partnership
Materials
Guide to Patient and Family
Engagement
Component 2
Organizational Partnership Materials
Implementation Handbook
Implementation Handbook: Organizational Partnership Materials
Implementation Handbook:
Organizational Partnership Materials
Table of Contents
Overview of the Organizational Partnership Materials Strategy .............................................1
What are the Organizational Partnership Materials tools? ..........................................................1
Rationale for Organizational Partnership Materials .................................................................5
Why are patient and family advisors important?........................................................................ 5
Implementing Organizational Partnership Materials ..................................................................6
Step 1: Identify a staff liaison......................................................................................................6
Step 2: Identify opportunities for involving patient and family advisors....................................6
Step 3: Prepare hospital leadership, clinicians, and staff to work with advisors ........................6
Step 4: Recruit, select, and train patient and family advisors .....................................................6
Step 5: Implement and coordinate advisor activities...................................................................6
Step 1: Identify a Staff Liaison .....................................................................................................7
Who should be a staff liaison? ....................................................................................................7
What are the staff liaison’s responsibilities? ...............................................................................7
Step 2: Identify Opportunities for Working With Patient and Family Advisors ....................9
Advisors on short-term projects ..................................................................................................9
Patient and family advisory councils...........................................................................................9
Advisors as members of quality and safety committees ...........................................................10
Step 3: Prepare Hospital Leadership, Clinicians, and Staff to Work With Advisors ...........11
Gathering information ...............................................................................................................11
Building support ........................................................................................................................12
Recognizing challenges .............................................................................................................13
Step 4: Recruit, Select, and Train Patient and Family Advisors .............................................15
Recruiting potential advisors .....................................................................................................15
Advisor qualifications .......................................................................................................... 15
Finding potential advisors ................................................................................................... 16
Recruiting advisors to be members of quality and safety committees ................................. 17
Implementation Handbook: Organizational Partnership Materials
Implementation Handbook:
Organizational Partnership Materials
Advisor information session......................................................................................................17
Selecting advisors: Applications and interviews .......................................................................18
Training advisors .......................................................................................................................19
Training for advisor members of quality and safety committees ......................................... 20
Feedback sessions and problem solving....................................................................................20
Step 5: Implement and Coordinate Advisor Activities .............................................................22
Identifying advisor opportunities ..............................................................................................22
Tracking and communicating advisor accomplishments ..........................................................22
Tracking advisor accomplishments ..................................................................................... 22
Communicating advisor accomplishments .......................................................................... 23
Appendix A. Working With Patient and Family Advisors on Short-Term Projects.............24
Three initial activities to conduct with patient and family advisors..........................................25
Activity 1: Sharing personal and professional experiences................................................. 25
Activity 2: Patient and family stories ................................................................................... 26
Activity 3: Conducting a “walk-about” from the patient and family perspective ............... 28
Appendix B. Establishing and Working With Patient and Family Advisory Councils ........31
Advisory council membership...................................................................................................31
Roles and responsibilities of advisory council members ..........................................................32
Time commitment .....................................................................................................................32
Advisory council mission statement..........................................................................................33
Advisory council bylaws ...........................................................................................................33
Advisory council goals ..............................................................................................................34
Budget considerations ...............................................................................................................34
Strategies for effective advisory council meetings....................................................................35
Topics to cover at the initial advisory council meeting ....................................................... 35
Topics to cover during subsequent meetings ....................................................................... 37
Evaluating the meeting ........................................................................................................ 38
Ongoing support of council members .......................................................................................38
Encourage participation ...................................................................................................... 38
Establish norms and ground rules ....................................................................................... 38
Implementation Handbook: Organizational Partnership Materials
Implementation Handbook:
Organizational Partnership Materials
Manage conflict ................................................................................................................... 39
Acknowledge difficult emotions ........................................................................................... 39
Debrief regularly ................................................................................................................. 40
Review annually ................................................................................................................... 40
Appendix C. Advisors as Members of Quality and Safety Committees .................................41
Preparing quality or safety committees for advisors’ participation ..........................................41
Preparing advisors to participate on quality and safety committees .........................................44
Quality improvement methodology ...................................................................................... 44
Exploring quality data ......................................................................................................... 44
Problem solving methodology ............................................................................................. 44
Importance of privacy and confidentiality ........................................................................... 45
Integrating patients and family advisors into quality and safety work: Initial steps .................45
Building a foundation for success: Tips for successful meetings and interactions ...................46
Getting started ..................................................................................................................... 46
Sustaining involvement ........................................................................................................ 47
Communication tips ............................................................................................................. 48
Patient and family advisors: Reaching out to current patients and families .............................50
Guidance for having patient and family advisors interact with current patients and family
members ............................................................................................................................... 51
References .....................................................................................................................................53
Implementation Handbook: Organizational Partnership Materials
Implementation Handbook:
Organizational Partnership Materials
The Guide to Patient and Family Engagement in Hospital Quality and Safety (the Guide) is a
resource to help hospitals develop effective partnerships with patients and family members, with
the ultimate goal of improving hospital quality and safety.1
Working with patients and families at an organizational level (i.e., as advisors) is a critical part
of patient and family engagement and patient- and family-centered approaches to improving
quality and safety. Patient and family advisors are valuable partners in efforts to reduce medical
errors and improve the safety and quality of health care.
The Organizational Partnership Materials component and its tools help hospitals implement and
develop effective partnerships with patients and family members at the organizational level.2
This handbook gives you an overview of and rationale for the component. It also outlines five
steps for putting this component into place at your hospital and includes specific suggestions for
how to work with patient and family advisors.
Overview of the Organizational Partnership Materials
Component
The goal of the Organizational Partnership Materials component is to bring the perspectives of
patients and families directly into the planning, delivery, and evaluation of care. The tools that
accompany this handbook are intended to help hospitals recruit and train patient and family
advisors, and prepare clinicians and hospital staff to work with patient and family advisors.
What are the Organizational Partnership Materials tools?
This section provides an overview of the tools included in this component.
Tool
Use this tool to…
Description and formatting
Gain the support of hospital leadership
Tool 1
Organizational
Partnership
Materials:
Leadership
Support
Build hospital leadership
support for working with
patient and family
advisors.
•
A PowerPoint presentation and talking
points for staff liaisons or others to use
in speaking with hospital leadership
about the benefits of working with
advisors and the leadership resources
needed.
•
Format: PowerPoint presentation slides
with talking points
Recruit patient and family advisors
Implementation Handbook: Organizational Partnership Materials
1
Tool
Use this tool to…
Description and formatting
Tool 2
Recruit new patient and
family advisors.
•
Brochure with information about who
patient and family advisors are, how
they help the hospital, and what it takes
to be an effective patient and family
advisor.
•
Format: Tri-fold brochure
•
Postcard for clinicians or hospital staff
to give to potential patient and family
advisors along with a verbal invitation
to get involved. The postcard describes
the role of an advisor and tells potential
advisors how to get more information.
•
Format: Postcard
•
Recruitment handout for patient and
family advisors who may be interested
in serving on hospital quality and safety
committees of different types. Gives
information about roles and
responsibilities and tells how to get
more information.
•
Format: 2-page handout
•
Form for potential advisors to complete.
Includes basic demographic
information, questions about why the
applicant wants to be an advisor, and
questions about prior relevant
experiences as advisors or volunteers.
•
Format: 2-page handout
•
Sample invitation and regret letters for
patients and family members who have
applied to be advisory council members.
Hospitals may wish to combine these
with a personal phone call.
•
Format: 1-page letters
Help Improve
Our Hospital:
Become a Patient
and Family
Advisor
Tool 3
Personal
Invitation for
Patient and
Family Advisors
Tool 4
Become a
Champion for
Health Care
Quality and
Safety
Recruit new patient and
family advisors.
Recruit experienced
patient and family
advisors to become
members of quality and
safety committees.
Identify and screen
potential patient and
Application Form
family advisors.
for Patient and
Family Advisors
Tool 5
Notify advisory council
applicants of their
Sample Invitation
acceptance or rejection.
and Regret
Letters for
Advisory Council
Applicants
Tool 6
Information session for patient and family advisors
2
Implementation Handbook: Organizational Partnership Materials
Tool
Use this tool to…
Description and formatting
Tool 7
Conduct an information
session for people who are
interested in becoming
advisors.
•
Gives information about who patient
and family advisors are, what they do,
how they help the hospital, and what it
takes to be an effective patient and
family advisor.
•
Format: PowerPoint presentation with
talking points
Help people who are
interested in becoming
advisors self-assess their
readiness.
•
Handout to be given at and completed
during the advisor information session.
•
Format: 1-page handout
Help potential patient and
family advisors begin to
plan how to talk about
their experiences.
•
Handout to be given at the advisor
information session.
•
Format: 1-page handout
Identify the specific
interests of potential
patient and family
advisors.
•
Form to be completed at the end of the
advisor information session.
•
Format: 1-page form
•
Gives information about hospital safety
and quality, what patient and family
advisors do, how they help the hospital,
and provides tips about being an
effective patient and family advisor.
•
Format: Manual
•
Sample confidentiality statement that
hospitals can ask patient and family
advisors or council members to sign
before participating in advisory
activities.
•
Format: 1-page handout
Patient and
Family Advisor
Information
Session
Tool 8
Am I Ready to
Become an
Advisor?
Tool 9
Sharing My
Story: A
Planning
Worksheet
Tool 10
My Participation
Interests
Train patient and family advisors
Tool 11
Patient and
Family Advisor
Training Manual
Tool 12
Sample
Confidentiality
Statement
Train patients and family
members who have been
selected to serve as
advisors.
Review confidentiality
requirements with all
patient and family
advisors.
Train clinicians and hospital staff
Implementation Handbook: Organizational Partnership Materials
3
Tool
Use this tool to…
Tool 13
Introduce clinicians and
•
hospital staff to the idea of
working with patient and
family advisors and to
develop their skills for
doing so.
Working With
Patient and
Family Advisors:
Presentation
Tool 14
Working With
Patient and
Family Advisors:
Handout
Tool 15
Working With
Patient and
Family Advisors
on Short-Term
Projects
Tool 16
Readiness to
Partner With
Patient and
Family Advisors
4
Description and formatting
Two-part training presentation. Part 1
(Introduction and Overview) discusses
who patient and family advisors are, the
benefits of working with them, and the
opportunities for doing so. Part 2
(Building Effective Partnerships) helps
clinicians and hospital staff develop
partnership skills.
•
Format: PowerPoint presentation and
talking points
Provide clinicians and
hospital staff with an
overview of working with
patient and family
advisors.
•
Outlines the role of patient and family
advisors and the opportunities for their
involvement.
•
Format: 2-page handout
Help clinicians and
hospital staff identify
opportunities for working
with patient and family
advisors.
•
Contains suggestions for ways in which
to incorporate advisors on short-term
projects along with a form to request
advisor participation.
•
Format: 4-page handout
Help clinicians and
hospital staff identify
attitudes and behaviors
that may prevent them
from partnering
effectively with advisors.
•
Checklist of behaviors and attitudes.
•
Format: 1-page handout.
Implementation Handbook: Organizational Partnership Materials
Rationale for Organizational Partnership Materials
The goal of patient and family engagement is to create an environment where patients, families,
clinicians, and hospital staff all work together as partners to improve the quality and safety of
hospital care. Patient and family engagement encompasses behaviors by patients, family
members, clinicians, and hospital staff, as well the organizational policies and procedures that
support these behaviors.
Why are patient and family advisors important?
Patient and family advisors are individuals who have received care at your hospital and who
offer insights and input to help hospitals provide care and services that are based on patient- and
family-identified needs rather than the assumptions of clinicians or other hospital staff about
what patients and families want.
Patient and family advisors help identify those things your hospital is doing well and also help
pinpoint areas for improvement. Advisors can help your hospital move beyond the “what is
wrong” stage to developing effective solutions.
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 longerterm benefits including:(1)
Better health outcomes for patients.
•
Reduced errors and adverse events.
•
Increased patient loyalty.
•
Malpractice risk reduction.
•
Increased employee satisfaction.
•
Improved financial performance.
We envisage patients as essential and
respected partners in their own care and in the
design and execution of all aspects of
healthcare.
In this new world of healthcare, organizations
publicly and consistently affirm the centrality of
patient- and family-centered care. They seek out
patients, listen to them, hear their stories, are
open and honest with them, and take action with
them.
Leape L, Berwick D, Clancy C, Conway J, Gluck P,
Guest J, et al. Transforming healthcare: a safety
imperative. Qual Saf Health Care. 2009;18(6):424-8.
Implementation Handbook: Organizational Partnership Materials
5
Implementing the Organizational Partnership Materials
The Organizational Partnership Materials component 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 or move farther 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: Step 1: Identify a staff liaison.
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: Step 2: Identify opportunities for involving patient and family advisors.
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 advisors.
Learn more: Step 3: Prepare hospital leadership, clinicians, and staff to work with advisors.
Step 4: Recruit, select, and train patient and family advisors
One of the best ways to ensure successful partnerships is to recruit advisors who are a good
match with your organization’s needs and then make sure they receive appropriate training.
Learn more: Step 4: Recruit, select, and train patient and family advisors.
Step 5: Implement and coordinate advisor activities
Successful staff liaisons identify advisor activities and also track and communicate advisor
accomplishments.
Learn more: Step 5: Implement and coordinate advisor activities.
6
Implementation Handbook: Organizational Partnership Materials
Step 1: Identify a Staff Liaison
Hospitals that are most effective in engaging patient and family advisors have a designated
clinician or staff member who serves as a staff liaison. This individual 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.
The staff liaison’s job is to facilitate partnerships and ensure that advisors are ready to
participate.
Who should be a staff liaison?
In hospitals that are just starting to work with patient and family advisors, the staff liaison is
usually someone who is already on staff. This may be someone who already does work with
patient and family education, quality improvement, or administration. The staff liaison should be
someone who has a passion for patient- and family-centered care, and who is willing to devote
time to the role of staff liaison.
Staff liaisons will work with a variety of people to build support for advisor engagement and
participation. Because of this, it is helpful for the staff liaison to be someone who has or can
build a strong rapport with hospital leadership, clinicians, staff, and patients and family
members. It also is helpful for staff liaisons to have the following qualities:
•
A passion for patient- and family-centered care.
•
The ability to listen and be open to new ideas.
•
The ability to work positively and proactively.
•
The willingness to both learn and educate.
•
Patience and perserverance.
•
The ability to see strengths in all people in all situations and to build on these strengths.
•
Flexibility and a sense of humor.
What are the staff liaison’s responsibilities?
The staff liaison is a consultant, educator, guide, and mentor. As such, the staff liaison has
responsibilities to hospital leadership, clincians, staff, and advisors.(2)
Implementation Handbook: Organizational Partnership Materials
7
Staff liaison responsibilities to hospital leadership include:
•
Working with hospital administrators to get their buy-in and commitment for working
with patient and family advisors (see Step 3: Prepare Hospital Leadership, Clinicians, and
Staff to Work With Advisors for more information).
•
Keeping leadership apprised of advisor activities and accomplishments.
Staff liaison responsibilities to hospital staff (clinicians and other staff) include:
•
Educating staff about the roles of advisors and opportunities for working with them.
•
Assisting staff with developing plans for involving advisors on specific projects or
workgroups.
•
Helping staff understand how to act on and implement advisor suggestions or to provide
feedback about why changes are not possible.
•
Problem-solving in challenging situations.
Staff liaison responsibilities to patient and family advisors include:
•
Obtaining the necessary resources.
•
Cultivating opportunities for advisor involvement.
•
Overseeing the recruitment and selection of advisors.
•
Training advisors and helping them understand how the organization works.
•
Overseeing advisor activities and facilitating the engagement of advisors.
•
Bringing concerns of advisors to hospital leaders or helping create direct connections
between advisors and leaders.
•
Tracking advisor accomplishments.
8
Implementation Handbook: Organizational Partnership Materials
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 not mutually exclusive, nor
do they represent the only ways of working with patient and family advisors. For more detailed
information about implementing the opportunities in this section, refer to the appendices 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 (for example, 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 change and improvement.
•
Work with advisors to obtain feedback on draft versions of written and audiovisual
materials, such as patient and family handbooks, informational videos, or care
instructions.
•
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 in Appendix A: Working With Patient and Family Advisors on Short-Term Projects.
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.
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 practices, program
planning and evaluation, and providing input on
institutional policies, programs, and practices.(3)
Implementation Handbook: Organizational Partnership Materials
What is an advisory council?
An advisory council is an active
partnership between patients and
family members and hospital staff.
It is not a support group,
grievance committee, staff
meeting, or presentation forum.
9
Prior to implementing a patient and family advisory council, the staff liaison should specify
eligibility criteria for membership, outline general roles and responsibilities, draft a general
mission statement and bylaws, and identify general opportunities for council involvement.
Learn more in Appendix B: Establishing and Working With Patient and Family Advisory
Councils.
Advisors as members of quality and safety committees
Hospitals that have more extensive experience working with patient and family advisors may be
ready to take the next step and incorporate advisors as members of quality and safety
committees. As members of quality and safety committees, patient and family advisors may be
asked to participate in the following activities:
•
Review and interpret the results of patient surveys and other data about hospital quality
and safety, and develop strategies for improvement.
•
Participate in quality improvement projects.
•
Reach out to patients and families in the hospital to identify ideas for improving quality
and safety.
•
Co-present in training sessions for nurses, doctors, and other staff focused on improving
communication, safety, and quality.
Learn more in Appendix C: Working with Advisors as Members of Hospital Quality and Safety
Committees.
10
Implementation Handbook: Organizational Partnership Materials
Step 3: Prepare Hospital Leadership, Clinicians, and
Staff to Work With Advisors
The most important factor for ensuring the success of patient and family advisory efforts is the
belief that partnering with patients and families is
“The single most important factor for ensuring
absolutely essential to improving hospital quality
the successful involvement of patients and
and safety.
families in policy and program activities is
This section of the implementation handbook
provides guidance for staff liaisons to help build
partnerships and garner support for patient and
family advisors among hospital leadership,
clinicians, and staff. Without this support,
sustained and meaningful partnerships with
advisors cannot be realized.
commitment to the idea. This point cannot be
overstated. Without a deeply held belief that
patients and families have unique expertise
and knowledge and that their participation is
essential to improving services, true
collaboration will not occur.”
Essential allies: patients and families as
advisors. (In press). Institute for Patient- and
Family-Centered Care.
Gathering information
As a staff liaison, one of the first things you can do to build support for working with advisors is
to ensure a strong understanding of your hospital’s culture, current policies, and decisionmaking
processes.
Ways to do this include:
•
Identify and get to know the formal and informal leaders in the hospital. The support
and approval of both formal and informal leaders is needed to affect change. To identify
informal leaders, talk to clinicians and staff to find out whom they listen to and respect.
