PATIENT AND FAMILY

CENTERED CARE (PFCC)

EDUCATIONAL RESOURCE
PFCC Learning Huddle Material

Developed by
PFCC Resource Team
Covenant Health
Spring 2016
PFCC LEARNING HUDDLE MATERIAL
Spring 2016

 Developed by the PFCC Resource

Learning Huddle Material
Support Team to facilitate local
discussion and learning about PFCC Adverse Events

 Each Huddle Discussion guide briefly Care Environment

presents the topic, provides some Communication (101, 102, 103)

discussion points and a link for further Continuity of Care

resources on the topic Client Experience Dimensions

Dignity Preserving Care
 Materials are to be used in the way
Leading PFCC Practices (IDEAL Model)
most useful to your needs and settings
Measuring & Monitoring PFCC Practices
– for self learning, in “Friday Files” or
Team Performance
other electronic communication with
What Is PFCC
staff, in team meetings or as posters

 You will have an opportunity to provide

evaluation of the material and make

suggestions for new topics

 An electronic copy of this material can

* For additional Information: Please contact
be found on CompassionNET - Patient Carol Ellis, Clinical Quality Consultant;
Relations Page 780-735-2589

PFCC Resource Team:

Carol Ellis Joy Hurst Loren Jacula

Clinical Quality Consultant Corporate Lead, Patient Organizational Development
Relations Consultant
Patient & Family Centered Care (PFCC)
What is Patient & Family
Centered Care?

Patient and family-centered care (PFCC)

is a method of planning, delivery, and
evaluation of health care that is based on
mutually beneficial partnerships among
health care providers, patients, and families.*
It is both organizational and personal.

Resources: What Is PFCC? PFCC is an approach to care that shifts from

https://www.youtube.com/watch?v=6UnEDk4JaCU
Person-Centered Care:
https://www.youtube.com/watch?v=6Dk3CV-Wt38
PFCC - Definitions resources:
*http://www.ipfcc.org/pdf/CoreConcepts.pdf
http://www.Plaintree.org
http://cgp.pickerinstitute.org/?page_id=1319
“doing for” to “doing with.” It is a whole person
approach to understanding the holistic needs
of those we serve.
PFCC is a way to live the mission, vision
and values of Covenant Health.

PFCC is defined in different ways by those who use it.

The links above will help explore how PFCC is described
by 3 leaders in Health Care Research:
IPCC, Planetree, and Picker Institute

https://www.saintelizabeth .com/Services-and-Programs/Research-
Centre/Person-and-Family-Centred-Care.aspx

Guiding Principles:
1) Respect & Dignity
2) Information Sharing
3) Participation
4) Collaboration

Discuss: What do these practices mean from a patient’s point of view?

Describe a scenario entirely from the patient perspective.
How is it different from a provider’s viewpoint?

For more information please contact Carol Ellis, Clinical Quality Consultant.
May 2016
 PFCC Leading Practices

The IDEAL* discharge planning model follows the

Include
patient journey from admission through discharge.
When patients and families are engaged in their care Discuss
the benefits are measureable improvements in safety, Educate
quality and satisfaction.
Assess
Include the patient and family as full Listen
partners in the discharge planning
process

Discuss with the patient and family five

key areas to prevent problems at home:
• Describe what life at home will be like
• Review medications
• Highlight warning signs and problems
• Explain test results Self Reflection:
• Make follow-up appointments

Educate the patient and family in plain

language about the patient’s condition, the
What are some of the
discharge process, and next steps at methods I can use to
every opportunity throughout the hospital
stay engage patients and
Assess how well doctors and nurses families?
explain the diagnosis, condition, and next
steps in the patient’s care to the patient
and family and use teach back.

Listen to and honor the patient and

family’s goals, preferences, observations,
and concerns.

