Patient Family-Centered Care
Group
Problem
Patient family centered care: The manager of a medical surgical unit has experienced a significant drop in patient satisfaction with the primary complaints being a lack of communication to patients and their family members. Our task is to propose a move towards a patient-family centered care environment that will address this issue.
Strengths “Caregivers’ rating of nurses’ warmth of greeting as “excellent” improved from 62.5% at baseline to 75.0% post-intervention” (Bayer, 2021). Addressing families’ and patients’ complaint and concerns to improve family involvement in care (Jazieh et al., 2018). Multidisciplinary team reviewing family involvement in patient care (Jazieh et al., 2018). HowRU (ipads) closely simulates open and flexible visiting and ensures patient and family privacy, dignity, and security (Thomas et al., 2021). Virtually visits can be initiated by family, staff or patient at any time (Thomas et al., 2021). Include communication between patients/families in meetings with health care workers, inter-departmental communication, consults, and chaplains (Thomas et al., 2021). Weaknesses Hawthorne effect Communication models may not be generalized, as they are developed to tackle a specific aspect of communication (Jazieh et al., 2018). Time consuming to identify the right family member to talk to about the patient’s condition (Jazieh et al., 2018). Lack of support (Thomas et al., 2021). Study only includes English-speaking family members, which may not fully reflect the patient population (Kalocsai et al, 2018).
Opportunities Implementing the intervention in other specialty units (Thomas et al., 2021). The standardized communication model is flexible for different individuals and setting to facilitate family’s participation in the plan of care (Jazieh et al., 2018). Patient and family education can be used to enhance patient-family centered care (Jazieh et al., 2018). Patient Satisfaction Staff Satisfaction Threats Communication model has not been tested through a randomized control trial (Jazieh et al., 2018). A standardized communication model may not be suitable to families from all cultures (Jazieh et al., 2018). Cost of implementation, individual ipads and programs (Thomas et al., 2021).
Strengths:
“Caregivers’ rating of nurses’ warmth of greeting as “excellent” improved from 62.5% at baseline to 75.0% post-intervention” (Bayer, 2021).
Addressing families’ and patients’ complaint and concerns to improve family involvement in care (Jazieh et al., 2018).
Multidisciplinary team reviewing family involvement in patient care (Jazieh et al., 2018).
HowRU (ipads) closely simulates open and flexible visiting while ensuring patient and family privacy, dignity, and security.
virtually visiting can be initiated by family, ICU staff or patient at any time by simply opening the family space. No planning is required
Include communication between patients/families in meetings with health care workers, inter-departmental communication, consults, and chaplains.
Weaknesses
Study measured subjective perceptions by the caregivers, Hawthorne effect should be considered
Communication models may not be generalized, as they are developed to tackle a specific aspect of communication (Jazieh et al., 2018).
It can be time consuming to identify the right family member to talk to about the patient’s condition (Jazieh et al., 2018).
Lack of support: Understanding value of the HowRU system will be challenging for hospital leaders looking to implement technological communication systems. Communicating and justifying “why” it is important
The study only includes English-speaking family members, which may not fully reflect the patient population nowadays which is very diverse in demographics and cultures (Kalocsai et al, 2018)
Opportunities
Implementing the intervention in other specialty units, and having the study longer to increase validity.
The standardized communication model is flexible for different individuals and setting to facilitate family’s participation in the plan of care (Jazieh et al., 2018).
Patient and family education can be used to enhance patient-family centered care (Jazieh et al., 2018).
Patient Satisfaction: This team was unable to collect data on the actual patient satisfaction levels. This would be a critical step proceeding
Staff Satisfaction: As the ICU staff will be the ones utilizing these devices on a routine bases, data on their opinions is necessary
Threats
The communication model has not been tested through a randomized control trial (Jazieh et al., 2018).
A standardized communication model may not be suitable to families from all cultures (Jazieh et al., 2018).
Cost of implementation: This article does not include the potential cost of implementation. However, the plan proposes the purchasing of an iPad for each ICU bed, purchasing of HowRU software, and having 24/7 support staff. The cost is significant. The return on investment is more patient-family-centered care, improved mental health of patients and families, and staff morale, and overall satisfaction.
Limitations and barriers: As stated the maximum benefit of the HowRU system is seen in an ICU with high acuity, with patients who are unconscious or dependent on ICU staff for communication. Therefore, in lower acuity ICUs where there are more patients able to use their own devices, the perception of the value of HowRU may be diminished.
Assessment
“It is evident that family members went from being care providers in the home to outsiders as the new institutional culture of hospitals developed” (Clark et al., 2017).
