Advancing Patient Family Centred Care in the Central Okanagan

1. Advancing Patient & Family Centred Care in the Central Okanagan Tracy MacDonald Health Services Administrator, KGH

2. What does Patient Centred Care actually mean? Dr. Don Berwick, Co-founder, of Institute for Healthcare ImprovementPlenary Speech International Conference of Quality & Safety, (Berlin 2009) � Speaks on Patient and Family Centered Carehttp://www.youtube.com/watch?v=SSauhroFTpk

3. Today�s Presentation Context - evolution of patient centred care Our journey in the Central Okanagan Share some of our successes Future Direction

4. Historical Perspective Plane Tree Model, 1978 Picker Commonwealth Program for Patient Centred Care, 1988 Institute for Healthcare Improvement, founded 1991

5. Historical journeycontinues Institute for Patient & Family Centred Care, established in USA in 1992 �Crossing the Quality Chasm: A New Health System for the 21st Century.� Institute of Medicine, 2001 � Seeing the Person in the Patient: the Point of Care Review Paper.� The Kings Fund, UK, 2008

8. Interior Health Journey to Advance Patient& Family Centred Care, CO Patient Centred Care, IHARP Elder Friendly Care, CO Patient Centred Care, Kootenays Strategy on Patient Centredness & Engagement, CIHS

9. What is embedded in patient-centredness Health care should be based on continuous healing relationships Care should be individualized It is important for patients to be involved in their own care decision Patients and families should have improved access to information. Health care should become more transparent

10. NRC- Picker model Respect for patient�s values, preferences and expressed needs Coordination and integration of care Information, communication and education Physical comfort Emotional support and alleviation of fear and anxiety Involvement of family and friends Transition and continuity Access to care

11. One Patient�s Story http://youtu.be/LOtNdn_GsMc

12. At the cusp of change KGH is at a crossroad with the new UBC Southern Medical Program , new capital projects and new programming Opportunity to re-define KGH as a teaching hospital offering highly specialized tertiary services KGH senior leaders defined vision for KGH as �Achieving quality patient and family centered care through a culture of learning and caring.� Fall 2009 Our goal: enhance your ability and capacity to practice patient and family-centered care 24/7

13. Our Journey to Enhance PFCC Engage staff & clinicians in a shared vision Leader, Cultural Engagement, Central Okanagan leadership team Create Steering Committee & Working Group Representatives from across CO with complementary expertise Defined model reflective of input from key stakeholders Communicate, communicate, communicate Educate Support innovation

14. Conceptual model

15. Patient & Family Centered Care is an approach to care that consciously adopts the patient�s and family�s perspective about what matters in the planning, delivery and evaluation of care. We see patients and their families as partners in their care and actively engage and empower them.

16. PFCC Model � Dimensions of Care Dignity and Respect Effective Treatment � evidence informed Quality and Safety Information Sharing Participation � Partners in Care Collaboration and Teamwork Continuity and smooth transition of care Holistic � sensitive to spiritual dimensions of health Care for the caregiver

17. Early Successes Support for Definition & Dimensions of Care Behavioural Attributes associated with Dimensions of Care Engage family members in our Steering Committee Development of foundational education program Reflective learning, values, Measuring Patient Satisfaction (QIV 2010/11) Alignment with LEAN management principles � improving process through the eyes of the patients

18. Behavioural Attributes Compassion Takes time to listen Meets others where they are at & communicates appropriately Demonstrates a non-judgemental approach to all Takes initiative to help others Fosters a feeling of comfort and safety within the team

19. Respect & Dignity Privacy Screens Creation of smudging room at KGH Ask to all staff to always introduce themselves to patients & family

20. Collaboration & teamwork Build on critical care interdisciplinary rounds Ongoing support for interdisciplinary Geriatric Steering Committee

21. Participation- Partners in Care

22. Patients as Partners Shift from acute episodes of care to chronic illness Engage with patients & families in chronic disease management

23. Continuity &  Smooth Transition of Care Transition Nurses Access & Flow Meeting LEAN projects

24. Building on PFCC Dimensions Use of Whiteboards Name of assigned nurse Goals for day Introduction of self to patient Bedside report 4West Project KGH

25. Renal Program�s Journey towards Patient & Family Centred Care Purpose �To embed patient and family centered care principles and methods that will become the cornerstone of high quality, effective, efficient and timely care for renal patients across Interior Health� Principles Dignity and Respect Information Sharing Collaboration Participation Seamless care across the continuum

26. BC Quality & Safety Council Award

27. Future Direction

28. Patient & Family Centred Care ��.the secret of the care of the patient is caring for the patient�� Francis W. Peabody, 1927

29. Thank you Questions