Confusion over the check-in process. A missing sign. A bathroom that needs cleaning. A route difficult to navigate with a wheelchair.
These are things that Vanderbilt University Medical Center staff can easily overlook but can make or break a patient’s experience.
Through its Patient and Family Advisory Councils, VUMC has tapped into its best resources — the patients and families who experience its hospitals firsthand — and turned them into the ultimate collaborators.
“This is the right thing to do in the business of health care. They’re the ones receiving that care, and we want to know if we’re giving them our best,” said Terrell Smith, MSN, R.N., director of Patient and Family Centered Care.
“We want to make the campus inviting and comfortable, give them a smooth and productive visit and send them home prepared to care for themselves. The bottom line is improving health care, and these are the partners to help us do that.”
The three councils — longstanding at Vanderbilt University Hospital and the Monroe Carell Jr. Children’s Hospital at Vanderbilt and just established at Vanderbilt Psychiatric Hospital — meet once a month in the evening over dinner and average about 15 attendees.
They often have action items, such as designing a new patient handbook or giving feedback on education materials, but also take time for an open forum to report new observations and suggest improvements.
“As patients and caregivers, we’re in the hospital so much and see so much. Our ears are open and we’re always looking for ways to improve,” said Mary Ann Peugeot, chair of the VUH advisory council. “I’m a CPA and don’t have any medical training, but I have my Ph.D. in being a patient and family member. Although my situation is not nearly as serious as many others, I am very motivated to try to make things the best they can be for others who walk in the door at Vanderbilt. Since we are seeing it all from the patient side, we may see things that the staff and administrators might never notice.”
The VUH council has given input on projects ranging from improving MyHealth@Vanderbilt to the furnishings and visitation policy of the Critical Care Tower, and was a major impetus for VUMC’s clinic redesign project.
Smith said what makes the advisory councils so successful is how invested leaders are in attending council sessions and heeding their suggestions.
“Our CEOs and chief nursing officers are at nearly every meeting. A lot of administrators at other institutions are reluctant to get involved and don’t want to hear a lot of this after a long day. But our leaders do, and always listen and process what is said.”
Children’s Hospital Chief Nursing Officer Susan Hernandez, MBA, R.N., said at a recent meeting, “When I’m here, I get excited. I’m passionate about this work and everyone always has insightful comments and ways to make things better.”
The Children’s Hospital advisory council, the first one established at VUMC, in 1995, revised its charter last fall and is now developing a screening, orientation and training process for members to share with all the councils. It recently gave feedback on the hospital’s 33-bed expansion and is working on peer-to-peer support groups for each clinical area.
The council’s facilitator is Janet Cross, director of Patient and Family-Centered Care at Children’s Hospital.
As parents of children ranging from toddlers to 21-year-olds and diagnoses including heart defects, leukemia, broken bones and Down syndrome, these council members focus on telling their story.
“One of the things we’re really working on is refining how to tell that story to have the most impact,” said Kara Adams, chair of the Children’s Hospital advisory council. “We attend FOCUS training to tell those stories and let new staff hear real stories that represent the children and families they will be caring for.
“We want to be a voice of integrity in all parts of the hospital, and we take our role as council members very seriously because we are making changes that affect all patients and families as well as staff,” Adams said.
Members of both the VUH and Children’s Hospital advisory councils, plus Vanderbilt administrators, are active in the national patient and family-centered care movement. Delegates attended the National Patient Safety Foundation conference and presented a poster at the Institute for Patient and Family-Centered Care’s international conference.
VUH council chair Peugeot and VUH CEO David Posch gave a presentation on how to effectively use a council.
“Vanderbilt is light years ahead of some other hospitals who are just beginning to form councils. These conferences are a great way to validate that we’re doing many things right but also pick up new ideas for the future,” Smith said.
Vanderbilt Psychiatric Hospital (VPH) is the latest to put an emphasis on patient- and family-centered care. As it redesigned its interiors and changed protocols over the last year, a top priority was forming a Patient and Family Advisory Council.
“We want to be one of the best psychiatric hospitals in the country, and that takes the involvement of all stakeholders, including hearing from patients and families. We saw the councils work at the children’s and adult hospitals and thought ‘why not us?’” said Bill Parsons, Ph.D., chief administrator.
“We’re expanding visitation and really embracing our patients and families. In psychiatry, families have traditionally been in the background and not been active, but there is a big push to change that here,” added Avni Cirpili, MSN, R.N., chief nursing officer.
Rhonda Ashley-Dixon, director of outreach and development, facilitates the Psychiatric Hospital’s advisory council.
At a recent meeting, the energy of the new advisory council was palpable. There was unanimous enthusiasm for updating the website and patient handbooks and creating a list of resources for patients and families affected by mental illness. They especially wanted the website to be more visual and comforting, letting patients and families know who their treatment team is and what to expect at the hospital.
Council Chair Pat Williams feels she has a lot to share.
“Having been involved in the mental health community for many years because of my family member’s illness, I have participated in support groups and served on advisory councils and boards for decades, so I regularly hear stories from other families about their experiences before, during and after hospitalizations of their loved ones. I am delighted that VPH has initiated this council, and hope that my knowledge can contribute to improving the system for everyone.”
All members of the advisory councils agree that their voices are heard and appreciated.
“This is a focus group to the nth degree,” said VUH council member Joel Buckberg. “We’re able to energize, mobilize, educate and then repeat, so you get the benefit of the group not once, but 12 times a year. No one ever wants hospital services, but Vanderbilt is taking our learning experiences and harnessing them for the greater community.”
