Staff Competencies for Patient
and Family Centered Care
Ann Buzaid & Kirk Hennig
Co-leads of the Rehabilitation Services Patient
and Family Advisory Council at University of
Washington Medical Center
University of Washington Medical Center
Department of Rehabilitation Medicine
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Inpatient Acute Rehabilitation Unit:
20 Bed, CARF Accredited Unit
Team approach with patient & family including:
Physiatrist
Occupational Therapist
Physical Therapist
Speech Language Pathologist
Recreational Therapist
Nurse
Psychologist
Rehabilitation Counselor
Prosthetics and Orthotics
Department of Rehabilitation Medicine
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Outpatient Services
Outpatient Rehabilitation Medicine and
Therapy clinics
 Inpatient services provided throughout the
Medical Center
Rehabilitation Services Patient & Family
Advisory Council
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Founded in January 2003
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Composed of 10 patient and family advisors,
the medical director, occupational therapy
manager, and 4 direct care staff. Ad hoc
members include the inpatient nurse
manager, outpatient medical clinic manager,
and the patient care services administrator.
Rehabilitation Patient & Family Advisory
Council
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Meets monthly
Develops annual work plan
Participates in facility and departmental
initiatives
Members of the Rehab Advisory Council
serve on other hospital committees such as
the ADA committee, the Aesthetics
committee, and other special projects
Development of staff competencies for
patient and family centered care
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Council has always been interested in developing
ways of bringing patient and family centered
principles into direct patient care by training staff in
patient family centered principles and behaviors.
Competencies are reviewed with staff annually as
part of the performance review process and training
to these competencies is provided to staff.
Development of patient family centered
competencies was specifically made part of the Sept
2006 work plan for the council.
Preparation
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Reviewed outside literature
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Reviewed behavioral dimensions developed by the
Perinatal/NICU Advisory councils, patient
satisfaction results, PFCC patient satisfaction
questions, and the annual performance evaluation
including the job description and competencies
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Formed a sub-committee that consisted of 3 patient
advisors, the Occupational Therapy Manager &
council co-lead and a direct care staff person (PT)
Review of literature
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“Templates – Philosophy of Care Statements,
Definitions of Quality, and Position
Descriptions” from the Institute for FamilyCentered Care developed through a
subcontract with Axiom Resource
Management, Inc. Sept 27, 2005-Sept 26,
2006
Behavioral Dimensions for PFCC
Perinatal & NICU Councils
1)
2)
3)
4)
5)
6)
Demonstrates respectful caring.
Demonstrates collaborative orientation to working
with patients and families.
Understands and describes patient perspective.
Recognizes and empathizes with multiple points of
view.
Demonstrates knowledge and application of
patient and family centered care.
General communication approaches.
Patient Satisfaction
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Press Ganey survey
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Patient Family Centered Care steering
committee developed 5 custom questions to
be included in the survey.
Custom Questions
1)
2)
3)
4)
5)
How well staff member explained his/her role.
The degree to which staff supported your family.
The degree to which your choice to have family
present is respected.
The degree to which staff respected your cultural
and spiritual needs.
The degree to which staff supported your
participation in decisions regarding your health
care.
Job Descriptions/Performance
Evaluations/Competencies
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12 page document that is reviewed with staff upon
hire, 6 mos, and then annually
Occupational Therapist II job description was
selected to represent Rehabilitation Services
Manager is on Rehabilitation Advisory Council
Majority of Occupational Therapists are
Occupational Therapist II
Duties represented would be able to be generalized
to other job descriptions
Format
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Job Summary
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Duties and Responsibilities
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UWMC–Wide Competencies
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Professional Requirements
Human Resource considerations
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Meeting with human resource manager:
Not able to change the UWMC-wide as the
competencies require an approval process
that had already been completed.
Hospital is in process of standardizing total
number of duties and responsibilities to 12.
Need to use the current rating scale.
4 hour sub-committee retreat
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Changed language of the Job Summary –
was important that the first sentence start
with the inclusion of patients and their
families (see handouts).
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Identified 8 out of 18 duties and
responsibilities that contain patient and family
competencies.
Sub-committee retreat
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Introduced 1 new competency to professional
requirements.
