AAMC Patient and Family Centered Inpatient White Boards

AAMC Patient and Family Centered Inpatient
White Boards: Engaging Patients and Families
in Their Care
Presenters:
Shirley Knelly, MS, LCADC, CPHQ
Vice President Quality and Patient Safety
Anne Arundel Medical Center
Lucretia Jackson, MS
Patient and Family Advisor
Anne Arundel Medical Center
These speakers have indicated no conflict of interest to disclose
Anne Arundel Medical Center
Goal
• Anne Arundel Medical Center’s Patient Safety
Committee’s goal was to devise a communication
tool, that would :
– Allow patients to freely participate,
– Be both patient and healthcare friendly, and
– Improve communication between the patient, family
and healthcare professional.
Learning Objectives:
• To improve coordination between the
healthcare team, patients and their families
with involvement in decision making.
• Helping to breakdown communication barriers
between the patient, family, and healthcare
professionals
• Highlight specific patient safety precautions
that will both educate and empower patients
and families.
Problem
• Driving a Culture Shift
from:
“Serving” to “Partnering”
&
Recognizing the Value of
the Patient and Family
Perspective in Patient
Safety
Committee Members
Lucretia Jackson – Patient Advisor (Lead)
William Millios – Patient Advisor
Shirley Knelly – Patient Safety Officer
Anne Van Waes – Director of Infection Control
Kamila Frederick – Director IP Rehab/Respiratory
Lil Banchero – Director of Patient Access
Cathaleen Ley – Director of Nursing Quality & Research
Kathy Whittaker – Manager of Patient Advocacy
Ann Marie Pessagno – Senior Nursing Director of Acute
Care Services
Jill Smitley – Clinical Director for Labor & Delivery
Mark Sanchez - Physician
Role of Patients in the Care Process
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Role of Patients in the Care Process
TRADITIONAL:
• Passive Spectators
• Only experts are qualified to diagnosis and
treat diseases
• All decisions rely entirely on knowledge of
healthcare workers
• Healthcare workers are the guardians of
patient’s interest and well being
Role of Patients in the Care Process
Role of Patients in the Care Process
The Why
Research
 The Mayo clinic research showed “out of
roughly 2000 surveyed patients, the
majority of them said they wanted to help
providers prevent medical errors,
highlighting patients willingness to be
involved” Longtin, et al., Patient Participation: Current
Knowledge Applicability to Patient Safety. Mayo Clinic Proc. 2010;
85(1):53 – 62
 Based on a Dana Farber study, after
patients began providing the organization
with input and increasing patient-physician
communication, there was a 50% decrease
in medication errors per 10,000 doses.
The Why
Origin of Focus:
 Desire to focus on Patient
and Family Centered Care
 Voice and Perspective of
patient missing
 Including patient
perspective on safety
would provide level of
transparency and
improvements
 Patients as part of the
team in preventing errors
The How
The Patient Safety Committee, Lead by AAMC’s
Patient Safety Committee Patient Advisors,:
• Determined that developing a new design for patient
whiteboards as a communication and trigger tool will
enhance communication, participation and education.
• Collection of best practices for patient whiteboards specific
to patient safety
• Contacted three manufactures looking for sample boards
• Developed sample whiteboards and vetting them with
various healthcare professionals
• Presented sample boards to AAMC’s Patient and Family
Advisory Committee
Key Points
Key point in discussion:
“What do patients want to know”
as opposed to
“What staff want patients to know”
Key Points
Redesign of patient boards:
– Completely
headed by patient
advisors
– Patient-first
perspective
 Focused
on not what the doctors
wanted to communicate to patients
but what patients and their
families wanted to know
●
Emergency contact information
●
Care plan for that day
●
Fall information
●
Pain score
●
Medication information
●
Rapid Response Safety Team
First Things First
• Tour of rooms to
determine placement for
optimum visibility by
patient and family
• Pilot Units Selected
– MedSurg Unit
– Mother/Baby Unit
– Heart and Vascular Unit
• 3 Month Pilot Timeframe
• Staff Education
Developed
Survey Tool
• 25 Patients Per Unit
• Patients/families interview
by Hospital Advocates
• Objectives:
– The patient will be able to
identify the board in the
room
– The patient will be able to
answer the questions from
information filled out on the
board
– The staff will understand the
importance of filling out the
information on the board
Survey Questions
• Do you know the name and # of
the nurse/tech taking care of
you today?
• Do you know your physician’s
name?
• Did anyone explain goals for you
today?
• Do you know of any tests
scheduled for you today?
• Did the staff explain to you
about how to use your board?
• How useful is the board to you?
• Do you have any other feedback
about the board?
Survey Results
• Do you know the name and # of the
nurse/tech taking care of you today?
92% reported Yes
• Do you know your physician’s name?
81% reported Yes
• Did anyone explain goals for you
today? 67% reported Yes
• Do you know of any tests scheduled
for you today? 71% reported Yes
• Did the staff explain to you about
how to use your board? 73%
reported Yes
• How useful is the board to you? 91%
responded positively
• Do you have any other feedback
about the board? All Positive
feedback
Obstacle's
 Staffing adherence
to filling out the
boards
 Pens and Erasers
 Patient participation
 Language Barriers
 Cost
 Staff Education
 Design and Content
Sustainability
Future
In the future, the patient boards will be utilized in
the bedside shift report process by having clinical
staff engage the patient and family by reviewing
the information on the whiteboard.
Attributes
Unique attributes include:
 Enlisted the patient advisors in the development of the
patient boards
 The development of a tool that engages the patient and
family in their care
 Advocating for the patient and family as partners in care
delivery and decision making
 Providing an additional level of transparency as patients
become partners from a safety perspective
 Helping to breakdown communication barriers between
the patient, family and healthcare professionals
 Highlight specific safety precautions that will both educate
and empower patients and families