Think about ways to bring leaders into the process of working with patient and family
advisors.
•
Learn how decisions are made. Understanding established processes and protocols for
making changes will help you identify who and what influences decisions about advisor
involvement.
•
Learn about the clinicians and staff in the hospital. A key factor for success is
clinician and staff willingness to be involved in a multidisciplinary, collaborative
approach that includes patients and families. Gathering information about clinicians’ and
staff’s experiences, ideas for changes and improvements, and questions or concerns about
advisor participation can help you prepare clinicians and staff to partner with advisors.
•
Assess your hospital’s experience with including patient and family perspectives in
previous change and improvement initiatives. Learning about the process and outcomes
of these experiences will help identify lessons learned, potential barriers, and successes
upon which to build.
Implementation Handbook: Organizational Partnership Materials
11
•
Consider opportunities for patients and families to serve as advisors. If your hospital
is new to working with advisors, think about a short-term task or project that can benefit
from patient and family advisor participation (see Appendix A). If your hospital already
has experience working with patient and family advisors, you may want to consider
moving to the next step and creating a patient and family advisory council (see Appendix
B). If your hospital is more experienced, consider incorporating advisors as members of
hospital quality and safety committees (see Appendix C).
Building support
The next step is to build a broad base of support from key individuals and groups, including
hospital administration, managers, task force leaders, patient advocates, support groups, and
other patient groups. The process of obtaining buy-in will not be a one-time occurrence. Regular
communication with leadership, clinicians, and staff is important to help them understand the
process of working with patient and family advisors – and the opportunities for doing so.
Practical steps to take in building support include:
•
Talk to hospital leaders about the importance and value of patient and family
advisors.
Guide Resource
•
Meet with clinicians and staff individually and in groups about what it means to
work with patient and family advisors. These efforts should be discussed as deeprooted, long-term commitments to evolve the system of care. Hospital staff and clinicians
also need to know about the expected benefits of working with advisors along with what
will be expected of them. Ask to be put on the agenda of a staff meeting or invite
clinicians and staff to a brown bag lunch discussion.
Guide Resource
12
Tool 1: Organizational Partnership Materials: Leadership
Support is a PowerPoint presentation with talking points
that you can use to talk to hospital leadership about the
benefits of working with advisors and the support that is
needed.
Tool 13: Working With Patient and Family Advisors: Part
1. Introduction and Overview is a PowerPoint presentation
with talking points that you can use to introduce clinicians
and staff to the idea of working with advisors. The session
includes a handout titled Working With Patient and Family
Advisors that provides an introduction to the topic. You
may also want to ask a patient or family member to share
their story during this presentation.
Implementation Handbook: Organizational Partnership Materials
•
Identify individuals on the staff who can help “champion” the idea of patient and
family advisors. Invite these individuals to participate in a training session to learn how
to work effectively with patient and family advisors.
Guide Resource
•
Tool 13: Working With Patient and Family Advisors: Part
2. Building Effective Partnerships is a PowerPoint
presentation with talking points and exercises that you can
use to help clinicians and staff develop skills for effective
partnerships. The session includes a handout called
Readiness to Partner With Patient and Family Advisors to
help clinicians and staff assess their readiness.
Inviting staff and leadership to do a “walk-about” to explore how the hospital
welcomes, engages, and supports patients and families. Begin at the first point of entry
into the hospital (e.g., the parking lot), and continue to the inpatient unit and throughout
the unit, including the patient room, treatment rooms, admitting area, family lounge, and
other areas visible to patients and families. These findings will give a new context for
your discussions about working with patient and family advisors to make improvements.
Learn more about conducting a walk-about in Appendix A: Working With Patient and
Family Advisors on Short-Term Projects.
Recognizing challenges
It helps to be aware of sources of resistance and challenges that you may encounter in your
conversations about working with patient and family advisors. These challenges may include:
•
Administrative barriers: Training and supporting patient and family advisors and
clinicians and hospital staff to engage in partnerships requires a commitment of personnel
and financial resources. With an eye on the bottom line, some administrators may see
only the associated costs and not the long-term value of these partnerships.
Administrators may also believe that privacy policies severely restrict the role for patients
and families in discussions that occur when changes and improvements are being
planned, implemented, and evaluated.
•
Clinician and hospital staff attitudes: Partnering with patient and family advisors is not
something that most clinicians and hospital staff have been trained to do or learned about
in their education. As such, they may have concerns about working with advisors and
sharing ideas for change and improvement. They may feel that their expertise is not being
validated, that advisors will disclose private information to others outside of the hospital,
that advisors will make unreasonable or impractical suggestions, or that patients and
families do not have the time to participate as advisors.
Implementation Handbook: Organizational Partnership Materials
13
•
Patient and family attitudes: When contemplating becoming an advisor, patients and
family members may have doubts about how helpful they can be. Patients and families
may see clinicians and hospital staff as having expertise that outweighs any ideas they
may have. They also may not want to share concerns or negative experiences they had at
the hospital directly with clinicians and hospital staff.
Listen carefully to the reasons you hear for resistance and try to address them. One way to
address resistance among leaders, clinicians, and staff is to find ways for them to see examples of
collaboration with patients and family members “in action.” Try to create opportunities for
interaction with patients and family members or with clinicians and staff who have worked with
advisors.
You also may want to develop talking points that highlight the resources that will be available to
support patient and family advisor engagement. For example:
•
The staff liaison will be responsible for coordinating advisor recruitment, selection,
orientation, training, placement, and supervision.
•
All advisors will be carefully screened to ensure that the role is a good fit.
•
All advisors will undergo training about their responsibilities and will sign HIPAA
confidentiality statements to affirm their commitment to keeping protected health
information private and data confidential.
•
The staff liaison will screen and train advisors to ensure readiness before invitations for
placement on quality and safety committees are extended.
•
The staff liaison is available as a resource to clinicians and staff should concerns arise
about the readiness, accountability, or skills of an advisor.
14
Implementation Handbook: Organizational Partnership Materials
Step 4: Recruit, Select, and Train Patient and Family
Advisors
This section of the implementation handbook provides guidance for staff liaisons to help
identify, select, and train patient and family advisors. One of the best ways to ensure successful
partnerships with patient and family advisors is to recruit patients and family members who are a
good match with your organization’s needs and then make sure they receive appropriate training.
This section outlines the following steps for recruiting, selecting, and training patient and family
advisors:
•
Identify potential advisors.
•
Hold an information session for patients and family members who are interested in
becoming advisors.
•
Interview and select advisors.
•
Train advisors.
Recruiting potential advisors
A patient or family advisor is an individual or family member who has experienced care in your
hospital. It is best to recruit advisors who have received care at your hospital within the past 3 to
5 years. This helps ensure that their experiences and recommendations reflect the current patient
and family experience. It is also helpful to recruit advisors who have diverse health care
experiences and who reflect the diversity of the patients and families your hospital serves.
Advisor qualifications
No special experience, qualifications, or expertise is necessary to be a patient or family advisor.
However, it is helpful to look for individuals who:
•
Are coping well with their hospital experiences.
•
Are willing to talk about their experiences and can effectively share insights and
information.
•
Demonstrate a passion for improving health care for others.
•
Have the ability to listen well, respect the perspectives of others, interact well with many
different kinds of people, and work in partnership.
•
Enjoy working with others, show a positive outlook on life, and bring a sense of humor.
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Finding potential advisors
To identify potential advisors or advisory council members, look for people who have
demonstrated an interest in being actively involved in their care or the care of their family
member. You may also want to consider individuals who have provided constructive feedback in
the past. Other suggestions for identifying potential advisors or advisory council members
include:
•
Enlist the support of clinicians and staff. Patient and family advisors often say that a
personal invitation from a clinician or other hospital staff member is the deciding factor
in encouraging them to become an advisor. Ask clinicians and staff to provide you with
the names of potential advisors. Some hospitals create competitions to recognize the
clinical areas that identify the largest number of prospective patient and family advisors.
Guide Resource
•
Give the Tool 3: Personal Invitation for Patient and Family
Advisors postcard to clinicians and staff. Ask them to
distribute the postcard to individuals who they think would
be effective advisors.
Distribute recruitment brochures. Place advisor recruitment brochures in easily
accessible locations on units for staff to distribute. You may also wish to include these
brochures in discharge packets, informational materials, welcome packets, or patient
satisfaction survey mailings.
Guide Resource
Tool 2: Help Improve Our Hospital: Become a Patient and
Family Advisor is a brochure you can customize and use to
recruit patient and family advisors.
•
Review letters or emails from patients and family members to identify individuals
who have provided constructive feedback to the hospital in the past.
•
Advertise opportunities at support groups or other patient meetings. Distribute
recruitment materials at patient education meetings and support groups within the
hospital.
•
Work with patient representatives, ombudsmen, and other hospital staff, such as
social workers, to identify potential advisors.
•
Advertise opportunities on the hospital website. Work with the hospital’s marketing
department to create a page on the hospital website that contains information about
advisory opportunities. Include the recruitment brochures and advisor application form
on the website.
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Recruiting advisors to be members of quality and safety committees
The strategies listed above are appropriate for identifying general advisors. However, candidates
for becoming members of quality and improvement committees are typically individuals who are
or have been advisors in other roles in your hospital. To identify these individuals, ask hospital
staff who have worked with advisors for suggestions. The staff liaison or committee chair should
contact potential advisors individually to inquire about their interest and ability to serve as a
quality or safety committee member.
Guide Resource
Tool 4: Become a Champion for Health Care Quality and
Safety is a recruitment handout that you can distribute to
potential quality and safety advisors.
Be clear on participation term limits with prospective patient and family advisors for committee
involvement. Most often, a minimum of a 1 year commitment is desired because the projects
these committees are involved in often take at least a year to plan, implement, test, review, and
reach their goal. Advisors should also be given a description of the committee’s purpose or
charge, information about committee meeting frequency and schedule, and a summary of recent
projects the committee has completed. It may also be helpful to coordinate a meeting or
conference call to introduce patient and family advisors to the leader of the committee and give
them the opportunity to ask questions so they can make an informed decision about participation.
Advisor information session
Before people can make the decision about whether they want to serve as an advisor, they need
to understand the responsibilities associated with the role. A good way to provide this
information is to hold an information session for individuals who are interested in becoming
advisors. The session is designed to help patients and family members determine whether they
are interested in serving as advisors and to determine for themselves whether they are ready.
Guide Resource
Tool 7: Become a Patient and Family Advisor: Information
Session is a PowerPoint presentation with talking points.
The session includes handouts called Tool 8: Am I Ready to
Become an Advisor? and Tool 9: Sharing My Story: A
Planning Worksheet to help patients and family members
determine their readiness to be an advisor.
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Information to provide during this session includes:
•
The role of patient and family advisors, including responsibilities and the benefits of
participation.
•
Logistic information, including time commitments, whether reimbursement or
compensation is provided, what kind of training and support is available, and how the
application process works.
•
Specific opportunities available for advisors at the hospital.
Guide Resource
Tool 10: My Participation Interests is a form for advisors
to complete during the information session to indicate their
interest in specific topic areas or initiatives.
Selecting advisors: Applications and interviews
Patients and family members who are interested in serving as advisors should complete an
application. For individuals who are interested in serving as advisors on short-term projects,
having a completed application may be sufficient, meaning that advisors do not need to go
through a formal interview and selection process.
Guide Resource
Tool 5: Application Form for Patient and Family Advisors
is a form for advisors to complete to provide information
about themselves and their interest in serving as a patient
and family advisor.
A more formal structure is recommended for selecting members of advisory councils, since
membership on an advisory council typically requires a commitment of 1 to 2 years. All potential
council members should be interviewed by the staff liaison and the council’s key contact, if this
person is different from the staff liaison. Select additional interviewers as appropriate. Once the
council is well-established, the chair(s) of the council or other council members typically
participate in interviewing potential members as well. Interviews can be conducted in-person or
via telephone.
During the interview, explore the applicant’s responses to the open-ended questions included in
their application form, including their reasons for wanting to become an advisor. Additional
questions to ask include:
•
As an advisor, what strengths and skills would you bring?
•
Tell us about a group situation where you were involved in a disagreement or had a
different opinion than others. How did you attempt to resolve the situation? This can be
within the hospital, school, at work, with family, or another setting. How did you feel
about hearing opinions with which you disagree?
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•
How much time are you likely to have in your schedule to participate as an advisor?
In making decisions about applicants, look for patients and family members who have diverse
health care experiences in the hospital and who reflect the diversity of your patient and
community population. If you are looking for advisors for a particular unit, select patient and
family members who have care experiences within that unit.
Inform patients and family members about selection in a timely manner. If there is not an
appropriate match at the time, extend the invitation to explore future options for serving as an
advisor.
Guide Resource
The Tool 6: Sample Letter of Invitation can be customized
by hospitals to invite selected advisor applicants to join an
advisory council. This letter is accompanied by a Tool 6:
Sample Letter of Regret for applicants who are not selected.
Training advisors
At most hospitals, advisors undergo general orientation with the training or volunteer office. This
training typically includes information about confidentiality and other requirements, such as
vaccinations.
After this general orientation, the staff liaison should meet with new advisors (either individually
or as a group). Topics to cover in this meeting include:
•
Background information about hospital quality and safety, patient and family
engagement, and the principles of patient- and family-centered care.
•
Information about how patient and family advisors help improve hospital quality and
safety.
•
An explanation of the responsibilities of and expectations for advisors.
•
Tips for being an effective advisor and sharing personal stories about health care
experiences.
•
Information about how the staff liaison will support the advisor.
It is helpful to allow time during this meeting for questions, and also for a quick tour of the
hospital.
Guide Resource
Tool 11: Patient and Family Advisor Training Manual is a
manual that hospitals can use and customize.
Tool 12: Sample Confidentiality Statement provides an
example of the type of confidentiality forms that advisors
should complete.
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Training for advisor members of quality and safety committees
Advisors who will be serving as members of quality and safety committees will already be
familiar with the general roles and responsibilities of advisors and the hospital environment.
However, these individuals will need additional coaching and mentoring and specific training
directed to the work they will be doing on quality and safety committees. Potential topics to
address with these advisors will depend on your specific hospital system and needs, but may
include quality improvement models and methodologies used at the hospital, different types of
quality data collected, and a review of the importance of confidentiality and privacy.
Feedback sessions and problem solving
As staff liaison, one of your responsibilities is to provide feedback to and solicit feedback from
patient and family advisors. If you have advisors who are working on short-term projects, check
in with them periodically to see how the work is going. For advisors who are council members,
you may want to schedule a quarterly meeting to talk about how the experience is going and to
identify whether there are any areas in which the advisor needs or wants to develop their skills.
Occasionally, you may find that despite careful recruitment, selection, and training, a patient and
family advisor is struggling. If this is the case, find out why. Perhaps the advisor needs additional
training or would benefit from working closely with a mentor. Perhaps the advisor is not working
on a project or in a situation that is a good match with their skills and interests. Or perhaps the
advisor is not working in a supportive environment and is facing resistance from clinicians, staff,
or other advisors. In this case, it may be helpful to work with clinicians and staff to help them
develop more effective partnership skills.
Guide Resource
20
Tool 13: Working With Patient and Family Advisors: Part
2. Building Effective Partnerships is a PowerPoint
presentation with talking points and exercises that you can
use to help clinicians and staff develop skills for effective
partnerships. The session includes a handout called
Readiness to Partner With Patient and Family Advisors to
help clinicians and staff assess their readiness.
Implementation Handbook: Organizational Partnership Materials
Sometimes, the role of a patient and family advisor is not a good match. You may be able to
Thank you for your commitment over the last year(s) in helping us to provide a patient's (family's)
perspective on the care that we provide to our community. We have really appreciated your honest
and thoughtful comments and are hopeful that you also found the experience meaningful.
In order to get a broad understanding of what other patients (families) have experienced, we are going
to be rotating the patient (family) membership of our quality (other) committee to a new person. We
appreciate your help in this important work and want to continue to receive any thoughts and feedback
that you think may be helpful to us. If you have further ideas, please feel free to share them by
contacting [name] at [contact information] so that we can make sure we catalogue them and share
them appropriately with the committee moving forward. Thank you again for your help.
identify other ways to work with that patient and family member. In very rare cases, you may
need to ask an advisor to step down from their position. In this case, work with your volunteer
office and talk with them about how they handle these types of situations with volunteers.
Sample language for a letter asking an advisor to step down is provided below. (4)
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Step 5: Implement and Coordinate Advisor Activities
This section of the implementation handbook provides guidance for staff liaisons to help track
and communicate advisor activities.
Identifying advisor opportunities
In working with patient and family advisory councils, the staff liaison should remain alert for
strategic opportunities for advisor input. Encourage clinicians and staff to involve advisors in
making changes and improvements, and stay informed about upcoming initiatives in the hospital
that might benefit from input. Encourage staff to think about ways in which they can leverage
advisor input. In the beginning, you may need to remind clinicians and staff about the ways in
which patient and family advisors are available to help.
Guide Resource
Tool 15: Working With Patient and Family Advisors on
Short-Term Projects is a handout you can distribute to
clinicians and staff to help them think about ways in which
they can work with advisors.
It is helpful to keep a database of all advisors that includes their interests, availability, contact
information, and participation history. If your hospital will be working with patient and family
advisors on short-term or occasional projects, when staff members have specific requests, you
can use the database to identify which advisors are most suitable for the project.
If your hospital is working with advisors as members of hospital quality and safety committees,
the staff liaison should keep a current list of the committees that are seeking patient and family
advisors. The list of available opportunities can then be reviewed with advisors who might
consider taking on this new role.
Tracking and communicating advisor accomplishments
Tracking advisor accomplishments
A critical strategy for sustaining and increasing advisor engagement is informing the entire
hospital community about the work and accomplishments of advisors. This requires tracking
involvement and collecting illustrative examples to share with the hospital community.
As staff liaison, you should devise a system for measuring and tracking advisor activities, the
outcomes of projects in which advisors were involved, and the growth of advisor engagement
over time. If possible, integrate these efforts into existing processes and monitoring efforts for
volunteers at your hospital.
Information to consider collecting and reporting includes:
•
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The number of advisors or advisory council members.
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•
The number of distinct efforts in which advisors participated (e.g., councils, committees,
training and orientation events, facility design planning, feedback sessions, workgroups).
•
Total hours volunteered by advisors per year.
•
Examples of work completed (e.g., minutes from council meetings; print, web, or video
resources; revisions to hospital policies or procedures).
If advisors consult on quality and safety initiatives, work with your quality improvement
department to identify and monitor measures tied to these initiatives (e.g., outcomes, experiences
of care, risk management).
