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Page |1 Putting the Pieces Together Patient and Family Centered Care and Patient Engagement Facility Self-Assessment How Are We Doing? This self-assessment tool provides a platform for dialysis facilities to determine the degree to which patient- and family-centered principles, concepts, and patient engagement approaches are embedded in their current organizational culture. Ideally, the assessment is completed individually by leadership at the facility level - the medical director, facility administrator, nurse manager, the social worker, and the dietitian. Then combine results and hold a meeting to discuss findings and plan accordingly. Instructions: 1. Complete the table below by marking the box that most appropriately captures the current status of the described practice at your facility. 2. Use the following criteria: Fully Implemented Fully implemented throughout the facility for both patients and families, if patients and families are indicated on the statement. Partially Implemented In progress or in place in some areas, but not all. There are specific statements that reflect the practice is in place for patients and family/family members. — If the practice is implemented for patients but not family members, circle P for Patients. — If the practice is implemented for family members but not patients, circle F for Family. — If the practice is implemented for patients and family/family members, but is in progress and not fully implemented or is in some areas but not all, circle O for Other No Activity There is no activity in place for this practice. Not Applicable The majority of the items on this tool are applicable to all dialysis facilities. An example for when to choose Not Applicable is if a facility has only one patient population that speaks only one language, then Not Applicable is appropriate as an answer for item # 40 “Trained interpreters are available”. 3. Provide Comments to back up responses, as necessary. Page |2 Fully Implemented Partially Implemented No Activity Not Applicable Fully Implemented Partially Implemented No Activity Not Applicable LEADERSHIP, STRUCTURE The facility’s vision, mission, philosophy, core values reflect the principles of patientand family- centered care. The facility’s vision, mission, philosophy, core values which reflect the principles of 2 patient and family centered care are formally and consistently communicated with patient, families, visitors, staff, leadership, and medical staff. Patient-centered behavior expectations are included in all job descriptions, 3 performance evaluations, and contracts. The facility’s leaders through their words and actions hold staff and clinicians 4 accountable for collaborating with patients and families. 5 Facility leaders are held accountable for “walking the talk” of patient centered care. 6 Physicians are held accountable for “walking the talk” of patient centered care. Staff, at all levels, clinical and non-clinical, have the opportunity to voice their ideas 7 and suggestions for improvement. Comments 1 PATIENTS AND FAMILIES AS ADVISORS Patients and family members have been invited to share their experience by attending one or more of the following: P 8 a patient council P 9 support group P 10 vocational rehabilitation group P new patient adjustment group 11 F F F F O O O O The organization conducts patient and family centered meetings which include one or more of the following: 12 13 14 a patient council support group vocational rehabilitation group P F P F P F O O O Page |3 Fully Implemented new patient adjustment group Patient and family members have been invited to participate in the facility’s Quality 16 Assessment/Performance Improvement (QAPI) Committee meetings. Patients and family members participate in the organization’s QAPI Committee by 17 attending the facility’s QAPI Committee meeting or portion thereof. Patient and family members have been invited to participate in the facility’s 18 Governing Board meetings. Patients and family members participate in the organization’s Governing Board 19 Committee by attending the facility’s Governing Board Committee meeting or portion thereof. The input provided by patients and families is used to inform and guide the facility’s 20 strategies, action plans, and improvement projects. Comments 15 Partially Implemented P F O P F O P F O P F O P F O P F O Fully Partially Implemented Implemented PATIENT AND FAMILY PARTICIPATION IN CARE AND DECISION-MAKING; PERSONALIZATION OF CARE Policies, programs, and staff practices are consistent with the view that patients and P F O 21 families are allies for patient health, safety, and well being. Patients and family members are made aware of how to raise a concern related to P F O 22 patient safety and/or their care. 23 Patients and families are encouraged to ask questions. P F O Systems are in place to capture questions that arise when caregivers are not present 24 to answer them. Systems are in place to assist patients and families in knowing who is providing their P F O 25 care and what the role is of each person on the care team. Resources are available to staff to educate them on different cultural 26 beliefs/traditions related to health and healing. Patient and their family members, according to patient preference, are encouraged P F O 27 and supported to participate in care planning meetings. 