Barbara’s Blog

June 9, 2015

How to Run a Successful First Meeting with Your New PFAC

In previous blog posts, I advised where to find Patient and Family Advisory Council applicants and provided suggestions on how to implement the application process. In this blog post, I will discuss how to run a successful first meeting with your new council.

The first meeting is important in that it sets the stage for the successful launch of the PFAC. The meeting room should be comfortable with non-alcoholic drinks and snacks served for a relaxing social atmosphere. Chairs should be arranged so that everyone can see each other. Meetings should always begin and end on time, and should include an agenda that, for subsequent meetings, should be distributed prior to the meeting.

The PFAC hospital liaison should lead off the meeting with welcoming the attendees, introducing himself/herself and describing the purpose of the PFAC. AHRQ has an example of a 31 slide introduction PPT on their website, plus a handout, “Am I Ready to Become an Advisor?” and an orientation manual.

http://www.ahrq.gov/professionals/systems/hospital/engagingfamilies/strategy1/index.html

Next, the chair should ask each person to introduce himself/herself, including his/her professional and personal background and the reason why he/she is interested in the joining the PFAC. The chair’s role is to assess the individuals’ interactions with each other, looking for the qualities identified for ideal candidates.

Next, the chair can distribute the PFAC member job description and ask for a discussion about the qualities.

Finally, the chair should close the meeting, mentioning that formal invitations will be sent out within the week. The debrief after the meeting should include a discussion about each person’s interaction, contribution and perspective as a council member who will offer constructive suggestions, as opposed to having an axe to grind.

GRHealth defines a patient and family advisor: “Any role that enables patients and families to have direct input and influence on the policies, programs and practices that affect the care and services individuals and their families receive.”

Rather than taking time to sign non-disclosure/confidentiality documents at the meeting, send the documents by email and ask for electronic signature or fax or snail mail.  See the AHRQ for a confidentiality form:

http://www.ahrq.gov/professionals/systems/hospital/engagingfamilies/strategy1/index.html

This information and much more can be accessed through a document I created, Starting and Sustaining Patient & Family Advisory Councils: from Leadership Assessment to Success Metrics, located on Google Drive.

You can access this document, by clicking here, or by copying and pasting the following link into your browser:

http://joansfamilybillofrights.com/pfacs-from-starting-up-to-sustaining/

May 19, 2015

Using an Application Process for Potential PFAC Members

In the last blog post, I discussed where to find PFAC applicants. This blog post discusses the application process.

Once you have compiled a list of potential PFAC members, you should request that PFAC applicants fill out a comprehensive application to ensure that candidates are well-suited for the role. In addition to name, address and contact information, applications should contain work and volunteer history. Questions could include:

  • Why do you want to serve on the PFAC?
  • In what areas can you potentially contribute to a PFAC?
  • What are your areas of interest?
  • What are you expectations of the PFAC?

In an effort to reflect the demographics of the hospital, questions could also include the following: age, gender, ethnicity, languages spoken, sexual orientation, etc. (Check with your legal department to make sure these questions are appropriate.) Another question should ask about the candidate’s experience in the hospital such as hospitalization, emergency room, intensive care unit, etc.

Track the source of applicants to determine which are successful by asking, “how did you hear about us?”

AHRQ has an example of an application on their website as Word and PDF documents:
http://www.ahrq.gov/professionals/systems/hospital/engagingfamilies/strategy1/index.html

This information and much more can be accessed through a document I created, Starting and Sustaining Patient & Family Advisory Councils: from Leadership Assessment to Success Metrics, located on Google Drive.

You can access this document, by clicking here, or by copying and pasting the following link into your browser:

http://joansfamilybillofrights.com/pfacs-from-starting-up-to-sustaining/

April 6, 2015

Searching for PFAC Members

Patient and Family Advisory Councils (PFACs) are, oftentimes, challenged by where to find council members.

Over the past year and a half, I’ve been researching PFACs and gathering information that I put into a document, Starting and Sustaining Patient & Family Advisory Councils: from Leadership Assessment to Success Metrics, located on Google Drive. This document has a list of ways to find members.

