BY BRIGITTE PETERSEN
Patient and family advisors are at the heart of a new model of care designed to improve overall satisfaction at Thunder Bay Regional Health Sciences Centre.
As part of a new Patient and Family Centred Care (PFCC) philosophy, former patients and family members from the community were brought on board in 2009 to advise hospital staff about how to improve the patient and family experience. Advisors provide first-hand knowledge of how services impact patients, and are asked to provide input for all services at the facility.
Bonnie Nicholas, PFCC lead and patient advocate, said advisors have become an integral part of the health-care team, leading to a partnership between staff members, patients and family members.
“They offer us a perspective that we were lacking before,” said Nicholas. “It’s critical to making improvements in patient satisfaction. Who knows best about their own health and satisfaction than the patients and families themselves?”
Thunder Bay Regional currently has 76 patient and family advisors sitting on about 200 committees, teams and working groups advising hospital staff and administration. All of the advisors have had experience either as a patient or a health-care partner at the hospital in the past two years.
“We want people with recent care experience,” said Nicholas. “They can be any age. We’ve have patient and family advisors who are as young as eight years old and as old as 83. They’re involved in everything we do.”
The National Research Corporation’s NRC Picker has been used to conduct confidential anonymous patient satisfaction surveys during the last couple of years to help Thunder Bay Regional monitor its progress in the area of patient and family care improvements.
“When we started our journey to Patient and Family Centred Care, we had scores that were below the Ontario average,” said Nicholas. “Now, two years later, we are exceeding the Ontario average.”
Accreditation Canada
Accreditation Canada has recognized the hospital’s PFCC strategy as a “leading practice,” making Thunder Bay Regional the first and only organization in Canada with that designation.
Lori Marshall, vice-president of strategy, performance and aboriginal health, said the inclusion of advisors has become a healthy habit at the hospital.
“It’s been truly transformational to this organization,” said Marshall. “I think it would be odd for anyone to do anything now without involving a patient and family advisor.”
Patient and family advisors have helped introduce new concepts and have directly impacted improvements at the hospital. Examples of these include smoother transitions from the Emergency Department to the Intensive Care Unit, paediatric Operating Room tours, improved wait times in the Fracture Clinic, better discharge information for patients, the introduction of bedside communication whiteboards, and improved meal times and dietary choices.
Keith Taylor, chair of the hospital’s Patient and Family Advisory Team, has volunteered as an advisor for more than two years.
“They don’t do anything under that roof without an advisor,” said Taylor, who currently sits on a variety of advisory committees. “After sitting on a few committees, I saw that it wasn’t just for show. I found out that advisors have a say, and it’s a voice that is heard. It makes you feel like you are actually making a difference.”
Philosophical shift
Rhonda Crocker Ellacott, executive vice-president of patient care, health professions and chief nursing executive, has been involved with the development of PFCC since its inception. She spearheaded a team-driven review of the facility’s model of care during a four-year strategic planning process, which began in 2006. After much collaboration and research, the team launched PFCC.
“We first coined it just patient centred care, however, through our learnings and experiences, we changed it to Patient and Family Centred Care, recognizing the importance of families in the care process,” said Crocker Ellacott.
The PFCC steering committee and leadership team created specific strategies. Thunder Bay Regional experienced a critical shift in philosophy from “serving patients” to “partnering with patients and families”, according to Crocker Ellacott.
“Hospital systems are typically not organized around the needs of patients, but rather the needs of providers,” she said. “This creates a system-centred or provider-centred approach to care, which does not respect and value the individual needs of patients and their families.”
Today, the core concepts of PFCC are dignity and respect, communication and information sharing, collaboration and participation.
“The recognition of these core concepts means that we have changed the way we do our business,” said Crocker Ellacott. “The power of the patient story has led us to bring patient and family advisors into all committees and teams throughout the organization - from program planning to facility design, policy development and implementation, quality, and hiring.”
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