Communicating advisor accomplishments
Communicating accomplishments and achievements to clinicians, staff, hospital leadership,
advisors, and the community provides incentives for sustaining initiatives and can help create an
even broader base of support. Ways to celebrate and communicate accomplishments include the
following:
•
Publicize information about activities that involved patient and family advisors in a
variety of venues. These venues may include the hospital’s annual report, employee
newsletters, community newsletters, the hospital Web site, hospital patient television
education station, and hospital display boards. Make sure the information you provide
includes examples of ways that advisors had an impact.
•
Create opportunities to share accomplishments with leadership, for example through
the use of monthly leadership email bulletins or a summary of accomplishments. Another
idea is to develop a brief presentation for the leadership team or governing board and to
co-present with an advisor. You can also invite members of the hospital leadership team
to meet with patient and family advisors or observe activities in which they are involved.
•
Share improvements and lessons learned with others at local, regional, and national
meetings. Look for opportunities to present at conferences or to share your experiences
with workgroups or other hospitals. One of the most important things you can do is to
model patient and family engagement by co-presenting with a patient or family advisor.
Regardless of the mechanism for publicizing accomplishments, it is important to provide
ongoing and positive feedback to patient and family advisors and to the leaders, staff, and
clinicians who partner with them. This reinforces the message that the hospital is committed to
the meaningful involvement of patients and families and to engaging in effective, long-term
partnerships.
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Appendix A: Strategy 1: Patients and families as
hospital advisors
This appendix provides information about ways in which you can partner with patient and family
advisors on short-term projects.(5)
One way in which you may want to work with patient and family advisors is in implementing
other strategies from the Guide to Patient and Family Engagement. For example:
•
Solicit input from patient and family advisors about which of the Working With Patients
and Family at the Bedside strategies to pursue (e.g., Strategy 1: Communicating to
Improve Quality, Strategy 2: Nurse Bedside Change of Shift Report, Strategy 3: IDEAL
Discharge Planning).
•
Ask patient and family advisors to help you tailor and customize the Guide materials to
best meet the needs of your hospital.
•
Involve patient and family advisors in planning to implement the strategies and in
training sessions for clinicians and hospital staff.
•
Ask patient and family advisors to participate in evaluation and feedback activities to
assess how well the strategy is received and what improvements can be made.
Other examples of ways to work with patient and family advisors on short-term projects include:
•
Appoint patients and families to task forces and work groups related to facility design,
registration procedures, documentation systems, patient safety, and other quality
improvement endeavors.
•
Hold brainstorming sessions with patients and families before developing patient
education materials and involve them throughout the development process.
•
Ask patients and families to assist in adapting patient information materials to meet the
literacy and language needs of patients and families.
•
Offer opportunities for patients and families to lead or colead educational and support
programs for other patients and family members.
•
Solicit patient and family involvement in building relationships with community
programs and resources.
•
Ask patients and families to join staff when they meet with funders and community
groups.
•
Invite patients or families to present at staff orientation and inservice programs.
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•
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.
•
Convene focus groups of patients and families as specific issues arise. Ask a patient or
family member to cofacilitate 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 Walk-About 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.
Ac tivity 1: S h a rin g p e rs o n a l a n d p ro fe s s ion a l e xpe rie nc e s
This activity increases staff awareness of how care is experienced as a patient and/or family
member. It also offers an opportunity to reflect on what it is like to be actively engaged (or not)
in care and decisionmaking. It can be conducted during a training and orientation session,
committee meeting, or inservice session.
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 (6)
Core Concepts of Patient- and Family-Centered Care
Dignity and Respect. Health care practitioners listen to and honor patient and family perspectives
and choices. Patient and family knowledge, values, beliefs and cultural backgrounds are
incorporated into the planning and delivery of care.
Information Sharing. Health care practitioners communicate and share complete and unbiased
information with patients and families in ways that are affirming and useful. Patients and families
receive timely, complete and accurate information in order to effectively participate in care and
decisionmaking.
Participation. Patients and families are encouraged and supported in participating in care and
decisionmaking at the level they choose.
Collaboration. Patients, families, health care practitioners, and health care leaders collaborate in
policy and program development, implementation and evaluation; in facility design; in patient safety
and quality initiatives; and in professional education, as well as in the delivery of care.
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Ask each person to share a personal or professional example of a direct care experience that
illustrates partnerships. Encourage people to share examples that had a profound effect on them.
The examples can either be positive or negative. Although clinicians and staff can describe a
professional work experience, this activity is more meaningful when participants share a
personal experience with the health care system. Remind all 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 2-3 minutes to tell their story. Encourage everyone to
participate, but be prepared that some people might decline.
During the exercise: Be prepared to be a timekeeper and provide reminders of the 2-3 minute
expectation. Listen to the stories and include your observations of how the stories illustrate one
or more of the core concepts of patient- and family-centered care, and as appropriate, point out
how these stories illustrate important qualities of the partnership between patients and their
families and staff.
Conclusion: Thank people for sharing their experiences. As possible, note commonalities that
emerged in the storytelling process and summarize how they illustrate partnerships.
Ac tivity 2: P a tie n t a nd fa m ily s to rie s
Invite patients and family advisors to share their stories with clinicians and other hospital staff
(e.g., during meetings, workships, or training sessions). Work with advisors prior to the meeting
or training to prepare them to tell their story.
Following is a structure that it may be helpful to follow.
•
[INTRODUCE PATIENT / FAMILY MEMBER.] Thank you for talking with us today.
Stories provide a mechanism by which clinicians and hospital staff and patients can
communicate and develop a shared understanding.
•
[PATIENT OR FAMILY MEMBER] is here to share their experiences at our hospital,
including what went well, what did not go well, and what we might have done or can do
differently to improve the experiences of care.
You can either ask the patient or family member to recount their story, or use a guided technique
where you ask patients and family members to address specific questions. For example:
•
Please share with us a little about who you are, and, if you are comfortable, what
condition or diagnosis brought you to the hospital. Also tell us a little bit about your
family, if you don’t mind.
•
Please tell us about a care experience that went particularly well.
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•
Please share with us a care experience that did not go so well. If you could make a
change in the care you received, what would it be?
•
Thank you for sharing these powerful personal experiences. Your courage and generosity
will benefit all future patients and their families. Do you have anything else that you want
to share with us?
Potential additional questions include:
•
Please tell us about your first encounter with the hospital as a patient:
o What were your feelings when you arrived at the hospital? Were you frightened?
Overwhelmed? Confident? Relieved? Prepared?
•
We would welcome some insights about your hospitalization experience:
o How were you given the opportunity to communicate whether you wanted a
family member or close friend with you during your care? Was your family’s
presence and participation in your care supported in the way you wished?
o Did you, and if appropriate, did your family or trusted friend get information
about your care in a way you could understand? Was the information what you
needed and wanted?
o Were your observations and concerns about your care respected and addressed by
clinicians and staff members? Was there time available for you to ask questions?
o Can you tell us about the positive connections you made with clinicians and staff
here? What specifically did they do to build your comfort and/or trust and make
that connection?
o What did someone say or do or not say and do that failed to make a connection?
o During your hospital stay, did you feel welcomed? Did people introduce
themselves to you and your family members?
o Did you know everyone’s job title and function? Did clinicians and staff explain
their roles in your care?
o Did clinicians and staff tell you what to expect during your stay? Did they
routinely explain procedures before they were carried out and in ways you could
understand?
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Ac tivity 3: Co n d u c tin g a “wa lk-a b o u t” fro m th e p a tie n t a n d fa m ily p e rs p e c tive
The walk-about focuses attention on the expertise that patient and family advisors bring to the
table and helps build trust in and comfort with the collaborative process.
The walk-about and related meetings can also be beneficial for patients and families. It builds
their understanding of staff and clinician perspectives, and helps them understand care processes
and the environment of care. It also allows them to begin to get a broader view of the positive
elements of the system of care as well as areas for quality and safety improvement.
Instructions for the walk-about
For the walk-about, it is helpful to have two or three patient and family advisor participants.
Invite hospital leaders, clinicians, and staff to participate. One option is to tour
the facility or unit as a group. Another option is to split up into smaller groups and explore
different elements of the hospital (e.g., registration and admission process; engaging patients and
families in care, decisionmaking, and safety; and discharge process). Each of the smaller groups
should contain at least one patient and family advisor. The group should be able to complete this
activity in two hours or less.
Before starting, share the objective of the walk-about – to capture the processes, interactions,
documents, and environment of the hospital from the perspectives of patients and families. Begin
the walk-about at the first point of entry into the hospital (e.g., the parking lot), and continue to
the inpatient unit and throughout the unit. Be sure to include all areas accessible to patients and
families, including a patient room, treatment rooms, family lounge, communication center,
and/or nursing station(s).
During the walk-about, the group should explore how well the following elements support
patients and families and encourage their active engagement in care, decisionmaking, and quality
and safety:
•
Registration and admission.
•
Exchange of information among patients, their families, staff, and physicians (e.g., nurse
change of shift report, rounds, or discharge planning meetings).
•
Information about family presence during procedures.
•
Patient and family informational and educational materials or programs (e.g., support
groups, videos, inpatient television programming).
•
Process for transitions across care settings.
•
Discharge information, packets, and processes.
•
Characteristics of the physical environment (e.g., signage, wayfinding elements, artwork,
arrangement of furnishings, and sleep spaces for families).
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During the walk-about, the team should also collect “evidence.” Assign people to document the
walk-about through:
•
Digital photos or videotape.
•
Notes of observations (one individual should be designated as note-taker).
•
Blank samples of documents used throughout a patient’s hospitalization (e.g., admission
forms, informed consent, discharge materials).
•
Samples of informational and educational materials for patients and families.
•
Specific quotes or messages on posters or other public announcements.
Throughout the walk-about, encourage patient and family advisors to share their perceptions. All
team members should be given the opportunity to identify elements and processes that contribute
to the patient and family experience of care.
Hold a meeting to discuss findings
An important part of the walk-about is holding a followup meeting to discuss what was
discovered. Bring all the “evidence” to the meeting, including notes, photos or videos taken, and
forms and materials collected. The group can use a root-cause analysis model for questions and
discussion. Example questions include:
•
What do you see here?
•
What is really happening here?
•
How does this relate to the experience of care? Does it encourage and support patient and
family engagement in care and decision-making? Does it encourage and support the
engagement of patients and families?
•
Why does this current practice, situation, or concern exist?
•
How can we use the walk-about information to reinforce current best practices and guide
change and improvement in partnering with patients and families?
A facilitator should lead the meeting to ensure that all members have the opportunity to offer
their perspective and thoughts about the walk-about findings. Record all observations and
suggestions. Before the meeting ends, ask each participant to identify one change they believe
could improve quality and safety. These ideas should be documented to help foster discussion in
future meetings about planning improvements. Save and archive all of the evidence collected so
that it can serve as a resource for the planning committee. This will also provide the committee
with a historical reference to use when communicating changes and outcomes to hospital leaders,
clinicians, and other staff.
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Planning changes
After the initial meeting to discuss the walk-about findings, form a committee of patient and
family advisors and hospital staff to begin prioritizing items for change and develop action plans.
The list of changes generated during the walk-about should be shared with all committee
members at least 1 week prior to the meeting. The leader of the committee should ask members
to review the list and think about what one to three changes they view as high priority. The group
can then propose one or two projects based on the results of the walk-about.
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Appendix B: Strategy 2: Patients and families as
advisory council members
An advisory council is a formal group that meets regularly for active collaboration between
clinicians, hospital staff, and patient and family advisors on policy and program decisions. This
appendix provides information about:
•
Advisory council membership.
•
Roles and responsibilities of advisory council members.
•
Time commitments.
•
Advisory council mission statement, bylaws, and goals.
•
Budget considerations.
•
Strategies for effective advisory council meetings.
•
Ongoing support of advisory council members.
Advisory council membership
Eligibility requirements for advisory councils vary among hospitals. Some advisory councils are
made up of mostly patients and families with a few representatives from hospital staff. Other
councils find a closer balance between patients, families, clinicins, and hospital staff, although
patients and families should still be the majority membership. At a minimum, the staff liaison
attends council meetings to facilitate interactions and report feedback.
When looking for clinicians and other hospital staff to
How many people should be on
serve as council members, seek individuals who can help
an advisory council?
build relationships between the advisory council and the
Councils work best when they
hospital or unit. Look for individuals who are
have between 12 to 25 members.
enthusiastic about partnering with patients and families
Avoid creating a council that is too
and who model these behaviors in their everyday
small to accomplish its goals, or a
council that is so large it becomes
practice. Hospital staff council members should be
difficult to manage and come to
comfortable speaking about their experiences with
consensus.
patient and family members and demonstrate
commitment to improving quality and safety. For a hospital-wide advisory council, it is helpful
to recruit staff and clinicians from a variety of units and disciplines.
For information about recruiting patients and family members for advisory council membership,
see Step 4: Recruit, Select, and Train Patient and Family Advisors.
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Roles and responsibilities of advisory council members
Most advisory councils include the following roles:
•
Chair or Co-chair. The chair(s) works closely with the staff liaison to keep the council
running smoothly. This includes ensuring that the council is on track to meet its goals,
that all members are actively participating in meetings, and that activities and outcomes
of the council are communicated throughout the hospital and community. Successful
patient and family advisory councils select a patient or family member to fill at least one
of the chair positions.
•
Staff liaison. In addition to general advisor management duties, the staff liaison supports
the council and its members and helps ensure that council activities are meaningfully
integrated into changes and improvements within the hospital. The staff liaison typically
is the lead contact for other hospital members seeking to be included on the council’s
agenda.
•
Patient and family members. Patient and family council members attend meetings and
actively participate by sharing their perspectives, ideas, and feedback. They are expected
to complete orientation, annual training, and other requirements as indicated by the
council. Some councils choose to rotate positions such as meeting facilitator, time keeper,
and secretary.
•
Hospital staff or clinician members. Members of the council who are from the hospital
staff attend all council meetings and make the time to implement council initiatives in
between meetings. Staff are expected to complete any orientation and training necessary
for council members.
Time commitment
•
•
32
Most advisory councils meet once a
month for 9 to 10 months of the year
(taking one or two summer months and
December off).
Council meetings typically last between
1 ½ to 2 hours. When there is work for
members to complete in between council
meetings, this work should not take
more than 2 to 4 hours per month.
Sustaining Involvement
Most hospitals offer ways for patient and
family council members to continue to serve
as advisors after their council term is
completed.
You might ask these individuals to do things
such as serve as faculty for clinician and
staff orientation and in-service training or
join a committee such as the patient safety
committee.
Implementation Handbook: Organizational Partnership Materials
•
Patient and family advisory council members usually serve 1 to 2 year terms. It is helpful
to stagger membership terms to ensure that you have a balance of new and experienced
members. For example, as you are starting a council, you can accept 12 to 15 members in
the first year. For the second year, recruit 10 to 12 additional members. In this way, you
have the benefit of new advisors who bring fresh perspectives coupled with veteran
members who can mentor and support the new members.
Advisory council mission statement
Creating a mission statement helps guide and focus the work of the advisory council. Mission
statements typically indicate the purpose for the council, outline major goals, and identify the
key stakeholders.
Mission Statement from the Dana-Farber Cancer Institute’s Adult Patient and Family Advisory
Council
The Adult Patient and Family Advisory Council is dedicated to assuring the delivery of the highest
standards of comprehensive and compassionate health care by Dana-Farber/Brigham and Women's
Cancer Center. We do this by working in active partnership with our health care providers to:
•
Strengthen communication and collaboration among patients, families, caregivers and staff.
•
Promote patient and family advocacy and involvement.
•
Propose and participate in oncology programs, services, and policies.
Advisory council bylaws
Advisory councils may also establish bylaws to guide how the council functions and to outline
the responsibilities of council members.
These bylaws typically include functional
issues such as:
•
Who is eligible for membership.
•
Expectations for how long a
member serves on the council.
•
Council meeting schedule.
•
Specific council member roles and
responsibilities.
Find sample bylaws on the following hospitals’
websites:
•
Dana-Farber/Brigham and Women’s Center
(Boston, MA) Adult Patient and Family
Advisory Council Bylaws: Available at:
www.dana-farber.org/pat/pfac/establishingpatient-centered-care.html
•
Eastern Maine Medical Center, (Bangor, ME)
Advisory Council Bylaws: Available at:
www.emmc.org/family_centered_care.aspx?id
=33368.
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33
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.
For additional detail and information
about developing advisory councils,
see the Guide for Developing
Community-Based Patient Safety
Advisory Council, Available at:
www.ahrq.gov/qual/advisorycouncil
Bylaw development and approval can take time since the bylaws should be established in
conjunction with all members of the council. A new advisory council may want to generate a few
guiding principles or norms and then wait until a sub-committee can be formed to develop more
formal bylaws.
Advisory council goals
If the council is a new venture, 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, talk about, 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.
Budget considerations
At a minimum, hospitals should reimburse patients
and families for expenses incurred during their
work on the advisory council (e.g., parking,
transportation, child care). 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.
Download A Patient and Family Advisory
Council Workplan: Getting Started to help
organize the creation and maintenance of
patient and family advisory councils.
Available at:
www.ipfcc.org/tools/downloads.html under
“Tools to Foster Collaboration with Patient
and Family Advisors.”
This tool is from the Institute for Patient- and
Family-Centered Care.
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.
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Think creatively about 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 other hospitals write
grants to community organizations or foundations.
Strategies for effective advisory council meetings
The first few patient and family advisory council meetings are critical for setting the tone and
establishing an appropriate meeting structure. The strategies in this section will help you prepare
for and run effective meetings.
Prior to the meeting, make sure you know how members prefer to have materials sent to them
(e.g., email, fax, or regular mail). At least one week before the meeting, mail out the agenda and
any materials to give council members the chance to prepare. Many councils also find it helpful
to have staff or a council member volunteer make a reminder phone call to council members two
to three days before the meeting.
On the day of the meeting, place signs to let advisory council members know where to go. Plan
to be in the meeting room at least 30 minutes ahead of start time to set up the room, distribute
materials, set out name tags or tent cards, organize refreshments, and set up and test any
audiovisual or computer equipment. This allows for you to be fully present to welcome and help
council members settle in before the meeting starts.
Consider how the room is set up to ensure that all members can see one another and that there is
room for wheelchairs or other adaptive equipment, as appropriate. If you have advisors who have
limited functionality, request a quick consult from an Occupational Therapist or other
appropriate staff member at your hospital about how you might adapt the room to make it more
comfortable and not draw attention to the different functional levels of advisors.
As members enter the meeting room, make sure that each person is personally welcomed by the
staff liaison and the chair of the council (if one has been identified in the council member
selection process). Make sure council members know where refreshments are and where the
nearest restroom is located. Find out if they have any logistical questions, such as parking
reimbursement, if there is time before the meeting begins.
To p ic s to c o ve r a t th e in itia l a d vis o ry c o u n c il m e e tin g
At the very first advisory council meeting, much of the agenda will be devoted to introductions
and reviewing the purpose, goals, and structure of the advisory council.
