Editor’s Note: Health Central Hospital’s Patient and Family Advisory Council was recognized as a finalist for the 2018 Sherman Award for Excellence in Patient Engagement. The Sherman Award is co-sponsored by Taylor Healthcare and the IHI/NPSF Lucian Leape Institute. In addition to selecting Sherman Award winners each year, the judges name finalists when the caliber of their projects warrants special recognition. Winners and finalists were announced at the IHI/NPSF Patient Safety Congress held in Boston, Massachusetts, in May.
Staff members at Health Central Hospital in Ocoee, Florida, strive continuously to innovate and improve the quality of care they provide. Achieving that vision requires every team member and physician to work together to coordinate all aspects of the patient experience. In that spirit of continuous improvement, Health Central wanted to make the patient voice more present in all its endeavors.
Health Central, therefore, established its first Patient and Family Advisory Council (PFAC) in 2012 to ensure that those at the heart of the hospital had a voice at the table. Patient and Family Advisors (PFAs) now play a critical role at Health Central, serving on the PFAC and in many other roles throughout the organization. In 2016 alone, PFAs participated on 12 hospital committees, conducted 11,306 patient experience visits, and donated 6,658 hours (92% of which supported PFA patient rounding, recognized as a “best practice” during Health Central’s recent Joint Commission survey). They also serve as champions and mentors of this work, as faculty for the Florida Hospital Association’s Patient and Family Engagement (PFE) Learning Collaborative.
Looking beyond those quantifiable results, Health Central Hospital’s commitment to patient and family engagement is distinguished by its courage to step outside of the box. The hospital has developed new opportunities to advance the quality of care, many of which can be replicated in other hospitals.
Patient & Family Advisor rounding program
PFAs regularly observe key touch points between clinical staff and patients and their family members, independently conducting rounds on patients in the hospital and emergency department (ED). The program’s goal is to identify and address the immediate needs of current patients and collect information to guide long-term policy and service delivery changes. This practice moves beyond traditional interdisciplinary patient rounding. PFAs are able to obtain information that may not be readily available to time-pressed clinicians and hospital staff. They are able to relate naturally to patients as peers.
PFAs work closely with management and administration to report their insights on opportunities to improve the care experience, as well as identify successes and best practices.
Results of this innovative program have included a new ED policy to allow bereaved family members to remain with loved ones while clinicians removed life-sustaining equipment; a reduction in patient falls; and improved patient experience scores regarding staff concern for privacy. The federal Agency for Healthcare Research and Quality formally recognized and highlighted this initiative on its Health Care Innovations Exchange, which is governed by an Editorial Board of luminaries in the field of implementation science.
Executive leadership round-table discussions
Through round-table discussions, C-suite executives have an opportunity to meet with PFAs to hear the patient and family perspective when considering a variety of strategic planning and conceptual ideas, e.g., patient care proposals, possible modifications to operational business models, proposed changes to patient procedures and processes, and patient-centered service development ideas. By offering this formal mode of communication between the hospital and patients and their family members, administrators are provided with guidance and critical insight not otherwise available to them.
This practice has profoundly improved “touch-point practices,” a quality improvement concept that addresses each point at which a health care provider or team member interacts with patients and families. Health Central’s administrators know that streamlining, strengthening, and improving each contact with the patient, as well as coordinating transitions between each of the many touch-points, is key to top quality care. Recent touch-point adjustments resulting from this collaborative process resulted in improvements to food services delivery, patient communication education through AIDET (Acknowledge, Introduce, Duration, Explanation, and Thank You) simulation training, discharge planning, and the in-room patient whiteboard communication initiative.
Health insurance navigator
Recognizing that many patients lacked health care coverage, and understanding the psychological and financial ramifications that may result, leadership arranged for a PFAC member to receive Health Insurance Navigator training. This PFA has been instrumental in helping the uninsured population in West Orange County enroll in health plans through the Health Insurance Marketplace. In addition to deploying this PFA to local community events, Health Central has designated a space adjacent to the patient registration area for Navigators to enroll uninsured patients and provide clarity and understanding about the confusing and difficult world of health care insurance. This program has been successful in empowering patients in health care decision-making while allowing them to focus solely on regaining their health.