Patient Experience Journal (PXJ, The Beryl Institute)

This case examines the highlights of Vidant Health’s journey to a more intentional focus on patient experience. Organizational inconsistencies lead to a focused long term plan putting a culture of patient centeredness at the core of Vidant’s efforts. The results show a clear and measured improvement in safety, quality and experience overall

Jones, Amy

Dutton, Kathy

Patient Experience Journal Volume 1 Issue 1 Inaugural Issue Article 8 2014 Patients and families as partners in safety, quality, and experiences of care Amy Jones Office of Patient-Family Experience, Vidant Health, amjones@vidanthealth.com Kathy Dutton Office of Patient-Family Experience, Vidant Medical Center, kdutton@vidanthealth.com Follow this and additional works at: https://pxjournal.org/journal  Part of the Health and Medical Administration Commons, Health Policy Commons, Health Services Administration Commons, and the Health Services Research Commons Recommended Citation Jones, Amy and Dutton, Kathy (2014) "Patients and families as partners in safety, quality, and experiences of care," Patient Experience Journal: Vol. 1 : Iss. 1 , Article 8. DOI: 10.35680/2372-0247.1007 Available at: https://pxjournal.org/journal/vol1/iss1/8 This Article is brought to you for free and open access by Patient Experience Journal. It has been accepted for inclusion in Patient Experience Journal by an authorized editor of Patient Experience Journal.  Patient Experience Journal  Volume 1, Issue 1 - April 2014, pp.    Patient Experience Journal, Volume 1, Issue 1 - April 2014© The Author(s), 2014. Published in association with The Beryl Institute and Patient Experience InstituteDownloaded from www.pxjournal.org Patient- and Family-Centeredness – Case  Patients and families as partners in safety, quality, and experiences of careAmy Jones, Office of Patient-Family ExperienceKathy Dutton, Office of Patient-Family Experience  Abstract This case examines the highlights of Vidant Health’s journey to a more intentional focus on patient experience. Organizational inconsistencies lead to a focused long term Vidant’s efforts. The results show a clear and measured improvement in safety, quality and experience overall. Keywords Patient and family partnerships, patient and family advisor, patientengagement   Vidant Health (VH) is a private, not-for-system in eastern North Carolina and consists of nine hospitals, home health, hospice, wellness centers, a freestanding surgery center and over 70 ambulatory care practices.  Efforts to advance a culture of patientcentered care began in the late 1990s in the James and Connie Maynard Children’s Hospital and the Regional Rehabilitation Center at Vidant Medical Center, the health system’s 909-bed academic medical center.  These efforts, while valuable, failed to spread beyond Children’s Hospital and the Regional Rehabilitation Center, whichinconsistencies in culture and experiences for patientfamilies receiving care.  The Impetus for Change  These inconsistencies were shared with the team by an employee of the Regional Rehabilitation Center in the Spring of 2007.  The employee described how her family was treated as “visitors” during her brother’s hospitalization in an adult intensive care unit. The visitation policy restricted her family access to the intensive care unit to 15 minutes at a time, six times a day. This limited their access to information and heightened fear and anxieties for her brother and family. Unfortunately, because of the system’s visitation policy, her brother died alone, with no family by his side.   This story ignited VH’s patient-family centered care transformation.  After hearing this account, the system’s executive team, board of directors and physician leaders committed to advancing a culture of patient and family engagement across Vidant Health.    48-49   , Vidant Health , Vidant Medical Center plan putting a culture of patient centeredness at the core of - and family- centered care, culture change, physician profit health -family  created s and VH Executive  Primary Drivers To Enhance Patient and Family Partnerships  In the Fall of 2007, VH developed the first longquality plan for the system. Primary drivers for this plan focused on board leadership, patienttransparency, and a culture of continuous improvement and commitment to excellence. Specific strategies and tactics for each of the drivers were laid out over a five year time frame and were based on best practices white papers such as the Institute for Healthcare Improvement (IHI) Seven Leadership Leverage Points. In 2008, an aggressive transparency policy was established and the restrictive visitation policy was replaced with guidelines promoting and supporting family presence.  Vidant Medical Center’s Office of PatientExperience was also established in 2008 and the Corporate Office of Patient-Family Experience in 2009. VH then became one of the first systems to post harmful event data on a public-facing website and began to use raw numbers in reporting events of harm, so it could tie individual patient experiences to quality data.  The VH Board was recognized as a mentor board for the IHI “boards on board” plank of the 5 Million Lives Campaign.  Their engagement continued to grow and in 2010, board members began hearing quality concerns directly from patients and families. The first patient advisor to share her experiences associated with ventilatorassociated pneumonia stated, “That scorecard yevery month, I am one of those numbers.” Subsequently, this advisor was asked to serve on the Board’s Quality Improvement Committee to provide the unique perspective of patients and families. 48   -range -family partnerships, outlined in  -Family  -ou see  Patients and families as partners, Jones & Dutton 49  Patient Experience Journal, Volume 1,  Issue 1 - April 2014 There are currently more than 150 patient-family advisors partnering with leaders, physicians, and front line staff in quality, safety and patient experience work across Vidant Health.  The recommendations of the Institute for Patient and Family Centered Care for active advisor engagement led to patient and family advisors serving on performance improvement committees, making safety rounds, impacting the system of patient education, serving on interview committees and presenting at local, state, and national meetings.  VH has been in the national spotlight due to the success of patient and family partnerships, with active participation in the Partnership for Patients Campaign.  Key Challenges   The greatest challenge associated with this type of cultural change was transitioning from viewing patients and families as passive recipients of care to active and engaged partners at all levels of care and decision making.  To assist in changing this view, patient engagement executive and physician sponsors were identified, key individuals and functional areas for patient experience were established and front-line staff champions were identified to provide peer-to-peer mentoring and education.  Additionally, patient engagement principles continue to be imbedded in key documents.  A standardized patient engagement curriculum was developed by leaders from human resources, education, patient experience and patient and family advisors and is incorporated into continuous education for all VH employees.  Outcomes Achieved  Vidant Health has seen an 83% reduction in serious safety events since 2008, a 62% reduction in hospital acquired infections since 2009, 99% optimal care on CMS core measures, HCAHPS performance consistently well above top quartile performance in all dimensions of care and a significant increase in the number of patient-family advisors.    All VH entities use the Institute of Medicine dimensions to define quality: safe, timely, efficient, effective, equitable, and patient centered care.  We have found an overarching culture of patient and family centered care is a critical factor in the achievement of desired outcomes and foundational for our system’s future success.  Building on that foundation is key to sustaining our system’s commitment to achieve our ultimate goal of zero events of preventable harm, 100% optimal care and exceptional patient-family experiences every time for every patient we serve. 

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