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According to Beverly H. Johnson, president and chief executive officer of the Institute of Family-Centered Care in Bethesda, MD, a lot of hospitals believe they already offer family-centered care to their patients. But she says that before you make that claim, you should do a self-assessment. The institute offers a comprehensive assessment tool that addresses each of the following 10 areas:
1. Vision, mission, and philosophy of care. Vision, mission, and philosophy of care statements are key documents that set the tone and direction for the institution and the services it offers. Does yours convey an explicit commitment to patient-and-family-centered care? Do they show that the beliefs, values, and priorities of patients and families are key considerations in hospital services? And do these statements convey respect for families and their pivotal role in promoting the health and well-being of patients and families?
2. Facility design and allocation of space to support family-centered care. The physical environment of your facility can either support or hinder the practice of patient-and-family-centered care. Do your facilities — including parking, the lobby, and entrances to departments and units — convey positive and welcoming first impressions? Do your facilities encourage family participation in care?
3. Patient and family participation in care. The wording of policies and dissemination of information about participation in care can impact the patient and family’s participation in decision-making, and the attitudes of patients’ families about health care. You should ask yourself if patients and their families are seen as important members of the health care team. Are they encouraged and supported in care planning and decision-making? Are family members considered visitors, and are they welcome at all times, regardless of rounds, changes of shift, or other unit events? Can patients have their families with them during procedures and treatments? Even the words you use in policies can have an effect. Do yours include flexible, positive words like offer, choose, and support, rather than allow, permit, and require?
4. Information to patients and families. Providing information in ways that patients and families see as helpful empowers and supports them in nurturing. Offering them the kind of information they want, in the format they wish, is important, says Johnson. Do patients and families have opportunities to ask questions of physicians and nurses? Are patients and families involved in the ways that the hospital and its staff provide information? Do you have a patient and family resource library? Can patients and their families use the hospital medical library?
5. Facilitation of peer support and family-to-family support. For many families, meeting others who have gone through what they are experiencing is as valuable as getting support from health care professionals. Do you give patients and their families information about peer support groups? Do you hire patients or family members to facilitate peer or family-to-family support groups? Do you have a patient or family liaison on staff?
6. Documentation and charting. The charting policies and forms you use in your facility can foster patient and family dependence, or they can help encourage patient and family participation. Do your forms promote the identification of patient and family strengths and goals? Are patients and families (with the patient’s permission) allowed to read their charts and record comments and observations in it?
7. Links to home and community resources. The transition to and coordination of services are important. Is there a single person assigned to help patients and families with discharge or transition planning? Do you link patients and families with services such as respite care, hospice care, home health services, or transportation assistance?
8. Recruitment and selection of personnel, job descriptions, performance appraisals. The human resources department can ensure that your staff, across all disciplines and departments, have the knowledge and skills to deliver family-centered care. Are your job descriptions and performance appraisals written in ways that are consistent with patient and family-centered principles — especially regarding communication and patient/family/physician collaboration? Do your orientation and continuing education programs convey information about family-centered care and the skills needed to deliver it?
9. Approaches to assist students and professionals-in-training in acquiring patient and family-centered knowledge, skills, and attitudes. To acquire patient-centered and family-centered knowledge, students and professionals in training need the chance to learn directly from patients and their families, and work both in the hospital and in non-clinical settings. Do you facilitate this?
10. Quality improvement. How are patients who have been consumers of health care services and their families getting involved in planning, evaluation, and quality improvement initiatives for your facility? Do you have a patient and family advisory council included in your quality improvement program? Do you use patients and their families to find solutions to ideas, suggestions, and concerns raised in your patient satisfaction surveys?
The tool asks the above-listed questions, and asks for a ranking of your facility’s performance in each area. After rating each item, the tool asks for specific examples that illustrate how family-centered care is or is not happening in relation to each item.
Once you have completed the assessment, the tool helps you plan how to implement — or better implement — the principles of family-centered care at your hospital.