Being Patient and Family Centered: Things Customers Would Tell You If You Asked
Recently, executives at American Airlines, Starbucks, and Build-A-Bear have had to reevaluate and hold up the mirror to see themselves as their customers see them. Starbucks is one company that appears to have seized the opportunity to listen to their customers and make important changes. For example, Starbucks closed all of their stores the same evening for racial bias training for every employee. Only time will tell if Starbucks is making enough of the right changes to really address their customers’ needs.
Hopefully, you aren’t in a crisis with a huge segment of patients. But now is a great time to hold up the mirror and take a look at what your patients think of you. Being a patient- and family-centered organization is a proven step in the right direction. If you’re ready to explore solutions, read on!
Ask healthcare leaders what Patient and Family Centered Care is, and you’re likely to get a variety of definitions. However, those who are experts on the subject will agree that the Patient and Family Centered Care is an integrated approach to the planning, delivery, and evaluation of healthcare. It is a model built on dignity and respect, information sharing, participation, and collaboration among those who provide care and those who receive care.¹ Every person brings their own expertise to interactions, including and especially patients and their families. This model aligns perfectly with the Healthcare Experience Foundation’s (HXF) mission – “to shape cultures through innovation so every person can receive and deliver the best healthcare”.
After working for years with many selfless, dedicated healthcare workers committed to taking excellent care of patients, I know there are many factors that get in the way of great care interactions. These workers still want to be collaborative, compassionate, and empathetic, but in the minutiae of the day-to-day, those aspirations somehow can get lost. Most leaders in hospitals and clinics we at the HXF have worked with have voiced similar frustrations.
So, with all the good intentions and a myriad of caring individuals, why are our patient experience scores not what we expect them to be?
“Houston, we have a problem.”²
So, what exactly is that problem? Although not nearly as complicated as getting Apollo 13 and the crew back to earth safely, it does require expertise and the recognition that there are issues. Although it’s probably not the methodology or that you have unique patients at your facility…but you certainly might!
Wouldn’t you like to know how to provide the type of experience that your unique patients – all of your patients – expect and deserve?
Additionally, there are clinical reasons to develop a patient- and family-centered culture. There is a growing body of evidence showing that patients who are cared for in a patient- and family-centered care environment have better health outcomes and care experiences.³
HXF’s approach is such a model, providing healthcare leaders with all the tools needed to achieve stellar patient experience scores. In any business, listening to your customers is crucial to success. Similarly, in healthcare, when we listen to our patients, we learn things we might never have known. The story of Christine, whose husband was a long-term patient, provides great examples of how families can partner with leadership to change thinking to improve not only patient care but also the patient experience.
Positive Association Between a Good Patient Experience and Outcomes
A positive patient experience is an important goal in its own right. Moreover, substantial evidence points to a positive association between various aspects of patient experiences, such as good communication between providers and patients, and several important healthcare processes and outcomes. These processes include patient adherence to medical advice, better clinical outcomes, improved patient safety practices, and lower utilization of unnecessary healthcare service.4
The Powerful Voice of a Patient or Family
There are a number of ways to ensure that you and your team are hearing your patients and their families.
• Regularly reviewing, distributing, and appropriately responding to patient feedback in surveys are important.
• Intentional rounding and being open and engaging with patients or families in your facility can give you great insight.
• Another highly productive method comes from involving former patients or their families in working with your teams as partners in improving the healthcare experience.
Here is a powerful story from a family partner I’ve worked with that exhibits the difference one family member made on a team of critical care nurse leaders as well as our health system’s re-approach to including families in care.
Christine’s husband, Kevin, was a navy pilot during the first Iraq war, and exposure to chemicals severely impacted his health. He developed Multiple Sclerosis, heart disease, advanced vision issues, including cataracts and also joint problems, and other serious health issues. This is the story Christine told a team of critical care unit nursing directors, most of whom were very negative about a family presence in the CCUs. In fact, when I had talked with them about a family presence in the critical care units, most of them expressed doubt about it through crossed arms and scowls, as well as telling me it could never happen. I brought Christine to their next meeting where she told her story and shared pictures of her husband dressed in his navy pilot uniform, robust-looking and handsome, pictured as he had been not so many years ago. Then she showed a recent picture of Kevin, which was heartbreaking. He has lost muscle tone, was stooped and wrinkled, wore very heavy glasses and looked thirty years older than his age. After she shared her story and Kevin’s pictures, every nurse leader walked out of the meeting determined to make a family presence at the bedside in their units work. And they did. This story strongly illustrates the value of family presence in critical care, where patients are most vulnerable. It told the nurse leaders clearly how a family member who knows the patient well can help calm and soothe a patient, as well as protect them from harm. (Participation). It also convinced me and others I worked with of the power of a patient’s family member’s voice to help us change hearts and minds, and the policies. (Collaboration)
“Kevin was admitted through the Emergency Department for a life-threatening abdominal infection and was taken right to surgery. Upon arrival in the ICU, I asked if I could please sit in the corner of his room; I promised to be quiet and not get in the way. It was the worst night of my life because my heart was in that bed, and he was so sick we did not know if he would survive the night. Fortunately, Kevin’s nurse was kind and allowed me to stay. (Respect and dignity) Through the night, the nurse was supportive and thanked me for helping with Kevin. (Participation)
Several times during that night, Kevin awoke and was very frightened until he saw me. I spoke to him soothingly, ‘You are OK; you had surgery and it went well. I will be here all night; go back to sleep; you are in good hands.’ The next day, a new nurse came in and started to remove some tape on his arm so she could apply fresh strips. I asked her not to because Kevin’s skin was so delicate, ‘like tissue paper.’ I explained that his admitting nurse had used a different type of tape that was gentler. (Communication and Information Sharing) The nurse applied the tape anyway, and when she moved it around on his arm, it ripped his skin and he began to bleed. At this point, the nurse got very upset that she had hurt her patient. Not only did it cause Kevin unnecessary pain, but I had one more thing to take care of when I got home. If the nurse had listened to me, it would not have happened. After this more of the nurses began to listen to me more often; they understood that I knew Kevin so well that I could contribute to his safety and care.
When I shared this story with the CCU nurse leaders, they were wonderful and said they understood the importance of family presence at the bedside in critical care. I am so pleased now that all of the CCUs in this health system’s hospitals support family presence at the bedside. It also heartens me that our experiences opened the minds of so many of the staff and physicians so that patients and their families are heard.”
We are ready to help improve the Patient and Family Centered Care at your organization.
- Institute for Patient- and Family-Centered Care (2018). Retrieved from http://www.ipfcc.org/about/pfcc.html
- Houston We Have a Problem. Retrieved from https://www.youtube.com/watch?v=lTSVOnhLtCs
- Hibbard, J. and Greene, J. (2013). What the evidence shows about patient activation: Better health outcomes and care experiences, although fewer data on costs. Health Affairs, 32, 2, pp. 207-214.
- Agency for Healthcare Research and Quality (2018). Retrieved from https://www.ahrq.gov/cahps/about-cahps/patient-experience/index.htm