Profiles of Change
The Children's Hospital of Philadelphia
The Children's Hospital of Philadelphia—a pioneer in fully involving patients and families as key partners in the healing process—is an award-winning hospital. The Children's Hospital of Philadelphia (CHOP) is again tied for the No. 1 overall ranking on the elite U.S.News & World Report's Best Children's 2012-13 Honor Roll. According to that survey, CHOP is ranked Number 1 in six of 10 specialties and has more Number 1 rankings than any other children's hospital in the nation. In 2013, Parents magazine named The Children's Hospital of Philadelphia the best pediatric hospital in the nation, based on a comprehensive, data-driven survey. The magazine also ranked CHOP in the top 3 in all 6 specialties included in the survey, and ranked its Cancer Center and the emergency medicine division Number 1. The American Nurses Credentialing Center (ANCC), an arm of the American Nurses Association, awarded the hospital Magnet Status for Nursing Excellence, a designation achieved by only 2 to 3 percent of hospitals nationwide. Learn more about CHOPs Awards.
The Children's Hospital of Philadelphia is a leader in patient- and family-centered care. The hospital—which recognizes that when a child is sick, the entire family is affected-—makes family-centered care a priority by integrating core concepts of collaboration, flexibility, support, and information for families into all of its programs and policies. The hospital also works to educate families as partners in their children's care, and relies on their feedback to improve services. The hospital's approach is internationally recognized for integrating families as valued partners in the care of their child. "The vision of The Children's Hospital of Philadelphia is to set the highest standard of pediatric patient care, education and research worldwide, and to offer the safest and highest quality of care to every patient and family we serve." Steven M. Altschuler, M.D., Chief Executive Officer.
The Children's Hospital of Philadelphia continually expands its efforts to make the hospital experience more positive for children and their families. Here are some highlights:
"At Children's Hospital, family-centered care is the commitment to integrate the parent perspective in all we do so family members and patients are partners in our mission to provide the best, safest care possible. It's the recognition that including families in decision-making, whether for an individual patient or for a Hospital-wide initiative, ensures better outcomes and adds value. Family-centered care goes far beyond customer service or providing amenities- it is about the experience of care and the promise of partnership"
Madeline Bell, President and Chief Operating Officer
The Evolution of Family Centered Care at CHOP
- The Hospital created the Family Consultant Program and currently employs paid professional family leaders (whose children either are or were patients in the hospital) to work directly with families to assist them in navigating the health care experience. The Family Consultants bring a unique understanding and compassion when addressing families' needs and bring a patient and family voice to communications and patient care by serving and representing family interests on a wide range of hospital committees and planning initiatives.
- CHOP established the Family Advisory Council (FAC), to provide the patient and family perspective to hospital projects, programs, and policy development. The FAC is comprised of families from a variety of backgrounds with diverse diagnoses and experiences within CHOP's network. The Council also includes staff from many disciplines, all committed to advancing patient- and family-centered care. The Council works to inform senior administrators and clinical leaders at the strategic planning level while also working with key hospital committees when planning and creating new programs.
- The Connelly Resource Center for Families opened in the main building, providing space for information, support, and other resources. Today, the hospital also has five family resource centers in ambulatory care locations. These resource centers provide quiet places to take a break or nap, browse through information on health care, finances, parenting and education, speak with the family librarian, surf the Internet, attend a coffee hour, or select children's books and videos.
- The Youth Advisory Council (YAC) was formed to provide the unique perspective of the child or teen patient, or sibling of a patient, regarding hospital programs and policies. The YAC meets monthly providing input to improve the hospital socially and physically for patients and families, and to voice opinions and concerns regarding their needs, and to have an impact on the care they receive. Examples of projects include leading Grand Rounds, creating a training video for the healthcare team, conducting patient food surveys and developing teen night activities.
- A family-centered approach to care continues to influence patient care practices. The Children's Hospital of Philadelphia welcomes family presence at physician-led patient rounds and in the Emergency Department during resuscitation; the new unit design of critical beds in the CICU and PICU incorporates family sleep space; and family members are represented on key hospital committees including bioethics, clinical research, and patient safety.
- The hospital introduced the Little Rock Foundation Family Resource Room, a resource room for blind, visually impaired, deaf and hard-of-hearing children and their families. The Little Rock Resource Room offers high-tech amenities such as a computer that scans books and reads them aloud, a phone that allows parties to communicate by typing instead of talking and Braille typewriter and embosser that allows children to print documents in Braille from a computer.
- The hospital launched the Family-Centered Care Employee Intranet site, which is a vital tool to help communicate to employees the principles of family-centered care and provide information about the many resources staff can share with families, across the CHOP Care Network.
- CHOP created family-centered communication tip sheets—.Talking with Your Health Care Team, Phone Tips for Families, Patient Safety Tips for Families, Patient and Family Tips for Participation in Rounds, and Building Partnerships Through Collaboration—and "Things You Don't Want to Forget" tablets to assist family members with communicating and partnering with their child's care team.
