Patient and Family Advisory Councils
Wendy Waddell, PhD(c), MSN, RN
Director of Inpatient Mental Health Services & Alcohol
Drug Abuse, Regions Hospital
Melissa Hensley, MSW, MHA, PhD, LISW
Assistant 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
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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
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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
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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
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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
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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 readmission?
Upcoming RARE Events….
Stay tuned for the next RARE Mental Health events….
Webinar
Connecting Through Conversations
December 4, 2014
12-1pm
Final Face-to-Face
Tuesday February 24, 2015
Maplewood Community Center
More information to come