University HospitalsProposed 2007 Quality

Priorities

February 2007

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UHC – CCF Patient Experience SummitMay 19, 2014Cleveland Convention Center

ETeam™A New Patient Engagement Tool

Catherine S. Koppelman, RN, MSN, NEA-BCChief Nursing & Patient Experience Officer

UH & UH/CMCcatherine.koppelman@uhhospitals.org

Chrissie N. Blackburn, MHAPrincipal Advisor, Patient and Family Engagement

UH/CMC

2

Lily

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Current Roles• President, Rainbow Babies and Children’s Hospital’s

Family Advisory Council• CMS’ Partnership for Patients Campaign’s Patient

and Family Engagement Network• Children’s Hospital Solutions’ for Patient Safety

Family Engagement Task ForceOhio KePRO’s (QIO) Hospital Acquired Infection Learning and Action Network

• Ohio Patient Safety Institute Board• Children’s Hospital Association’s Speak Now for Kids

Advisory Board• Institute of Medicine’s Patient and Family Network

Leadership Council5/19/14 3

What is Patient and Family Engagement?

A set of behaviors by patients, family members, and health professionals and a set of organizational policies and procedures that foster both the inclusion of patients and family members as active members of the health care team and collaborative partnerships with providers and provider organizations to improve quality and safety within a health care organization (AHRQ, 2013).

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What is the ETeam™?

• A tool to engage patients and families• Teaches behaviors for hospital success• Teaches what to say and ask• Training for all hospital staff• Helps all staff to engage patients

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What does the ETeam™ mean?

• Engage and empower me• Take your time with me• Explain things to me in words I understand• Appreciate my situation• Meet my needs™

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The purpose of the ETeam™

• Builds a bridge of trust• Enhances accountability of care• Teaches patient responsibility, behavior, and

communication• Guides patient and family through

hospitalization or procedures• Teaches patient and family engagement

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Components of the ETeam™

• Customized communication lists developed by Patient and Family Advisory Councils

• Staff training for utilization and patient education

• 8 week pilot performed at UH/CMC• Surveys to analyze tool utilization

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ETeam™ Implementation

• Planning• Review of ETeam content• Groups

• Physicians• Nursing/Social Work• Literacy experts

• Finalization of tool content

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ETeam™ Implementation

• Planning• One Pilot unit

• Pediatrics• Adult Medical Surgical• Seidman Cancer Hospital

• Criteria• Commitment – nursing leadership• Physician engagement• Applicability to other units

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ETeam™ Implementation

• Planning Committee• Pilot Units

• Physicians• Nursing• Social work

• Others• Quality• Educators• PFC members - each hospital

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ETeam™ Implementation

• Planning Committee• Decision – how tool introduced

• Allow for individualization• Which role to introduce?• Method – hand out/journal• Timeline – 2 months

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ETeam™ Implementation

• Planning Committee• Education

• Decentralized• Web based tool• History/rationale• Content• How introduced/utilized

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ETeam™ Implementation

• Pre/post measurement• Pre

• Clinician “Patient Centered Care” survey• Patient satisfaction – Communication & D/C Information

• During pilot• Patient Family Council/member – Interview patients• Training of PFC members

• Post pilot• Clinician – “Patient Centered Care”• Patient Satisfaction – Communication & D/C Information

Pre-Post ID Team SurveyPerceptions of Patient Centered Care

RN Responses

Pre PostSample size 59 27Introduction & explain role 3.93 3.89Daily sit down round 2.88 3.64Listening & understanding 3.69 3.63Patient right to ask direct questions 3.83 3.93Patient/family perspective → POC 3.62 3.56Avoidance of medical jargon 3.5 3.41

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Pre-Post ID Team SurveyPerceptions of Patient Centered Care

RN Responses

“I have seen patients really open up and get involved in their care more with ETeam.”

“ETeam has better formalized patient centered care.”

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Patient Family Council MembersInterview Summary

Total Interview 46 Patients

• Provided the Tool 65%• Tool explained 54%• Use the tool 30%

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Patient Family Council MembersInterview Summary

Total Interview 46 Patients• Felt include in care - 76%• Staff sensitive to hospital/illness - 76%• Feel all needs being met - 76%• Knowledge of diagnosis + plan of care- 70%

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60%

65%

70%

75%

80%

85%

90%

95%

Dec-13 Jan-14 Feb-14 Mar-14

% T

op B

oxSeidman 4 HCAHPS % Top Box Response

CommW/Nurses

Commw/Doctors

Discharge Info

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50%

55%

60%

65%

70%

75%

80%

85%

90%

95%

Dec-13 Jan-14 Feb-14 Mar-14

% T

op B

ox

Lakeside 55 HCAHPS % Top Response

CommW/Nurses

Commw/Doctors

Discharge Info

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0.010.020.030.040.050.060.070.080.090.0

100.0

Dec-13 Jan-14 Feb-14 Mar-14

Perc

ent T

op B

ox

UH Rainbow Babies & Children's Hospital R5 Instructions for Child's Home Care

Instructions forChild's HomeCare

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ETeam™ Education of Outcomes

• Lessons learned• Physician engagement• Patient readiness• Gap between

• Clinician perception of patient centered behavior• Patient perception of clinician

• Halo effect of the “process”

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ETeam™ Education of Outcomes

• Next steps• Standardize adult tool + “packaging”• Revision of clinician education• Expansion to next 3 pilots• Expansion to community hospital innovation unit

Lily’s Reminder