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Agenda for Today

Presentation: Engaging Families at the Bedside • Team Sharing and Questions • Upcoming Due Dates

•   Presentation: Engaging Families at the Bedside •   Team Sharing and Questions •  

Engaging Families at the Bedside

Tara Bristol Rouse Director of Patient and Family Partnerships PQCNC

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What is it like being a patient?

Clinicians and hospital staff

Patients and family members

Know how the hospital works and how to get things done

Are strangers in this environment Do not understand the system or culture Know about their body and life situation better than hospital staff

Know who hospital staff are and what they do

Do not know who different staff are and what they do May want family or friends to support them Want to know the name and phone number of the one person to call if they have problems

Are busy and under a lot of stress

Are often in pain or uncomfortable, vulnerable, or afraid Are worried and want to do what they can for the patient (family members) May not understand all the written information they receive related to discharge May feel rushed on the day of discharge Aware that hospital staff are busy and may not want to bother you

Want to provide high-quality and safe care

May not know all the questions they should ask or what they need to know when they are home Trust hospital staff to provide safe and high-quality care

Communicating to Improve Quality – What will you need to do?

Before you enter the room:

Read the patient’s chart

When you enter the room:

Make eye contact with the patient Smile, if appropriate Introduce yourself by name and role Introduce new people in the room by name, role, and what they will do Have conversations at eye level

Communicating to Improve Quality – What will you need to do? (continued)

When you first assess the patient:

Ask how the patient prefers to be addressed Identify family who should be partners in care Highlight main points of communication tools Invite the patient and family to use the white board to “talk” with clinicians

Communicating to Improve Quality – What you will need to do throughout the hospital stay?

Include the patient and family as members of the health care team:

Welcome the patient and family and acknowledge their expertise React positively when people ask questions, volunteer information, share concerns, or want to take part in treatment decisions

Communicating to Improve Quality – What you will need to do throughout the hospital stay? (continued)

Ask about and listen to the patient and family’s needs and concerns:

Use open-ended questions Try to see the experience through their eyes Listen to, respect, and act on what the patient and family say Help them articulate their concerns when needed

Communicating to Improve Quality – What you will need to do throughout the hospital stay? (continued 2)

Help the patient and family understand the diagnosis, condition, and next steps:

Give timely and complete information Take every opportunity to educate the patient and family Use teach back to make sure you explained clearly Find out how much information they want to know Speak slowly Use plain language Invite them to take notes Find someone who can answer a question if you cannot

PFE Strategies and Tools – What is teach back?

An opportunity to assess how well clinicians explained a concept, and, if necessary, re-teach the information Ask the patient and family to repeat back in their own words what they need to know or do to be sure you explained things well Tips for teach back:

Start slowly Do not ask yes or no questions Chunk information when explaining more than one concept and use teach back after each concept

PFE Strategies and Tools – What is bedside shift report?

Nursing staff conducts shift change reports at the patient’s bedside Patient can identify a family member or close friend to participate Report should take about 5 minutes per patient Purpose:

To engage the patient and family in hospital care To share accurate and useful information between nurses, patients, and families

PFE Strategies and Tools – What is IDEAL Discharge Planning?

Include the patient and family as full partners

Discuss with the patient and family five key areas to prevent problems at home

Educate the patient and family throughout the hospital stay

A ssess how well doctors and nurses explain the diagnosis, condition, and next steps in their care and use teach back

Listen to and honor the patient and family’s goals, preferences, observations, and concerns

More Information on IDEAL Discharge Planning

More Information on IDEAL Discharge Planning

http://www.ahrq.gov/professionals/systems/hospital/engagingfamilies/strategy4/index.html

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Potential Challenges of Bedside Engagement

New diagnosis or information patient is not yet aware of (e.g., waiting for doctor to discuss) Patient is “noncompliant” and you need to share information with oncoming nurse Patient or family has a complex question or needs a lengthy clarification Semi-private rooms and HIPAA concerns Difficult to identify family members who will be caregivers Discharge plans change immediately before discharge Patient unable to read, write, or articulate questions or concerns

Using Scenario-Based Learning to Address Potential Challenges of Bedside Engagement

Offers an opportunity to practice Allows clinicians and staff to become comfortable with partnership language Provides an opportunity to look at a situation through the patient and family perspective Allows for a safe place to express discomfort Provides the opportunity to receive instant feedback in a safe learning environment

Final Thoughts

Your hospitals are committed to patient and family engagement – everyone plays a critical part Your job is to make it safe for them to be here, not just as patients but as partners in their care Patients and families won’t engage if they believe that you don’t want them to—it is simply too risky for them

Team Sharing/Questions

Team Sharing/Questions

Thank you!

Thank you!