Partnering with Patients and Families in the PICU and Pediatric Emergency Department

1. Partnering with Patients and Families in the PICU and Pediatric Emergency Department Picture 1 Picture 2 Picture 3 Picture 4 Picture 5 Picture 6 Picture 7 Picture 8 Liz DuBois MS, RN NE,BC, Tuesday Cirillo RN, MA, APN, Patricia Cupka RN, MSN, APN, Siobhan Reid, Parent Advisor Goryeb Children’s Hospital, Morristown N.J. • Pediatric Emergency Department Development: • Parent advisors assisted in changing signage • Development of Pediatric specific discharge instructions in conjunction with Peds ED Family Advisors • Development of monthly family advisor meetings with ED staff. • Dry Erase Boards established in every room in Peds ED to communicate RN, tech, and MD names to patients/families. • Continued Family Presence in Trauma, Triage and Radiology • Development of Parent Information Folder. • Methods • Parent advisors assisted in creating a PICU and Pediatric ED survey tool which consisted of 8 sections where parents were asked to answer questions on a Likert scale (1=never to 7=always). • Sections included questions that pertained to the ED process, patients' admission, during hospital stay, and discharge process. • Questions on the survey related to patients’ and parents’ perception regarding how well we integrate the core values and principles of Patient and Family Centered Care. Tools Introduction Throughout the U.S., many children (and adults) die each year due to medical errors. Ineffective communication can result in poorly documented or lost medical information, and mistakes can be made with the failure to understand patients’ or families’ perspectives. The Goryeb Children’s Hospital received a grant from the Baby R Foundation and this grant is aimed at optimizing communication between healthcare professionals and patients. By eliminating inefficient communication, a model of family-centered care rather than a provider-centered approach will allow for an environment with true collaboration, better exchange of ideas and shared decision-making. A Family Assessment Survey was created for both the PICU and Pediatric ED to help us understand our strengths and needs for improvement in the involvement of families in our departments. Prior to the development of the Parent Survey, all staff from both units, including physicians, nurses, techs, and administration were all surveyed to ascertain baseline perceptions of staff regarding patient-and-family-centered care principles. • PICU Development • PICU Doors unlocked & Parents have 24/7 access. • Parents now able to sleep at bedside in PICU • Parent Advisor group meets monthly with PICU staff. • Visitor guidelines changed to “Friends and Family Guidelines” with help from Family Advisors. • Parents assisted in development of Rapid Response Guidelines and now Parents Advisors assist in all policy development for PICU and Pediatric Unit. • Parent Advisor a permanent member of Unit Based Shared Governance. • Parent advisor is member of Unit based Patient Satisfaction Committee. • Parents have choices to stay for procedures and resuscitation. • Development of Red Light/Green Light signage for parents who want to be awakened for morning nurse turn over. • Benefit package New Forms and Procedures Developed in conjunction with Family Advisory Board PICU survey results regarding rounding by the team and by nursing suggest that parents do not always feel included in discussions, nurses do not always invite parents to participate in nursing rounds,. Parents also did not feel prepared to participate in medical rounds. So we focused our initial goals to improve rounding with families. PICU Team Rounds with parent participation. Use of Dry Erase Boards in Peds ED Parent perceptions regarding discharge instructions from Pediatric ED Parents felts welcomed and supported and were able to participate in decisions about their child’s care. But interestingly, staff did not always introduce themselves and explain their roles in the child’s care. Parent presence for intubation in PICU Parent presence in Peds ED