•
Introductions. Allow enough time for all advisory council members to introduce
themselves (2 to 3 minutes per person). You may want to introduce yourself first to help
model an introduction that keeps within the allotted time. Consider adding an icebreaker
question to help people get to know each other on a more personal level. Let council
Implementation Handbook: Organizational Partnership Materials
35
members know that there will be time on the agenda for the first several meetings to
share more about themselves.
•
Purpose and goals of the council. The purpose and general goals of the council will
likely have been communicated to all council members, but it is helpful to review. You
may want to type the purpose and goals on the bottom of the agenda or post them on a
flip chart for everyone to see throughout the meeting. Let the council know that at the
next several meetings they will be asked to suggest, discuss, and prioritize specific goals
and activities for the council to work on. Mention that the group also may decide to
develop a mission statement after a few meetings.
•
Meeting procedures. The chair(s) and/or staff liaison will lead and facilitate the
meetings, but councils may want to identify additional roles to ensure the effectiveness of
the meetings. For example, it is helpful to have a secretary who is responsible for taking
notes during the meeting and developing minutes to distribute to council members. For a
new advisory council, this role is best assigned to a hospital staff member. It is also
useful to have a timekeeper to ensure that meetings are productive and stay on track. This
person should monitor times allotted for specific agenda items and give members a
warning a few minutes before time is up. Another decision to be made in the first meeting
is about the best times for future meetings. If consensus cannot be reached about the
“best” time to meet, the group may wish to rotate meeting times.
•
Ideas for improvement. During the first council meeting, there may not be time to
discuss specific activities. However, if the staff liaison and/or chair have identified an
initial activity for the council to begin working on, the council members can provide
early input and feedback. It is best to select an initial activity that will be relatively easy
for the council to accomplish within a few months. For example, you could ask council
members to think about their experience of the admission process, and share one thing
they would change. If there is not time on the agenda, this could be planned as an activity
to think about and discuss at the next meeting.
•
Closing. The staff liaison or chair should ask if there are any questions or comments
before the meeting ends. Let all council members know the appropriate person (e.g., staff
liaison, advisory council co-chair) to reach if they have questions before the next meeting
and make sure they have accurate contact information. Also let them know that the staff
liaison will contact each council member to have a short discussion about their reactions
to the first council meeting.
A sample agenda for the initial advisory council meeting is shown on the next page.
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Sample Advisory Council Meeting Agenda (2 hours)
•
Introductions (60 minutes). Each member takes 2 to 3 minutes to tell a bit about
themselves.
o
o
o
o
o
My name is…
For patient and family advisors: I choose this hospital for my care because…
For staff members: I choose to work at this hospital because…
I wanted to join the advisory council because…
Optional icebreaker question: One thing about me you would not guess is…
•
Review agenda (5 minutes)
•
Purpose and goals of the patient and family advisory council (15 minutes)
o
o
•
Purpose: [Edit as necessary.] The purpose of the advisory council is to bring
together, on a regular basis, patient and family advisors with hospital staff to plan
and discuss changes that will help improve the safety and quality of care at this
hospital.
Goals: [Edit as necessary.] The general goals are: (1) To provide feedback and
advice for changes to hospital policies, care practices, and materials that will help
patients and families be actively involved in their own health care. (2) To help create
materials and strategies for improving health care quality and safety for all patients.
(3) To help hospital staff carry out changes and improvements in the experience of
care.
Meeting procedures and roles (10 minutes)
o
o
o
Secretary
Timekeeper
Meeting dates and times
•
Ideas for improvement and potential initial activities (20 minutes)
•
Closing (10 minutes)
To p ic s to c o ve r d u rin g s u b s e q u e n t me e ting s
For future meetings, the council chair(s) should develop an agenda with council member input.
Because a key goal of the council is to elicit multiple points-of-view and allow time for
discussion, be sure the agenda includes ample time for these discussions. In the beginning, it may
be helpful to schedule time for small group breakout discussions to allow members to become
comfortable working with each other. As the council matures, most of the agenda will be
devoted to the work and less time will be needed for relationship building.
Agendas should also include time for:
•
Introducing any guests or new members.
Implementation Handbook: Organizational Partnership Materials
37
•
Announcements from members.
•
Evaluating the meeting and getting ideas for meeting improvement.
•
Identifying follow-up items (including due dates and the names of members who are
responsible for them).
•
Soliciting suggestions for the next council meeting agenda.
Eva lu a tin g th e m e e tin g
Quick written or verbal meeting debriefs at the end of council meetings can help in making
adjustments to council operations and functions. Spend a few minutes asking questions such as
“What went well during this meeting?” and “How can we improve future meetings?” Keep
people focused on the process and not individual behaviors. For example, “I noticed the
discussion around XX got a little off topic” and not “XX spent too much time talking about an
unrelated issue.” Be sure to take time at each meeting and at least once a year to celebrate
accomplishments – big and small.
Ongoing support of council members
One of the most critical roles of the staff liaison is to provide ongoing support and guidance to
council members.
En c o u ra g e pa rtic ipa tio n
During advisory council meetings, the staff liaison should work closely with the council chair(s)
to support active participation of all members. If someone has not had a chance to share an idea
or give feedback, the staff liaison can make sure that the chair(s) calls on the individual and asks
if they have something to share. Other more spontaneous methods to encourage and support
participation are one-on-one discussions on select topics with followup reporting, or asking
everyone to write their ideas related to a specific topic and then share with the group. Not
everyone will have an idea or anything to add, but you want to ensure that anyone who wants to
participate in discussions has a chance to do so. If a member is routinely not participating in
advisory council meetings, the staff liaison and council chair(s) can offer to meet with this
person to find out if there are ways they can be supported to be more active.
Es ta b lis h n o rm s a n d g ro u n d ru le s
Advisory council members need to know what is expected of them. An obvious expectation is
that council members will show up for and participate in meetings, or inform the liaison or
chair(s) if they are going to be absent. When patients and families serve as advisors, there may
be events or circumstances that prevent them from coming to a meeting (e.g., a hospitalization,
an acute or chronic illness that limits their activity). If an advisor misses several meetings, the
staff liaison should call them and find out if they need additional support to get to meetings or if
they need to take time off from the council or resign their position.
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During meetings, remind council members of the importance of sticking to the time limits for
each agenda item. If a council member is going on too long or getting off topic, politely stop
them, and either let them know that you want to make sure that there is enough time in the
agenda to let everyone have a chance to speak or that the topic they are bringing up may be
appropriate for a future meeting. You can say, “I wonder if we can stop here and ask others for
ideas…” or “It sounds like this is an important issue for you, so we may want to allocate time in
a future meeting for discussion or I can discuss it with you after the meeting…”
Ma n a g e c o n flic t
There may be times when challenging situations arise during an advisory council meeting. One
of the most important roles for the staff liaison and chair(s) will be to identify and manage
conflicts constructively as they arise. Here are some helpful strategies:
•
Acknowledge that, at times, there will be tensions and differing opinions.
•
If you become aware of a conflict during a meeting, take the time to stop the group and
reflect back to the group what you are hearing. Listen to each side. Remind everyone of
the topic of discussion and ask for ideas about resolving the disagreement.
•
If the conflict cannot be managed effectively within the council meeting, offer the
opportunity to hold a discussion before the next meeting.
•
Make sure that everyone who wants to participate is invited to discuss the conflict and
work on resolution.
•
During the conflict resolution meeting, ensure that everyone has a chance to voice their
perspective. Clarify perspectives and also how each is connected to the goals of the
council. Keep the focus on the goal and purpose of the original task and not the conflict
or individuals involved.
•
Be available to debrief with all meeting participants.
•
On the rare occasion that you are not able to manage the conflict, you may want to
consider asking a hospital staff member with experience in facilitation to lead the
discussion.
Ac kn owle d g e d iffic u lt e m o tio n s
There may be times when council members experience strong emotions – for example, telling
their own story, or hearing a story that triggers memories. The staff liaison and chair(s) should be
mindful of these occurrences and make sure the council member receives support. After the
member finishes sharing their experience, it may be helpful to step back from the agenda item
and acknowledge the emotions the story brought up and ask if anyone wants to reflect. Ask if the
council needs a short break before coming back to the agenda. After the meeting, the liaison can
check in with any members that may need an individual reflection.
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39
De b rie f re g u la rly
In between meetings, it is important for the liaison and council chair(s) to be available to all
council members for feedback and encouragement. For new council members, it is helpful to
debrief regularly about their participation on the council. This is an opportunity to identify
strengths that you see, solicit thoughts about how the council member wants to improve their
involvement, and gently offer suggestions for improvement. If they desire, they can make a goal
with you and you can set a future date to discuss progress.
Re vie w a n n u a lly
All council members should go through an annual review process. This process can be tailored
according to the review process you have for other hospital volunteers.
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Implementation Handbook: Organizational Partnership Materials
Appendix C: Strategy 3: Patients and families as
members of hospital quality and safety committees
Engaging patient and family advisors as members of quality and safety committees requires
close collaboration between the hospital leadership team, existing members of hospital quality
and safety committees, patient and family advisors, and the staff liaison for patient and family
advisors. In particular, the staff liaison has a critical role in supporting operational processes for
advisor engagement, modeling collaboration, and providing mentorship for these efforts.
Preparing quality or safety committees for advisors’ participation
The first step in the process is to assess the committees’ readiness to partner with patient and
family advisors. The staff liaison can schedule an initial meeting to discuss advisor participation.
During the meeting, allow time for committee members to raise challenges and concerns, and
explore how confident each member is about involving patients and families on the committee.
As needed throughout the meeting, address concerns and ask members to generate possible
solutions. Also recognize that not all concerns may be addressed in one meeting; plan to follow
up as needed. Specific topics to discuss during the meeting include:
•
Benefits of patient and family involvement.
•
Previous experiences with patient and family advisors.
•
Underlying fears and concerns about working with
patient and family advisors.
•
Committee members’ perspectives on data transparency.
•
Flexibility around general aims and specific
improvement projects.
•
Senior leadership support for patient and family
involvement.
•
Collaboration and teamwork.
Advancing the Practice –
Patient and Family Advisors
and Leaders contains
information about and
examples of how patient and
family advisors have been
involved with safety and quality
programs. Available from the
Institute for Patient- and
Family-Centered Care at:
www.ipfcc.org/advance/pafam.
html
The Partnering With Patients and Families to Accelerate Improvement: Readiness Assessment
(7) shown on the next pages is a tool that can be used to guide the committee’s discussion and
identify planning steps for involving patient and family advisors on the committee.
Implementation Handbook: Organizational Partnership Materials
41
Partnering With Patients and Families to Accelerate Improvement: Readiness Assessment
Area
For each item, circle the box that best describes your team’s perspective and experience.
Data transparency
Our team is uncomfortable with the
possibility of sharing performance
data with patients and family
members.
Our team is comfortable with sharing
improvement data with patients and
families related to current
improvement projects.
This organization has experience with
sharing performance data with patients
and families.
Flexibility around
aims and specific
changes of
improvement project
We have limited ability to refine the
project’s aims or planned changes.
We have some flexibility to refine the
project’s aims and the planned
changes.
We are open to changing both the
aims and specific changes that we test
based on patient and family members’
perspectives.
Underlying fears and
concerns
We have identified several concerns
about involving patient and families
on improvement teams and would
need assistance in creating a plan
for addressing them.
We have identified several concerns
related to involving patients and
families on improvement teams but
believe we can create a plan for how
to address or manage them.
We have a plan to manage and/or
mitigate issues that may arise due to
patient and family member
involvement on our team.
Perceived value and
purpose of patient
and family
involvement
There is no clear agreement that
patient and family involvement on
improvement teams is necessary to
achieve our current improvement
aim.
A few of us believe patient and family
involvement would be beneficial to
our improvement work, but there is
not universal consensus.
There is clear recognition that patient
and family involvement is critical to
achieving our current improvement
aim.
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Implementation Handbook: Organizational Partnership Materials
Area
For each item, circle the box that best describes your team’s perspective and experience.
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.
1. What supports moving in the direction of involving patient and family advisors?
2. What are your current challenges?
3. How confident are you on 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)? _______
Implementation Handbook: Organizational Partnership Materials
43
Preparing advisors to participate on quality and safety committees
As members of quality and safety committees, advisors will need additional information and
training to help them perform effectively in their role. Depending on the committee and tasks,
this may include training on quality improvement methodology, quality data, problem solving
methodology, and privacy and confidentiality.
Qu a lity im p ro ve m e n t m e th o d o lo g y
To better understand the quality improvement
process, it is helpful for advisors to become familiar
with the specific model for improvement used at the
hospital. This will help advisors develop a more
complete understanding of how changes are planned,
implemented, evaluated, and disseminated.
The Institute for Healthcare
Improvement has information about
quality improvement methods on their
website that hospitals may wish to share
with advisors. Available at:
http://www.ihi.org/IHI/Topics/Improvement/I
mprovementMethods/
Exploring quality data
Quality and safety committees frequently work with quality and safety data, including data from
patient and family experience of care surveys. Patient and family advisors will benefit from a
basic understanding of how to interpret and apply quality data to generate solutions or
improvement processes.
Staff liaisons may wish to provide advisors with the following:
•
An orientation to survey instruments that are
used to collect quality data.
•
A high-level overview of implementation
methodology.
•
Training to strengthen numerical literacy (i.e.,
help them interpret numbers and statistics).
Using Patient Feedback: A Practical
Guide to Improving Patient Experience
is a resource developed by the Picker
Institute to help people understand how to
use information from patient experience of
care surveys. Available at:
www.pickereurope.org/usingpatientfeedba
ck.
Problem solving methodology
A common activity for safety committees is examining specific errors that occur in the hospital
and identifying changes that can prevent the error from being repeated. Many hospitals use a
process called root-cause analysis to illuminate the events and decisions that led up to the error.
Patient and family advisors who serve on a safety committee may need information and training
on the specific process your hospital uses to investigate safety events and errors. It also may be
helpful to review several case studies with advisors to walk them through the analysis process.
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Implementation Handbook: Organizational Partnership Materials
Importance of privacy and confidentiality
During orientation to become an advisor or a member of an advisory committee, advisors signed
a confidentiality agreement. Because committees focused on quality and safety often share data
about the hospital and conduct individual case reviews, it is important to routinely review this
statement and remind all committee members of their commitment to maintain privacy and
confidentiality.
Guide Resource
Tool 12: Sample Confidentiality Statement provides an
example of a confidentiality agreement for advisors.
Integrating patients and family advisors into quality and safety work:
Initial steps
The following strategies and tips can help expand your efforts to integrate patients and family
advisors into quality and safety work.
•
During the hospital’s annual planning process, encourage staff and administrators to
incorporate specific patient and family engagement initiative(s) and strategies into their
unit’s or department’s goals.
•
Review current literature related to
involving patient and family advisors in
quality improvement initiatives. This is a
way to build capacity for effective
participation in quality improvement and
other initiatives. If the hospital has journal
clubs, provide resources to help broaden
the number of staff and faculty who are
knowledgeable about the current
literature.
•
Current bibliographies of quality and safety
topics are available from:
The Institute for Patient- and FamilyCentered Care, available at:
www.ipfcc.org/advance/supporting.html
The Picker Institute, available at:
www.investinengagement.info/SiteGuidetop
Create positive experiences for staff to experience the benefits of advisor perspectives
and guidance by:
o Supporting opportunities for advisors to share their stories at staff meetings,
clinician trainings, and other hospital presentations.
o Acknowledging advisor contributions to new materials, redesigned processes, or
other projects.
o 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.
Implementation Handbook: Organizational Partnership Materials
45
•
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 in quality and safety improvement initiatives. 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 quality and safety committees, 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 committee members to participate actively in the orientation of new patient
and family advisor members. This helps patient and family advisors feel welcome and
also facilitates their understanding of the purpose of and goals for the committee.
•
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 committee rosters and use
tent cards to help with name recognition.
•
Encourage the committee to build in agenda time for sharing of stories or ice-breaker
activities that help all members build trust and establish a good working relationship.
•
Ask the committee chair to recruit experienced
members of the committee to mentor a new patient or
family advisor on the committee. Mentors can contact
the advisor after each meeting to answer questions and
make sure the advisor remains confident with their
participation. This commitment does not need to be
long standing; 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 they need the mentorship to continue.
46
The Quality Improvement Toolkit is
a resource from the Cystic Fibrosis
(CF) Foundation designed to help
patients with CF and their families
become partners in improving care
quality. Although it is written for CF
patients and their families, the
resource contains useful information
about supporting patients and families
as partners in quality improvement.
Available at:
www.cff.org/LivingWithCF/QualityImpr
ovement.
Implementation Handbook: Organizational Partnership Materials
•
Encourage the chair of the committee to strategically analyze the tasks and goals of the
committee to seek opportunities for involving advisors in both short and long-term
initiatives the committee is addressing. As possible, encourage an initial focus on projects
that have the potential to be “small successes” (i.e., short-term projects that are highly
likely to succeed). Make sure that these successes are celebrated and communicated
throughout the hospital (e.g., through employee newsletters or internal employee
listservs).
Sustaining involvement
•
Ideally, when committees engage patient and family advisor members, advisor
involvement is throughout all phases of an initiative – from conception of the idea to
planning, implementation, evaluation, and sustaining the effort over time. However, there
will be times when advisor participation may be requested mid-stream in the design of a
project. In this case, ask the committee chair to ensure that advisors are given sufficient
information to help them understand the background of the project and steps already
completed.
•
As committee chairs develop plans to involve patient and family advisors, encourage
them to consider which aims and specific charges of the project are flexible. Keeping the
focus on these aspects of the projects ensures that advisors’ time is directed at those
features that are amenable to change. Likewise, committee chairs should also be
encouraged to develop advisor members’ understanding of standards of practice,
regulatory standards, or other features of the care delivery system that cannot be changed
or modified, including the reasons why.
•
Encourage committee chairs to model transparency and ownership of patient safety and
quality related issues, including acknowledging issues that are ongoing problems
requiring attention. Encourage the chair to frame discussions of safety issues in a way
that embraces just culture and the view that errors represent systems breakdowns as
opposed to an individual’s mistake.
•
The staff liaison should be accessible to and supportive of committees as they work to
embrace potential solutions that may create a “new way of doing things.” The staff
liaison can work alongside the committee’s chair if help is needed to gain cooperation
from other departments and leadership.
•
Acknowledge that there will be differing opinions and perceptions, and occasionally
tensions. When there are extreme differences in opinions or perceptions, the staff liaison
should encourage the committee chair to consider facilitation methods to navigate and
bridge these differences. This may include:
Implementation Handbook: Organizational Partnership Materials
47
o Asking for assistance from a hospital staff member who is not part of the
committee and who is recognized as a skilled facilitator.
o Appointing a task force or subcommittee for further study of the issue.
o Asking the opinion of another group (e.g., another committee with experience
involving patient and family advisors or a patient and family advisory council).
o Delaying a decision and gathering additional information as needed, and
developing a timeline for final decisionmaking.
