Relationship Based Care:

1

• Relationship Based Care
• Family Centered Relationship Based
• Communication Guide
• 3/31/11

2
risk management cases

• challenging cases
• protracted illness
• errors
• poor prognosis
• complications
• Cleveland Police called by family

3
personnel affected

• nursing staff coverage
• attending physician coverage
• physical distress

4
impact on care

• creates barriers to care
• creates barriers to communication
• longer patient hospitalization
• extensive use of resources

5
data

• patient advocate contacts for families
• staff or practitioner
• family
• code violet
• for families
• ethics consults
• family conflicts

6
algorithm overview

• recognize the patient as the center of care
• recognize the family as a patient system
• assessment and documentation of the family /
  visitor
• implementing an interdisciplinary plan

7
algorithm overview

• recognizing when the plan is not effective
• notifying management and administration
• creating verbal and written contracts and
  agreements
• empowering the bedside providers

8
color coded categories

• receptive Green
• requires attention - Yellow
• concerning Orange
• urgent Red

9
green receptive

• the typical relationship enjoyed
• involved in planning and sharing information
• the familys needs are being addressed
• the family is expressing satisfaction regarding
  the resolved needs

10
requires attention

• family or visitors have verbalized some type of
  an issue/s
• team communication
• unanswered questions
• address bad experience
• home / work issues
• anxiety / stress
• personal needs meals / rest / hygiene
• advanced directives

11
concerning

• family or visitor is exhibiting conflict
• concerns regarding issues previously addressed
• behaviors that demonstrate excessive worry or
  anxiety
• aggressively challenging physician and nursing
  care
• threatening patient transfer
• threatening legal action

12
urgent

• exhibits physical or verbal aggression
• interferes with patient care, does not follow
  staff directives of staff
• the family / visitor are not abiding by
  agreements or contracts.
• the clinical team is supported to implement
  necessary actions

13
questions