Family care model even works in billing
Bring families in at the start
At Children’s Hospitals and Clinics, Minneapolis-St. Paul, the philosophy of family-centered care has been extended to some unusual parts of access services, with results that some may find surprising.
In addition to participating in such projects as writing a new smoking policy, creating a personal health record for children with highest needs, and developing a safety program, patients’ families are being included in an initiative to improve the organization’s billing process, says Pat Tommet, RN, PhD, CPNP, director of family-centered care.
"We have had some situations where, because we outsource billing, there were customer service issues and processes in place that weren’t working," she says. "There were delays in families being called back and letters sent out that weren’t family-friendly. It was a process that didn’t work for the hospital and, as a result, was not working well for families."
Collaboration can reduce costs
The traditional practice when such issues arise is for the health care professionals to figure out what they think are the problems and attempt to resolve them, she points out. "In this case, we realized that if we truly want to be family-centered, we would work with the families to understand what the issues are, and then continue to work with them to develop solutions."
Some of the professionals involved, she says, were concerned that the families would have unrealistic goals or would come up with very expensive solutions; they also felt uncomfortable working directly with customers. "We all have learned that we went to school to become experts and that we know best."
Both of those preconceptions were shattered, she notes, when the collaboration on billing issues actually began. "We learned that families live with having to make ends meet on a regular basis, and were used to looking for cost-efficient methods. They had great ideas." That process continues, Tommet says.
Family members also are integral in examining how patients access services, she notes, including what happens when the hospitals are full and patients are sent elsewhere for treatment.
It’s important to bring the families in early in the process, not just as sounding boards for plans that are already made, Tommet emphasizes. Getting family input after a program is developed "decreases what the possibilities are because you’ve already gone down a path. When you bring families in at the get-go, everybody has an opportunity to benefit. You plan together what the path will be."
Families make great consultants
When groups of health care professionals look at, say, the admitting process, they look at it based on things like staffing needs, she points out. "What we hear from families is that they are the ones who are the constant — from walking in the door through all the processes of the hospital — so if we want to know what works and doesn’t work, ask them. They’re the ones who wait a long time in admissions, go through registration, and then on to the lab and X-ray."
The two Children’s Hospitals, which formerly were independent entities, had programs that predated the term "family-centered care" but incorporated the same philosophy, Tommet notes. The Minneapolis campus used the term "human ecology" to describe such efforts, she says.
"The St. Paul campus didn’t use the words but had many of the practices in place, such as parents staying overnight with their children," Tommet adds. "Now many adult organizations are working to make their hospitals and systems more family-centered. Many new hospital rooms have sleep space [for family members] and family resource centers."
At Children’s Hospitals, she says, the department of family-centered care is at the helm of a "family-centered care grouping" that includes Child Life, Family Resources, Interpreter Services, Sudden Infant Death Center, and Children’s Library Services. At the Family Resource Center, for example, patients’ families can obtain "a whole packet of information" on the child’s medical condition and learn about support groups that are available, Tommet adds.
The Family Advisory Council at one hospital campus, she says, recently requested that the process of connecting a "veteran" parent with the parent of a newly diagnosed patient become a formal program, as it is on the other campus. Tommet was in the process of interviewing for a parent-to-parent coordinator.
"The whole consumer movement has given everyone more interest in defining the service level they need," she points out, "whether it’s health care or other purchases you make. We’ve moved away from the belief that health care providers tell everybody what to do. To make the protocols work, you need everybody’s involvement and understanding. Families want to be involved in the design of their services."
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