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Revised the Service Orientation and Relationships
and Teamwork competencies under UWMC-Wide as
a recommendation to Human Resources.
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All changes made by the sub-committee were
reviewed by the full Rehab Patient Family Advisory
Council.
Original Job Summary
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Job Summary: Responsible for evaluation, planning, directing and
administering occupational therapy evaluation and intervention to
patients referred by a licensed provider. Administers treatments,
training and physical agents as determined by the evaluation in an
effort to restore function and prevent disability following injury, disease
or physical disability. Evaluates and administers treatment for
functional living skills such as self care, homemaking, range of motion,
muscle testing, cognitive, visual perception, vocational and avocational
skills, splinting, assistive technology and community integration.
Reports data in both written and oral form following the policy and
procedures of the OT department and the Medical Center. Provides
supervision to less experienced therapists, students, COTAs, aides, and
volunteers. Participates in the operational aspects of the department,
maintains performance improvement activities within the department
and participates in Quality Improvement activities. Follows procedures
and standards for cost effectiveness. Ensures that patient charges are
accurate and entered in a timely basis. Participates in all infection
control, departmental equipment training, organizational safety and fire
safety programs.
Patient/Family Centered Changes to the
Job Summary
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Job Summary: In collaboration with patients, families (as defined by the
patient), and staff across disciplines and departments is responsible for
evaluation, planning, directing and administering occupational therapy
evaluation and intervention to patients referred by a licensed provider.
Administers treatments, training and physical agents as determined by the
evaluation in an effort to restore function and prevent further disability following
injury, disease or physical disability. Partners with the patient and family and,
considering the patient’s environment, evaluates and administers treatment for
functional living skills such as self care, homemaking, range of motion, muscle
testing, cognitive, visual perception, vocational and avocational skills, splinting,
assistive technology and community integration. Reports data in both written
and oral form following the policy and procedures of the OT department and the
Medical Center. Provides supervision to COTAs, aides, and volunteers.
Participates in operational aspects of the department, maintains performance
improvement activities within the department and participates in Quality
Improvement activities. Follows procedures and standards for cost
effectiveness . Ensures that patient charges are accurate and entered in a
timely basis. Participates in all infection control, departmental equipment
training, organizational safety and fire safety programs.
Original Duties and Responsibilities
2. Ability to observe and evaluate treatment effect.
Communicates with physician and other team
members as needed.
3. Ability to perform an appropriate evaluation on all
patients as related to the therapy requested and
provided and reassessments as per protocol. This
includes adolescent, geriatric patients and the
general patient population.
Patient/Family Centered Changes
1. Using feedback from the patient and family,
performs an appropriate evaluation as
related to the therapy requested, observes
and evaluates the effect of treatment, and
progresses the plan accordingly.
Original Duty and Responsibility
10. Interacts professionally with patient/family
and involves patient/family in the
formulation of the plan of care.
Patient/Family Centered Changes
2. Involves the patient/family in the formulation
of the plan of care by interacting
professionally and compassionately with the
patient/family.
Original Duty and Responsibility
4. Able to assess patient pain interfering with
optimal level of function or participation in
rehabilitation – makes appropriate physician
contact for intervention.
Patient/Family Centered Changes
3. In discussion with the patient and/or family,
assesses patient pain interfering with optimal
level of function or participation in
rehabilitation, makes appropriate provider
contact for intervention.
Original Duty and Responsibility
6. Formulates a teaching plan based upon
identified learning needs and evaluates
effectiveness of learning, family is included
teaching as appropriate.
Patient/Family Centered Changes
4. Formulates a teaching plan, with the patient
and family members, based upon identified
learning needs and evaluates effectiveness
of learning.
Original Duty and Responsibility
11. Communicates appropriately and clearly to
physicians, staff and administrative team.
Patient/Family Centered changes
5. Communicates, orally and in writing,
appropriately and clearly to physicians, staff,
patients and their families, the administrative
team, and outside entities. Maintains records
pertinent to personnel and operation of the
department.
Original Duty and Responsibility
8. Treats patients and their families with
respect and dignity. Identifies and
addresses psychosocial, cultural, ethnic and
religious/spiritual needs of patients and their
families.
