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Numerous hospitals, community medical centers, and policy groups are recognizing the importance of collaborating with patients and families to improve safety, quality, and treatment outcomes. For some organizations, family- and patient-centered care has long been a part of the organization’s culture and approach to health care. The Children’s Hospital of Philadelphia (CHOP) has consistently been ranked by U.S. News & World Report, Child Magazine, and other organizations as the best hospital for children in the United States. Those awards are the result of the hospital’s top notch clinical programs and clinicians as well as their commitment to involving patients and families as integral partners in the care process as much as possible.
According to the Director of Family Relations at CHOP, Rachel Biblow-Leone, MSW, LCSW, family centered care (FCC) is not just a "box to check off, it’s how we do what we do”. Since 1994, CHOP leaders have worked hard to create a culture that makes family-centered care a priority. Indeed, when hiring new professional staff, hospital leaders seek professionals who consider it a privilege to collaborate and communicate with patients and their families. Family Consultants (family members of past patients who are paid staff members) even participate in the hiring process and orientation of new hospital professionals. The first touch point during orientation is with a Family Consultant who shares a personal story with new hires that illustrates the standard of care at CHOP.
|Family Consultants, who play an invaluable role at CHOP, also help families navigate the complex healthcare system by offering a personal perspective and by communicating patient and family needs to nurses and physicians. They also serve on a large number of hospital committees and planning projects. Other FCC initiatives, among many, include: the Family Advisory Council, a multidisciplinary group consisting of hospital professionals and family members with a wide range of backgrounds and diseases who offer input on hospital projects, programs, and policy development; family resource centers, which provide families a place for information, rest, support, and other resources; the Youth Advisory Council, a group that provides the child and teen patient perspective for hospital projects; and Family Partners who are credentialed volunteers who work alongside Family Consultants.
Quality improvement, especially patient safety, is an ongoing goal for CHOP and patients and families play an important role in improving hospital services. In fact, preliminary data has shown that family members were instrumental in reporting over 90 "catches” of patient safety events in real-time situations to staff who listened and responded (e.g., questioning medication that looks different before it is given to a patient to prevent a potential medication error). "This is a clear sign that when working with families, as partners, we are better able to deliver safer and higher quality care because there is mutual trust and encouragement for everyone to speak up for safety” says Rachel. Tip sheets are given to families that detail common safety concerns and strategies for communicating these concerns to hospital staff.
During bedside rounds, family members are consistently included to help physicians and nurses identify potential problems. Including families during bedside rounds also helps hospital staff to measure the amount and accuracy of information that family members have about patients’ condition and treatment. Although some have argued this model increases the length of time for rounds, the reality is that bedside rounds allow physicians to answer the questions and concerns of family members, which can save time in the long run and improve the hospital discharge process.
| "Family-centered care can seem like common sense, but we know common sense is not always commonly practiced.” says Rachel. CHOP maintains their commitment to keeping patients and families at the center of everything they do. They also continue to set an inspiring example to other organizations looking to offer family-centered care. As Rachel concludes so well, "this is the right work to be doing. We have the same goals. We want to be more effective, more accountable, and provide greater health outcomes. We want to see a better approach to well-being and achieve the optimal state of health”.
||Matt Martin is a licensed marriage and family therapist and is currently working as a post-doctoral fellow with the Chicago Center for Family Health and the Illinois Masonic Family Practice Residency Program. He received a master’s degree in Marriage and Family Therapy from Brigham Young University and just recently a doctoral degree in Medical Family Therapy from East Carolina University. His interests include integrated primary care, behavioral health, and family medicine residency education.|