TREATMENT PARTNERS

Patient, family now treated as partners in health care

Patient- and family-centered care gathers momentum at hospitals, including Methodist Le Bonheur Healthcare.

From his bed at Methodist Le Bonheur Germantown Hospital, Calvin Hill had seen an example of “patient and family centered care” practiced right in front of him, but he didn’t know it.

As they changed shifts the evening before his scheduled surgery, registered nurses Erica Jennings and Marylee Berro glided to Hill’s bedside with a computer workstation on wheels.

Jennings, near the end of her shift, for several minutes briefed Berro about Hill as the conges- tive heart failure patient looked on, able to participate in the conversation. His brother wasn’t present, but as a family member approved by Hill, his brother also could have gathered and offered information.

Before the concept of patient and family centered care took root at the hospital about two years ago, the nurses would have huddled at a hallway workstation, with no opportu- nity for Hill or those with him to listen, offer corrections, or add details.

And “what the nurses tell us is that they really, really like shift change at the bedside,” said Michelle Collis, vice president of patient and family centered care for Methodist Le Bonheur Healthcare. “It really helps them hold one another accountable.”

Treating patients and their families more like partners and less like pas- sive consumers is a trend gathering momentum as reforms challenge the health care industry, said Bev Johnson, chief executive officer of the Institute for Patient and Family Centered Care in Bethesda, Md.

“I think the real trend is the growing awareness that we need to build a health care system that encourages and supports the active engagement of the patient, and if they wish, their family, in health care,” Johnson said.”

“Patient and family centered care is an approach to the planning, implementation and evaluation of health care where patients and families are respected as true partners in their own care,” she said.

In Memphis, Methodist Le Bonheur Healthcare exemplifies the trend, Johnson said.

Le Bonheur Children’s Hospital started first in about 2005 and the hospital system’s board revised its mission and vision in 2009 to include patient and family centered care, Collis said.

Today, the seven-hospital system has almost 160 “family partners,” former patients or members of their families, who serve on hospital “family partner councils” and up to the hospital system level, she said. They help develop services, write policies and make decisions.

“We identify and recruit family partners in the same way that you would a highly valued associate, because these are the individuals who are respectful, collaborative and willing to listen to other people,” Collis said.

The shift changes for nurses are one result of what Collis said is a change sought because of patient and family centered care.

Another example was doing away with traditional visiting hours, even in previously off-limits critical care units.

“Family presence is supported hospital wide,” Collis said. “Our research supports that patients typically do better.”

Pet visitation policy is being updated now, she said.

Glen Mullins, chairman of the family partner council at Methodist North Hospital, said he was skeptical at first, but learned that hospital officials have been respectful and responsive. The council has dealt with issues including advanced directives, do-not-resuscitate initiation, discharge planning and intensive care waiting room design. A surgical technologist, Mullins, 56, said he’s impressed with how the hospital has embraced the culture.

Other local hospitals including St. Jude Children’s Research Hospi- tal and Baptist Memorial Health Care, which has a six-member Patient and Family Advisory Council, reflect patient and family centered care as well.

Family i nvolvement had always been a key issue for St. Jude, but the hospital formally adopted it in 2007, said Alicia Huettel, coordinator of family centered care. The hospital has a Family Advisory Council with about 28 parent members as well as quality of life and parent mentor steering councils that help set policy. Huettel said.

Johnson said that defining the term “family” should be left to the patient. The Joint Commission, the powerful hospital accreditation agency, highlights effective communication, cultural competence and patient- and family- centered care as routes to improving safety, quality, patient satisfaction and treatments.

Health care consumers can expect to see the idea of patient- and familycentered care spreading to doctor’s offices and clinics.

“If we’re going to build an affordable care system, we’ve got to build a very strong primary care system in our country and that’s happening with the patient- centered medical home,” Johnson said. “So we have a chance to partner with patients and families again as we build that primary care system.”

In his hospital bed at Methodist Le Bonheur Germantown, 52-year-old Hill said the bedside session with the two nurses reminded him of “tailgate discussions” held by employees at Memphis Light, Gas and Water Division, where he is a customer service field technician.

But Collis said the big difference is that “in customer service you do for; in patient and family centered care, we do with.”

Once aware that the nurses’ bedside exchange was to keep him in the loop, Hill gave his approval.

“It allows them to get a chance to know what’s going on,” he said. “I think it’s a good thing.”