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Partnership with Families on Quality & Safety Carole Hemmelgarn Matthew Vitaska, RN, ND Alyssa Hemmelgarn 2 History of Family Engagement in Quality and Safety • Family members have been on our hospital committees since 2009 Quality and Safety Committee of our Board of Directors Quality, Safety and Performance Improvement Council Patient Safety Committee Various microsystem Quality Committees and work groups 3 Our Journey • Step 1: Build Will Discussions with risk management/legal Discussions at Quality, Safety and Performance Improvement Council • Senior leadership Anonymous survey to committee members • Only a few had legal concerns • Step 2: Execution Developed an orientation program for family members • Introduction to quality & patient safety-basic concepts • Overview of CHCO quality & safety program • Orientation to building/life safety Orientation for committee members • Step 3: Ongoing Support Checking in with families and committee members 4 Ground Rules and Orientation: Family Participation in QI Committees and Initiatives Nationally, the inclusion of parents on quality related committees and projects is becoming increasingly common and accepted at Children’s Hospitals. We know there is a role for patients and families in the redesign of the health care systems in which they receive their care. We are pleased to welcome families into our work efforts. What we want Children’s staff to know: 1. We can be honest in our discussions. Parents who have been invited to join us understand our goal and the need for confidentiality about what is discussed. This is a safe environment for these discussions. 2. You may feel awkward discussing certain things; that is normal and expected. We will work through this area together. 3. There may be times when the parents challenge us. That is a good thing. We want their perspective to be included, being open to change and not accepting the status quo. It is important to remember that the family’s goals are EXACTLY aligned with our own- to have a safe, effective, patient and family centered course of care for their child. 4. This is somewhat of an unknown for the parents who are joining us. They are committed to and passionate about partnering with us. They want us to know that they are learning also and want to be sure they are being helpful. 5 What we want Parents to know: 1. We want you to know you are welcome members of our team. 2. Please understand that this is new for us too. It is hard to admit that we don’t always do things as well as we would want. We are continually working to improve and are asking you to be active participants in that journey. 3. We value your experiences and perspective and welcome your input. We invite you to share your experiences with us. Don’t hesitate to ask tough questions or raise issues of any concern. 4. It is important that the things we discuss remain confidential. We will not discuss names in any case, but even the general nature of the discussions and the issues we are addressing are things that we would not want to air publicly. 5. Some of the language or terms we use may be new to you, please ask us if you don’t understand what we are talking about. Defining Success: All participants, staff and parents: 1. Were open and honest in discussing topics and issues. 2. Gained a new perspective about how our organization performs. 3. Felt the experience facilitates further integration of families into quality work 4. Parents who participated have a better understanding about improving quality, patient safety and the challenges the hospital faces. 5. We ALL feel it was a success having parents join our committee AND, we would not hesitate to 6 consider involving families in any future quality or performance improvement efforts. Our Experience • Evaluation in Q4 2012 via survey Demographics • 62 Reponses 4 parent members 55 staff 3 board members • Approximately 30% participation rate 7 Family Member Feedback 8 Hospital Staff and Board Feedback 9 Parents Speaking Up-2 Views 10 Conclusions • Feedback is overwhelmingly positive on parent participation in committees at CHCO • Family members have helped call out the white elephants • Family members have challenged us to accelerate some of our work • Family members have brought forth view points that we wouldn’t have thought of 11 Lessons Learned • Spell things out on power points Acronyms & abbreviations • Checking in with the family members before and/or after meetings is helpful May need emotional support May need clarification of things that were talked about They may not always feel comfortable speaking up in a group setting • Request to provide family members with committee rosters that include pictures • If can be helpful to have someone with content knowledge sit next to the family member to “translate” medical jargon/concepts during the meeting 12 How You Can Get Started • • • • • • • • Find early adopter parent/patient/family, staff leaders Start with a project or task force, then another….. Develop, adapt or steal orientation materials PDSA Cycles! Patient/family selection strategies Hospital staff preparation Dealing with concerns/resistance “Start before you’re ready” 13