The New Patient/Family Volunteer and the Use of Patient/Family Advisory Councils

Today’s healthcare focus has shifted from acute, episodic, and hospital-centric to the outpatient ambulatory setting. To better meet the needs and expectations of our patients, The Virtua Medical Group (VMG) in New Jersey has instituted Patient/Family Advisory Councils. Our medical group is part of the larger Virtua Healthcare system, which includes over 60 primary, internal medicine, specialty, and urgent care practices. We serve a diverse population from birth to end of life. Our councils, who represent a sampling of this population, hear the consumer’s voice and steer practices toward providing patient-centered care and an excellent patient experience.

Patient and family-centered care is an innovative approach to the planning, delivery, and evaluation of health care that is grounded in mutually beneficial partnerships among health care providers, patients and families. Patient and family-centered care applies to patients of all ages, and it may be practiced in any health care setting.

—Adapted from The Institute for Patient- and Family-Centered Care website(1)

Our VMG council began its journey in January 2014. To be successful, we needed to select the right patients, staff, and family members. Patients and family members were chosen by their practices as individuals who were willing to volunteer time and openly share their perspective and ideas. The council is led by two co-chairs from corporate leadership, who report out meeting minutes at quarterly leadership meetings. Any issues that are considered a priority are immediately addressed with the practice manager and/or director. For example, one such incident involved a patient’s inability to call the practice during lunch hours. This particular office was shutting its phones down every day from noon to 1 PM. The practice manger was notified, and by the following day the phone lines remained open for all of the business day. Various staff members from the practices, including clinicians, practice managers, and directors, are invited to attend meetings on a rotating basis. Our membership roster consists of 20 volunteers and approximately 10 staff members. Our members are to be active participants rather than passive recipients of care. We reached out to our practices and had staff select individuals who shared common criteria, such as the ability to:

• Share insights and information about their experiences in ways that others can learn from;

• See beyond their personal experiences;

• Show concern for more than one issue;

• Listen well;

• Respect the perspective of others;

• Interact well with many different kinds of people;

• Show a positive outlook on life and a sense of humor;

• Speak comfortably in a group with candor; and

• Work in partnership with others.

We wanted individuals who could share insights and information about their experience while respecting the perspective of others. Members are encouraged to share their stories. We ask they keep in mind that they are a member of a team working together to improve the experience of other patients, so should choose language that builds relationships. We encourage members to focus on solutions from their experiences, even when identifying problems or concerns.

Leadership commitment and staff engagement are necessary to ensure that our council is perceived as credible and viable.

Members need to listen well and interact with people from various walks of life, so they will be able to form partnerships. Leadership commitment and staff engagement are necessary to ensure that our council is perceived as credible and viable.

Our focus is on promoting respectful, effective partnerships among patients, families, and staff.

At our kickoff meeting, the selected council members decided on the meeting requirements, such as where, when, and how the meetings take place. We wanted the council members to take ownership of this meeting. Our group decided to meet quarterly, which adds up to eight meetings over a two-year commitment. Members are required to attend 80% of the meetings per year to remain an active council member. Multiple possible locations for the meetings were discussed, and the group decided on the conference room at one of our hospitals, which is centrally located for many of the council members. Dinner is catered by the hospital services. A typical meeting begins with dinner from 6:00 to 6:30 PM. During this time, council members and staff socialize and get to know one another on a more personal level. (Many of our council members have formed friendships and have socialized outside our meetings.) For the remainder of our meeting, from 6:30 to 8 PM, we may provide a speaker on a current health topic or speak on an initiative that Virtua is undertaking. We always allow time for questions and discussion and to hear the voice of our customers. Our focus is on promoting respectful, effective partnerships among patients, families, and staff. Our mission statement says: The Family Advisory Board is a partnership between the community and the healthcare team that works collaboratively to enhance the patient and family experience in promoting quality care.

The core concepts of patient- and-family-centered care, which we promote, are(2):

• Dignity and respect: Healthcare practitioners listen to and honor patient and family perspectives and choices. Patient and family knowledge, values, beliefs, and cultural backgrounds are incorporated into planning the delivery of care.

• Information sharing: Healthcare practitioners communicate and share complete and unbiased information with patients and families in ways that are affirming and useful. Patients and families receive timely, complete, and accurate information to effectively participate in care and decision making.

• Participation: Patients and families are encouraged and supported in participating in care and decision-making at the level they choose.

• Collaboration: Patients and families also are included on an institution-wide basis. Healthcare leaders collaborate with patients and families in policy and program development, implementation, and evaluation; in healthcare facility design, and in professional education, as well as in the delivery of care.

The council brings the voice of the customer directly back to our practices to help shape how we care for our patients. Our council collaborates directly with clinicians, practice and office managers, and multiple other Virtua departments. Our clinicians and staff actively participate at our meetings to give their perspective about patient care issues. Staff and clinicians also volunteer their time as they recognize the importance of the feedback provided by our council members. Our council members have developed a trust and partnership with us, so they freely discuss the challenges that have been identified. There is no fear of retaliation or expectation of “favored service” from being a council member. Our staff and council members are well versed on the “Vegas rule.” As defined by the Urban dictionary “If you are having a private conversation that is not to be repeated you say “Vegas Rule”(3)—meaning conversations that take place between council members and Virtua staff are kept private.

Some of the changes that have been implemented are direct responses to the council’s suggestions and feedback. For example, communication and scheduling visits via phone calls in our practices were identified as a barrier to patients’ healthcare. Our visits are now scheduled through the Virtua Access Center and triaged with the help of clinical navigators. This has reduced wait times on the phone, increased availability and confirmation of appointments, and improved access to after-hours and weekend communication. We also heard from our council members that our front-end staff were not always professional and attentive with patients. These individuals are the first face you encounter when attending a practice visit. All employees were required to attend a class on customer service that was provided by a member of senior leadership. The education included a PowerPoint presentation and discussion on how to improve customer service. Compared with year 2014, our patient satisfaction surveys result has increased, and we are currently at our goal of 91.3.

We look forward to collaborating with this council in 2017 to enhance the patient and family experience. Our goal will be to develop and implement a project that is selected by our council and directly affects our practice services. Some potential projects may involve signage in our offices, waiting room greeting and updates, or electronic notification of appointments. Our volunteer Patient/Family council members are our patients, so their understanding and experience is crucial to make changes that have an impact. We are always eager to add new members, because they bring fresh ideas and perspective to the group. Council volunteers are an invaluable resource in today’s ambulatory healthcare setting.

For any group that is interested in beginning the journey of partnering with patients and family members, creating a Patient/Family Advisory council is the first step. A Patient/Family Advisory council is a vital link between you and the community. Like many new ideas, the concept may sound easy—but the actual implementation can be difficult and time consuming. However, we have found that the benefits outweigh the challenges.

For more information on Patient/Family Advisory councils, please refer to The Institute for Patient- and Family-Centered Care, at www.ipfcc.org .

References

1. Institute for Patient- and Family-Centered Care. www.ipfcc.org/ .

2. Johnson BH, Abraham MR. Partnering with Patients, Residents, and Families: A Resource for Leaders of Hospitals, Ambulatory Care Settings, and Long-Term Care Communities. Institute for Patient- and Family-Centered Care; 2012.

3. The Urban Dictionary. www.urbandictionary.com/define.php?term
   =Vegas+Rule .