I submit this application in nomination of Newton-Wellesley Hospital for the John Q. Sherman Award for Excellence in Patient Engagement in recognition of the work that Newton-Wellesley Hospital’s Patient and Family Advisory Council (PFAC) has accomplished in patient engagement in the award criteria areas of innovation, transformation, collaboration, and communication.
Newton-Wellesley Hospital is a 300+ bed, acute care, non-profit, community-teaching hospital, in the Boston suburbs, and a member of Partners HealthCare. The Patient and Family Advisory Council is comprised of approximately 20 members representing the hospital’s surrounding cities and towns and the demographics of the Hospital’s patient population.
The Patient and Family Advisory Council (PFAC) was founded in 2006, and has proven itself as a resource to improve patient engagement, patient and family experience, medical services, quality, safety, and operational improvements. One way Newton-Wellesley Hospital’s PFAC does this is by functioning as a consumer feedback group providing insight from the patient and family member perspective directly to hospital administrators, physicians, and nurses. At PFAC meetings, patients, family members, physicians, nurses, and administrators come together as partners to listen to one another, discuss problems, gain insights, and identify actionable steps. This process facilitates “aha moments.”
With increasing calls to improve quality, safety and patient satisfaction, practitioners need to learn what patients and family members are thinking and feeling, and understand their experience in order to make improvements. While patient satisfaction surveys take a broad pulse within departments, the PFAC offers hospital staff an opportunity for in depth discussion with patient and family members about specific, vexing problems and proposes solutions that consumers embrace. Administrators, physicians and nurses come away with a better understanding of critical issues, root causes, and a strategic roadmap and tactics to improve services and patient experience.
One example of this use of the PFAC began in January 2012 when the Director of Perioperative Services came to the PFAC meeting perplexed, asking, “Why, after many years of high patient satisfaction scores, had scores for the Gastrointestinal Unit fallen off?” Press-Ganey surveys indicated cleanliness was an issue but a recent state inspection had contradicted the findings. PFAC members discussed the question, drawing and building on their own, family, and friend experiences, and at the discussion’s end, developed seven recommendations.
Through the conversation, the Director was able to understand the experience from the patient and family perspective. The discussion and recommendations changed how the Director viewed the issue, and shaped the tactics her team developed. Based on these, the Director and her team improved systems and procedures in the GI unit, resulting in increases in patient satisfaction scores.
From January 1, 2012 through January 21, 2014, Newton-Wellesley Hospital’s Patient and Family Advisory Council met with physicians, nurses, and administrators from many departments: Emergency Department, Outpatient Surgery Center, Child and Adolescence Psychiatry, Patient Centered Medical Home Steering Committee, Palliative Care Service, and the Spiritual Care Department.
News of the value the PFAC provides is circulating around the Hospital. As part of Healthcare Quality Week, October 21-25, 2013, the PFAC, with support from the Department of Quality and Patient Safety, hosted an interactive display that quickly taught staff about the PFAC; that it is a proven resource to improve quality, safety, and patient engagement; and how staff can use the PFAC to improve their departments and programs. The display was also used at Leadership Institute, a quarterly meeting for hospital senior management. More than 200 people spoke with PFAC members and staff at these events, and an article about the PFAC, Using Newton-Wellesley Hospital’s Patient and Family Advisory Council to Improve Quality, Safety and Patient Satisfaction, ran in the Hospital’s internal newsletter reaching more staff. Newton-Wellesley Hospital’s PFAC is becoming the institutional infrastructure for including patient and family member perspective to improve patient engagement, services, quality, and safety.
As a result of meeting with the PFAC, the Director of Perioperative Services worked with her team to implement the PFAC advice. They:
- Submitted for and received $40,000 in funding to update the Waiting Room
- Improved the next day post-discharge call protocol
- Changed protocol for calling caregivers for patient pickup
- Reassessed GI greeter/receptionist position and better defined the role and skills needed for success
- Re-emphasized with staff that “it’s always about making the connection with the patient”
- Reduced steps in the multi-step flow in the GI Unit
These changes rolled out slowly from spring 2012 through the present. Despite monthly fluctuation, Press Ganey patient satisfaction scores (mean and percentile rank) have continued to climb.
Newton-Wellesley Hospital’s use of its Patient and Family Advisory Council as a consumer feedback group is uncommon and innovative. It requires collaboration on the part of patients, family members, administrators, physicians, and nurses. Clear communication is necessary throughout all steps of this feedback process among all participants; and equally important is how information is communicated to patients and family members at the point of care. Implementation of PFAC advice, that is insights from the consumer perspective, has been able to transform services so they focus not only on providing excellent medical care but on the entirety of the experience creating settings that are more welcoming and considerate of the needs of patients and families, and enabling patients to take a larger role in their own healthcare as important members of the healthcare team. For these reasons, I nominate Newton-Wellesley Hospital and its Patient and Family Advisory Council for the John Q. Sherman Award for Excellence in Patient Engagement.