*Strategy 4: Care Transitions From Hospital to Home: IDEAL Discharge Planning. June 2013. Agency for Healthcare
Research and Quality, Rockville, MD.
http://www.ahrq.gov/professionals/systems/hospital/engagingfamilies/strategy4/index.html

For more information please contact Carol Ellis, Clinical Quality Consultant.
May 2016
 Patient and Family Centered Care:
Measuring and Monitoring
PFCC Leading Practices

Sample Observation Tool

IDEAL* Behaviours Observation/Discussion Comments:

I – Include Examples

D – Discuss Interaction/Inclusion:

E – Educate Eye contact, NOD – name,

occupation, duty
A – Assess Identify family/friends

L – Listen Include in decisions

*Adapted from the Agency for Healthcare
Research and Quality
Discuss:
Review medications, treatments,
Can be a formal or informal Plan of care and discharge
process.
Educate:
Start by asking 1 patient per Demonstrated teach back methods
week about his/her Used timely, plain and easily
experience. understood language

Respond in a meaningful Assess:

way to the information Asked open ended questions.
received. Ask 3
Offered Comfort Rounds
Talk to staff about what is
working and what is not and Listen:
why? Heard, respected and acted on
goals, preferences and concerns
of the patient/family

Every interaction is an opportunity to build relationships, engage and improve

quality.

For more information please contact Carol Ellis, Clinical Quality Consultant.
May 2016
 Four Dimensions to measuring client experience:
Accreditation Canada
►Respecting client values, Sample Questions:
expressed needs and preferences Were you encouraged to participate in
decisions about your care?

►Sharing information, Did you understand your care plan

communication and education including your medications?

► Coordinating and integrating Did you get the help/information you

needed to prepare for admission,
services treatments, tests and discharge?

► Enhancing quality of life in the care Was your pain managed and did you
receive support and assistance when
environment and in activities of daily needed?
living

Partner with staff to choose a leading PFCC practice to implement.

How? By reflecting on the Core Principles of PFCC:
1. respect and dignity
2. information sharing
3. participation
4. and collaboration
Monitor progress through feedback from patients and staff members.
Share the results and plan for improvements.

Accreditation Standards:
Examples of PFCC Current Practices:
• Investing in Quality Services
- Path to Home – Bedside shift report,
NOD, Ask 3, Comfort Rounds
• Monitoring Quality and Achieving - Elder Friendly Care
Positive Outcomes - Baby Friendly Care
- Restorative Care
- Resident Family Councils
• Building a Prepared and Competent - Advanced Care Planning
- Falls Prevention
Team - Medication Reconciliation
- Patient admission database form

For more information please contact Carol Ellis, Clinical Quality Consultant.
May 2016
 Notes:

Resources:
http://insite.albertahealthservices.ca/pe/tms-pe-what-is-patient-family-centred-
care.pdf

The Institute for Patient and Family Centred Care

http://www.ipfcc.org/

Agency for Healthcare Research and Quality

http://www.ahrq.gov/professionals/systems/hospital/engagingfamilies/guide.html

Quality Improvement video:

https://www.youtube.com/watch?v=jq52ZjMzqyI

Speak up for Patient Safety

https://www.youtube.com/watch?v=URCIGK9upTE

For more information please contact Carol Ellis, Clinical Quality Consultant.
May 2016
 PFCC Learning Huddle Discussion Guide
Care Environment
Observe the surroundings from a
patient’s perspective.
What do you see? Hear? Smell?
A “walk-about” is an activity that can
be used to obtain patient and family
perspectives about the experience of
care and how organizational policies,
practices, and environment support
patients and families in engaging as
key partners on their health care team.*

Where do we start?
Take a look at the reception area, admitting office, lab, imaging services, inpatient units…can you
follow the patient’s journey?

Observe staff and clinician interactions – how are patients welcomed, orientated.
How and where is information presented? Is it accessible and are educational materials available? Are
there multiple formats ie brochures, pamphlets, posters, signage?

Are there assistive devices nearby, ie Wheelchairs, seating, washrooms?

Resource: https://www.youtube.com/watch?v=OIgBQcH-m2w

Skills Development Discussion

General:
Explore how to welcome, support, educate, and
comfort patients and families and encourage
active participation in care and decision-making.
Managers:
How will I support, engage and empower the unit and staff to
consider these questions and act in a responsive, intentional way?
Staff:
Ask yourself, how can I make a difference in this particular patient’s
stay on this particular day? How will I support and communicate
with my colleagues and my patients every day?

For more information please contact Carol Ellis, Clinical Quality Consultant.
May 2016
PFCC Learning Huddle Discussion Guide

Dignity Preserving
Care
Healthcare providers listen to and
honor patient and family perspectives
and choices. Patient and family make-
up, knowledge, values, beliefs, and
religious and cultural backgrounds are
incorporated into care planning and
delivery.

How do we demonstrate these behaviours?

