The PFE Metrics: What are we Really Measuring? Thomas Workman, PhD - PDF document

HIIN Patient and Family Engagement Summit July 21, 2017 The PFE Metrics: What are we Really Measuring? Thomas Workman, PhD Senior Advisor, PfP PFE Contractor July 21, 2017 Building the Culture of Engagement: Partnership at All Levels Partnership in Hospital Partnership Governance in Shaping Partnership Policy & in Safe, Procedures High Quality Direct Care PFE Metrics 1 & 2 PFE Metrics 3 & 4 PFE Metric 5 2 Florida Hospital Association 1

HIIN Patient and Family Engagement Summit July 21, 2017 Metric 1 Metric 1 Implementation of a planning checklist for patients known to be coming to the hospital 3 The Intent of Metric 1 The Intent of Metric 1 • For scheduled hospital admissions (surgery, testing, other treatment) • Create a mechanism for patients and families to discuss concerns, preferences, and issues for the hospital stay • The physical checklist serves as a list of items and topics for the conversation 4 Florida Hospital Association 2

HIIN Patient and Family Engagement Summit July 21, 2017 Why This is Important Why This is Important • Enables an active partnership in quality and safety from the very start of the hospital stay • Helps patients clarify expectations about the hospital stay and their care • Allows clinical staff to know the concerns, interests, and goals of the patient • Identifies potential safety issues so that patient and clinical staff can work in partnership to avoid them 5 Achieving the Metric Achieving the Metric We have achieved this metric when: • Hospital provides a pre-admissions checklist to patients with all scheduled admissions • At admission, hospital staff discuss checklist with patient and family 6 Florida Hospital Association 3

HIIN Patient and Family Engagement Summit July 21, 2017 Metric 2 Metric 2 Hospital conducts shift change huddles and bedside reporting with patients and family members in all feasible cases 7 The Intent of Metric 2 The Intent of Metric 2 • Include the patient and/or family member in as many conversations about their care as possible throughout the hospital stay • The patient and/or family member is able to hear, question, correct or confirm, and/or learn more about the next steps in their care as it is discussed between nurses changing shifts or clinicians making rounds 8 Florida Hospital Association 4

HIIN Patient and Family Engagement Summit July 21, 2017 Why This is Important Why This is Important • Enables the opportunity for correcting errors and clarifying care plans with the patient and family • Encourages the patient and family to be an active partner in their care to the degree they desire • Enables ongoing communication and interaction throughout care • Enhances the patient experience of care 9 Achieving the Metric Achieving the Metric We have achieved this metric when: • In as many units as possible, but in a minimum of at least one unit, nurse shift change huddles or clinician reports occur at the bedside and involves the patient and/or family members. 10 Florida Hospital Association 5

HIIN Patient and Family Engagement Summit July 21, 2017 Metric 3 Metric 3 Designation of an accountable leader in the hospital who is responsible for patient and family engagement 11 The Intent of Metric 3 The Intent of Metric 3 • PFE built into hospital management and operations • Visible leadership within the hospital • Manages PFE plans and activities • Has time dedicated to PFE 12 Florida Hospital Association 6

HIIN Patient and Family Engagement Summit July 21, 2017 Why This is Important Why This is Important • Communicates the value of PFE to all hospital staff, clinicians, patients, families, and the community • Enables the hospital to centralize and coordinate PFE efforts • Clarifies across the hospital who has authority and responsibility for PFE. • Provides a face and name to the hospital’s growing PFE culture 13 Achieving the Metric Achieving the Metric We have achieved this metric when: • There is a named hospital employee who is responsible for PFE efforts at the hospital either in a full-time position or as a percentage of time within their current position • Appropriate hospital staff and clinicians can identify the person named as responsible for PFE at the hospital 14 Florida Hospital Association 7