 These include:

  • Written comments in surveys
  • Patients and family members who have complimented and complained to the hospital and staff
  • Recommendations from staff, ombudsmen, etc.
  • Newsletter articles requesting volunteers
  • Website page that invites visitors to apply – Memorial Healthcare System in Hollywood, Florida devotes a website page to the accomplishments of their Patient & Family Advisor Councils.(http://www.mhs.net/patients/patient-care/accomplishments.cfm)
  • Pamphlets in clinics
  • Posters in the cafeteria
  • Messages in pharmacy bags
  • Local TV Public Service Announcement (PSA) – PSAs have worked well with several hospitals

You can access this document, by clicking here, or by copying and pasting the following link into your browser:

http://joansfamilybillofrights.com/pfacs-from-starting-up-to-sustaining/

June 17, 2014

Quest for Innovative Medicine – Our Vision for the Future

Last month, I went to Cedars Sinai Board of Governors Healthcare College invited by Bruce Hoffman, a member of the Board.

Alex Cohen, co-host KPCC’s Take Two Show, moderated the Quest for Innovative Medicine – Our Vision for the Future with panelists Dr. Bruce Gewertz, Department of Surgery Chair; Dr. Steven Platadosi, Director of the Samuel Oshin Comprehensive Cancer Institute; and Dr. Clive Svendsen, Director of the Regenerative Medicine Institute.

Dr. Platadosi discussed the approaching cancer vaccine as we develop more personalized medicine, where individuals receive customized treatments according to their genes. Dr. Gewertz discussed the transition of surgery from an individual sport to a team sport where surgery is performed virtually as practice for a multi-disciplinary team before the actual event. Dr. Svendsen described a Stanford project where research is underway to reverse Alzheimer’s, which is extremely underfunded compared to other diseases, yet one which will affect more people than any other one day as lives are extended.

Disease in a dish appears to be a popular way to solve medical mysteries after the Japanese scientist Shinya Yamanaka, won the Nobel Prize in 2012 for producing embryonic stem cells through adult skin and follicles. In the shortest time between research and winning the coveted Prize, Dr. Yamanaka proved that diseased skin cells in a petri dish can be treated and cured segueing to the patient with the disease. His discovery changed the way research is conducted.

A fascinating presentation by Dr. Hart Cohen cited statistics, coupled with new methods of identifying a number of diseases through eye tests, including Alzheimer’s. Hypertension can also be revealed through the eyes – a diagnosis that eluded President Franklin Roosevelt, whose blood pressure was 350/200 when he died of a stroke, according to Dr. Patrick Lyden, Director of the Stroke Center. Cedars is seeing more strokes resulting from energy drinks.

The annual conference was a stimulating and fascinating event proving their motto – the future is now!

April 11, 2014

Patient and Family Advisory Councils (PFACs)

What is the financial impact of Patient and Family Advisory Councils (PFACs) that provide input to hospitals from the patient and family member perspective?

That’s the question that I’m researching after attending the Institute for Healthcare Improvement (IHI) Conference in December and being told that there were audible groans from the audience when a keynote speaker suggested adding patients and family members to hospital committees. Rather than a mandate for PFACs, which exists in Massachusetts and New Hampshire, why not launch a PFAC because of the incredible value that patients and family members bring to the hospital?

That idea begs the question – What is the PFAC value, specifically, the financial contribution? Are PFACs saving hospitals money?

For the past couple of months, I’ve been researching this question. If you’re involved with a PFAC and know about projects that have saved hospitals money, please contact me.

Also, if you can take a three-minute survey about PFACs, I’d be most appreciative.

http://survey.constantcontact.com/survey/a07e94mep1fhtg82tgx/start

I’ll be talking about the results of my research, sponsored by the Beryl Institute, at the 2014 PFCC Conference on June 16th hosted by Libby Hoy, a legend in the patient and family centered care movement. The Conference is a great resource for patients, family members, hospitals and organizations.

April 4, 2014

Hospital Engagement Network Making Great Strides

Each month the Patient & Family Centered Care Partners, founded by Libby Hoy, hosts a meeting for a network of patient and family members to discuss valuable resources, education, support, best practices and to connect with state and national efforts to integrate the voice of the patient.

