Agenda for Today

Presentation: Engaging Patients and

Families at the Bedside
Team Sharing and Questions
Upcoming Due Dates

Engaging Patients and Families

at the Bedside
Tara Bristol Rouse
Director of Patient and Family Partnerships
PQCNC

What is it like being a patient?

Clinicians and hospital sta

Patients and family members

Know how the hospital works

and how to get things done

Are strangers in this environment

Do not understand the system or culture
Know about their body and life situation better than
hospital sta

Know who hospital sta

are and what they do

Do not know who dierent sta are and what they do

May want family or friends to support them
Want to know the name and phone number of the one
person to call if they have problems

Are busy and under a lot

of stress

Are often in pain or uncomfortable, vulnerable, or afraid

Are worried and want to do what they can for the patient
(family members)
May not understand all the written information they
receive related to discharge
May feel rushed on the day of discharge
Aware that hospital sta are busy and may not
want to bother you

Want to provide high-quality

and safe care

May not know all the questions they should ask or what
they need to know when they are home
Trust hospital sta to provide safe and high-quality care

AHRQ Guide to Patient and Family

Communicating to Improve Quality

What will you need to do?
Before you enter the room:
Read the patients chart

When you enter the room:

Make eye contact with the patient
Smile, if appropriate
Introduce yourself by name and role
Introduce new people in the room by name, role, and
what they will do
Have conversations at eye level

AHRQ Guide to Patient and Family

Communicating to Improve Quality

What will you need to do? (continued)
When you rst assess the patient:
Ask how the patient prefers to be addressed
Identify family who should be partners in care
Highlight main points of communication tools
Invite the patient and family to use the white board to
talk with clinicians

AHRQ Guide to Patient and Family

Communicating to Improve Quality What you

will need to do throughout the hospital stay?
Include the patient and family as members of the health
care team:
Welcome the patient and family and acknowledge their
expertise
React positively when people ask questions, volunteer
information, share concerns, or want to take part in
treatment decisions

AHRQ Guide to Patient and Family

Communicating to Improve Quality What you

will need to do throughout the hospital stay?
(continued)
Ask about and listen to the patient and familys needs
and concerns:
Use open-ended questions
Try to see the experience through their eyes
Listen to, respect, and act on what the patient
and family say
Help them articulate their concerns when needed

AHRQ Guide to Patient and Family

Communicating to Improve Quality What you

will need to do throughout the hospital stay?
(continued 2)
Help the patient and family understand the diagnosis,
condition, and next steps:

Give timely and complete information

Take every opportunity to educate the patient and family
Use teach back to make sure you explained clearly
Find out how much information they want to know
Speak slowly
Use plain language
Invite them to take notes
Find someone who can answer a question if you cannot

AHRQ Guide to Patient and Family

PFE Strategies and Tools What is teach back?

An opportunity to assess how well clinicians explained a
concept, and, if necessary, re-teach the information
Ask the patient and family to repeat back in their own
words what they need to know or do to be sure you
explained things well
Tips for teach back:
Start slowly
Do not ask yes or no questions
Chunk information when explaining more than one concept and
use teach back after each concept

AHRQ Guide to Patient and Family

PFE Strategies and Tools What is bedside shift

report?
Nursing sta conducts shift change reports
at the patients bedside
Patient can identify a family member
or close friend to participate
Report should take about 5 minutes per patient
Purpose:
To engage the patient and family in hospital care
To share accurate and useful information between nurses,
patients, and families

AHRQ Guide to Patient and Family

10

PFE Strategies and Tools What is IDEAL

Discharge Planning?

Include the patient and family as full partners

Discuss with the patient and family ve key areas
to prevent problems at home

Educate the patient and family throughout

the hospital stay

Assess how well doctors and nurses explain the diagnosis,

condition, and next steps in their care and use teach back

Listen to and honor the patient and familys goals,

preferences, observations, and concerns

AHRQ Guide to Patient and Family

11

More Information on IDEAL Discharge Planning

http://www.ahrq.gov/professionals/systems/hospital/engagingfamilies/strategy4/index.html

12

Potential Challenges of Bedside Engagement

New diagnosis or information patient is not yet aware of
(e.g., waiting for doctor to discuss)
Patient is noncompliant and you need to share
information with oncoming nurse
Patient or family has a complex question or needs a
lengthy clarication
Semi-private rooms and HIPAA concerns
Dicult to identify family members who will be caregivers
Discharge plans change immediately before discharge
Patient unable to read, write, or articulate questions or
concerns
AHRQ Guide to Patient and Family

13

Using Scenario-Based Learning to Address

Potential Challenges of Bedside Engagement
Oers an opportunity to practice
Allows clinicians and sta to become comfortable with
partnership language
Provides an opportunity to look at a situation through the
patient and family perspective
Allows for a safe place to express discomfort
Provides the opportunity to receive instant feedback in a
safe learning environment

PFCC Partners Completing

14

Final Thoughts
Your hospitals are committed to patient and family
engagement everyone plays a critical part
Your job is to make it safe for them to be here, not just as
patients but as partners in their care
Patients and families wont engage if they believe that you
dont want them toit is simply too risky for them

AHRQ Guide to Patient and Family

15

Team Sharing/Questions

Thank you!