Patient/Family Centered Changes
6. Interacts respectfully with patients and their
families. In collaboration with patients and
their families, identifies and addresses
psychosocial, cultural, ethnic and
religious/spiritual needs.
Original Duty and Responsibility
12. Coordinates and directs patient care to
ensure patients’ needs are met and hospital
policy is followed.
Patient/Family Centered Changes
7. Is attentive to ensure that the needs of
patients and their families are met and
hospital policy is followed. (For example:
offering a glass of water, ensuring that the
call light is accessible, etc).
Original Duty and Responsibility
14. Consults with other departments as
appropriate to collaborate in patient care
and performance improvement activities.
Patient/Family Centered Changes
10. Collaborates with patient and/or family
members, and other departments, in the
development of performance improvement
activities.
UWMC-Wide Competency
24. Service Orientation – Supports the organizational and service
area’s mission and vision. Demonstrates knowledge of and
applies the UWMC Standards for Service Excellence:
Introduces themselves; Escorts as needed; Responds and
follows through with complaints; Asks what name the person
wishes to be called; Refers people to those who can give
assistance; Apologizes and provides additional services for
patients who have been inconvenienced or who need special
assistance; Assists if someone looks lost; Privacy is maintained
and care-related discussions are conducted in private settings;
Anything else is always the manner in which conversations are
ended. Demonstrates the ARISE (Accountability Respect
Innovation Service Excellence) values.
Patient/Family Recommendations
24. Service Orientation – Supports the organizational and service area’s
mission and vision. Demonstrates knowledge of and applies the
UWMC Standards for Service Excellence:
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Introduces themselves.
Escorts as needed.
Responds and follows through with complaints.
Asks what name the person wishes to be called and ends conversations
by asking if anything else is needed.
Refers people to those who can give assistance.
Apologizes and provides additional services for patients who have been
inconvenienced.
Assists if someone looks lost or needs special assistance.
Privacy is maintained and care-related discussions are conducted in
private settings.
Demonstrates the ARISE (Accountability Respect Innovation Service
Excellence) values.
UWMC-Wide Competency
25. Relationships and Teamwork – Communicates
effectively and respectfully with individuals and
groups. Contributes to positive working
relationships and collaborative teamwork with all
disciplines and departments. Recognizes own stress and the
impact on others. Identifies and manages stressors utilizing the
guidance of others. Remains flexible with changes that are
occurring in the department and/or medical center.
Concerns/issues regarding departmental/organizational
operations are communicated to the employee’s
supervisor/manager.
Patient/Family Recommendations
25. Relationships and Teamwork – Communicates
effectively and respectfully with individuals and
groups. Contributes to positive working
relationships and collaborative teamwork with all
disciplines, departments, patients and their families.
Recognizes own stress and the impact on others. Identifies and
manages stressors utilizing the guidance of others. Remains
flexible with changes that are occurring in the department and/or
medical center. Concerns/issues regarding
departmental/organizational operations are communicated to
the employee’s supervisor/manager.
New Professional Requirement
31. Introduces self and explains his or her role
to patients and their families.
Rollout of New Competencies
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Reviewed and enthusiastically embraced by the
Occupational Therapy staff.
Reviewed by the Rehabilitation leadership of Rehab
Nursing, Physical Therapy, Speech Pathology,
Rehab Psychology, Therapeutic Recreation, and
Rehab Counseling. Commitment that all job
descriptions and competencies would include the
patient/family centered language by October, 2007.
Reviewed with Human Resources. UWMC-wide
recommendations to be discussed in the coming
year.
Staff development/training
Training program is being developed by the Rehab
Patient/Family Advisory council to include:
1) Introduces self and explaining his/her role.
2) Communicate with patients/families: allow time for
explanations and questions.
3) Involves the patient/family in the formulation of the
plan of care by interacting professionally and compassionately
with the patient and family.
4) Staff will work with patient/families to clarify needs and ensure
access in the environment.
5) Self examination of ones own biases towards other cultures and
professional background.
Resource contact information
Ann Buzaid
abuzaid@u.washington.edu
For templates:
e-mail Sarah Kaufman at IFCC
For powerpoint:
Tools for Change
www.familycenteredcare.org