Patient and Family Advisory Councils

Wendy Waddell, PhD(c), MSN, RNDirector of Inpatient Mental Health Services & Alcohol

Drug Abuse, Regions Hospital

Melissa Hensley, MSW, MHA, PhD, LISWAssistant Professor of Social Work, Augsburg College

Monday November 3, 2014

Participants:1-866-639-0744, access code 3720297

Patient and Family Advisory Councils

Objectives

• Describe the principles of Patient & Family focused care

• Outline a strategy for developing & using a Patient and Family Advisory Council

• Coordinate the use of an Advisory Council with readmission work

Patient- and Family-Centered Principles• People are treated with respect and dignity.• Health care providers communicate and share complete

and unbiased information with patients and families in ways that are affirming and useful.

• Individuals and families are encouraged and supporting in building on their strengths through participation in health care experiences at the levels they choose.

• Collaboration among patients, families, and providers occurs in policy and program development and professional education, as well as in the delivery of care.

Staff Mental Barriers

• We don’t have time for this.• Patients will hear the negatives about our hospital.• WE don’t want to air our dirty laundry.• This is nice to talk about, but…• Patients/families just don’t understand our system.• They will want things that cost too much and we’ll have to

tell them “no”.• We are not a hotel; we are here to save lives.• We need to be more organized before bringing

patients/families to the table.

Family and Consumer Mental Barriers

• Nobody is going to take what we say seriously• The hospital administrators are all talk and no

action• The attitudes of staff will never change• The hospital is just a revolving door anyway—

they’re not motivated to change• I’ll get in trouble if I speak up and then have to

use services again

Collaborative or Partnership Council

• Empowered to find solutions

• Staff and patient/family partners collaborate on decisions

• Partnership Council– Opinions are not

perceived as merely advisory

– Staff may bring issues looking for advice

Advisory Council

• Empowered to advise• Offer guidance; a group

providing expert information

• Advisory Council– Opinions may be

perceived as merely advisory

– Should be empowered to be more than advisory

Council Structure

Council Structure

• Size – 12-30

• Composition– Reflection constituencies/Member Diversity

• Terms of Membership– Staggered terms

Structure – Things to Think About

• Compensation and Reimbursement• Bylaws/guiding principles• Sub-Committees• Meeting times – convenient to staff, patients,

families• Monthly, 2 hours• Place – accessible, space• Refreshments

Conducting Effective Meetings

• Spend extra time on introductions.• Being some meetings with patient and family stories.• Discuss the concept of collaboration explicitly at the beginning

of a new endeavor and assess how it is working at the end of meetings.

• Stay on the agenda – must not be too long.• Avoid using jargon.• Encourage the participation of patient and family advisors,

validating their role as committee members.• Plan proactively for challenging situations. • Establish ground rules.

Successful Advisors

Successful Patient and Family Advisors

• See the “big” picture• Share personal experiences in ways that

others can learn from them• Interested in more than one agenda item• Represent patient population• Ability to listen and hear other points of view• Ability to connect with people

Successful Patient and Family Advisors

• Patient and family advisors can provide helpful feedback in a couple of ways:– There may be learning opportunities that arise

from patients taking the time to tell specific stories of particularly good or bad treatment.

– Patient and family advisors may be able to see and apply general patient-centered care principles to mental health care situations.

Recruitment

Recruitment

• Ask patients/families during a clinic visit or during hospital stay when appropriate.

• Ask staff and physicians for suggestions.• Contact support groups such as NAMI, Mental

Health Association• Call or send a mailing to patients and families.• Post signs/notices in clinics, hospitals, publications

and websites• Technology - Facebook, Twitter

Regions Hospital, St. Paul, MN

Regions Hospital

• 8 story Mental Health Building• 100 beds – all private rooms w/bathrooms• Nursing station – No Plexiglas• Comfort Rooms• Exposure to the outside

Mental Health: Regions Hospital

Accomplishments of Patient/Family Partners in Care Advisory Council

•Helped name the model of care: “Circle of Support”

Mental Health: Regions Hospital

Developed Core Values•Patient Centered Care•Safe Place to Be•Respect•Continuity of Care•Stewardship•Evidence Based Practice•Support System Involvement•Teamwork

Accomplishments

• Guided process of creating more patient and family centered visiting hours

• Promotion of having family members present at admissions and discharges

• Suggested development of family only support groups daily • Helped create Family Resource Library • Assisted with development of Anti-Stigma presentation to

all hospital staff • Gave valuable input into content of group programming,

patient aggregation, Team meeting protocols

Accomplishments

• Reviewed plans for physical environment and suggested revisions for comfort and safety

• Helped choose artwork for the building • Participated in staff education programs and videos • Suggested the employee wellness cart to assist staff with

stress reduction • Supported addition of Certified Peer Specialist to staff • Provided overall oversight from the patient/family point of

view to all decisions made regarding the Model of Care for Mental Health patients.

Fostering a Successful Council

Fostering a Successful Beginning: Orienting Patient and Family Advisors• Mission, Values, Priorities of the Unit, Clinic or Hospital• Meeting Attendance Expectations• Safety-Security Protocols• Hospital/Clinic Tour• Roles and Responsibilities on the Council

– Families, Staff, Patients• Confidentiality and Privacy• Set ground rules for discussion• Set stage for open, honest, frank discussions• Share own experiences

Fostering a Successful Beginning: Orienting Patient and Family Advisors• How to be an effective Advisor

– How to ask questions– What to do when there is a disagreement– Listening and learning from other’s viewpoints– Thinking beyond your own experience– Sharing your story– Telling “negative” stories in a positive way– The impact of anger

Fostering a Successful Beginning: Staff roles on the Council• Serve as a connection between other staff and the advisory

group• Be a Family Centered “Champion”• Respond to issues in their respective areas based on concerns

and/or suggestions presented to the advisory group• Provide information for the advisory group• Staff can play a key role in helping patient and family council

members feel welcome and comfortable.• Extending hospitality and a warm welcome to patient and family

members can help build a stronger sense of teamwork and shared mission.

Lessons Learned: A Patient-Member’s Perspective• The vast majority of mental health providers really

do want what is best for the people they serve.• Working together with family members and staff

members can indeed lead to real, constructive change.

• There are aspects of my own experience that can help inform current practice and hopefully prevent pitfalls in the future!

Readmissions

• Advisement on disposition & discharge practices• Assistance with identifying obstacles to discharge

(i.e. not having discharge conference)• Important to involve support system in aftercare –

compliance, aftercare• What services can the mental health unit add that

would help prevent the need for re-admission?

Upcoming RARE Events….

Stay tuned for the next RARE Mental Health events….

WebinarConnecting Through Conversations December 4, 2014 12-1pm

Final Face-to-Face Tuesday February 24, 2015Maplewood Community CenterMore information to come