We want to feel heard and feel valued

“We want to feel heard and feel valued. ” Collaborative Goal Setting with Families Alda Antunes Silvestre, RN, MSN Program Manager Acute Rehabilitation Program Rita Janke, RN, MSN Quality, Patient Safety Leader Sunny Hill Health Centre for Children

Family-centered care is neither a destination nor something that one instantly becomes. It is a continual pursuit of being responsive to the priorities and choices of families. - Bissell

Hearing from Families “Listen to parents, they know their child. ” Provide parents with control and choice whenever possible. ” “We want to be heard and feel valued. ” Engage child and parents in decision making. ” “Care is not always tailored to us”.

Hearing from Families: Family voice in the literature Families Want:

Why Goal Setting? Effective means of understanding and changing human behavior. Clear and functional goals enhance motivation, leading to improved outcomes (Oien et al. , 2010; Eccles & Wigfield, 2002; Locke & Latham, 2002; Mastos et al. , 2007). Implementing a family centered approach within a goal setting framework emphasizes parental involvement in decision-making, collaboration, and partnership, acceptance of the family’s choices, and empowerment (Law et al. 2003, 2005) Oien et al. , 2010); Wiart et al. , 2010).

Key Principles for Collaborative Goal Setting q. Family identified needs q. Shared responsibility q. Family empowerment q. Interprofessional Practice q. Specific tools and processes are needed to facilitate family collaboration in goal setting.

Value Stream Map Childcentered care Holding families and each other as capable, resourceful, and whole Family Integrated Care Unified and Integrated Team Optimizing child participation, motivation, and function

Inspiration from Mike (our family representative) “The concept of rehab is not just for the child but is a family process… Emphasizing to the family that they have a key role on the rehab team [because] they will be the teams eyes and ears for the extended parts of the day”

Current State: Problem and Aim Statements There is no documented, consistent collaborative goal setting process for children and families receiving Acute Rehabilitation services. 100% of children will have goals set using a validated goal setting tool. 100% of families will be satisfied with their participation in their child’s rehabilitation journey.

Intro to Team The Winning Team: With Family! Alda Antunes Silvestre, Tanya St. John, Sandy Tatla, Kim Magnus, Patricia Bastante, Daniel Budgell, Sarah Small, Tamara Zagustin, Michael Mc. Cormick, Rita Janke, Kristen Barnes

The Task! By the end of the week…. Choose/ develop a goal setting tool Establish outcome & process measures Develop a goal setting process which involves families Begin testing. Develop a “scale up” and sustainment plan

Our Process

Sustainment Plan

I feel the team plans with me so that we are working in the same direction. 70% 64% n= 25 60% 50% 40% 30% 12% 20% 10% 0% 0% 1 2 3 4 5 4% 4% 6 7 16% 0% 8 9 10

I have been treated as an equal member of the team. 68% 70% n= 25 60% 50% 40% 28% 30% 20% 10% 0% 1 2 3 4% 0% 0% 5 6 7 8 0% 4 9 10

The information that the team gave me was consistent from person to person. n= 25 60% 56% 50% 40% 30% 20% 12% 0% 0% 0% 1 2 3 4 5 6 12% 0% 7 8 9 10

I know how I can support my child's rehabilitation goals. 36% n= 25 40% 35% 30% 24% 25% 20% 12% 15% 10% 5% 4% 0% 0% 0% 3 4 5 0% 1 2 6 7 8 9 10

What families are saying… “As my child has changed so quickly the information provided has given me the information we will require to integrate back into our home. ” “Staff is respectful of me and asking to have my input. ” “Team supported us in our top priorities around feeding and toileting” “Again, I was included and able to assist in providing my child's care. ” “Everyone seems to be on the same page. ” “Consistency prevailed throughout our experience with therapists and nursing. ”

Lessons Learned: Our Ongoing Journey Family Centred Care Integratio n of New Processes Culture Change Owning the “Why” Integrated team goal setting

Lessons Learned: Our Ongoing Journey Team Involvement Family Daily Management Visual Cues Sustainment Domino Effect Coaching PDSAs Discussion

We are making a difference! “You guys make me feel so special. "