“Health-care providers (HCPs) may have to talk to multiple FMs repeatedly delivering same information. This current practice may lead to frustration and wasted time and may result in conflict between the HCP and demanding FMs or among FMs themselves” (Jazieh et al., 2018).
“Barriers to providing care have not been shown to occur, but rather family members more often serve to provide information, receive education, and facilitate communication between the patient and caregivers” (Clark et al., 2017).
“Families consider daily communication of clearly understandable information to be highly important, yet they rarely perceive adequate communication. As a consequence, patients’ unique values and preferences may often not be respected, and resource-intensive treatments prolong the dying process for many” (Scheumemann et al., 2011).
“Education level and background are major factors affecting communication between healthcare providers and families” (Jazieh et al., 2018).
“Miscommunication between healthcare providers and family members leads to conflicts and dissatisfaction with care” (Jazieh et al., 2018).
Diagnosis
Lack of communication to patients and their family members
Related to weak family-provider relationships
Evidence by
Time constraints
Lack of communication skills training
Unclear goals and processes
Challenging family dynamics
S.M.A.R.T. Goal
The use of a standardized communication model to guide communication between healthcare providers and family members would improve patient and family satisfaction with care by 30% within 6 months.
Leadership Model/Theory
Plan
References
Bayer, N. , Taylor, A. , Atabek, Z. , Santolaya, J. , Bamat, T. & Washington, N. (2021). Enhancing Residents’ Warmth in Greeting Caregivers: An Inpatient Intervention to Improve Family-Centered Communication. Journal for Healthcare Quality, 43 (3), 183-193. doi: 10.1097/JHQ.0000000000000263.
Boulton, R., & Boaz, A. (2019). The emotional labour of quality improvement work in end of life care: a qualitative study of Patient and Family Centred Care (PFCC) in England. BMC Health Services Research, 19(1), 923. https://doi-org.resu.idm.oclc.org/10.1186/s12913-019-4762-1
Clark, A. P., & Guzzetta, C. E. (2017). A Paradigm Shift for Patient/Family-Centered Care in Intensive Care Units: Bring in the Family. Critical care nurse, 37(2), 96–99. https://doi.org/10.4037/ccn2017142
Jazieh, A. R., Volker, S., & Taher, S. (2018). Involving the family in patient care: A culturally tailored
communication model. Global Journal on Quality and Safety in Healthcare, 1(2), 33-37.
https://doi.org/10.4103/JQSH.JQSH_3_18
Kalocsai, C., Amaral, A., Piquette, D., Walter, G., Dev, S. P., Taylor, P., Downar, J., & Gotlib Conn, L. (2018). “it’s better to have three brains working instead of one”: A qualitative study of building therapeutic alliance with family members of critically ill patients. BMC Health Services Research, 18(1). https://doi.org/10.1186/s12913-018-3341-1
Kokorelias, K. M., Gignac, M. A. M., Naglie, G., & Cameron, J. I. (2019). Towards a universal model of family centered care: a scoping review. BMC Health Services Research, 19(1), 564. https://doi-org.resu.idm.oclc.org/10.1186/s12913-019-4394-5
Scheumemann, L. P., McDevitt, M., Carson, S. S., & Hanson, L. C. (2011). Randomized, Controlled Trials of Interventions to Improve Communication in Intensive Care. CHEST, 139(3), 543–554. https://doi-org.resu.idm.oclc.org/10.1378/chest.10-0595
Thomas, K. A. S., O’Brien, B. F., Fryday, A. T., Robinson, E. C., Hales, M. J. L., Karipidis, S., Chadwick, A., Fleming, K. J., & Davey-Quinn, A. P. (2021). Developing an Innovative System of Open and Flexible, Patient-Family-Centered, Virtual Visiting in ICU During the COVID-19 Pandemic: A Collaboration of Staff, Patients, Families, and Technology Companies. Journal of Intensive Care Medicine, 36(10), 1130–1140. Doi 10.1177/08850666211030845
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Patient and Family Centered Care
Group
Problem
Patient-centered care: The manager of a medical surgical unit has noticed a dramatic decrease in patient satisfaction, with the primary issue being a lack of communication with patients and their family members. Our aim is to propose a shift toward a patient-family-centered care environment that addresses this challenge.
Strengths “Caregivers rated nurses’ warmth of greeting as “good” from 62.5 percent at baseline to 75.0 percent after the intervention” (Bayer, 2021). Addressing complaints and concerns of families and patients in order to improve family involvement in care (Jazieh et al., 2018). A multidisciplinary committee is evaluating the involvement of family members in patient care (Jazieh et al., 2018). HowRU (ipads) accurately resembles open and flexible visiting while also protecting patient and family privacy, dignity, and security (Thomas et al.).
