Patient and Family Advisors Help Redesign "Rounds"
Our Patient and Family Advisors (PFAs) are working to make hospital "rounding" more patient and family-centered, both in name and in action.
The term "rounding" comes from the perspective of the clinical team who make their rounds from one patient room to the next. PFAs worked with leaders from the hospital's Interdisciplinary Model of Care (IMOC) initiative to coin a new patient-centered name – Care Team Visits – and help shape a new model for this daily clinician patient/family interaction.
For providers and staff, rounds have traditionally been clinically focused. One of the goals of the Care Team Visit is to listen more to the concerns of patients and their families.
"A hospitalization is often a highly emotional event," says PFA Peggy Zimdars. "Listening is a powerful healing tool."
PFA Eric Sarno is an elite athlete who was hospitalized for seven months following a stroke and brain surgery. He knows firsthand the importance of understanding the patient's goals. He encourages staff to ask patients questions, instead of assuming.
"Everyone, including my friends and family, seemed to think that my recovery goal was to compete in races again," he says, "when, in fact, all I cared about was being able to hug my daughters when they visited me in the hospital."
"Recognizing there are differences between the care team's priorities and those of the patient and family may seem obvious, but learning about this from former patients has been very enlightening and has helped me to improve my own practice," says Robert J. Hoffman, MD, hospitalist, and medical director, Patient Relations. "I've learned a lot from our PFAs."
PFAs want to emphasize that nurses play an important role in the Care Team Visit.
"Nurses are in a perfect position to facilitate the discussion because they've developed a comfort and trust with the patient and family and can coach them on how to participate – empowering them from passive participants to active engagement in their care," says Peggy. "Nurses can elicit questions before the visit, know what was discussed during the visit and later address gaps in understanding."
Anne Mork, MS, RN, Nurse Manager, Trauma Life and Support Center, says there are benefits for staff as well. "Important patient information is discussed during the Care Team Visit, which helps ensure the team is all on the same page, preventing breakdowns in communication."
PFAs also have encouraged Care Team members to include patients and families in the conversation, instead of speaking over their head to colleagues. Establishing a consistent time for a patient's Care Team Visit makes it easier for family members to be present or know when to call in.
"Family members often feel invisible, but they are valuable members of the team since they know the patient well and can provide valuable insights," says Peggy. "They often remember more than the patient about what was discussed. Family members are keys to safe transitions, outcomes and motivation as they often become the home care team."
Now Eric, Peggy and fellow PFA Kristen Cassarini are taking part in staff training sessions as the new model for Care Team Visits is introduced to inpatient staff at University Hospital.
"The voice of the patient is incredibly powerful and truly captures the attention of clinicians. It ‘speaks to the heart' in a manner not often captured in surveys and reports," says Ann Malec, MS, RN, NEA-BC, director of medical nursing. "It inspires staff to build upon the great work already established around the interdisciplinary model of care."