January’s meeting featured Marty Hatlie of the Project Patient Care, who discussed the great strides made by the Partnership for Patients Campaign, which was launched in 2011 by CMS bolstered by a $218 million infusion for 26 Hospital Engagement Networks (HENs) across the country encompassing 3,700 hospitals, over 70 percent of the acute care hospitals in the U.S.

Partnering with federal agencies and several private and professional organizations, the Partnership for Patients has two primary aims to accomplish by the end of 2014: reduce preventable hospital-acquired conditions (HACs) by 40 percent compared to 2010, which would translate to approximately 1.8 million fewer injuries to patients and 60,000 lives saved; and reduce hospital readmissions by 20 percent compared to 2010. The HACs being tracked by the campaign include adverse drug events, catheter-associated urinary tract infections, central line-associated bloodstream infections, early elective deliveries, falls, obstetrical adverse events, pressure ulcers, preventable readmissions, surgical site infections, venous thromboembolism and ventilator-associated pneumonia.

The results are coming in and HEN hospitals report anywhere from a 20 percent to nearly 90 percent improvement in various HACs. While these outcomes need to be validated by other measurement systems, the HENs and their hospital members are clearly spreading innovation and reporting at unprecedented levels.

The Campaign also has integrate patient and family engagement as core strategy, and is measuring five ways in which participating hospitals are involving patients in achieving good outcomes. These include using checklists as part of the discharge process, doing nurse shift change reports at the patient bedside, designating a person or department in hospitals with responsibility for patient and family engagement, establishing patient and advisory councils, and nominating patients or family members of patients to serve on boards of directors.

UCLA Health Care Symposium

I was fortunate to be invited by Dr. Fred Hagigi, on the Health Care Symposium Board of Advisors, to the 18th Annual UCLA Health Care Symposium in January. With the theme Smart Medicine: New Diagnostics, New Frontiers, several doctors discussed the tremendous advances made in health care and challenged the imagination with thought provoking ideas about the future, including personal biometrics, diagnostic tools and big data.

Dr. Stanley Nelson, Vice Chair of Human Genetics, described the enormous progress made at UCLA on genome sequencing that is making a difference in the lives of nearly 70 percent of patients whose doctors request genetics analysis where a specific mutation is discovered. With dramatically dropping costs, as well as time, sequencing is now an effective way to solve medical mysteries that plague many families.

This opens a few questions about the pharmaceutical industry’s involvement in genome sequencing. With only 12 drugs approved by the FDA in 2012, and countless others failing to receive FDA approval, one wonders if drugs might interact differently with different genomes, stimulating personalized medicine. When will the pharma industry conduct drug trials that include genome sequencing?

One of the questions posed was what happens when technology collides with patient interaction and the doctor sits at a computer taking notes? In some hospitals, scribes accompany the doctor, so the physician can maintain continual eye contact and hands on the patient.

One speaker mentioned that medical schools are joining the Khan Academy format where lectures are watched at home and higher level problem solving is completed in the classroom.

Sponsored by medical students, the annual event highlights issues with the nation’s healthcare system. This is a challenging industry and an exciting time where one student can make a difference, such as the student who created an app for doctors to use when testing hearing ability.

IHI – Improving Healthcare for 25 Years

In December, I had the opportunity to attend the Institute for Healthcare Improvement’s (IHI) 25th Annual National Forum on Quality Improvement in Health Care in Orlando. As a family member who altered my career last year after my sister’s death to focus on improving the patient experience, the conference was a dream come true for me.

Cited by many as one of the best conferences in healthcare, the IHI Forum was an incredible experience with inspirational and thought provoking key notes, educational sessions, informative and interactive exhibits, a bookstore packed with knowledge and 6,000 people from around the world – all interested in improving healthcare. I met wonderful people, whom I hope will be my friends for life.

This was the backdrop for a terrific opportunity for me to give a private six-minute presentation that was videotaped and evaluated by two industry legends – Pat Mastors, a well-known television reporter and e-Patient Dave deBronkart, an international speaker. As a result of their wonderful feedback, I’ve honed my message. Hopefully, I’ll be speaking at healthcare organizations and hospitals in the near future.

