PQCNC PFCC Handout 2

8/9/2019 PQCNC PFCC Handout 2

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Collaboration with Patients andFamilies in Clinical Practice

William Schwab, M.D.Department of Family Medicine

University of WisconsinSchool of Medicine and Public Health

www.familycenteredcare.org



Collaboration

“Collaboration means that noone interest group is always

right. It means taking what youthink, and what I think, andwhat someone else thinks, and

coming up with something thatworks for everyone.”

Bev McConnell CriderFrom: Essential Allies: Families as



Elements of Collaboration

w Mutual respect for skills andknowledge.

w Honest and clear communication.

w Understanding and empathy.

w Mutually agreed upon goals.

w Shared planning and decision making.

w Open and two-way sharing of information.

w Accessibility and responsiveness.

w Joint evaluation of progress.



Family/ProfessionalCollaboration

At all Levels of Health Care

w In the care for an individualpatient.

w In program planning andevaluation.

w At the policy level.



“You will never develop truepatient- and family-centeredcare by using patients and

families merely as focusgroups”.

- Lawrence Schulman, M.D.Physician-in-Chief

Dana-Farber Cancer Center



Barriers to Collaboration

w Attitudes & perceptions about eachother.

w

Past experiences.w Cultural differences.

w Socioeconomic and educationalinfluences.

w Lack of skills.

w Lack of logistical & administrativesupport.



What Patients and Families Want toKnow From Clinicians

w What is the problem?

w How can it be diagnosed andtreated?

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What Patients and Families Want toKnow From Clinicians

w What is the problem?

w How can it be diagnosed and treated?

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w How can I contribute to the process toenhance the quality and safety of care?

When/where/how will we communicate?

Will you listen?w What does this mean for my family’s life?

What is the plan?

How will we best continue care at home?



Patient- and family-centered care is not just "being

nice." It is a direct and intentional effort to

unequivocally communicate to patients that they

are viewed as distinct and valuable individuals with a family and place in the community .

The individuality of each patient and family is

acknowledged.

Relationships between patients, families, and

providers are essential alliances and partnerships

with each bringing expertise to decision-making.

Communication



Institute of Medicine- The National Health Care Quality

Report



Rules for Health Care in the 21stCentury—The National Health CareQuality Report

wCare is based on continuous healingrelationships.

wCare is customized according to patientneeds and values.

w The patient is the source of control.

w

Knowledge is shared and informationflows freely.

wDecision making is evidence-based.

.



Rules for Health Care in the 21stCentury—The National Health CareQuality Report (cont’d)

wSafety is a system property.

w Transparency is necessary.

wNeeds are anticipated.wWaste is continuously decreased.

wCooperation among clinicians is a priority.

Crossing the the Quality Chasm: A NewHealth Care System for the 21st Century

Institute of Medicine, March 2001





Patient Centeredness: ADefinition

National Health Care Quality Report

Patient centeredness refers to health care that

establishes a partnership among practitioners,patients, and their families (when appropriate)to ensure that decisions respect patients’wants, needs, and preferences and thatpatients have the education and support they

require to make decisions and participate intheir own care.

Crossing the Quality Chasm: A New Health System for the 21st Century . Institute of Medicine, March 2001.



Patient- and Family-CenteredPrinciples

w People are treated with respect and dignity.

w Health care providers communicate andshare complete and unbiased informationwith families in ways that are affirming anduseful.

w Individuals and families build on theirstrengths by participating in experiences that

enhance control and independence.

w Collaboration among families and providersoccurs in policy and program developmentand professional education, as well as in the

delivery of care.



Patient- and Family-CenteredCare Rules to Live By

wAttitude is everything.

wValues determine outcomes.

w

All families have strengths.wSensitivity does not mean psychoanalysis.

wCase management is not the answer.

wPatients and families are the experts onthe experience of being serviceconsumers.

w The person with the most flexibility will be

the catalytic element in the system.



Patient- and Family-CenteredCare Tricks of the Trade

w Treat each person as an individual.w Respect patient and family knowledge

about their own health needs.w

Meet patients and families at their modelsof the world.w Negotiate your role and relationship (areas

of responsibility).w Share knowledge and information.

w Avoid psychological labeling.w Assist in problem solving.w Teach choice.w Honor natural supports.



Patient- and Family-CenteredCare Tricks of the Trade(cont’d)w Say “I don’t know,” when you don’t know.w Develop roles for patient and family consultants.w Consider functional issues in a gradual but

systematic way.

w Create alliances with other professionals at apersonal level.

w Make the primary care-specialist relationshipwork.

w Make sure that your staff knows about specialneeds.

w Anticipate cross coverage.

w Develop financial creativity.

w Make talk time available.

Documents

PQCNC PFCC Handout 2