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Make education a collaborative endeavor, including patients and staff
Family-centered care model erases lines
When Nick Masi, PhD, director of Family Centered Care at Joe DiMaggio Children's Hospital in Hollywood, FL, in 2002 began encouraging staff to obtain family input on health care issues, few saw the value of such teamwork. Finally, a family member joined the patient satisfaction committee to help review scores from patient satisfaction surveys.
Masi explains that the committee members kept asking how to address negative scores, and his suggestion was to add a family advisor to the committee. Six months later, a family member joined the committee. Now, it is difficult to fill all the requests from hospital committees to appoint family members.
"I think over the years, the staff has learned that they can learn from the patients and family, and they really see it in a different viewpoint," says Masi.
In addition to having family members on hospital committees, Joe DiMaggio Children's Hospital has a family advisory council that is involved in everything from architectural design to policy making.
The children's medical facility is one of seven hospitals within Memorial Healthcare System, the fifth-largest public health care system in the United States, that follows the patient- and family-centered care model, in which patients and families are equal partners in health care.
Such a partnership is important in patient education, whether creating programs and materials to educate patients, or training staff to implement a pathway or educate on a topic, says Susan Montgomery, MA, director of Patient and Family Centered Care Services for Memorial Regional Hospital in Hollywood, FL.
Patients and family members can provide valuable input on educational materials. Staff at Memorial Regional are encouraged to submit educational materials to the advisory council before they are distributed for use, whether the materials were purchased or created in-house, says Montgomery.
Patients and family members are very good at spotting terminology that is difficult to understand. Also, patients and family members recognize jargon often used in health care -- and understandable to those in the industry -- that professionals fail to recognize patients will most likely not understand what certain terms mean, explains Montgomery. This can include acronyms, abbreviations, and titles that are not commonplace to patients and families, such as "charge nurse." The advisory council members continuously instruct those who create educational materials to keep them simple and to avoid wordiness, says Montgomery.
Learning preferences are also something patients and family members can address, she adds. More and more, the health care system's customers are saying they don't want to read information; they would rather turn on the television.
Because council members and family advisors are part of the health care team, they don't wait to be approached by the health care professionals. Often, members of patient and family advisory councils identify issues that should be addressed to improve patient safety, satisfaction, and care.
For example, patients and family members at Memorial Regional ask certain questions repeatedly; therefore, the council filmed a short video for the in-house television system that provides answers to these common questions. Named "Hospital Briefings," the TV show provides information on such issues as the discharge process and can be viewed in a patient's room.
Also, the council noticed that people did not seem to think about end-of-life issues. So, they drafted a brochure that prompts people to consider issues that may need to be addressed when an illness is terminal, such as options concerning medical care.
No preconceived ideas
When a medical system is patient- and family-focused, there are no preconceived ideas of how patient education should be created and delivered, says Montgomery. Have the audience present in the formative stages, she advises. It's good not only to start with the audience in mind, but to have the audience provide input as much as possible, because they are the ones who can determine if the material or program will be useful to them.
"I personally believe there is never a time when patients and families should not be involved in the design of just about anything that affects them. They don't have the expertise related to content, but they do about themselves and their families; and they bring that to the table in everything we do," explains Montgomery.
She adds that instead of shaping a program or educational piece and then having the audience review it, PEMs should bring them in when it has no form, and through discussion it will take shape.
When members of a patient and family advisory council are included in the process of staff education, they begin to get a clearer understanding of the point of view of members of the health care team. This viewpoint helps when family advisors are asked to work on patient education projects.
At a recent meeting of the family advisory council at Memorial Regional Hospital, members decided it would be a good idea to educate patients and families on how to interact with health care staff. The goal was to help them become more effective in asking questions, says Montgomery. "They understand the dynamics and want to contribute," she explains.
All educational activities should take the patient/consumer into consideration. That includes times when a physician or nurse is learning a new technique or procedure, says Masi. He says in health care, there is a silo mentality, with patient education in a different silo from nurse education or physician education. Yet when patients and family are included in staff training, it helps these staff members see situations from a patient's perspective. Also, it helps those selected as patient and family advisors see the point of view of the health care provider.
When an asthma care pathway was developed at Joe DiMaggio Children's Hospital, one of the council members, who had a child with asthma, observed its implementation. She spent a couple of days on the floor watching how it was used by staff to educate families. Afterward, the necessary revisions were made.
Virtual trauma staged
Recently, Memorial Regional Hospital staged a virtual trauma that involved the trauma services team and a few family advisors who took part in the role-playing. The simulated incident began with a recent trauma patient of trauma services telling his experience. Montgomery says these life-like educational sessions for staff members are much more effective than a lecture or video.
How should patient education managers involve consumers in the development and implementation of educational programs and materials if there is no family advisory council?
Form focus groups to obtain the voice of the customer, but note that it is not necessarily the voice of an educated customer, says Montgomery. Focus group participants should undergo a screening process, so there is a better understanding of their viewpoint.
The best way to get patient and family input time and again is to form a hospitalwide advisory council, says Montgomery. It doesn't have to meet monthly, but the council is available to work with staff. Definitely put patients and family members on the patient education committee, she says.
"If you break the term collaboration down, it means co-labor or working together, and that is what it is all about collaborating to improve health care," says Montgomery.
For more information, contact:
Kerting Baldwin, Director, Media Relations, Memorial Healthcare System, Hollywood, FL. Telephone: (954) 265-5437. E-mail: KBaldwin@mhs.net.