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Connecting with the Family: A New Look at Family Centered Care
1. Teesha Miller, BS
Children’s Mercy Hospital
Parent to Parent Program Manager
Connecting with the Family:
A New Look at Family Centered Care
2. What is Family Centered Care?
“Patient- and family- centered care is
an approach to the planning, delivery,
and evaluation of health care that is
grounded in mutually beneficial
partnerships among patients, families,
and health care providers.”
Institute for Patient- and Family- Centered Care
3. Another Definition of PFCC
• The needs of the patient come first
• Nothing about me without me
• Every patient is the only patient
“physician tries to enter the patient’s world, to see
the illness through the patient’s eyes.”
Don Berwick, M.D. former President and CEO of
Institute for Healthcare Improvement (IHI)
4. Patient- and family- centered care
is founded on the understanding
that the family plays a vital role
in ensuring the health and
well-being of patients of all ages.
5. Core Concepts of
Family Centered Care
• Dignity and Respect
• Information Sharing
• Participation
• Collaboration
6. Dignity and Respect
• Listen to and honor patient and family
perspectives and choices
• Incorporate into care planning and
decision making
• Patient and family knowledge
• Values
• Beliefs
• Cultural backgrounds
7. Information Sharing
• Share complete and unbiased
information
• Remember that information sharing is
a two-way street
• Health care professionals provide timely and
accurate information to families
• Families are the experts on their child and have
valuable information to share with the team
8. Participation
• Patients and families are encouraged
and supported in participating in care
and decision making at the level they
choose
9. Collaboration
• Patients and families are included on
an institution-wide basis
• Policy and program development
• Health care facility design
• Professional education
• Delivery of care
10. “Patients and their families are treated
with compassion in a
family-centered environment
that recognizes their
physical, emotional, financial, social
and
spiritual needs.”
Children’s Mercy Hospitals and Clinics Mission Statement
11.
12.
13. Family feedback
• “I waited an hour and a half after our son was
out of surgery to see him, I sure wish I could
have gotten in sooner. I know to stay back and
let them work, we’ve been here so much.”
• “I waited for two hours in the Ronald McDonald
room and no one came to get me after surgery
until I went to the waiting area and asked. Then
I was able to see my daughter in about 10
minutes.”
14. Basic needs of families
• Information about their child
• Reassurance and support
• Need to be near patient
15. Literature shows…
• Acute illness causes significant distress for family caregivers
• Families that function well and provide adequate support
can improve the quality of life for an ill child
• Family stress interferes with the ability to receive and
comprehend information
• Repetition and presentation in multiple formats is important
for retention
16. What else do we know?
• Families benefit from a sense of order during a chaotic time
• Some structure and policy provide support and “safety” for families
• Inconsistency wreaks havoc over families who are struggling to
maintain control
• Bedside nurses can’t meet all the needs of families and provide care
to the patients alone – all the staff need knowledge and
training in how to provide Family Centered Care
17. Why Family Centered Care?
• It’s the right thing to do
• The Joint Commission
• New patient-centered communication standards
will be included in accreditation decision beginning
January 1, 2012
PC.02.01.21 The hospital effectively communicates
with patients when providing care, treatment, and
services.
RI.01.01.01 The hospital respects, protects, and
promotes patient rights.
18. YOU are a piece of the puzzle!
Child Life/Music Therapy
Respiratory Care
Volunteers
Social Work
Medical Team
Patient
Family
Chaplaincy
28. Resources
• Institute for Patient and Family Centered Care
www.ipfcc.org
• PFCC Partners at the Innovation Center of UPMC
www.innovationctr.org
• The Joint Commission
www.jointcommission.org
• Children’s Mercy Hospitals and Clinics
www.childrensmercy.org
29. References
• Balik, B., Conway, J., Zipperer, L., & Watson, J. (2011). Achieving an
exceptional patient and family experience of inpatient hospital care.
Institute for Healthcare Improvement Innovation Series 2011. Retrieved
on June 1, 2011 from www.IHI.org
• Chow, S. (1999). Challenging restricted visiting policies in critical care.
Journal of the Canadian Association of Critical Care Nurses. 10:2, p.
24-27.
• Griffin, J., Friedemann-Sanchez, G., Hall, C., Phelan, S., & van Ryn, M.
(2009). Families of patients with polytrauma: Understanding the
evidence and charting a new research agenda. Journal of Rehabilitation
Research & Development. 46:6, p. 879-892.
• Henneman & Cardin. (2002). Family-centered critical care: A practical
approach to making it happen. Critical Care Nurse. 22:6, p. 12-19.
30. References
• Honea, N., Brintnall, R., Given, B., Sherwood, P., Colao, D.,
Somers, S., & Northouse, L. (2007). Putting evidence into practice:
Nursing assessment and interventions to reduce family caregiver
strain and burden. Clinical Journal of Oncology Nursing. 12:3, p.
507-516
• Lee, M., Friedenberg, A., Mukpo, D., Conroy, K., Palmisciano, A., &
Levy, M., (2007). Visiting hours policieis in New England intensive
care units: Strategies for improvement. Critical Care Medicine. 35:2,
p. 497-501.
• Titler & Walsh. (1992). Visiting critically ill adults – strategies for
practice. Critical Care Nursing Clinics of North America. 4, p. 623-
632.
Taking a look at patient and family centered care relative to the respiratory therapist can be a bit challenging for our psyche.
Take into account the circumstances under which information is being shared
Families are under stress
Families come in “as we are”
Information will need to be shared multiple times – with dignity and respect
Families have different ways of coping
some become very involved while others cope by taking a back seat approach – both ways are respected
Imbedded within CMH Mission statement
That was an overview of what FCC is
Now let’s talk about how families and respiratory therapist interact.
The registered respiratory therapist (RRT) applies scientific knowledge and theory to practical clinical problems of respiratory care. The respiratory therapist is qualified to assume primary responsibility for all respiratory care modalities, including the supervision of certified respiratory therapist (CRT) functions. The respiratory therapist may be required to exercise considerable independent clinical judgment, under the supervision of a physician, in the treatment of patients with respiratory dysfunction.
Every family you meet is under stress
Every family deals with stress differently – how do you see families dealing with stress
Which way is the “right way”?
There are processes in place…..
Your opportunity is to realize where THIS family at THIS moment is and to be a source of comfort
Many layers of stress – what can I do to peel away a layer
Recognizing that these are very important needs for families – other information takes a back seat before these needs are met
How much thought do you give to BRAND RECOGNITION as a Respiratory Care professional?
In the era of Facebook, Instagram and Tumblr, consumers are even more aware of the purchasing power. The phenomena is the power of the opinion – and it matters! People are accustomed to addressing items concretely – either like or dislike
Thank the unit secretaries that approach work as a calling. That have a positive disposition with families and with each others. Explain why that characteristic is not only necessary but needed.
Chaos: disorder: a state of complete disorder and confusion
Calm: not anxious: without anxiety or strong emotion
Conversational: connected with conversation: relating to informal talking, especially to the ability to say interesting things
Calamity : distress: misery or distress resulting from a disastrous event
John Quiones – What Would You Do?
Partner with your neighbor and think of 3-5 ways you can begin to include patients and families in your everyday practice relative to your “environment.”