- The hospital sponsored and presented at the 4th International Patient- and Family-Centered Care Conference in Philadelphia, with Family Advisory Council members hosting tours of CHOP.
- The Family Relations Department is created as the key resource for bringing the family perspective into all areas of CHOP in order to improve the care experience and continually improve safety as well as patient and family satisfaction. The Family Partners Program is established in order to incorporate the family perspective across all divisions of CHOP. A formalized program for parents/caregivers of children who are or who have been patients at CHOP—it provides leadership and development training to promote effective partnership with health care professionals and staff across the hospital.
- The Department of Family Relations quarterly sponsors hospital-wide grand rounds targeting best practices for effective partnership. Presenters are established leaders who practice Family-Centered Care in their daily work and serve as mentors to strengthen practice across all levels of providers. One presentation titled Family-Centered Care: What It Is and What It Isn't featured a panel of leaders who explained the difference between family-centered care and family-directed care, provided methods to apply new communication strategies to successfully partner with patients and families for improved and safer patient outcomes, addressed perceived barriers to family-centered care communication skills, and gave strategies to overcome these obstacles.
- At the 5th International Conference (IPFCC) on Patient- and Family-Centered Care: Partnerships for Quality and Safety, Amy Kratchman, Family Consultant, Annique Hogan, MD, and Kathy Conaboy, Family Consultant, presented Family-Centered Care Grand Rounds and Patient Safety: Partnering to Prevent Harm. This presentation showcased CHOP's work of partnering with the Office of Patient Safety and Quality and using the Grand Rounds format to build awareness and acceptance of the connection between effective family engagement and increased patient safety.
- Rachel Biblow-Leone, MSW, Director of Family Relations, Darlene Barkman, MAT, Family Consultant, and Elizabeth A. Steinmiller, MSN, PMHCNS-BC, Behavioral Health Nurse Specialist, co-presented Don't label me "Difficult:" Strategies to Strengthen Partnerships within a Pediatric Patient- and Family-Centered Care Environment at the same IPFCC conference.
- Senior Vice President—CHOP Care Network, Amy Lambert, Susan N. Kamerling, RN, MSN, BC CHOP, and Family Consultant, Darlene Barkman, staffed and displayed two posters at the IPFCC conference: "Families in the Safekeeping Journey" and "Partnering with Families for the Ideal Perioperative Experience".
- Amy Kratchman, Family Consultant, is the first family member to serve as a co-investigator on a Patient-Centered Outcomes Research Institute (PCORI) funded research grant, serving along with Katherine Bevans, PhD, to develop and evaluate methods for eliciting and prioritizing health outcomes from the perspectives of children and their families. Having Amy as a co-investigator will be integral in addressing the gap of incorporating patients' views in clinical and comparative effectiveness research that currently exists in the pediatric world. The goal is to identify 'best practice' interventions that have an effect on the outcomes that matter most to patients and families.
- The hospital released the Promise of Partnership: Best Practices for Family-Centered Care, a 58-page hands-on, online toolkit designed to support education and adoption of patient- and family-centered care best practices in all areas of Children's Hospital. It is a collection of specific approaches and best-practice behaviors that illustrate the core concepts of family-centered care that staff can use every day to improve their skills. The Institute for Healthcare Improvement incorporated this innovative material into their "open school curriculum," which is a set of training courses made available to hospitals nationally and worldwide that want to move toward a patient- and family-centered approach to providing care.
- The Family Relations Department developed LearningLink modules for clinical managers and physicians to use in family-centered care training. The modules include videos, tools and education to promote effective partnership techniques pulled from the Partners for Excellence: Best Practices for Family-Centered Care.
- The Collaborative Family Healthcare Association (CFHA) blog featured a posting about The Children's Hospital of Philadelphia, as the first in an ongoing series highlighting hospitals across the United States that offer family-centered care.
- Kathy Conaboy, Family Consultant, and Maureen Connor, RN MPH, co-presented an Institute for Patient- and Family-Centered Care webinar called Learning from Medical Errors in a Patient and Family-Centered Care Culture. Cathy shared her personal experience with a medical error and discussed steps that medical teams can take to re-connect with families and rebuild trust after a mistake.
- Family Consultants and the Family Advisory Council collaborated with the hospital leadership team and staff to update the visitation policy for the flu season. They developed conversation tools and talking points for care teams to use to facilitate families partnering in their child's care and advocating for the safety of their child.
For further information about Family-Centered Care at The Children's Hospital of Philadelphia, see http://www.chop.edu/service/family-centered-care/about-family-centered-care/
Rachel Biblow-Leone, MSW, LCSW
Director of Family Relations
The Children's Hospital of Philadelphia
34th and Civic Center Blvd.
Philadelphia, PA. 19104