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

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

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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

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HIIN Patient and Family Engagement Summit July 21, 2017 Florida Hospital Association 1

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 Safe, High Quality Direct Care Partnership in Shaping Policy & Procedures Partnership in Hospital Governance

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PFE Metrics 1 & 2 PFE Metrics 3 & 4 PFE Metric 5

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HIIN Patient and Family Engagement Summit July 21, 2017 Florida Hospital Association 2

Metric 1 Metric 1

Implementation of a planning checklist for patients known to be coming to the hospital

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  • 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

The Intent of Metric 1 The Intent of Metric 1

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  • 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

Why This is Important Why This is Important

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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

Achieving the Metric Achieving the Metric

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Metric 2 Metric 2

Hospital conducts shift change huddles and bedside reporting with patients and family members in all feasible cases

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  • 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

The Intent of Metric 2 The Intent of Metric 2

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  • 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

Why This is Important Why This is Important

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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.

Achieving the Metric Achieving the Metric

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HIIN Patient and Family Engagement Summit July 21, 2017 Florida Hospital Association 6

Metric 3 Metric 3

Designation of an accountable leader in the hospital who is responsible for patient and family engagement

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  • PFE built into hospital management and
  • perations
  • Visible leadership within the hospital
  • Manages PFE plans and activities
  • Has time dedicated to PFE

The Intent of Metric 3 The Intent of Metric 3

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  • 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

Why This is Important Why This is Important

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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

Achieving the Metric Achieving the Metric

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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

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  • Hospital has a formal relationship with patient

and family advisors who help guide hospital

  • perations, 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

The Intent of Metric 4 The Intent of Metric 4

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HIIN Patient and Family Engagement Summit July 21, 2017 Florida Hospital Association 9

  • 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!

Why This is Important Why This is Important

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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

Achieving the Metric Achieving the Metric

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Metric 5 Metric 5

One or more patient representatives serving on the hospital Board of Directors

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  • 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

The Intent of Metric 5 The Intent of Metric 5

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  • 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

Reasonable Alternatives Reasonable Alternatives

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  • Patient and family needs, interests, and input
  • ccurs 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.

Why This is Important Why This is Important

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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

Achieving the Metric Achieving the Metric

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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

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Questions and Discussion

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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

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Thomas Workman, PhD 301-592-2215 tworkman@air.org 100 Europa Drive, Suite 315 Chapel Hill, NC 27517 www.air.org

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