Patient and Family Centered Care: What is It

1
Patient and Family Centered Care What is It
How Do We Get There?

• Ann Greiner, IHI Director
• Pat Rutherford, IHI VP

2
PFCC Breakout Agenda

• The Concept Measures (700 - 745)
• Sharing Experiences (745 - 815)
• More Coffee (Break) (815 - 830)
• Promising Changes (830 - 930)
• Setting Up Tests (930 -1000)

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PFCC Defining the Concept

• Resources to draw upon
• Center for Health Design (www.healthdesign.org)
• Institute for Family Centered Care
  (www.familycenteredcare.org)
• Picker Institute Through the Patients Eyes
  (Jossey Bass) (www.nrcpicker.org)
• Planetree (www.planetree.org)

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Nine PFCC Components

• Respect Patients Values, Preferences,
  Expressed Needs what they want and when
• Coordinate Integrate Care -- teams, patient
  support across settings
• Empower Patients via Information and Education
  -- IT, culture change

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9 PFCC Components, Cont

• Shared Decision Making shared responsibility,
  authority/culture shift
• Emotional Spiritual Support empathy, inner
  resources
• Involvement of Family and Friends the larger
  community

6
9 PFCC Components, Cont

• Insuring Patients Physical Comfort pain mgmt,
  services
• Architecture Physical Space Redesign
  ergonomic/furnishings, architectural
• Optimizing Transitions and Continuity -- good
  handoffs

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Patient/family Centered Care

• Honors the whole person family, respects
  individual values choices, and ensures
  continuity of care. Patients will say they give
  me exactly the help I need, when I want (and
  need) it.
• High leverage changes
• Support involve patients families
• Create healing environment

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Measuring PFCC Care

• Four item patient survey
• Willingness to recommend
• Your preferences were respected
• Your physical comfort was a priority
• Experience supportive of you and your familys
  emotional needs
• in Top box very poor, poor, good and very
  good minimum of 25 patients per month

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Current State of IC Based on 50 P.A. Response
Rate

• While bulk of teams garnered pt/family input in
  diverse ways, 5 out of 18 did not have a
  mechanism beyond surveys
• Most teams (16/18) are not conducting MDRs at the
  bedside w/pt and diverse team

10
Current State of IC Based on 50 P.A. Response
Rate

• More than half of the teams have taken some steps
  to create healing environments
• Most have made some effort to involve
  pts/families in their care, but about a 1/3 have
  not made strides in this area

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PFCC Overall

• Least developed evidence base of the four domains
  
• Very frequently mentioned as priority by IC teams
• External trends increasingly activated
  patients/families growing availability of health
  information, e.g., Medicares expected pt
  satisfaction survey requirement boomer
  clinicians