•
Encourage the chair to periodically place on meeting agendas time to discuss how well
the process of having patient and family advisors partnering with staff and clinicians is
working. Ask for suggestions and incorporate strategies to improve the involvement of
patient and family advisors.
Communication tips
The following tips can help all members of the quality and safety committee, including patient
and family advisors, engage in meaningful conversations.
•
Be wary of information overload; do not try to communicate everything at once. When
working with a complex issue, break it down into manageable pieces or elements. Find
ways to make complex issues understandable (e.g., through logic models, cause and
effect diagrams, or other schematic diagrams).
•
Be prepared with more detailed materials that the committee members can review after
the meeting.
•
Leave a substantial amount of time for questions.
•
Identify a feedback loop at the end of the meeting so that members can contact project
leads or presenters between meetings, if needed.
•
Develop and share plans for followup.
•
Committee members should be prepared to talk openly. Know that both staff and advisors
are prepared for honesty in these conversations.
In addition, during committee meetings, be mindful how communication style and language used
can either create an inclusive or exclusive environment. For example, using acronyms or medical
terms can create an atmosphere in which patients and family advisors feel like outsiders. The
following guidelines can help promote an inclusive atmosphere and facilitate comprehension:
• When reviewing or sharing data, present the information in a way that individuals
without a clinical or statistical background can understand. Explain data using plain
language and discuss what the data mean and why they are important.
48
Implementation Handbook: Organizational Partnership Materials
o Bring data and figures alive by including patient and family quotes, or by asking a
patient and family advisor to share a care experience that brings life to the
numbers.
o When presenting data, graphs often provide a better visual depiction than tables.
o When presenting data, use whole numbers, for example “about 1 out of 1000”
instead of “less than 0.08.” Also, use natural frequencies instead of percentages,
for example “3 out of 100” instead of “3 percent.” When possible, use a common
denominator and report the time frame.
o Help people understand the direction of an effect or the significance of results by
using evaluative labels with numbers or other anchors (e.g., better than, worse
than, the same as, common, rare, etc.).
• Unfortunately, some jargon and acronyms are hard
The Agency for Healthcare
Research and Quality provides
to avoid in quality and safety improvement projects.
a variety of patient safety
To avoid issues associated with jargon and
resources for health systems,
acronyms, encourage advisors to ask for an
providers, and consumers.
explanation or definition if anyone on a committee
Available at:
uses a term they do not understand. It may be
http://www.ahrq.gov/qual/pstool
s.htm
helpful to encourage committee members who are
beginning to work with patient and family advisors
to develop a list of any acronyms and jargon associated with safety and quality
improvement. Advisors and staff members can collaboratively develop and add on to
this list as necessary. Hospital staff who are new to quality and safety improvement also
find this list of acronyms and jargon to be helpful.
Safety and quality committees that are new to having patient and family advisors as members
should consider selecting initial projects that are most likely to be successful. For example, focus
on projects that:
•
Are identified as high priority by the majority of committee members, including patient
and family advisors.
•
Are not prohibitively complex (i.e., the effort can be broken down into small achievable
steps or designed as individual projects).
•
Can be measured.
•
Require minimal resources for changing.
•
Have a high likelihood of support from administrators, clinicians, and staff.
Implementation Handbook: Organizational Partnership Materials
49
Patient and family advisors: Reaching out to current patients and
families
Hospitals may also wish to involve patient and family advisors to quality and safety committees
in obtaining real-time feedback on hospital practices. Because patient and family advisors do not
provide direct care, patients and families may be more candid with them than they are likely to
be with clinicians or hospital staff that provide care to them or their family members. For this
reason, providing opportunities for patient and family advisors to communicate directly with
patients and families can help hospitals obtain a more complete picture of patients’ and families’
experiences of care. In addition, these opportunities can increase the visibility of patient and
family advisors, resulting in greater awareness of the role of patients and family members as
collaborators in system improvements.
There are multiple methods for collecting patients’ and families’ views and experiences with the
help of patient and family advisors. Options include asking advisors to:
• Facilitate a small group discussion with recent patients and family members to obtain
information about how to improve specific processses. The group should contain
between six and 10 people and last about 2 hours. Small group discussions are a good
opportunity to obtain a range of perspectives on a specific topic or issue (e.g., getting
feedback on the admissions process, bedside change of shift report, or discharge).
• Conduct one-on-one interviews with patients or family members to collect more detailed
information about experiences of care. These interviews can be conducted with recent
patients and family members, or even with current patients and family members (see
information below about having patient and family advisors visit units).
• Conduct an observation to obtain information about care processes. When implementing
a new patient safety or quality practice, it can be helpful to involve experienced patient
and family advisors as observers to collect information on new practices from a patient
and family perspective. Provide advisors with a checklist of things to assess (e.g.,
whether certain things happen during the bedside change of shift report) and provide
them with training about being an objective observer. Advisors also can be helpful in
soliciting real-time feedback from patients and families on the unit where changes have
been implemented, for example, by coupling the observation with real-time interviews.
• Assist with distributing and encouraging patients and family members to complete
questionnaires about their experiences in the hospital. Another option for obtaining realtime feedback is to create a brief survey with open-ended questions about the general
experience of care, environment of care, respectful communication experience, and/or
specific workflow issues. Hospitals may also wish to add questions to obtain feedback on
experiences related to a new process design (e.g., the patient and family perspective of
50
Implementation Handbook: Organizational Partnership Materials
bedside change of shift report). Getting patients and families to complete this type of
brief survey is not always easy. However, experienced patient and family advisors can be
trained to help increase the rate of response, while still being respectful of the patient’s
and family’s stress, mindset, and situation while in the hospital.
Guidance for having patient and family advisors interact with current patients and
family members
In planning for advisors to interact with current patients and family members, advisors will need
concrete information about roles and responsibilities, time commitments, and training activities.
On-the-unit roles also make it critically important that advisor training include background
checks, compliance with institutional training requirements for HIPAA, and required
immunizations and health screenings. Advisors also need to understand that respecting the
personal priorities of the patient and family is essential. The stress and exhaustion of a hospital
stay may lead to patients and families not wanting to speak with advisors.
In working with advisors in this capacity, the staff liaison or staff lead of the quality and safety
committee should:
•
Schedule advisor presence on the unit and make sure it is approved by the nurse manager
and/or charge nurse. Often, there are days of the week and times of day that are better in
terms of unit workflow and process.
•
Request that the advisor, upon entering the unit, locate and introduce him/herself to the
Charge Nurse or nurse lead for the day. The advisor should reconfirm that the time is still
convenient for the advisor to be on the unit. Additionally, the advisor should be prepared
to do the following:
o Confirm that the manager or Charge Nurse has informed the floor staff that the
advisor will be on the unit that day.
o Go over the list of patients and families on the floor with the Charge Nurse to
identify patients and families not to approach (e.g., due to health issues, infection
control constraints, or other staff concerns).
o Confirm the name and contact information for the person on the unit who is the
appropriate point of contact for the advisor if an issue needing immediate
attention is raised.
o Ask if an interpreter is needed to communicate with any of the patients and
families currently on the unit, and determine if this resource is available.
•
Advisors should always visibly wear their name badge on the unit. Upon entering a
patient’s room, advisors should introduce themselves, explain their role to the patient and
family, and ensure that it is a good time to speak with them.
Implementation Handbook: Organizational Partnership Materials
51
•
Advisors should be coached to return to a patient’s room at a later time if a clinician or
staff member is in the patient room, the patient is having their meal, or the patient is
actively undergoing treatment or testing.
•
Ensure that advisors thank the patient and family member they speak with, regardless of
the result of the encounter.
In speaking with hospitalized patients and families, advisors need to be prepared with strategies
for issues that may arise, including how to offer immediate communication to the unit or hospital
staff about urgent problems. Advisors should have information about who patients and families
can call if they want to initiate working with a staff member for resolution or clarification.
However, it is always important to distinguish between a concern or issue that needs immediate
attention and notification of a doctor, nurse, or patient advocate/patient relations representative
and concerns or issues that build awareness of the patient and family experience.
After the observation, it is important to work with advisors to ensure clear followup and
debriefing. Results of the observation and written reports should be communicated to both the
unit and the quality and safety committee. Results should be considered in terms of their abiltiy
to inform potential quality improvement projects and to identify areas in which patient and
family advisors can help improve systems and processes.
1
The Guide was developed for the Agency for Healthcare Research and Quality (AHRQ), in the U.S. Department of
Health and Human Services, by a collaboration of partners with experience in and commitment to patient and family
engagement, hospital quality, and safety. Led by the American Institutes for Research (AIR), the team included the
Institute for Patient and Family-Centered Care (IPFCC), Consumers Advancing Patient Safety (CAPS), the Joint
Commission, and the Health Research and Educational Trust (HRET). Other organizations contributing to the
project included Planetree, the Maryland Patient Safety Center (MPSC), and Aurora Health Care.
2
Materials in this handbook have been adapted from resources from the Institute for Patient- and Family-Centered
Care (IPFCC), Bethesda, MD, www.ipfcc.org, and from Leonhardt K, Bonin D, Pagel P. Guide for developing a
community-based patient safety advisory council. Rockville, MD: Agency for Healthcare Research and Quality;
2008. Available at: http://www.ahrq.gov/qual/advisorycouncil.
52
Implementation Handbook: Organizational Partnership Materials
References
1.
Charmel PA, Frampton SB. Building the business case for patient-centered care. Healthc
Financ Manage. 2008;62(3):80-5.
2.
Fondrick M, Guill Ryan H. The role of staff liaison for councils and other collaborative
roles with patients and families. Presented at Hospitals and Communities Moving Forward for
Patient- and Family-Centered Care 2010.
3.
Patient Family Advisory Council. Report to the Massachusetts Coalition for the
Prevention of Medical Errors. Boston, MA: Brigham and Women's Hospital; 2009.
4.
Slonim T. Personal communication. 2010.
5.
Jeppson E, Thomas J. Essential allies: families as advisors. Bethesda, MD: Institute for
Patient and Family-Centered Care; 1994.
6.
Institute for Patient- and Family-Centered Care. Frequently asked questions (FAQ).
Bethesda, MD: Institute for Patient- and Family-Centered Care; 2010 [updated December 29,
2010; cited 2011 January 28]; Available from: http://ipfcc.org/faq.html.
7.
Cincinnati Children’s Hospital Medical Center, Institute for Healthcare Improvement.
Partnering with patients and families to accelerate improvement: readiness assessment. [cited
2011 28 January]; Available from: http://www.newhealthpartnerships.org/provider.aspx?id=236.
Implementation Handbook: Organizational Partnership Materials
53
Organizational Partnership
Materials: Leadership Support
[Insert hospital name, presenter name and
title, date of presentation]
Organizational Partnership Tool 1: Leadership support presentation
Today’s presentation
Who are patient and family advisors and what
do they do?
What are the benefits of working with patient
and family advisors?
What leadership support is needed for this
effort?
Patient and family advisors
Who are they?
What do they do?
Advisors: Who they are
Patients and family members who have
received care at this hospital and who want to
help improve care experiences for others
♦
Undergo rigorous application screening
process
♦
Receive training
Advisors: What they do
Patient and family advisors help us improve the
quality and safety of the care we provide
♦
Provide input and feedback
♦
Identify potential changes and improvements
♦
Plan and implement changes that matter to
patients and families
The benefits of working with
patient and family advisors
Benefits of working with advisors
Insight to help translate actual care experiences
to improvements in care for other patients and
families
Integrates patients and families into developing
priorities for change
Leads to improved practices and better use of
resources - leading to higher quality, safer care
Why should we do this?
Consistency with our mission and vision
Desire to be at the forefront of where health
care is going
Consistency with our strategic priorities
Desire to demonstrate commitment to patientand family-centered care
What leadership support is
needed?
Importance of leadership support
Commitment of senior leaders is one of the
most critical determinants of success
Leaders:
♦
Set expectations
♦
Model behaviors
♦
Mobilize and help sustain the effort
♦
Provide resources
Leadership support needed
Designate resources to support operational
functions
Develop and support “staff liaison” position:
♦
Coordinates recruitment, selection, training,
and placement of advisors
♦
Mentors advisors and monitors progress
♦
Updates leadership, clinicians, and hospital
staff about accomplishments and outcomes
Leadership support needed (cont.)
Leadership participation to demonstrate
support
♦
Visible communications to spread and
reinforce importance of patient and family
advisors
♦
Alignment of Volunteer Services or HR or
Red Cross [choose one] to support advisor
recruitment and training
♦
Commitment to act on advisor guidance
[Note: hospitals may wish to end the
presentation in one of the following ways:
♦
Download and show the Best Practices AHA Video: Patient- and Family-Centered
Care: Partnerships for Quality and Safety
♦
Ask a patient or family advisor to speak to
leadership about their experiences]
“In a growing number of instances where truly
stunning levels of improvement have been
achieved, organizations have asked patients and
families to be directly involved in the process.
And those organizations’ leaders often cite this
change—putting patients in a position of real
power and influence, using their wisdom and
experience to redesign and improve care systems—
as being the single most powerful transformational
change in their history.”
Reinertsen, J.L., Bisognano, M., & Pugh, M.D. (2008). Seven leadership leverage
points for organizational-level improvement in health care (2nd ed.) Cambridge, MA:
Institute for Healthcare Improvement.
Thank you!
For questions or more information:
[Insert contact name and information]
[NOTE: Use this quote or include a quote
from someone at your own hospital.] “Patient
and family advisors have knowledge we don’t
have…It is so humbling to realize that patients
and families know more about [the hospital]
than you do.”
Pat Sodomka, former hospital administrator
What do patient and family
advisors do?
Why should you become a
patient and family advisor?
[NOTE: Personalize this section for your
hospital as appropriate.] As a patient and
family advisor, you may be asked to:
At [insert hospital name], patient and family
advisors help us improve the quality and
safety of care we provide.
•
Provide feedback on policies and care
practices. We may ask advisors about
how to improve the things we do, such as
discharging a patient from the hospital.
People who have been patient and family
advisors say they get something out of it too:
•
The chance to meet and work with other
people.
Review or help create informational
materials. As you know, we give a lot of
materials to patients and families while
they are in the hospital – forms, health
information, medication lists, and
discharge instructions. Patient and family
advisors can help by giving input into and
feedback on new and existing materials.
•
A sense of pride and accomplishment.
•
New skills.
•
Knowledge that they are helping to
improve the care experience for other
patients and families.
Become an advisor!
When you or your family members were in the
hospital, did you think there were things we
could have done better?
•
Do you have ideas about how to make sure
other patients and families get the best care
possible?
If so, please think about becoming a
patient and family advisor!
•
Serve on a patient and family advisory
council. The patient and family advisory
council helps plan and discuss changes to
improve hospital quality and safety. Most
of the members are patients and family
members. There are also a few hospital
staff members on the council.
•
Serve on a quality improvement
committee or work group. We have
committees and work groups made up of
doctors, nurses, and other hospital staff
that work to improve hospital quality and
safety. Patient and family advisors may be
invited to participate on these committees
or workgroups.
Who can be a patient and family
advisor?
You can be an advisor if you or a family
member received care at [insert hospital name]
in the last 5 years.
You do not need any special qualifications
to be an advisor. We are looking for people
who want to make a difference.
What’s most important is your experience as a
patient or family member. We will provide
you with any other training you need.
[NOTE: Insert picture or other graphic
specific to your hospital.]
Is being a patient and family
advisor right for you?
Are you thinking about becoming an advisor?
How do I become an advisor?
To get more information about being an
advisor at [hospital name] or to find out how
to apply:
Use the checklist below to help you figure out
if you are ready.
Call:
Effective advisors…
Email: Insert contact name and email address
Speak up and share suggestions and
Mail: Fill out the box below and mail to:
potential solutions to help improve
hospital care for others.
Are willing to talk about their experiences
as a patient or family member.
Are ready to move beyond any negative
care experiences and respectfully share
ideas about how things could have gone
differently.
Are willing to learn how to best serve as
Insert contact name and phone number
Contact name
Address
City, State, Zip Code
I would like to learn more about being a
patient and family advisor. Please contact
me.
Name:____________________________
Address: __________________________
an advisor.
Are able to work with people who may be
different than themselves.
Listen to and think about what others say,
Help
Improve
Our
Hospital
Become a
Patient and
Family Advisor
__________________________________
Email:_____________________________
Phone number(s):____________________
even when they disagree.
Bring a positive attitude to discussions.
Are willing to keep any information they
Best time to reach me:________________
__________________________________
may hear as an advisor private and
confidential.
Have the time to be an advisor (usually at
least 1 hour and not more than 4 hours per
month).
Come join us! Together we can work to
make our hospital the best it can be!
Organizational Partnership Tool 2: Help Improve Our Hospital:
Become a Patient and Family Advisor
Personal Invitation for Patient and
Family Advisors
Front of postcard:
Do you have
ideas to help
improve our
hospital?
Become a
patient and
family advisor.
I would like to invite you to find out more about
becoming a patient and family advisor at [insert
hospital name].
I think you may have great ideas about how we
can improve the health care experience for
patients and families.
I hope you are interested in learning more about
serving as a patient and family advisor. Please see
the back of this card for more information.
Sincerely,
________________________________________
[NOTE: Hospital staff member should sign and
personally give this to patient or family member.]
Organizational Partnership Tool 3: Personal Invitation for Patient and Family Advisors
1
Back of postcard:
There are many ways that patient and
family advisors help us:
• Share your story about your hospital
experience in training sessions for nurses,
doctors, and other hospital staff.
• Help create materials and plans to improve
health care quality and safety for all
patients.
• Provide input about how to improve our
policies and care practices.
• Give feedback about your hospital stay. Let
us know what went well and what we can
do better.
We are grateful to the patients and families
who become advisors.
What skills do advisors need?
You do not need any special qualifications
to be an advisor. We will provide any
training that you need.
Advisors…
• Listen and share their opinions
respectfully.
• Think about ways to improve health
care.
• Work well with others.
For more information about becoming
an advisor, please contact:
[Insert staff liaison name]
[Insert telephone]
[Insert email]
Come join us!
2
Organizational Partnership Materials Tool 3: Personal Invitation for Patient and Family Advisors
Become a Champion for
Quality and Safety
Become a Champion for Health Care Quality and
Safety
At [insert hospital name] we have been partnering with patient and family advisors to help us
make changes and improvements.
Now we are looking for patient and family advisors who are interested in working
together with hospital staff on committees that are focused solely on hospital
quality and safety.
