“…patients’ experience should be the fundamental source of any definition of quality.”
Don Berwick, President & CEO, Institute for Healthcare Improvement, 2002
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Adopt-a-Unit Rounds at MCGHealth, Augusta, GA brings together senior executives with mid-level managers and patients and families to promote mutual learning for quality improvement. |
Leaders of clinical programs, hospitals, community organizations, and public health agencies are in the unique position to shape health care policies and programs. Numerous leaders of health care organizations and associations are recognizing the value of collaborating with patients and families at both the clinical and policy levels to improve quality, safety, and the experience of care. The concepts of patient- and family-centered care are being integrated into unit and institutional visions and definitions of quality of care. Health care practitioner organizations are incorporating these concepts in their guidelines and standards of practice.
To truly be effective in enhancing quality and safety, patient- and family-centered care must be comprehensively integrated into organizational culture. For this reason, it is imperative that leaders at all levels have knowledge of the core concepts of patient- and family-centered care and ways in which they can support change.
Perspectives of Leaders
The vision and commitment of leaders are essential to advancing the practice of patient- and family-centered care within an organization. The experience and perspectives of leaders who have been on the forefront of changes in organizational culture can help inform the actions and processes developed by others.
Annette Bartley-a registered nurse with more than 27 years experience in health care-is currently Director of the UK Health Foundation's Safer Patient Network. Annette is a founding member of the Wales Faculty for Healthcare Improvement, where she supports the drive for quality improvement in health care across Wales. Annette leads a unique aspect of the 1000 Lives National Patient Safety Campaign-Wales, a program initiative aimed at improving patient safety and the quality of care at the frontline. The project, Transforming Care at the Bedside (TCAB), focuses specifically on improving patients' experience of care and is being 'tested' in three Welsh pilot sites... Read More
Annette Bartley, Director of UK Health Foundation's Safer Patient Network
When Susan Mitchell Grant became the Chief Nursing Officer (CNO) for Emory Healthcare (EHC) in the fall of 2006, she brought her vision-for partnerships and collaboration with patients, families, and professionals-that cuts across disciplines, departments, and settings. Susan, who reports to John T. Fox, CEO of the health system, is responsible for the nursing practice throughout Emory Healthcare, including inpatient care at four hospitals as well as the outpatient clinics. She serves as the Acting Dean, as well as Associate Dean for Clinical Leadership, at Emory University, Nell Hodgson School of Nursing.
Effective executive leadership, across disciplines, is crucial to the successful implementation of Emory Healthcare's vision for partnership and collaboration. Emory Healthcare's strategic plan includes clearly defined goals and measured objectives-which are being tracked-to further the implementation of patient- and family-centered care. One of the goals in the 2008-2012 Strategic Plan is to "Become nationally recognized for transforming health and healing through developing and implementing innovative patient- and family-centered care, research, and teaching models." Read More
Susan M. Grant, MS, RN, NEA, Chief Nursing Officer, Emory Healthcare, Atlanta, GA.
"We've started something new and exciting in the clinic this month. Our patient advisors are making rounds with our clinicians, observing the doctor-patient interactions, giving feedback, and coaching us on how to be more patient- and family-centered. It's wonderful; we've learned so much."
Dr. Mike Nelson, former Medical Director for the Presbyterian Medical Group in Albuquerque, NM, led the effort to develop a patient-centered multidisciplinary team primary care delivery model. RN care managers, diabetes educators, pharmacy clinicians and masters level mental health workers working in primary care offices are partnering with patients and physicians to develop and implement collaborative self management programs for people with chronic conditions. Read More
Dr. Mike Nelson, former Medical Director, Quality Improvement, Presbyterian Medical Group, Albuquerque, NM
"Whether you are talking to the Institute of Medicine, healthcare insurers, trustees and executives, the nurse in the NICU, or consumers, it is clear that to make the transformation we need in healthcare, we must have an active partnership with patients and families."
Don't miss Jim Conway's must read article in the Jan/Feb 2008 Healthcare Executive in which he calls to hospital trustees and executive leaders to... "make a commitment to patient- and family-centered care, to move it from a discussion of "if" to a discussion of "when and how." Read More
Also, check out Jim's thoughts on "Aligning Leadership Agendas for Quality, Safety, and Patient- and Family-Centered Care" shared at the Executive Leadership Forum held in conjunction with the Hospitals and Communities Moving Forward with Patient- and Family-Centered Care Intensive Training Seminar in Calgary, Alberta, Canada. Read More
Jim Conway, Senior Vice President, Institute for Healthcare Improvement, Cambridge, MA
"Good staff, good intentions, and hard work are not enough. . . .To make and sustain progress in patient- and family-centered care you need to have a system-wide approach, the right foundation-including resources, staff, policies, structures-and leadership. A system that consistently includes patients and families will be safer and will provide a better experience-for patients, families, and staff. . . . There is a change coming-it's really a question of are we going to be behind it, or are we going to be out in front of it?"
Jack Davis, former President & Chief Executive Officer, Calgary Health Region, Calgary, Alberta, Canada
"We all have our own cultures, and our own biases. The challenge is for us to join together, in a spirit of discovering common ground and honoring diversity, embracing all cultures with unbiased language to create a myriad of new and previously unlikely partnerships throughout the state."
Richard Aronson, MD, MPH, Medical Director of the Office of Maternal and Child Health, Division of Family Health, Maine Center for Disease Control and Prevention, Department of Health and Human Services, Augusta, ME
"Leaders are responsible for the values of their organization. They're the guardians of the ideals of patient care. . .We translated our values of patient- and family-centered care into standards for performance for our staff. These standards are part of every job description and they are introduced in new employee orientation. Thus every individual who goes through orientation for our health system knows that they are expected to be patient- and family-centered."
Pat Sodomka, MHA, FACHE, Senior Vice President, MCGHealth & Director for the Medical Col lege of Georgia Center for Patient- and Family-Centered Care, Augusta, GA
The following articles, written by organizational leaders, describe processes of change in three different types of organizations: a large academic medical center; a specialty cancer center; and a children’s hospital within a large adult care institution.
Hobbs, S. F. & Sodomka, P. F. (2000). Developing partnerships among patients, families, and staff at the Medical College of Georgia Hospital and Clinics. Journal of Quality Improvement, 26(5), 268-276.
Ponte P. R., Conlin G., Conway J. B., Grant S., Medeiros C., Nies J., Shulman L., Branowicki P., & Conley, K. (2003). Making patient-centered care come alive: Achieving full integration of the patient's perspective. Journal of Nursing Administration, 33(2), 82-90.
Smith, T. & Conant Rees, H. (2000). Making family-centered care a reality. Seminars for Nurse Managers, 8(3), 136-142.