The idea of patient-centered care resonates well with me, and other nurses who have long valued the central role of patients and families in the delivery of care. Some of my most memorable pediatric patients had miraculous recoveries, and the one aspect that all of these patients had in common was an engaging family support system. Many studies have also proven that patients do better and heal faster when they or a caregiver are involved in their care. In the landmark 2001 report, Crossing the Quality Chasm, the Institute of Medicine (IOM) strongly recommended a patient-centered approach, noting that patients’ sense of control and perceived quality of life are favorably impacted by involvement in their care.
Tuning into the Full Story
However, patient-centered care needs to go a step further than just family involvement at the time when a patient is sick, or in and out of the hospital. A patient-centered model of care has implications for every aspect of the clinical practice and the organization. Though the healthcare model has shifted to a more patient-centered approach over the last few years, many institutions still underestimate the organizational commitment associated with moving from a traditional provider model to one that is truly patient-centered. HCAHPS scores and satisfaction surveys are one way to give patients a voice for concerns or opinions. However, they often fall short of providing on-going, real-time patient feedback into organizational strategies and initiatives that affect patients as an entire entity. Organizations that rely solely on these snapshots of patient input often do not get the full picture of how patients feel about specific aspects of the organization, and about the organization’s attempts to improve.
Creating a Partnership for Problem-Solving
One way in which many forward-thinking hospitals have begun to implement a more patient-centered model is through a Patient and Family Advisory Council (PFAC). This organizational care structure involves collaboration from a number of groups — patients, family members and clinicians, as well as people representing departments from across the organization, such as risk management, process improvement, marketing, and safety and quality. These interdisciplinary teams are actively involved in a dialogue that is more focused than just angry patients who didn’t like the care that they received. The patients and family members involved in the PFAC actively engage as partners in the problem-solving process. These members are often recognized as the champions for patient and family engagement within the organization.
The Patient and Family Advisory Council
Many nationally recognized organizations are also supporting Patient and Family Advisory Councils. The Institute of Patient and Family Centered Care (IPFCC) has teamed up with the Agency for Healthcare Research and Quality (AHRQ) and defined a strategy and implementation handbook specifically for healthcare organizations when working with patients and families in an advisory role. The IOM has also cited patient- and family-centered care as one of the foundational elements in achieving the best care at lower cost. The 2012 IOM report recommends, “Patients and families should be given the opportunity to be fully engaged participants at all levels, including individual care decisions, health system learning and improvement activities, and community-based interventions to promote health.”
A typical Patient and Family Advisory Council recruits patient and family members, past and present, who are passionate about the role that they play in the well-being of the patient. This gives the organization an invaluable opportunity to view their care through a patient/family perspective. It is expected that members of the council will actively collaborate with the organization, having a voice in setting organizational policies, advising on process improvement, and working with staff on ideas to enhance communication between the patient and family. Most PFACs meet on a regular schedule for 2-3 hours every other month with members giving the organization a 1-2 year commitment to serve on the council. Members of the council also have the opportunity to serve on many different types of subcommittees of the organization, such as Bioethics, Safety and Quality, Risk, Marketing, and Patient Engagement committees.
The First Step in a Journey
Before an organization can begin to include patients and families into their organizational efforts, a strong relationship between staff and patients, and family members alike must be forged repeatedly. A dedicated and committed community that fully trusts the organization in their care and well-being will deliver the best type of members of the PFAC. Developing a patient-centric model is a journey and cannot be completed just by having a PFAC, but it is the first step in recognizing what it means to be patient- and family-centered. It opens up countless opportunities for the organization to improve the quality of care for patients and families along the path to better health and well-being.