Patient and Family Led Feedback Forums Angela Morin

Patient and Family Led Feedback Forums Angela Morin – Patient and Family Experience Advisor Kellie Kitchen – Director SPA and Maternal Child

Faculty/Presenter Disclosure • Name of Presenter(s): Angela Morin, and Kellie Kitchen • Relationships with Commercial Interests: None • Grants/Research Support: None • Speakers Bureau/Honoraria: None • Consulting Fees: None

Disclosure of Commercial Interests • This presentation has received financial support from: no parties • This presentation has received in-kind support from: no parties • Potential for Conflict of Interest: None

PFCC at KGH

Objectives • Understand how to implement patient led feedback forums in your own organization • Recognize potential risks and opportunities in partnering with patients and families to provide educational opportunities for staff. • Recount the actual experience of a patient who has led a forum.

Performance Improvement using Feedback Forums • • • Strategic Initiative Patient Quality and Safety Staff Education and Engagement Communication Monitoring and reporting Accreditation Standards

Identify patient/family • Staff referrals • Patient Relations Department • Family feels safe and comfortable in speaking to a group of healthcare staff • Learning opportunities for staff • Able to share positive and negative aspects • Don’t have an axe to grind • Want to improve the patient experience

Support and prepare patient/family • • Initial meeting Role of the facilitator Hearing the experience Deciding on main learning opportunities for staff • Set date and time • Provide “Tips for the patient/family”

Some “tips” for patients and families • • Discuss experience with facilitator Determine what you want to share Share good and the bad Language/Phrasing Talk about behaviours not people What might my experience teach? Practice what you want to say. . out loud

Facilitators • Set the tone for the meeting • Lay out purpose and format • Support patient/family in sharing important aspects of their experience • Keep staff focused at a “feeling level” rather than a defensive one • ? ’s to keep in mind: What did you need at that time? ”, “How could we have done better? ”, “What was helpful?

Gather staff and physicians: • Provide advance notice • Hold forum near care area • Invite others in organization who impacted the patient experience • Acknowledge that some may need to leave to care for patients • Provide “Tips for staff and physicians”

Some “tips” for staff • There will always be aspects of the patient and family experience which can be improved • Not a time to defend why something might have happened • There always staff behaviours which positively affect a hospital experience • Be prepared to truly appreciate the hospital experience from the perspective of a patient or family.

Telling the story • • Speak from your heart Be respectful Use your own style Not about blaming and shaming…sharing and learning • You/staff may get emotional • De-brief

Opportunities to Improve the Patient Experience • Improving communication • New strategies to improve and support privacy and confidentiality • Attention to staff behaviour and actions • Incorporation of volunteers to support patients • Developing diversion strategies • Supporting the patient's autonomy

Close loop with patient/family/staff • Letter of thanks • List what you heard and what you are doing to support or remedy • Provide all staff with synopsis of forum and plans for moving forward • Engage staff with identifying and creating the improvements • Share improvement initiatives with entire organization

Thanks and re-cap Dear Mrs. X, Thank you very much……. I would like to assure you that I am following up on your observations. Your observations included concern for: • Inconsistencies with the application of unit guidelines for patients – initially there was approval for your daughter to watch a video and then approval was revoked, and this generated some animosity between you and your daughter. • Insufficient communication from the staff about your daughter’s activities on the unit, her medication regime, her meetings with the psychiatrist, her overall well-being, and her progress. • Insufficient information about the nature of the group activities on the unit – leaving you to wonder whether she was spending excessive amounts of time watching television and not receiving specially designed group therapy. • Some staff members not recognizing your apprehension at leaving your daughter on the unit and not always demonstrating interpersonal communication in a manner that would be consistent with alleviating your apprehension.

Moving forward • In the meantime, efforts are underway to address your concerns. These include: A review and re-wording of the unit guidelines through a collaboration involving the unit staff our Clinical Educator and a patient advisor. The clarified guidelines should be available by July 31 st for everyone --- staff, patients, and families. • Development, by August 31, of a report for families so that each day they know what has transpired with their child and how their child is progressing. • Development, by July 31, of a written schedule of the activities on the unit – so that patients and family members have knowledge of the nature and sequence of daily therapeutic activities. • Some current changes in the staffing complement that will generate conditions for improved interpersonal communication with patients and family members. • A plan is also in development for providing a post-discharge phone call to patients and family members --- to check on the progress with achieving the goals of the discharge plan. We hope to have this in place by August 31. Thanks again Mrs. X for taking time …. Especially, I appreciate your compliment to the staff about the importance of their work. This is a message that I will bring to the staff at our staff meetings on July 24 th. Sincerely, XX Manager, Mental Health Program

Some lessons learned • Chose not to video tape • Downside is more staff could hear experience • Trying to shortcut by eliminating initial meeting • Forums will sometimes fall through because P/F change their minds, become ill etc. • No outsiders (voyeuristic) • Learning opportunity for medical students

Thank you!! Questions? Comments? Discussion!

Contact information Angela: Morina@kgh. kari. net Daryl: Belld@kgh. kari. net Kellie: kitchenk@kgh. kari. net