Invite questions
Include family members
Goals of Care discussions
Ask what is important to him/her.
Show your compassion and kindness
Acknowledge the whole person instead of “the patient”

Resource: https://youtube/OIgBQcH-m2w

Skill Development Discussion

Be fully present in interactions. What is your patient feeling, thinking, seeing and
hearing?
Reflect on your own attitudes, assumptions, personal belief and values. How do
they influence your interactions in care?
Consider the person first, not the diagnosis. How do YOU show compassion,
respect and kindness?
How do we recognize and respond to individual needs, make shared-decisions,
advocate and actively listen?

For more information please contact Carol Ellis, Clinical Quality Consultant.
May 2016
 PFCC Learning Huddle Discussion Guide
Team Performance
As a team leader or member,
communicate respectfully, clearly and
provide sufficient information in a timely
way. Create a shared vision for
compassionate, responsive,
knowledgeable care.

Good Practices:*
Know your role and the role
of others.

Communicate clearly and as

often as necessary among
all members of the team.

Be supportive.

Resources:
* https://www.cmpa-acpm.ca/serve/docs/ela/goodpracticesguide/pages/key_concepts/key_concepts-
e.html?open=patient_safety

Collaborative practice
http://www.compassionnet.ca/Page2183.aspx

https://www.youtube.com/watch?v=ue3hCVHtZZY

Skill Development Discussion

Consider: How could you share and approach team members about patient and
family centered care practices.

Discuss: We are trying to ensure our care is supportive and information is shared
appropriately and effectively.

Ask: Staff and patients - How would you describe YOUR experience?
What is working well for you? What could be improved?
Is there anything you would like me to know to help with providing/receiving care?

For more information please contact Carol Ellis, Clinical Quality Consultant.
May 2016
 PFCC Learning Huddle Discussion Guide
Continuity of Care
Ever increasing complexity of care
often means patients are seeing a wide
variety of care providers in multiple
settings. As a result, important
information may be missed,
misunderstood or misinterpreted.
Connecting all the different pieces
along the patient’s journey is
challenging but can be critical.

Continuity of care requires effective

information sharing and service
coordination.

Resources: http://www.compassionnet.ca/Policies/vii-b-255_Internal_Transfer_Report.pdf

Skill Development Discussion

Discuss: What enhances or detracts from continuity of care?
What are some of the methods we use to ensure timely information-sharing and follow up?
Eg: bedside shift report, transfer of accountability record, documentation, policy and procedures,
continuing care shift report, care conferences, discharge planning conferences.

What do we mean by Continuity of Care?¹

Relational: relationships that take place with providers.
Informational: Communication and information transfer across care settings; gathering of holistic
information about the patient
Management: accessibility between care levels, individualized care and supportive discharge
process; patient involvement

What are some of the key benefits and/or challenges of multidisciplinary teamwork? How do
we communicate effectively?
Eg: Know and understand the skills, competencies, experience and scopes of practice of team
members, including overlaps and gaps in the team’s capabilities.
Protect privacy and confidentiality; use plain, jargon-free language, support
oral and written information with patient education tools. Communicate with
other providers clearly and check for understanding during transfers of care.

¹“What do we know about Patients’ Perceptions of Continuity of Care?”

International Journal for Quality in Health Care. 2012;24(1):39-48.

For more information please contact Carol Ellis, Clinical Quality Consultant.
May 2016
 PFCC Learning Huddle Discussion Guide
Communication 101
Safe, high-quality care is dependent on
effective, clear communication between
health care providers, patients, and
families.
Communication is an ongoing process
and includes written, verbal and non-
verbal methods.

Did you know…*

Face-to face communication is affected by:
58 % body language
35% tone of voice
7% content or words used
If you can do nothing else, you Telephone communication:
can always be KIND. 18% words used
82% tone of voice

Resource: https://www.youtube.com/watch?v=-4EDhdAHrOg * Information Technology Project Management Fifth Edition,

copyright 2007

Skills Development Discussion

Respect and empathy are cornerstones to effective communication. Understand and be aware of both
your own and a patient/family’s personal values, culture, and perspectives. Communication also
includes clear, concise documentation and includes actions taken.
Communication Basics:
• Respect.
• Cooperate.
• Clarify.
• Listen.

WHAT are you communicating? Is it urgent? Time-sensitive?

