February 12, 2010

Initiatives set to enhance patient care experience

Initiatives set to enhance patient care experience

Recognizing that patients and families are essential partners for improving the safety and quality of health care, staff at Vanderbilt University Medical Center are enhancing many initiatives surrounding Patient and Family Centered Care.

The goal is a more comprehensive engagement with patients and families.

“We're moving to partnership, and that means that patients and families are not passive recipients of our expertise, but are actively engaged in planning, decision-making, and delivery of care to the extent that they are able to do so,” said Julie Morath, R.N., M.S., Chief Quality and Patient Safety Officer.

Julie Morath, R.N., M.S.

Julie Morath, R.N., M.S.

“We don't work from assumptions of what our patients and families need. We learn from them about how to create a care experience that is effective and brings value and comfort to them.”

Terrell Smith, M.S.N., R.N.

Terrell Smith, M.S.N., R.N.

Patients and families are already heavily involved in advisory councils for various VUMC hospitals and clinics, and for the first time, patients are members of the institution-wide Patient Safety and Quality Committees.

“This represents our commitment to transparency, engagement, and trustful relationships,” Morath said. “Organizations are often anxious about disclosing and working this closely with patients and families, believing that families may be frightened or worried that things might go wrong in their care. But what we have found is quite the opposite — families are appreciative and relieved that we care as much about the quality and safety of their care as they do.”

Communication is a consistent suggestion for improvement from patients and families. Last year, thousands of patient education documents were reviewed, and it was discovered that the reading levels varied widely. All surgical consent documents were revised to remove medical jargon and increase readability and then taken to Patient and Family Advisory Councils for testing and approval. The new consent forms are now being used across the Medical Center.

In a similar vein, Terrell Smith, M.S.N., R.N., director of Patient and Family Centered Care, is leading efforts to revise inpatient education booklets.

“We have tried to create a version that is more user-friendly,” Smith said. “It will put the basic message on the cover, and on page 2 we invite patients and families to learn how they can partner with us for safety. It will have easy-to-read fonts, illustrations, and be in a format for readers to easily thumb through.”

Smith said there are also efforts under way to improve cultural competency and translation, moving from a literal word-for-word translation to a deeper understanding of a patient's beliefs, values and wishes.

A key challenge in all these improvements surrounding Patient and Family Centered Care, Smith said, is the complexity of working in a high-pressure health care setting and the changing expectations for health care providers.

“This is an evolving philosophy,” Smith said. “This is not the way health care was taught when I went to nursing school. Now it is evolving to a whole different model, requiring new skill sets.”

A critical element is helping caregivers learn how to create a care environment that is predictable, safe and comfortable for every patient, every time.

Though they expect to have the majority of patient education documents revised by 2011, Morath and Smith agree that improving patient/fami-ly-centeredness in patient safety and quality is a never-ending process.
“With any work in improvement, the more you know, the more you learn, the more you see,” Morath said.

“There will be a lot of discoveries along the way as we get better at getting better. So there is never an endpoint.”