The conference was bookended by two inspiring speakers – Maureen Bisognano, the President of IHI and Don Berwick, the founder of IHI 25 years ago.

Maureen kicked off the conference with a thought provoking message to “flip healthcare.” Just as other industries are flipping, such as education where lessons are learned at home and “homework” is done in classrooms under the teachers’ watchful eyes, Maureen’s request was for the audience to discover a new model of healthcare.

Her message was complemented by Don Berwick’s remarkable closing keynote.

 

December 18, 2013

I recently had the opportunity to attend the Institute for Healthcare Improvement’s 25th Annual National Forum on Quality Improvement in Health Care in Orlando. As a family member who altered my career last year after my sister’s death to focus on improving the patient experience, the conference was a dream come true for me. Cited by many as one of the best conferences in healthcare, the IHI Forum was an incredible experience with inspirational and thought provoking key notes, educational sessions, informative and interactive exhibits, a bookstore packed with knowledge and 6,000 people from around the world – all interested in improving healthcare. I met wonderful people, whom I hope will be my friends for life.

This was the backdrop for a terrific opportunity for me to give a private presentation that was videotaped and evaluated by two industry legends – Pat Mastors, a well-known television reporter and e-Patient Dave deBronkart, an international speaker. As a result of their wonderful feedback, I’ve repositioned my message. Hopefully, I’ll be speaking at healthcare organizations and hospitals in the near future.

The conference was bookended by two inspiring speakers – Maureen Bisognano, the President of IHI and Don Berwick, the founder of IHI 25 years ago.

Maureen kicked off the conference with a thought provoking message to “flip healthcare.” Just as other industries are flipping, such as education where lessons are learned at home and “homework” is done in classrooms under the teachers’ watchful eyes, Maureen’s request was for the audience to discover a new model of healthcare.

Her message was complemented by Don Berwick’s remarkable closing keynote. Using the analogy of John Harrison in the 1700s, who researched for 47 years and invented four apparatuses that map longitude and time, healthcare initiatives can be just as revolutionary…and take just as long.

His inspirational message invoked Maureen’s flip it theme by imagining a world where we don’t just focus on health care, but rather health creation. He cited four pillars of human flourishing: psychological resilience, social support and cohesion, exercise movement and sleep, and health exposure to substances in diet and environment. He went on to discuss the characteristics of Dan Buettner’s Blue Zone communities: move naturally, know your purpose – have a reason for waking up, kick back – shed stress, eat less, eat less meat, drink in moderation, have faith, power of love – family first and stay social. The effects of these activities have enormous impact on health.

Don reinforced his new health vision when he described a car trip to visit his two-year old grandson, Caleb. Don started the drive upset with tense shoulders and neck, and stomach pains. But as he drove closer to the little boy who would jump in his arms, his pains, his aches and his tensions melted. Don created good health through Caleb. He concluded his powerful presentation by asking the rapt audiences: Who or what is your Caleb?

The recent upheaval in healthcare presents a rare opportunity for transforming an industry that is crying for change in so many areas. And if you think that you can’t do much yourself, remember Lindsay Beck.

In her keynote interview with NBC medical editor Nancy Snyderman, Lindsay told her sometimes funny and poignant story. Through her treatment for a cancerous tongue, she ultimately forced all U.S. doctors to inform patients that chemotherapy could sterilize them and convinced every insurance company to pay for freezing a woman’s eggs or a man’s sperm. As Nancy pointed out, Lindsay changed western medicine.

What can you do? Don had five suggestions:

  1. Reconsider you own concept of health.
  2. Reconsider the form and function of your piece of the health care system.
  3. Take account of healing tools you and your patients have that lie outside the boundaries of the health care system.
  4. Bring systems thinking to the pursuit of well-being.
  5. Re-establish your faith in and use of connectedness and interpersonal relationships.
  6. Remember, embrace and celebrate that kindness is inseparable from healing and good health.

Let’s get started…we’ve got a lot to do.