[NOTE: Edit the list below as appropriate for your hospital’s priorities]
As an advisor for hospital safety and quality, you may be asked to do things like:
•
Help us review and interpret the results of patient surveys and other data about hospital
quality and safety.
•
Help us develop strategies for improvement and plan changes to improve the quality and
safety of care we provide.
•
Have discussions with patients and families in the hospital to identify ideas for improving
quality and safety.
•
Participate in quality improvement projects that plan and test changes to make sure we
are achieving the desired outcomes.
•
Review materials we give to patients and families and help us change them to make them
easier to understand and more helpful.
•
Review how we partner with patients and families when they are in the hospital and help
us improve the ways in which we encourage patients and families to be active
participants in care and decisionmaking.
•
Give presentations at training sessions for nurses, doctors, and other staff focused on
improving communication, safety, and quality.
Organizational Partnership Tool 4: Become a Champion for Health Care Quality and Safety
1
There are many ways to get involved in quality and safety initiatives. The following committees
are looking for experienced patient and family advisors:
[NOTE: Insert the names and a brief description of committees that are interested in working
with advisors].
•
[Insert committee name and description]
•
[Insert committee name and description]
Am I ready to become an advisor for quality and safety?
Are you thinking about becoming an advisor for quality and safety but wonder whether you are
ready? Complete the following checklist to see.
I’m ready to become an advisor for patient safety when…
I have served as a patient or family advisor at [insert hospital name].
If I, or my family member, experienced a safety issue or medical error while in the
hospital, I am coping well with the experience.
I am ready to respectfully share my experiences and ideas about how to prevent errors
and improve safety.
I listen to and think about what others say, even when I disagree.
I bring a positive attitude to discussions.
I am willing to keep any information I may hear as an advisor private and confidential.
I am willing to go through additional training to become an effective member of quality
and safety teams.
I have time in my schedule to be an advisor. Usually advisors for quality and safety
volunteer between 2 to 4 hours per month.
I can commit to serve on a committee for a minimum of 1 year.
Please join us!
To get more information becoming an advisor for safety and quality at [insert hospital name],
contact [insert contact name and information].
We are grateful to the patient and family advisors who volunteer their time and share their
energy and knowledge with us. Thank you for helping [insert hospital name] be the best we can
be!
2
Organizational Partnership Tool 4: Become a Champion for Health Care Quality and Safety
Application Form: Patient and
Family Advisors
Return this form to: [Insert patient and family advisor liaison name and contact
information]
Your Contact Information
Name (first and last):
Street Address:
City:
State:
Home phone:
(
)
-
Cell phone:
(
)
-
Zip Code:
Email address:
Preferred contact (circle one):
Home phone
Cell phone
Email
The following questions will help us get to know you better.
1.
What language(s) do you speak? ______________________________________________
2.
Are you a…
Patient
Family member of a patient
3.
The dates of my care experiences at this hospital are: (check all that apply)
2010 to current year
2009
2008
2007
2006 or before
Organizational Partnership Tool 5: Application Form for Patient and Family Advisors
1
4.
I (or my family member) received care on the following unit(s): (check all that apply)
[Insert name of unit]
[Insert name of unit]
5.
[Insert name of unit]
[Insert name of unit]
We recognize that our patient and family advisors have busy lives. How much time do
you have to commit to being a patient and family advisor? (check one)
Less than 1 hour per month
1 to 2 hours per month
3 to 4 hours per month
More than 4 hours per month
6.
Are you available to serve as an advisor for at least 1 to 2 years? (You can still be an
advisor if you answer “no.”)
Yes
No
7.
I am interested in helping in the following ways: (check all of your interest areas) [NOTE:
Edit the list below as appropriate for your hospital’s priorities]
Serving as a member of the patient and family advisory council. Potential advisory
council members should be ready to commit to serving on the council for at least 1 to
2 years. The advisory council meets once a month for 1 ½ to 2 hours.
Helping to develop or review informational materials for patients and family
members.
Reviewing procedures and providing input to improve the hospital admission process.
Providing input to help implement bedside change of shift report, where nurses give
their shift change report at the patient’s bedside.
Reviewing procedures and providing input to improve transitions in care (for
example, between hospital units, or discharge from hospital to home).
Improving patient safety and the prevention of medical errors.
Improving the patient and family role in care decisionmaking.
Improving the hospital facilities (for example, patient care areas).
Helping to educate or train hospital staff and clinicians.
Other issues (please describe)________________________________
2
Organizational Partnership Tool 5: Application Form for Patient and Family Advisors
Please tell us a bit about yourself by answering the following questions.
8. Why do you want to become a patient and family advisor?
9. If you have served as an advisor, been an active volunteer, or done public speaking, please
briefly describe this experience.
10. Please describe any specific things that doctors and hospital staff did or said that were
helpful to you or your family.
11. Please describe any specific things that you think doctors and hospital staff could have
done differently in order to be more helpful.
12. We believe that our patient and family advisors should reflect the diversity of the patients
and families we serve. Please share anything about yourself that you think would add to
the diversity of our advisors.
Organizational Partnership Tool 5: Application Form for Patient and Family Advisors
3
Sample Letters of Invitation and Regret
for Advisory Council Applicants
Sample Letter of Invitation for Advisory Council
Applicants
Dear [insert name],
I am pleased to invite you to join the [patient and family advisory council or name of the council
if it has been chosen].
Our first meeting will be held on [insert day and date] from [insert times] in the [insert
room number or name and building number or name].
[NOTE: Insert information about whether refreshments will be provided. Also insert logistical
information about where to park, parking reimbursement and procedures, child care
arrangements, stipends, or any other reimbursements provided]
At this first meeting, we will take time for introductions, review the purpose and general goals of
the advisory council, discuss initial steps, answer any questions you have, and decide on the best
times for future meetings.
If you cannot attend this important meeting, please let me know as soon as possible.
We are looking forward to working with you to improve our care and services at [insert hospital
name]. If you have any questions before the first meeting, please feel free to contact me.
Sincerely,
[Staff liaison or key contact name, position title, and contact information]
Organizational Partnership Tool 6: Sample Letters of Invitation and Regret for Advisory Council Applicants
1
Sample Letter of Regret for Advisory Council
Applicants
Dear [insert name],
Thank you for your interest in joining the [insert patient and family advisory council or the name
of council if it has been chosen] at [insert name of hospital]. At this time, due to the limited
number of positions, we will not be able to offer you a position as an advisory council member.
I would be pleased to speak with you about other opportunities for advisors or other volunteer
roles that you might be interested in. If you are interested, please contact me.
We also will keep your name and contact information in our database. Please let us know if you
do not want to be considered for another position in the future.
Again, thank you for your interest in serving as an advisor at [insert name of hospital]. We
appreciate your desire to improve the care experience for our patients and families.
Sincerely,
[Insert staff liaison or key contact name, position title, and contact information]
2
Organizational Partnership Tool 6: Sample Letters of Invitation and Regret for Advisory Council Applicants
Become a Patient and Family
Advisor:
Information Session
[Insert hospital name, presenter name and title,
date of presentation]
Organizational Partnership Tool 7: Patient and Family Advisor Information Session
Today’s session
How do patient and family advisors help improve
hospital quality and safety?
Who are patient and family advisors? What do
they do?
What opportunities are available for patient and
family advisors at our hospital?
What is the application process?
Questions?
Working with patients and
families as partners
Improving the quality and safety of hospital
care
Hospital quality
Patients get care that is safe
No differences in treatment based on race,
ethnicity, income, education, or social status
Care is patient- and family-centered
Patients get the right care for their condition
Patients get care they need when they need it
Patients get care that makes wise use of
resources
Patient- and family-centered care
Mutually beneficial partnerships among
clinicians and hospital staff, patients, and
families
Core concepts:
♦
Dignity and respect
♦
Information sharing
♦
Participation
♦
Collaboration
Patient and family engagement
Critical component of patient- and familycentered care
Patients and family members as:
♦
Members of the health care team
♦
Advisors working with staff, clinicians, and
leaders to improve policies and procedures
Goal of patient and family engagement
Create an environment where patients, families,
clinicians, and hospital staff all work together as
partners to improve the quality and safety of
hospital care
Patient and family advisors
Who are advisors?
What do they do?
Advisors: Who they are
Patients and family members who have
experienced care at our hospital
Your experiences qualify you for the role
We provide any additional training needed
Advisors: What they do
Provide input into or feedback about:
♦
Policies and care practices
♦
Informational materials we give to patients
and families
♦
Facility design
♦
Your care experiences
Your experiences are a powerful tool for
inspiring change!
Patient and family advisor
opportunities at [Insert
hospital name]
How can I get involved?
Note: This presentation discusses several ways of
working with advisors:
1.
Patients and families as advisors on individual
projects, typically on an as-needed basis
2.
Patients and families as advisory council members
3.
Patient and family advisors as members of hospital
quality and safety committees
Not all hospitals will choose to work with advisors in all
3 ways. Select and adapt the slides that are appropriate
to the opportunities available within your organization,
and delete the others.
Advisors for short-term projects
Participate in a discussion group to provide input
into proposed changes in care practices or
policies
Serve as a member of a workgroup or
committee
Review, revise, or help create informational
materials for patients and families
Share your story with hospital clinicians and
other staff
Example projects
[Insert examples of
opportunities for
advisors at your
hospital to participate in
specific projects, or
include examples of
past projects– e.g.,
review materials,
participate in discussion
groups, tell your story]
[Insert photo or
illustrative example]
Advisor commitments
[Insert info on typical time commitment for
short-term advisors per month]
[Insert info on procedures – how do advisors
know when you need their assistance?]
[Insert any information on stipends or
reimbursement]
[Note: The following slides are about patient
and family advisory councils. If your hospital
does not offer this opportunity, delete these
slides.]
Advisors as council members
Patient and family advisory councils are a more
formal way to create partnerships
♦
Membership: Patients, families, hospital staff,
clinicians
Our advisory council
♦
[Insert purpose statement or goals for patient
and family advisory councils at your hospital
(either in existence or planned)]
Example advisory council projects
[Insert examples of
advisory council
projects and efforts at
your hospital (either
based on past
experiences or
anticipated needs)]
[Insert photo or
illustrative example]
Advisory council commitments
[Insert information about how often the council
meets and for how long]
[Insert information about time commitment, term
length, compensation, and training]
[Note: The following slides are about patient
and family advisors as members of hospital
quality and safety committees. If your hospital
will not offer this opportunity, delete these
slides.]
Quality and safety advisor opportunities
Patient and family advisors as members of
hospital quality and safety committees
[Insert information about specific opportunities
at your hospital (either in existence or
planned)]
• Names of committees
Example quality and safety committee
projects
[Insert examples of how
patient and family
advisors have served or
could serve as
members to facilitate
the work of different
committees]
[Insert photo or
illustrative example]
Quality and safety advisor commitments
Your responsibilities as a committee member
♦
[Insert info about how often the committee(s)
meet and for how long]
♦
[Insert information about time commitment,
term lengths, compensation, training]
Preparing to become an
advisor
Am I ready to become an advisor?
Tips for being an effective advisor
How we will help you prepare
The importance of your experiences
While you were in the hospital, did you ever
think there were things we could have done
better or differently?
OR
While you were in the hospital was there a time
when you felt encouraged by us to participate
actively in your care or decisionmaking?
What does it take to be a good advisor?
Listen to and respect the perspectives of others
Share insights and information in ways that help
others learn
See beyond your own experiences
Partner with different kinds of people
Speak comfortably and candidly in group
settings
Show concern for more than one issue or
agenda
Am I ready to become an advisor?
Patients and family members are ready to
become advisors when:
♦
They are willing to talk about their experience
in a constructive manner
♦
They are ready to work with people from
different backgrounds who may have differing
viewpoints
♦
They are willing to keep information they hear
private and confidential
What are some tips for being
an effective advisor?
Listen well
Ask questions
Share your views
Keep an open mind
Be willing to cope with disagreement
Ask for feedback
Keep commitments
Think about your story
How will we help you prepare
to be an advisor?
Our staff liaison, [insert liaison name] is here
to support advisors
♦
Recruitment
♦
Orientation
♦
Coaching and training
Questions?
Questions from you?
Final thoughts
Your perspectives and experiences provide the
rich data we need to improve our services
Your participation allows us to work together to
improve care experiences
Continuous improvement is a journey, not a
destination – your stories make the journey
worthwhile
Thank you!
For questions or more information:
[Insert name and contact information of patient
and family advisor liaison]
Patient and Family Advisor
Information Session: Handout 1
Am I Ready to Become an Advisor?
Are you thinking about becoming an advisor? Complete the checklist below to see if you are
ready.
I am ready to be an advisor when…
I am willing to talk about my experiences as a patient or family member.
I am coping well with the experiences I had when my family member or I was
hospitalized.
I am ready to move beyond any negative experiences I had in the hospital and
respectfully share my ideas about how things could have gone differently.
I am ready to speak up and share suggestions and potential solutions to help improve
hospital care for others.
I enjoy working with people who are different than me.
I can listen to and think about what others say, even when I disagree.
I can bring a positive attitude to discussions.
I am willing to keep any information I may hear as an advisor private and confidential.
I am willing to learn how to best serve as an advisor.
I have time in my schedule to be an advisor. Usually advisors spend at least 1 hour a
month and not more than 4 hours per month on advisor work.
Adapted from resources from the Institute for Patient- and Family-Centered Care, Bethesda, MD,
www.ipfcc.org.
Organizational Partnership Tool 8: Am I Ready to Become an Advisor?
1
Patient and Family Advisor
Information Session: Handout 2
Sharing My Story: A Planning Worksheet
Use this worksheet to help plan what you want to share about your hospital experience.
Key Points About Your Hospital Experiences
What went well during your hospital experience? What things did people say or do that were
helpful?
What did not go well during your hospital experience? What things did people say or do that
were not helpful?
What improvements would you suggest?
Adapted from University of Washington Medical Center, Patient and Family Centered Care and
Education Services, 1959 N.E. Pacific Street, Box 358126 Seattle, WA 98195.
Organizational Partnership Tool 9: Sharing My Story: A Planning Worksheet
1
Patient and Family Advisor
Information Session: Handout 3
My Participation Interests
Contact information
Name (first and last):
Street Address:
City:
State:
Home phone:
(
)
-
Cell phone:
(
)
-
Zip Code:
Email address:
Preferred contact (circle one):
Home phone
Cell phone
Email
I am interested in more information about the following activities (please check all that apply):
[NOTE: Edit the list below as appropriate for your hospital’s priorities.]
Helping to develop or review informational materials for patients and family members.
Providing feedback on and helping to improve hospital policies, staff and clinician practices,
programs, or the design of facilities.
Helping to educate or train hospital staff, clinicians, and trainees in the health professions.
Sharing my story with health care providers or others.
Serving as a member of the patient and family advisory council.
Serving on [insert name of committee].
Other:
_________________________________________________________________.
Thank you for your interest! Please return this form to:
[Insert hospital name, staff liaison name, and email and phone contact information]
Organizational Partnership Tool 10: My Participation Interests
1
Guide to Patient and Family
Engagement
Co m p o n e n t 2, To o l 11:
Patient and Family Advisor Training Manual
Organizational Partnership Materials Tool 11: Patient and Family Advisor Training Manual
Patient and Family Advisor Training
Manual
Table of Contents
About This Training Manual ........................................................................................................1
Section 1. Responsibilities and Expectations ...............................................................................2
Key contacts for the patient and family advisor program ...........................................................3
Training and orientation ..............................................................................................................3
Other requirements ......................................................................................................................3
Time commitments ......................................................................................................................3
Reimbursements and stipends .....................................................................................................4
Confidentiality agreements ..........................................................................................................4
Feedback and review process ......................................................................................................4
Section 2. Tips for Being an Effective Advisor ............................................................................5
Six tips for being a successful advisor ........................................................................................5
Sharing your story .......................................................................................................................8
Section 3. Health Care Quality and Safety ................................................................................12
What is health care quality? ......................................................................................................12
How do we know whether patients are getting quality care? ....................................................13
Patient and family advisors working to improve hospital quality and safety............................14
Section 4. How Things Work at [insert hospital name] ............................................................15
Section 5. Ways to Learn More ..................................................................................................16
Notes ..............................................................................................................................................18
Organizational Partnership Tool 11: Patient and Family Advisor Training Manual
Patient and Family Advisor Training
Manual
About This Training Manual
This training manual is for all patient and family advisors. This manual covers:
•
Section 1. What you should know about the responsibilities of and expectations for
patient and family advisors.
•
Section 2. Tips for being an effective patient and family advisor.
•
Section 3. Information about hospital quality and safety and how patient and family
advisors help us improve hospital quality and safety.
•
Section 4. How things work at [insert hospital name].
•
Section 5. Ways to learn more about health care quality, patient safety, and being a
patient and family advisor.
Organizational Partnership Tool 11: Patient and Family Advisor Training Manual
1
Section 1. Responsibilities and Expectations
As a patient and family advisor, your experiences are a powerful tool for inspiring change at our
hospital. By sharing your perspectives and working with hospital staff and other patient and
family advisors, you can make a real difference. The time and energy you invest helps us make
important changes and improve the care experience for other patients and families.
As an advisor, there are things that we will ask you to do. There also are things we will do to
make sure we are doing our best to build a strong partnership with you.
We promise to:
• Provide you with the training you need to
be an effective advisor.
We ask you to:
• Support and commit to the mission and
vision of our hospital.
•
Identify a staff liaison who will help you
prepare for meetings, provide you with
information, and be available if you have
comments, questions, or concerns about
your role.
•
Attend orientation and training.
•
Prepare for meetings as needed – for
example, by reviewing materials, reading a
report, or completing a task before a
meeting.
•
Listen and respond to your ideas and
suggestions.
•
•
Keep you informed about how your
feedback and ideas contribute to changes
and improvements.
Attend meetings as required. If for some
reason, you cannot attend a meeting, please
call your staff liaison. You can also ask if
there is another way you can participate
(for example, by phone).
•
Provide you with reimbursement for
•
expenses related directly to your attendance
at advisory meetings. [NOTE: Revise this
•
bullet as needed based on your
reimbursement policies.]
Actively participate in meetings by sharing
your input and opinions.
2
Maintain confidentiality. As a patient and
family advisor, you may have access to
protected health information about other
patients. We ask that you follow the rule,
“What you see or hear here, must remain
here.”
Organizational Partnership Tool 11: Patient and Family Advisor Training Manual
Key contacts for the patient and family advisor program
[NOTE: Insert information about who is in charge of the patient and family advisor program
(e.g., the staff liaison). Include contact information and summarize the liaison’s role and
responsibilities. Sample text is provided below. If your hospital has an advisory council, insert
contact information for the council chair or other key council contacts.]