28 Opportunities exist for patients and family members to meet with multiple members P F O No Activity Not Applicable No Activity Not Applicable Page |4 Fully Implemented of the patient’s health care team (including the nurse and physician) at one time. The cultural and spiritual practices of patient and family members are respected and 29 incorporated into care planning and decision-making. Education regarding food options and dietary needs are available to meet the 30 preferences of different ethnic groups. Providers encourage and support patients and their families, according to patient 31 preference, to set goals and create action plans for self-management of end-stage renal disease. Comments Fully Implemented ACCESS TO INFORMATION, EDUCATION, AND SUPPORT A process is in place by which patients and family members may request additional 32 information on their diagnosis , treatment options, etc. Patients, according to their preference, have easy and continuing access to their 33 medical record while being treated, and are assisted in understanding the information contained within. Patients are made aware of the opportunities to review their medical record with the 34 support of a health care professional. 35 Patients are able to contribute their own progress notes in their medical record. Patients and family members are offered a way to collect and organize personal 36 health information (e.g., patient portals to the electronic medical record, electronic personal health record). A range of informational and educational programs and materials are consistently 37 available to patients and families. Written, audiovisual, and web-based information and educational resources are 38 provided in primary languages and at appropriate literacy levels for patients and families served by the facility. Written, audiovisual, and web-based information and educational resources include 39 examples and images that reflect the diversity of patients and families served by the facility. 40 Trained interpreters are available. Partially Implemented P F O P F O Partially Implemented P F O P F O P F O P F O P F O No Activity Not Applicable No Activity Not Applicable Page |5 Fully Implemented 41 A peer-led educational program is available and accessible to patients and families. Web-based opportunities for information-sharing and networking are offered to 42 patients and families. A process is in place to disclose unanticipated outcomes to patients and family 43 members, as appropriate. Comments Partially Implemented P F O P F O P F Fully Implemented CONTINUITY OF CARE 44 Plans of care are written in language that patients and families can understand. Tools are provided to patients to help them manage their medications, medical 45 appointments, and other health care needs. Comments Fully Implemented Partially Implemented 46 47 P F No Activity Not Applicable No Activity Not Applicable O FAMILY INVOLVEMENT “Family” is defined by the patient. Visitation is flexible and patient-directed. Formalized training/education is available for a patient’s loved one who may be 48 providing routine care for the patient at home. 49 Support is provided to patients and families involved in an adverse event. 50 Support is provided to patients’ informal caregivers. Comments Not Applicable O Partially Implemented P F No Activity O Page |6 Fully Implemented Partially Implemented No Activity Not Applicable Fully Implemented Partially Implemented No Activity Not Applicable ENVIRONMENT OF CARE The following spaces create a first impression of “welcome”, “comfort” and “healing” 51 Main Lobby 52 Parking Lots/Garage 53 Front Desk 54 Treatment Bays 55 Patients are afforded privacy during check-in. 56 Accommodations are available for patients to have a private conversation. 57 Patients are able to adjust the lighting and temperature at their treatment station. 58 Patients have views to the outdoors. 59 A range of diversionary activities, beyond the television, are available to patients. 60 Overhead paging has been eliminated (with the exception of emergent needs). 61 Pleasant smelling, non-toxic cleaning products are used. Signage reflects primary languages of populations served, and uses icons to aid in 62 comprehension. 63 Patients can easily find their way from the parking areas to their destination. Comments SPIRITUALITY Resources are available to staff to educate them on different religious beliefs, 64 traditions related to health and healing. Spiritual assessments look beyond a patient’s faith traditions to also capture what 65 comforts and centers them. Comments Page |7 Fully Implemented Partially Implemented No Activity Not Applicable INTEGRATIVE MEDICINE Complementary and integrative therapies are available based on patient interest and 66 community utilization patterns. Comments The ESRD Network of Texas acknowledges the following resources which were utilized, and in some cases modified, in developing this assessment 1. Advancing the Practice of Patient- and Family- Centered Care in Primary Care and Other Ambulatory Settings, How to Get Started by the Institute for Patient-and Family-Centered Care, www.ipfcc.org, http://www.ipfcc.org/advance/topics/primary-care.html : items 1,4,21,27,29,31,33,36-42 2. Self Assessment Tool from the Patient-Centered Care Improvement Guide by Planetree (www.planetree.org) and Picker Institute (www.pickerinstitue.org): items 2-7,22-26,28,30,32-35,43-66