WHO needs to know?
WHY does he or she need this information?
HOW will you provide It? ie written, verbal, nonverbal, electronic
WHEN is the information needed?

For more information please contact Carol Ellis, Clinical Quality Consultant.
May 2016
PFCC Learning Huddle Discussion Guide
Communication 102
Interpersonal Conflict:
Conflict can occur anywhere,
particularly when the stakes are high
and the investment is personal, such as
between colleagues, management,
care providers and even with patients
and families.

Conflict is often the result of a

breakdown in communication. It is
important to recognize that our
behaviours can cause conflict or make
it worse. However, there are skills that
we can use to help ease a situation
and/or prevent it from happening in the
first place.
Try the following self-assessment and find out your score on http://compassionnet.ca/Tip_Sheet.PDF
how you react to conflict.

Go to http://www.dalecarnegie.ca/wp-content/files/remote/Conflict_Resolution_Guide.pdf

Skills Development Discussion

Discuss: What did you think and/or feel about your score profile? Did you recognize yourself in
any of the descriptions?

Reflect: Can you think of any times or situations on your unit that lead to conflict? Was it
resolved? If so, how? What behaviours initiated or escalated the conflict? What strategies
could be used to create a better outcome?

Tips for coping with conflict:

Stop. Take a breath. Pay attention and actively hear the words, the tone and the volume of
what is being said. Watch for nonverbal cues. Anxiety is often masked as aggression.
Ask respectful questions. Use “I” and “we” messages instead of “you.”
Avoid blame. Focus on fixing the problem, not on the person and
look for a workable solution.
If necessary, take a break and allow for space and time to think.
Admitting a mistake and a sincere apology goes a long way.
Be brave. Not all conflict is negative. Express yourself
and be willing to acknowledge another point of view.
For more information please contact Carol Ellis, Clinical Quality Consultant.
May 2016
 PFCC Learning Huddle Discussion Guide
Communications 103
Intentional Relationships:
*All parties involved in relationship-
centered care should experience a
sense of:
• Security – safety within the
relationship
• Belonging – to feel a part of things
• Continuity - consistency
• Purpose – a personal goal
• Achievement – progress towards the
goal
• Significance – to feel he/she matters
*“What families and patients say about their needs and
interactions with professionals” ppt Nov. 2015
ES Brintnell, University of Alberta

Resource: http://www.compassionnet.ca/Patient-PatientRelations-RelateRespond.pdf

Skills Development Discussion

We all have ways or patterns of communicating and may tend to default to our
favored method in most situations. However, there are times in a therapeutic
relationship when purposeful communication refers to:*
1. Advocacy – speaking on behalf of our patients and acting as a
representative for his/her needs.
2. Collaboration – cooperation with our multi-disciplinary partners including
our patients
3. Empathy – respect and seeing another’s perspective; “walking in their
shoes”
4. Encouragement – providing support, building confidence and hope
5. Instructional – providing education, training and guidance
6. Problem-solving – the process of finding solutions
at times includes unique or complicated situations

Discuss: What is your preferred communication

method?

For more information please contact Carol Ellis, Clinical Quality Consultant.
May 2016
 PFCC Learning Huddle Discussion Guide
Adverse Events
Reporting and Learning
System (RLS)
RLS is a province-wide method
of electronic reporting of patient
safety incidents. Consistent
reporting of hazards, close calls
and adverse events is
encouraged for the purpose of
learning about and improving
patient safety.

Resources:
http://insite.albertahealthservices.ca/assets/et/rls/et-rls-12-3-qrg-severityalgorithm.pdf

Skills Development Discussion

Key Principles of the System
• Everyone feels safe and encouraged to report patient safety hazards, close
calls and adverse events
• Patient safety events are often driven by system errors rather than human
error
• Learning by analyzing trends and sharing information
• Reporting is not to be used for performance management
• Accessible and intuitive online or telephone reporting

Discuss:
How do we access the RLS? (refer to listed resources)
• AHS Reporting & Learning System for Patient Safety (RLS)
http://insite.albertahealthservices.ca/1820.asp

Did you know?

The RLS website offers E-learning modules on how to complete an RLS
• http://ahamms01.http.internapcdn.net/ahamms01/Content/InSite_Videos/Employee_Tools/
et-rls-every-report-matters/story.html

For more information please contact Carol Ellis, Clinical Quality Consultant.
May 2016