[NOTE: insert name and correct title here] coordinates all the activities of patient and family
advisors. [NOTE: She or He] will make sure you get the training you need and that you complete
all the necessary requirements. [NOTE: Insert name] also works with hospital staff to prepare
them to work together with patient and family advisors.
[NOTE: She or He] is always available to you by phone, email, or in-person to answer any
questions you have or to discuss your participation as an advisor.
Training and orientation
We are committed to making sure that you have the training you need to feel confident in your
role as a patient and family advisor. This manual is only one part of your training. Other parts of
your training will include:
•
[NOTE: Insert information about other training. This many include the hospital volunteer
orientation, HIPAA training, and advisor orientation. Be specific about the topics that
will be covered in each part of training / orientation and the time commitment associated
with each.]
Other requirements
[NOTE: List any other requirements. For instance, will advisors have to complete a background
check? Do they need any tests for TB or are they eligible for a waiver? ]
Time commitments
The amount of time you spend on advisor activities depends on your specific role. [NOTE:
Tailor this information depending on the advisory opportunities offered by your hospital.]
•
[NOTE: Insert information about meetings: How often advisors meet, when meetings are
held, how long the meetings are, whether there is a minimum attendance expectation.]
•
[NOTE: Insert information about other time commitments outside of meetings: Time
spent reviewing documents or materials, preparing for meetings, or completing other
tasks.] You may be asked to review materials to prepare for a meeting. We will make
Organizational Partnership Tool 11: Patient and Family Advisor Training Manual
3
sure you have enough time to review materials. We will send these materials to you either
by mail or by email, depending on your preference.
[NOTE: If your hospital will be working with advisors on a short-term basis, insert information
about how advisors will be informed about opportunities.]
Reimbursements and stipends
[NOTE: Describe any reimbursements for parking, transportation, or child care. Note any
stipends. Delete this section if you will not provide any reimbursements or stipends.]
Confidentiality agreements
As a patient and family advisor, you may have access to protected health information about other
patients. It is important for you to know that any protected health information can only be used
and disclosed as permitted by law. This means that protected health information cannot be shared
outside the hospital or health care facility. It cannot be shared in any written, verbal, or email
communications with friends, family, or anyone else unless specifically permitted. The easiest
way to remember what this means is the saying, “What you see or hear here must remain
here.” We will ask you to read and sign a confidentiality agreement to indicate your cooperation
with these requirements.
Feedback and review process
Your feedback helps us better understand how we can support you and your advisor work. The
staff liaison will meet with you on a regular basis to get your feedback about how things are
going. These meetings are also a chance for you to let the staff liaison know how we can
improve and expand our advisory activities. During these meetings, the staff liaison will also ask
you about your goals, and whether there are any areas in which you would like to strengthen or
expand your skills.
[NOTE: Insert a brief narrative describing the specific feedback or review process the hospital
volunteer office or unit may ask advisors to participate in (e.g., feedback survey). Also describe
any process that the hospital has for working with patient and family advisors (e.g., meetings to
review advisor’s work and to get their feedback about how things are going).]
4
Organizational Partnership Tool 11: Patient and Family Advisor Training Manual
Section 2. Tips for Being an Effective Advisor
Read this section for tips from other patient and family advisors about how to be an effective
advisor. As you read, make note of things that you think might be difficult for you. Discuss these
with your staff liaison and ask for more help if needed.
Six tips for being a successful advisor
Tip 1. Share your views
You have been asked to be an advisor because your ideas are valuable. You know what it is like
to get care in our hospital. We want to hear your ideas about how we can help other patients and
families have a good experience. We also want to hear your ideas about how we can improve the
quality and safety of the care we provide.
•
Build on positive experiences whenever possible. For example: “We found that things
worked well for our family when…” It can be helpful to share negative experiences, but
when you do, try to offer positive suggestions and possible solutions. Problem-solving is
always appreciated!
•
Think carefully about the words you use. If you want to tell a story that will bring up
strong emotions, ask your staff liaison or another advisor to help you think about what
you want to say and how you want to say it. Try to remember that anger usually does not
produce good results.
•
Respect people’s privacy. Feel free to share your experiences and the experiences of
patients and family members other than yourself. If you do share someone else’s story, let
people know that this experience did not happen to you and avoid using the person’s
name. When speaking about experiences in the hospital, try not to use the names of
individual staff members.
Tip 2. Communicate clearly
As an advisor, you will work with many types of people from different backgrounds. You may
work with health care providers, hospital staff, hospital leaders, and other patients and family
members. Good communication skills will help you explain your ideas clearly. They can also
help you develop good working relationships.
•
Listen well. When someone is speaking, it is natural to think about what you are going to
say in response. However, it is important to give all of your attention to the person who is
speaking and to hear them out before you respond.
Organizational Partnership Tool 11: Patient and Family Advisor Training Manual
5
•
Keep an open mind. Keep an open mind and be willing to see past your own views and
experiences. You will be working with doctors, nurses, hospital staff, and other patient
and family advisors who bring their own views. These different perspectives lead to
better conversations and outcomes.
•
Try not to jump to a response or conclusion about what other people are saying. One
way to make sure you understand someone’s point is to reflect back to them by saying,
“What I hear you saying is…” and then repeating what you heard them say. This gives
people a chance to clarify their points if needed.
•
Be aware of how you are sharing time with others when you are speaking. If needed,
make adjustments to give others time to express their ideas.
Tip 3. Ask questions
When you or your family members were in the hospital, there may have been times when
hospital staff used terms or language that you did not understand. That can happen when you are
working as an advisor too. If it does, speak up and ask people to explain what they mean.
•
Ask clarifying questions. For example: “Let me make sure I understand correctly. I
heard you say…”
•
Ask for definitions of medical terms, abbreviations, or other terms. For example:
“I’m not sure I know what Hospital CAHPS means. Would you please explain it to
me?”(See the Health Care Quality and Safety section of this training manual for
information about the CAHPS® Hospital Survey.)
•
Ask for more details. For example: “Can you walk me through this so I can picture it?”
Tip 4. Be ready to cope with disagreements
Disagreements are a natural part of working on a team, even when everyone is doing their best to
communicate effectively. Learning how to express your views when they are different from the
views of others can be challenging. However, your honest opinion can lead to greater
understanding.
•
Describe your point of view in terms of your perception or opinion rather than as a
fact or the truth for all families. For example: “I see it differently,” “I have a different
priority,” or “That doesn’t work so well for us.”
•
Ask for more background information when people say that a change is not
possible. For example: “Help me understand why this change is not possible. What have
you tried?” Sometimes doctors, nurses, and other hospital staff are so used to the “way
6
Organizational Partnership Tool 11: Patient and Family Advisor Training Manual
things have always been done” that it is hard for them to see other ways of doing things.
Sometimes, there are things that really cannot be changed. In this case, it is important for
you to understand the reasons why.
•
If you find yourself upset after a meeting, talk to your staff liaison at the hospital. Your
staff liaison can make sure that your concerns are addressed and help you resolve them.
Tip 5. Keep your commitments
When you agree to become an advisor, make sure you fully understand the commitment you are
making, and then keep these commitments.
•
If there are responsibilities that you are asked to fulfill in between meetings, come to the
meeting prepared to share information about your progress on these activities and
projects.
•
Be on time for meetings and stay until the meetings are completed.
•
If you are not able to attend a meeting in person, ask if you can call in (through
conference call or speaker phone) as an option.
•
If you cannot participate in a meeting at all, notify your key contact or staff liaison. Ask
if you can get an update before the next meeting.
•
If you find that you are having difficulty balancing your personal and family life with
advisory activities, talk to your staff liaison about whether you can cut back on some of
your advisor duties or take a short-term break.
Tip 6. Ask for feedback
One of the best ways to develop your skills as an advisor is to ask for feedback. Talk to your
staff liaison about your participation, including what is going well, and what skills you would
like to work on. Getting feedback is especially important if you would like to expand your
involvement and take on new roles and responsibilities.
•
If you are participating in a one-time discussion group or very short-term work group, ask
your staff liaison if you can talk to them about your participation after you have
completed the task.
•
If you will be serving as an advisor for several months or more, ask your staff liaison to
meet with you on a regular basis so that you can become aware of your strengths and
areas for improvement.
Organizational Partnership Tool 11: Patient and Family Advisor Training Manual
7
•
If there is a topic you would like to learn more about or some skill you would like to
work on, ask your staff liaison for resources, individuals to meet with, or time to discuss
it further.
•
Ask for support from other advisors when you need it. And always be ready to provide
support to them.
•
[NOTE: Revise this bullet according to your hospital’s review process for
advisors/volunteers and according to the level of involvement of the advisor.] The
hospital’s volunteer office will have your staff liaison complete an annual review with
you to identify how to continue to best support you as an advisor and to help you improve
your participation as an advisor.
Above all, have faith in your participation as an advisor and keep at it! Bring your sense of
humor, and expect the best from your participation.
Sharing your story
Sharing your story can help others understand your health care experiences and how these
experiences have affected you and your family.
For example, you may be asked to share your story with hospital
leaders to help them understand why it is important for our
hospital to work with patient and family advisors. You may be
asked to help educate doctors, nurses, and other hospital staff
about why it is important to conduct bedside shift report or to
involve patients and families in the discharge process. Or you
may be asked to speak to a group of patients and family members
about becoming advisors.
Sharing your experiences
as a patient or family
member is a powerful way
to help implement specific
changes and improvements
at the hospital.
We will provide you with training and support for each of these opportunities. For any
invitations, you should accept only if you are comfortable with the request.
Before you agree to share your story
Before you agree to share your story in a training, meeting, or presentation, get information
about what is expected of you and what you can expect. Ask the following questions:
•
When and where do you want me to speak? How long do you want me to speak?
•
Why do you want me to speak? What do you hope will happen as a result of me sharing
my story?
8
Organizational Partnership Tool 11: Patient and Family Advisor Training Manual
•
Who is the audience or group? How many people will be there?
•
Who else will be speaking? Will there be other patients and families? Will doctors,
nurses, or other hospital staff be speaking?
•
Will I be answering questions from the audience?
•
Will the session be audio- or videotaped?
•
Is there reimbursement for child-care or transportation?
•
When do you need an answer?
Preparing to share your story
If you have decided to share your story, sit down and think about what you want to say and how
you want to say it. Some people write down their main points to keep them focused. You can use
the worksheet below called Sharing Your Story to help you organize your thoughts.
Before you speak in a meeting or to a group, it also helps to practice. Time yourself and see if
you are staying within the requested time frame.
As you are preparing what you want to say, think about the following questions:
•
Why was I asked to share my story? What is the desired outcome?
•
What am I willing to share? What do I feel is too private to share? What does my family
not want me to talk about?
•
What are the key messages I want to share? What are the two or three specific points that
I want to the audience to remember?
•
What examples can I give of when things went well? What examples can I give of things
that could have gone better? What ideas do I have about how my experience could have
been improved?
Also keep in mind the following tips:
•
If you still feel very angry about a certain situation or event and do not think you can talk
about it in a helpful manner, it may best not to share that part. You can also talk about it
with someone you trust. Ask for ideas about how to share that part of the story in a way
in which people will listen.
•
Avoid using the names of doctors, nurses, and other staff. If you talk about another
facility where you have received care, please do not mention it by name.
Organizational Partnership Tool 11: Patient and Family Advisor Training Manual
9
•
Expect that some people who hear your story may be deeply moved. Also remember that
you may feel emotional when you tell your story.
•
If people ask you questions and you do not know the answer, say so. If you do not want
to answer a question, say so.
10
Organizational Partnership Tool 11: Patient and Family Advisor Training Manual
Sharing Your Story – A Planning Worksheet1
Use this worksheet to help plan what you want to share about your hospital experience.
Key Points About Your Hospital Experiences
What went well during your hospital experience? What things did people say or do that were
helpful?
What did not go well during your hospital experience? What things did people say or do that
were not helpful?
What improvements would you suggest?
1
Adapted from University of Washington Medical Center, Patient and Family Centered Care and Education Services,
1959 N.E. Pacific Street, Box 358126, Seattle, WA, 98195
Organizational Partnership Tool 11: Patient and Family Advisor Training Manual
11
Section 3. Health Care Quality and Safety
As an advisor, you will hear people talk about the importance of health care quality and safety.
You probably have your own ideas about what it means to get good quality health care. You may
be able to think of some times when you or your family member got “good” quality care in the
hospital. And you also may be able to think of some times when you or your family member did
not get good quality care.
One of your jobs as a patient and family advisor is to help us improve the quality and safety of
the care we provide in the hospital. But what does this really mean?
What is health care quality?
If patients are getting high quality health care, it means that:
•
Patients get care that is safe. Patients get care that is free from medical errors. The tests
and treatments they get do not cause any harm.
•
Patients get the right care for their condition. Patients get the tests and treatments that
are recommended for their condition. The tests and treatments they get are based on what
research has shown works best.
•
Patients get the care they need when they need it. There are no delays in care. Patients
get the tests and treatments they need at the time when they will do the most good.
•
Patients get care that makes wise use of resources. Patients get as much care as they
need, but no unnecessary care.
•
Patients are not treated differently based on their race, ethnicity, income, level of
education, or social status. Everyone is entitled to high quality healthcare. This includes
people of all cultures and backgrounds.
•
Patients get care that is patient- and family-centered. Health care providers ask about
and respect each patient's and family’s values, preferences, and goals. The patient’s care
represents a partnership between the patient, family, and health care providers. The four
core concepts of patient- and family-centered care include: 2
o Dignity and respect: Health care providers ask about, listen to, and respect
patient and family perspectives and preferences. Patients get care that reflects the
patient’s and family’s knowledge, values, beliefs and cultural backgrounds.
Advancing the Practice of Patient- and Family-Centered Care: How To Get Started. The Institute for Patient- and
Family-Centered Care. Available at http://www.ipfcc.org/pdf/getting_started.pdf
2
12
Organizational Partnership Tool 11: Patient and Family Advisor Training Manual
o Information sharing: Health care providers communicate clearly. They share
complete and unbiased information with patients and families in ways that are
easy to understand and act on. Patients and families receive timely and accurate
information so they can participate in care and decisionmaking.
o Participation: Health care providers encourage patients and families to
participate in care and decisionmaking to the extent they choose. Patients and
families are supported in whatever way they choose to participate.
o Collaboration: Health care leaders work with patients and families to develop,
implement, and evaluate policies and programs; partner with them to design
health care facilities; work with them to educate clinicians and hospital staff; and
seek their feedback about how care is provided.
How do we know whether patients are getting quality care?
One way to tell if patients are getting high quality care is to look at whether the “right” things
happen as part of the patient’s treatment. For example, do patients get the medicines they need
when they are supposed to? Do they get the correct tests and treatments?
Another important way to tell if patients are getting high quality care is to ask them about their
experiences. For example, many hospitals ask patients to fill out surveys about their experiences
in the hospital.
One survey that you may hear about as an advisor is
called the CAHPS® Hospital Survey. Most hospitals in
the United States give this survey to patients.
The CAHPS® Hospital Survey asks patients to answer
questions about how well health care providers did at
sharing information and listening. The survey also asks
patients to rate how well their care was coordinated, how
well their pain was managed, and whether they had the
information they needed to take care of themselves after
going home.
Learn more
You can see how well hospitals did
on the CAHPS® Hospital Survey
on the “Hospital Compare” website.
The Hospital Compare Web site
also lets you compare the quality of
care provided by different
hospitals.
Web site:
www.hospitalcompare.hhs.gov
Results from the CAHPS® Hospital Survey help hospitals learn where we could be doing a
better job. One of the ways we may ask advisors to help is by identifying things we could do to
improve patients’ experiences in specific areas measured by the CAHPS® Hospital Survey.
Organizational Partnership Tool 11: Patient and Family Advisor Training Manual
13
Patient and family advisors working to improve hospital quality and
safety
Improving health care quality and safety is a challenging task. Health care is a lot better when
everyone—patients, families, doctors, nurses, and other hospital staff—works together to ensure
the quality and safety of the care we provide.
Because health care quality and safety have a
direct effect on patients and families, it is
particularly important for patients and families to
participate in changes and improvements. As a
patient or family advisor, you will be asked to
share your ideas about ways to improve the
quality and safety of care that patients get in our
hospital. This helps make sure the care and
services we provide are based on “patient- and
family-identified” needs rather than the
assumptions of clinicians and hospital staff about
what patients and families want.
…Leaders often cite this change—putting
patients in a position of real power and
influence, using their wisdom and experience
to redesign and improve care systems—as
being the single most powerful
transformational change in their history.
Reinertsen J. L., Bisognano, M., & Pugh, M.
D. (2008). Seven leadership leverage points
for organization-level improvement in health
care (2nd ed.). Cambridge, MA: Institute for
Healthcare Improvement.
Specific ways in which we may ask patient and family advisors to help include:
•
[NOTE: Edit bullets as appropriate for the opportunities available at your hospital.]
•
Participating in discussions about health care quality and safety with doctors, nurses,
hospital staff, and other patients and families, including helping to identify places where
errors might occur.
•
Sharing ideas about how to make sure that patients and families have meaningful
opportunities to participate in their care and decisions about their care.
•
Revising or helping to create informational and educational materials for patients and
families.
•
Participating in training sessions for doctors, nurses, and other hospital staff.
14
Organizational Partnership Tool 11: Patient and Family Advisor Training Manual
Section 4. How Things Work at [insert hospital name]
Customize this section with information to help patient and family advisors understand how
things work at your hospital. Consider including the following:
•
Organizational chart for the unit, hospital, and / or system.
•
Mission statement.
•
Who’s who? A list of hospital leaders and key personnel.
•
Information about who patient and family advisors report to.
•
Hospital strategic plans.
Organizational Partnership Tool 11: Patient and Family Advisor Training Manual
15
Section 5. Ways to Learn More
The Web sites listed below have information about health care quality, patient safety, and being
a patient and family advisor.
Agency for Healthcare Research and Quality (AHRQ)
AHRQ is a U.S. government agency that is part of the Department of Health and Human
Services. AHRQ funds, conducts, and disseminates research to improve the quality, safety,
efficiency, and effectiveness of health care. Their Web site has information to help patients,
families, clinicians, leaders, and others make informed decisions about health care.
Web site:
www.ahrq.gov
Consumers Advancing Patient Safety (CAPS)
CAPS believes that consumers and health care providers should work together as partners to
create healthcare systems that are safe, compassionate, and just. Their Web site has information
and resources for patients and health care providers.
Web site:
www.patientsafety.org
Institute for Healthcare Improvement (IHI)
IHI is a non-profit organization dedicated to improving health care. Their Web site has resources
and improvement tools to promote health care quality and safety.
Web site:
www.ihi.org
Institute for Patient- and Family-Centered Care (IPFCC)
IPFCC provides leadership to advance the understanding and practice of patient- and familycentered care. Their Web site has guidance, information, and resources related to patient- and
family-centered care and how to involve patients and family advisors in the planning, delivery,
and evaluation of care.
