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The Patient

Family Voices

emily
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The Patient

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    1. The Patient/Family Centered Medical Home Carolyn J. Allshouse Sr. Program Planner-Minnesota Department of Health State Coordinator, Family Voices of Minnesota Carolyn.allshouse@state.mn.us

    3. Patient/Family-Centered Medical Home in Minnesota Medical Home Learning Collaborative began in 2004 focused on children with chronic, complex health conditions and disabilities Based upon the NICHQ (National Initiatives for Child Health Quality) Medical Home Collaborative Consumers and families as quality improvement partners, supporters and drivers Initially pediatricians, then family physicians and nurse practionersInitially pediatricians, then family physicians and nurse practioners

    4. Defining Patient/Family Centered Care Patient and family centered care redefines relationships in health care. It means having meaningful partnerships with patients and families at the clinical level … with the experience of care ... AND

    5. The concept of patient/family-centered partnerships means: Partnerships with patients and families in quality improvement and in policy and program development, health care redesign, education of physicians and other health professionals, and research Institute for Family-Centered Care

    6. Defining Patient/Family-Centered Care Recognizes that everyone has unique expertise and experience that has equal value. Family-centered care utilizes this expertise as programs are: developed, implemented, evaluated and, in the care of individual patients

    7. Patient/Family Centered Care in Quality Improvement “Making patients and their families truly the force that drives everything else in health care is perhaps the most revolutionary tool of all. It’s importance is evident at the system level, but it comes through even more strongly at the personal level.” Donald Berwick, CEO The Institute for Healthcare Improvement

    8. Utilize all your resources Consumers and families are resources to: Evaluate systems and services Suggest creative ideas for improvements Explain how services really work Help professionals understand other systems Energize and support health professionals

    9. Strategies for PFCC Include consumers and families on all quality improvement teams Implement consumer/family advisory councils Connect with consumer/family advisory councils in the community Utilize consumers and families in training staff Utilize patient/family perception surveys

    10. Medical Home - A patient and family-centered approach to an otherwise chaotic system The Quality Standard for 21st Century Primary Care A medical home is a community-based primary care setting which provides and coordinates high quality, planned, patient and family-centered health promotion, acute illness care and chronic condition management. CMHI 2008

    11. Medical Home Learning Collaborative in Minnesota 25 Teams across the State working to improve the quality of care provided to children with special health care needs Each team includes: A primary care provider, a clinic based care coordinator and at least two parents of children with special health care needs Teams expand to include others: Parents, other clinic staff, school and community

    12. Measuring improvement Medical Home provider and parent index: Self rating tool that measures Medical “Homeness”, filled out once each year Parent surveys are collected that ask the family/patient about their health care experience Monthly reports: number of children identified, number of care plans, what they are working on. Learning Session evaluations: how will they apply what they learn

    13. Medical Home Family Index – completed by Team Parent Partners

    14. Family Perception of Medical Home Child visited an emergency room. (previous 3 months): 46% of the medical home teams showed improvement – that is a decline in ED use. Child missed school or adult missed work due to child’s poor health (previous 12 months): 69% of the participating clinics improved in this area – that is fewer missed school / work days.

    15. Family Perception of Medical Home– Services Provided Help or advice over the phone 54% improved in the ability to consistently provide needed advice Discuss what happened at a specialist visit 62% improved in following up with families after specialty care was received Ease in accessing specialty care 46% of the teams saw improvement

    16. What’s Different Now Care coordinator identified Systematic way of identifying patients with complex needs and implementing improvements for them Care Plans developed and updated Improved scheduling Longer appointments Planned Care Visits Direct ‘rooming’ when needed Pre-visit planning

    17. What’s Different Now Improved Access Direct numbers / e-mail Changes in physical environment Direct access to lab Added evening clinic Linguistically Diverse Materials

    18. What’s Different Now Engaged Supported Patients and Families Engaged communities connecting with clinics Improved communication with specialty care

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