HIIN Patient and Family Engagement Summit July 21, 2017 Metric 4 Metric 4 Hospital has an active Patient and Family Engagement Committee OR at least one former patient that serves on a patient safety or quality improvement committee or team 15 The Intent of Metric 4 The Intent of Metric 4 • Hospital has a formal relationship with patient and family advisors who help guide hospital operations, policies, procedures, and quality improvement efforts • May be via Patient and Family Advisory Council OR inclusion of advisors on hospital quality or safety (or related) committee • Patient/Family Advisors have the same rights and privileges as all other committee members 16 Florida Hospital Association 8

HIIN Patient and Family Engagement Summit July 21, 2017 Why This is Important Why This is Important • Help hospital provide care and services based on patient- and family-identified needs and solutions rather than assumptions about what patients and families want or need • Improve overall systems and processes of care, including reduced errors and adverse events – patient-centered systems require patient input! 17 Achieving the Metric Achieving the Metric We have achieved this metric when: • Multiple patient and/or family representatives from the community have been formally named as members of a PFAC • At least one patient serves on another hospital committee • Meetings of the PFAC or other committees with patient and family representatives have been scheduled and/or conducted 18 Florida Hospital Association 9

HIIN Patient and Family Engagement Summit July 21, 2017 Metric 5 Metric 5 One or more patient representatives serving on the hospital Board of Directors 19 The Intent of Metric 5 The Intent of Metric 5 • Ensure that at least one Board member with full voting rights and privileges provides the patient and family perspective on all matters before the Board, similar to other Board members who represent specific interests in the community • The ultimate goal of this activity is to ensure that the Board works with patient and family perspectives when making governance decisions at the hospital 20 Florida Hospital Association 10

HIIN Patient and Family Engagement Summit July 21, 2017 Reasonable Alternatives Reasonable Alternatives • Asking for PFEC input on matters before the Board, and incorporating a PFEC report into the Board agenda • Identifying elected or appointed Board members to serve in a specific role, with a written role definition, as representing the patient and family voice on all matters before the Board • Requiring all Board members to conduct activities that connect them closer to patients and families, such as visiting actual care units in the hospital two times per year and/or attending two PFEC meetings per year 21 Why This is Important Why This is Important • Patient and family needs, interests, and input occurs at the level of hospital governance. • Encourages patient-centered decisionmaking by the Board. • Communicates a commitment to the community about the role of patients and family members in the hospital’s operations. • Enables patients and families to contribute viable solutions and ideas to accomplishing the mission of the hospital. 22 Florida Hospital Association 11

HIIN Patient and Family Engagement Summit July 21, 2017 Achieving the Metric Achieving the Metric We have achieved this metric when: • The hospital has at least one position on the Board designated for a patient or family member who is appointed to represent that perspective • If a specific board representative is not possible, an alternative exists to work with patients and families when making hospital governance decisions 23 Impact of Involving Patient and Family Representatives “When you are sitting at the Board table looking at a patient advisor, the numbers you are reviewing become that person’s face and that is powerful.” -Board Member “When the advisor at the table says, ‘I was one of those complications, what are you going to do about it?’, it really helped to drive change in the reduction of infections and serious safety events.” -Surgeon and Board Chair “When the Board pays attention and talks about circumstances around what happened to the patient; they get the data off the paper and into minds and hearts.” -Patient/Family Advisor, Board Quality Committee 24 Florida Hospital Association 12

HIIN Patient and Family Engagement Summit July 21, 2017 Questions and Discussion 25 Resources • PfP Strategic Vision Roadmap for PFE : Provides six strategies to guide efforts to (1) implement PFE that is effective, sustainable, and reflect the core principles of PFE and (2) meet the five PfP PFE metrics to improve patient safety • PFE Metric Learning Modules: Recorded webinars provide “just in time training” to help hospitals implement and meet the five PFE Metrics (each training addresses a specific PFE Metric) Available in the PfP Resource Library at: www.healthcarecommunities.org/ResourceCenter/PartnershipforPatients Library.aspx 26 Florida Hospital Association 13