Web site:
www.ipfcc.org
Josie King Foundation
This Web site provides information and resources about patient safety, preventing medical
errors, and how health care providers and consumers can work together.
Web site:
16
www.josieking.org
Organizational Partnership Tool 11: Patient and Family Advisor Training Manual
Medically Induced Trauma Support Services (MITSS)
MITSS is a non-profit organization that was founded to create awareness, promote open and
honest communication, and to provide services to patients, families, and clinicians affected by
medically induced trauma.
Web site:
www.mitss.org
Medline Plus
Medline Plus is the National Institutes of Health's website for patients and families. The Web site
has information about diseases, conditions, and wellness issues in plain language. The Web site
also includes a medical dictionary.
Web site:
www.nlm.nih.gov/medlineplus
National Family Caregivers Association (NFCA)
NFCA provides information and support for individuals who care for others who are aged,
disabled, or chronically ill. Their Web site has tools and stories to educate and empower
caregivers.
Web site:
www.nfcacares.org
National Patient Safety Foundation (NPSF)
NPSF is dedicated to improving the safety of patients through education and raising public
awareness. Their Web site has information about patient safety issues and a variety of resource
links.
Web site:
www.npsf.org
Organizational Partnership Tool 11: Patient and Family Advisor Training Manual
17
Notes
Use the space below to make notes about any questions you have. Talk to your staff liaison about
these questions: [NOTE: Insert name and contact information].
Unless otherwise noted, material in this handbook has been adapted from resources from the Institute
for Patient- and Family-Centered Care, Bethesda, MD, www.ipfcc.org.
18
Organizational Partnership Tool 11: Patient and Family Advisor Training Manual
Patient and Family Advisor Training:
Sample Confidentiality Statement
Sample Confidentiality Statement for Advisors
As a patient and family advisor here at [insert hospital name], you will be trusted with
information about our hospital and patients. This may include information about patient care
experiences, diagnoses, hospital quality and safety, and other sensitive information. It may also
include protected health information about patients.
Protected health information includes any information about a patient's visit at [insert hospital
name]. This information includes, but is not limited to, a patient's name, address, phone number,
date of birth, financial information, diagnosis, and treatment.
A federal law called “HIPAA” (pronounced “hip-uh”) explains what health care providers must
do to safeguard protected health information. HIPAA stands for Health Insurance Portability and
Accountability Act. HIPAA requires us to define the minimum necessary information to which
employees, volunteers, contracted agencies, and other individuals can have access.
As a patient and family advisor, you may have access to protected health information about other
patients. It is important for you to know that any protected health information can only be used
and disclosed as permitted by law. This means that protected health information cannot be shared
outside the hospital or health care facility, and it cannot be shared in any written, verbal, or email
communications with friends or family unless specifically permitted by law.
The easiest way to remember what this law means is the saying, “What you see or hear
here must remain here.” We require your cooperation in following these rules.
Please sign below to let us know that you have reviewed this information, understand it,
and agree to it. Signing your name means that you have read and understood the information,
that you have had a chance to ask questions, and that you agree to follow these guidelines.
Name (please print) ________________________________________________
Signature ________________________________________________________
Date ____________________________________________________________
Adapted from Leonhardt K, Bonin K, Pagel P. Guide for Developing a Community-Based Patient Safety
Advisory Council. Prepared by Aurora Health Care, Wisconsin. AHRQ Publication No. 08-0048.
Rockville, MD: Agency for Healthcare Research and Quality. April 2008.
Organizational Partnership Tool 12: Sample Confidentiality Statement
1
Working with Patient and Family
Advisors:
Part 1. Introduction and Overview
[Insert hospital name, presenter name and title, date
of presentation]
Organizational Partnership Tool 13: Working With Advisors Health Care Professional Training
Presentation
Today’s session
What is patient and family engagement?
What are the benefits of working with patient and
family advisors?
What are the opportunities for working with
patient and family advisors?
What are we asking you to do?
Who are patient and family advisors? What do
they do?
What is patient and family
engagement?
Hospital quality
Patients get care that is safe
No differences in treatment based on race,
ethnicity, income, education, or social status
Care is patient- and family-centered
Patients get the right care for their condition
Patients get care they need when they need it
Patients get care that makes wise use of
resources
Patient- and family-centered care
Mutually beneficial partnerships among
clinicians, hospital staff, patients, and families
Core concepts:
♦
Dignity and respect
♦
Information sharing
♦
Participation
♦
Collaboration
What is patient and family engagement?
Critical component of patient- and familycentered care
Patient and family engagement means
involving patients and family members as:
♦
Members of the health care team
♦
Advisors working with clinicians and leaders
to improve policies and procedures
Goal of patient and family engagement
To create an environment where clinicians,
hospital staff, patients, and families all work
together as partners to improve the quality and
safety of hospital care
Patient and family advisors
Who are they?
What do they do?
Advisors: Who they are
Patients and family members who have
received care at this hospital and who want to
help improve care experiences for others
♦
Rigorous application and screening process
♦
Training provided
Advisors: What they do
Help us improve the quality and safety of the
care we provide
♦
Provide input and feedback
♦
Identify potential changes and improvements
♦
Plan and implement changes that matter to
patients and families
The benefits of working with
patient and family advisors
Benefits of working with advisors
Engaging patients and family members as:
♦
Essential members of the health care team
♦
Collaborative partners in hospital policies,
procedures, practices
Benefits of working with advisors
Help translate patient care experiences to
improvements in care for others
♦
Areas where things went well
♦
Areas where things could have gone better
(e.g., near misses, failures in handoffs,
communication breakdowns)
Benefits of working with advisors
Long term benefits:
♦
Better health outcomes for patients
♦
Better business outcomes for the hospital
♦
Better experiences of care – for patients,
family members, clinicians, and staffs
Why are we doing this?
Consistency with our mission and vision
Desire to be at the forefront of where health
care is going
Consistency with our strategic priorities
Desire to demonstrate commitment to patientand family-centered care
Video
American Hospital Association / Institute for
Patient- and Family-Centered Care Video
Patient- and Family-Centered Care:
Partnerships for Quality and Safety
Why are we doing this?
“In a growing number of instances where truly stunning
levels of improvement have been achieved, organizations
have asked patients and families to be directly involved in
the process.
And those organizations’ leaders often cite this change—
putting patients in a position of real power and
influence, using their wisdom and experience to redesign
and improve care systems—as being the single most
powerful transformational change in their history.”
Reinertsen, J.L., Bisognano, M., & Pugh, M.D. (2008). Seven leadership
leverage points for organizational-level improvement in health care (2nd ed.)
Cambridge, MA: Institute for Healthcare Improvement.
Opportunities for working with
patient and family advisors
[Note: This presentation discusses three different ways
of working with advisors:
1.
As advisors on short-term projects
2.
As advisory council members
3.
As members of hospital quality and safety
committees
Not all hospitals are ready to offer all three
opportunities. Select the slides that are appropriate to
the opportunities available within your organization,
and delete the others.]
Patient and family advisors on shortterm projects
[Insert examples of
opportunities for
advisors to work on
short-term projects at
your hospital – e.g.,
review materials,
participate in discussion
groups, tell your story]
[Insert photo or
illustrative example]
[Note: The following slides are about patient and
family advisory councils. If your hospital does
not offer this opportunity at this time, delete
these slides.]
Patient and family advisory councils
Formal group that meets regularly
♦
Membership: Majority patients and families,
small number of hospital staff and clinicians
Helps hospital leadership and staff integrate
and apply patient and family insights
[Note: The following slides are about patient
and family advisors as members of hospital
quality and safety committees. If your hospital
does not offer this opportunity at this time,
delete these slides.]
Quality and safety advisor opportunities
Experienced advisors who have membership on
quality and safety committees
[Insert information about specific opportunities
at your hospital (either in existence or planned)]
• Names of committees
Patient and family stories
“Facts bring us to knowledge, but stories bring
us to wisdom.”
Rachel Naomi Remen, M.D.
Kitchen Table Wisdom
Working with patient and
family advisors:
What we are asking you to do
What we are asking you to do
Help identify prospective patient and family
advisors
Look for opportunities to involve patient and
family advisors
Create settings where planning and
decisionmaking is shared
Help create teamwork and trust between
advisors, staff, and clinicians
Identify potential advisors
Think about patients or family members who:
♦
Share insights and experiences in productive
ways
♦
Listen well and speak comfortably
♦
Express an interest in improving health care
for others
Distribute recruitment materials
♦
Brochure
♦
Personal invitation and postcard
For more information
For questions or more information
♦
[Insert name and contact information of staff
liaison]
♦
Attend Part 2 of this presentation: Building
effective partnerships
[Note: insert hospital logo here]
Working with Patient and Family
Advisors
Part 2. Building Effective Partnerships
[Insert hospital name, presenter name and title, date
of presentation]
Today’s session
What does it mean to work with patient and
family advisors in “true” partnerships?
What are some principles for effective
partnerships?
What are the opportunities for working with
patient and family advisors?
Working with patient
and family advisors
Patients and family members as:
♦
Essential members of the health care team
♦
Collaborative partners in hospital policies,
procedures, practices
Principles of effective
partnerships
Principles of effective partnerships
Practice exercise: Patient and family
engagement or not?
Scenario 1
Three patient and family advisors are invited
to join a patient safety team that is beginning
an initiative to improve medication
reconciliation
Scenario 2
An administrator invites patients and families to
comment on the final plans for the facility’s
upcoming renovation
Scenario 3
A multidisciplinary committee develops new
educational materials about diabetes
management and treatment for patients and
their families
Scenario 4
A surgeon asks family members, who
experienced a complicated surgical procedure
with their adult son, to join the surgical residents’
noon conference to discuss what
communication from physicians was helpful and
what was not
Principles for effective partnership
Define a clear role for advisor participation
♦
Provide opportunities to contribute where they
can make a tangible difference
Give information about purpose, goals, and
intended outcomes of the effort
Clearly define expectations, including timelines,
deadlines, and responsibilities
Principles for effective partnership
Designate a staff member or key contact for
working with patient and family advisors
Provide background information about the
project
♦
Avoid acronyms and jargon whenever
possible
Actively invite participation
Listen with an open mind
Principles of effective partnership
Practice exercise: Readiness to collaborate with
patients and family members
Identifying opportunities
Practice exercise: Identify areas in which patient
and family advisors could make a contribution
♦
Quality improvement and safety initiatives?
♦
Facility design?
♦
Patient and family participation in care and
decisionmaking?
♦
Patient and family information and education?
♦
Health information technology?
♦
Clinician and staff training?
Taking action
Patient and family advisor request form
Committee membership
Thank you!
For questions or more information
[Insert name and contact information of patient
and family advisor liaison]
Health Care Professional Training:
Handout 1
Working With Patient and Family Advisors
Patient and family advisors have knowledge we don’t have…It is so humbling to realize that
patients and families know more about [the hospital] than you do. Pat Sodomka, Former Vice
President for Patient and Family Centered Care, MCGHealth, Augusta, GA.
The benefits of working with patient and family advisors
Working with patient and family advisors helps us improve the quality and safety of the care we
provide. Patient and family advisors:
•
Offer insights that illustrate what we do well and highlight where changes may be
needed.
•
Help us develop priorities and make improvements based on patient- and familyidentified needs rather than on our own professional assumptions.
•
Bring a fresh perspective and help us come up with solutions that clinicians and staff
have not thought about.
Working with patient and family advisors helps build a shared agreement around safety and
quality priorities. This shared sense of priorities fosters partnerships in care, enhances the care
experience, and improves outcomes.
Working with advisors is part of patient- and family-centered care
Bringing the perspectives of patients and families directly into the planning, delivery, and
evaluation of care is a key component of patient and family engagement and patient- and
family-centered approaches to improve safety and quality.
As defined by the Institute for Patient- and Family-Centered Care (IPFCC), patient- and familycentered care emphasizes collaboration with patients and families at all levels of care and in all
health care settings. In patient- and family-centered care, patients and families are allies for
quality and safety within the health care system.
Organizational Partnership Tool 14: Working with Patient and Family Advisors Handout 1
1
The core concepts of patient- and family-centered care are:
•
Dignity and Respect. Health care practitioners listen to and honor patient and family
perspectives and choices. Patient and family knowledge, values, beliefs, and cultural
backgrounds are incorporated into the planning and delivery of care.
•
Information Sharing. Clinicians and hospital staff communicate and share complete and
unbiased information with patients and families in ways that are affirming and useful.
Patients and families receive timely, complete, and accurate information in order to
effectively participate in care and decisionmaking.
•
Participation. Patients and families are encouraged and supported to participate in care
and decisionmaking at the level they choose.
•
Collaboration. Patients, families, clinicians, hospital staff, and health care leaders
collaborate in policy and program development, in implementation and evaluation; in
facility design; and in professional education, as well as in the delivery of care.
Ways to get started
There are countless ways that you can partner with patient and family advisors. Getting started
involves small steps, often working with advisors on one specific issue or project. Below are
examples of some initial strategies to begin working with patient and family advisors.
•
Invite two or three patient and family members to a team meeting to discuss their hospital
stay. Ask them to share with the team what went well, what could have been done better,
and any ideas they have for change and improvement.
•
Ask patients and families to give feedback on educational materials such as patient and
family handbooks, a video script of instructions for home care after a hospital stay, or
care transition instructions.
•
Invite patients and families 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.
•
Explore your hospital and unit through the eyes of patients and their families by doing a
“walk-about” to explore how your unit welcomes, supports, and comforts patients and
families and encourages their active participation in care and decisionmaking. These
findings will give a different kind of context for your staff discussions. Begin at the first
point of entry into the hospital (e.g., the parking lot), and continue to the inpatient unit
and throughout the unit, including the patient room, treatment rooms, admitting area,
family lounge, and other areas visible to patients and families.
Adapted from resources from the Institute for Patient- and Family-Centered Care, Bethesda, MD,
www.ipfcc.org.
2
Organizational Partnership Tool 14: Working With Patient and Family Advisors Handout 1
Health Care Professional Training:
Handout 2
Working With Patient and Family Advisors on ShortTerm Projects
Are you (or is your unit) planning to work on a short-term project to revise or create materials or
to improve quality and safety? This document can help you identify how you may be able to
partner with patient and family advisors to gain valuable insight and improve the work you do.
Examples of how advisors can participate in short-term projects
Patient and family advisors are invaluable in providing their perspective of the experience of care
in our hospital. Ways in which they can contribute include:
•
Participating in a discussion group. We can call a group of patient and family advisors
together for a meeting to get feedback on a specific resource for patients and families or a
specific process.
•
Revising or helping create educational or informational materials for patients and
families. Patient and family advisors can help create new materials or revise existing
materials (e.g., forms, letters, handouts, and instructions). Advisors can work with you
over a few months to complete the work on the materials.
•
Serving on a committee or work group. Hospital and unit committees and work groups
can invite patient and family advisors to participate for a short time period (e.g., one or
two meetings) to get feedback and ideas on a specific topic.
How are advisors selected for a project?
The staff liaison for patient and family advisors coordinates advisor participation. We have a
database of all patient and family advisors that we use to identify which advisors are most
suitable for your project based on available time, areas of interest, and experience.
Organizational Partnership Tool 15: Working on Short-Term Projects Handout 2
1
Steps for working with patient and family advisors
Use the checklist below to ensure effective collaboration in working with patient and family
advisors.
Prior to the first meeting with patient and family advisors:
Prepare a brief written introduction to what you are planning to work on.
Provide a copy of any current materials or tools you are looking to revise.
Identify specific issues on which you would like input or feedback.
Identify questions you would like to have answered by advisors.
Specify the number of meetings and length of meetings you anticipate this project will
require.
Provide a list of the anticipated start date, end date, and meeting times.
Submit the Request for Patient and Family Advisors form to the staff liaison (see next page).
The staff liaison will review your request and assist you in scheduling meetings and sending
materials to advisors for review.
During meetings with patient and family advisors:
Actively listen to feedback and ideas from advisors.
Make sure that everyone in the group – staff and patient and family advisors – is encouraged
to participate in the discussion.
Stay focused on the current project.
Identify a feedback loop at the end of the meeting. Provide e-mail or other contact
information to accept additional comments or feedback.
Develop and share ideas about how best to follow up once you have completed the project
(such as followup meeting, conference call, or timeline for a progress report.)
2
Organizational Partnership Tool 15: Working on Short-Term Projects Handout 2
Request form for patient and family advisors
Complete the following form if you are interested in working with patient and family advisors.
Requestor’s name:
Date:
Unit:
Contact Information:
Provide a brief introduction (or context) about what you are planning to work on.
What specific issues would you like input or feedback on?
What specific questions would you like patient and family advisors to answer?
1.
2.
Is there anything else you would like potential advisors to know about your project?
Organizational Partnership Tool 15: Working on Short-Term Projects Handout 2
3
Information about schedule and time commitment:
•
What is the anticipated start date for advisor involvement?
•
How long will advisor participation last?
•
Will the project require a one-time meeting or multiple meetings?
•
If multiple meetings, how frequently will you meet?
•
How long will the meetings run?
•
What preferences do you have for meeting days? Meeting times?
What activities do you anticipate advisors may have to do between meetings (include how
much time activities will require)?
If you are revising a current tool or materials, please attach a copy.
Please submit this form to:
[NOTE: Insert staff liaison name and contact information]
4
Organizational Partnership Tool 15: Working on Short-Term Projects Handout 2
Health Care Professional Training:
Handout 3
Readiness to Partner With Patient and Family
Advisors
As a clinician or staff member, I am ready to work with patient and family advisors
when…
I am willing to talk about my experiences as a clinician or staff member with patient and
family advisors and share suggestions, ideas, and potential solutions that will help
improve hospital care.
I feel comfortable listening and respectfully responding to both positive and negative care
experiences that patient and family advisors may share.
I enjoy working with people who are different than me.
I can listen to and think about what others say, even when I disagree.
I can bring a positive attitude to discussions about improving hospital care.
I consistently let colleagues know that I value the insights of patient and family advisors.
I believe in the importance of patient and family participation in planning and
decisionmaking at the program and policy level.
I believe that patients and family members bring a perspective to a project that no one
else can provide.
I believe that the perspectives and opinions of patient and family advisors, staff, and
clinicians are equally valid in planning and decisionmaking at the program and policy
level.
I believe that patients, family members, staff, and clinicians can look beyond their own
experiences and issues to come up with practical ideas and solutions.
I am comfortable requesting that patient and family advisors be invited to participate in
improvement initiatives in which I am involved.
Organizational Partnership Tool 16: Readiness to Partner With Patient and Family Advisors Handout 3
1
| File Type | application/pdf |
| Author | Information Technology |
| File Modified | 2011-02-04 |
| File Created | 2011-02-04 |