The primary goal of the Patient- and Family-Centered Care (PFCC) Learning Community (LC) was to support member hospitals in adopting and implementing strategies from a “cluster” of innovations, selected from the Agency for Healthcare Research and Quality (AHRQ) Health Care Innovations Exchange, to advance the practice of PFCC. The LC was comprised of eleven Florida-based hospitals that committed to developing a new, or enhancing an existing patient and family advisor program. In addition, LC members implemented one or more other PFCC strategies identified in the cluster, based upon each hospital’s specific needs and unique contexts.
With the support of the AHRQ Innovations Exchange, and in collaboration with the Institute for Patient- and Family-Centered Care (IPFCC) and the Florida Hospital Association (FHA), the PFCC LC was launched in October 2014. Teams from member hospitals received guidance and technical assistance through monthly coaching calls and virtual membership meetings. Meetings offered participants an opportunity to learn from a nationally-recognized subject matter expert on specific hospital-based PFCC strategies, as well as from innovators who offered insights based on their own personal experience successfully implementing strategies described in the profile cluster.
Learning Community Aims
The LC’s specific aims were as follows:
- Aim #1: Engage stakeholders using an evidence-based patient- and family-centered framework that addresses a) leadership, b) patient and family partnerships, c) staff engagement, and d) performance improvement.
- Aim #2: Assist hospitals in tailoring and implementing strategies from the Innovations Exchange to advance the practice of PFCC within their own organizational culture and context.
- Aim #3: Achieve and document improvement in process and outcome measures tailored to the specific strategies/interventions.
Activities and Accomplishments
During its two-year operation under the AHRQ Innovations Exchange, the LC held monthly virtual membership meetings, core team meetings, individual hospital team coaching calls, and two in-person meetings in Orlando. Coaching calls with Innovations Exchange staff helped to monitor progress, troubleshoot challenges, offer insights, and provide tailored technical assistance. The LC also produced monthly newsletters, which profiled individual member hospitals and highlighted other resources.
As specified in the LC charter, members were required to adopt one common innovation—the formation or enhancement of a patient and family advisor program—based on work at Augusta University Medical Center (previously known as Georgia Regents Medical Center) described in the innovation profile, Patient Advisors Participate in Hospital Councils, Committees, Staff Training, and Other Activities, Contributing to Improved Patient Satisfaction and Better Organizational Performance. To aid in this effort, the LC built and maintained an online collaborative site featuring resources designed to help support the implementation of patient and family advisor programs and other PFCC strategies.
Other Innovations Exchange profiles that informed the work of the PFCC LC included:
- Organization-Wide Adoption of Patient- and Family-Centered Care Leads to Consistently High Levels of Patient Satisfaction
- Patient Notepad Improves Communication With Physicians, Including Likelihood of Having Questions Answered
- Inclusive Policies, Communication Protocols and Ongoing Training Lead to Culturally Competent Care for Lesbian, Gay, Bisexual, and Transgender Patients
- Cardiac Unit Features Acuity-Adjustable Rooms and Other Patient-Centered Programs, Leading to Well-Above Average Outcomes and Patient Satisfaction
- Welcome Policy Eliminates Visiting Restrictions and Allows Loved Ones To Be With Patients Round-the-Clock, Generating Positive Feedback From All Stakeholders
In addition, the LC activity spurred the development of a new innovation profile highlighting work undertaken by a LC member hospital:
- Patient and Family Advisor Rounding Contributes to Reduction in Falls and to Better Performance on Key Patient Experience Metrics
At the outset of the LC, 4 of the 11 participating hospitals had some form of a patient advisor program, involving an aggregate total of 56 patient and family advisors (PFAs). As of June 2016, all 11 member hospitals established patient and family advisory councils (PFACs)1 with an aggregate total of 129 active advisors.
In the past 2 years, patient and family advisors became involved in a range of activities at the member hospitals. As of June 30, 2016:
- Seven hospitals engage PFAs in patient rounding.
- Eight have PFAs serving on committees or workgroups about discharge or transition planning.
- Nine have PFAs serving on patient safety committees or workgroups.
Based on estimates provided by the participating hospitals, PFAs volunteered over 3,700 hours to LC member hospitals from September 2015 to July 2016.
In addition to these accomplishments, LC members made significant progress adopting other patient- and family-centered care strategies published in the Innovations Exchange:
- Eight implemented a 24-hour patient access policy.
- Ten evaluated hospital processes or protocols for patient-centeredness.
- Six developed staff training on PFCC.
- Seven implemented a patient communication “notepad.”
- Seven include PFCC concepts in written hospital policies, philosophies, and processes.
In year one, LC members relayed a common need for guidance and materials they could use to establish a formal orientation process for new PFAs. To meet this need, the LC developed an LC product titled Patient and Family Advisor Orientation: Helpful Resources for Hospitals. This document builds upon existing AHRQ-developed resources by adding practical materials that individual LC members developed with vignettes of how LC members operationalized their orientation process. Once published, this document will help both newly established PFACs, and those hospitals interested in starting a PFA program.
Over the two-year period, several LC members raised concerns regarding insufficient staffing to accomplish all they hoped to do. In addition, staff turnover both at the upper management level and within the hospital teams themselves posed a challenge for some members. The LC support team helped address such challenges in the monthly coaching calls and offered supplemental orientation and support to new hospital team members.
In September 2016, the Florida Hospital Association (FHA) will assume responsibility for facilitation of the PFCC LC. The LC’s work is aligned with FHA’s mission to support its member hospitals in advancing the practice of patient- and family-centered care. FHA will expand the LC beyond its current membership and leverage the experiences of current participants as “faculty” and mentors to new members. FHA plans to sustain the PFCC LC’s aim of helping hospitals implement patient and family advisor programs and adopt other PFCC innovations captured in the Innovations Exchange.
1In the second year of the LC, one hospital member resigned and another hospital joined the LC; the newest member anticipates launching its PFAC in September 2016.