Quality Compass - Patient Experience

Overview

Updated on October 27, 2015

Issue

Patient experience is an important measure of Ontarians’ experience with the health care system. Patients and families have the unique experience, expertise, insights, and perspectives that can be invaluable to bringing about transformational change in health care and enhancing quality and safety.¹^,² A paradigm shift toward a patient-centred health system is needed in order to deliver care that is sensitive to patients’ concerns and comfort, and that actively involves patients and family members in shared decision-making about their care. The Picker Institute outlines eight principles of patient- centered care:³

Respect for patients’ values, preferences and expressed needs
Coordination and integration of care
Information, communication and education
Physical comfort
Emotional support and alleviation of fear and anxiety
Involvement of family and friends
Transition and continuity
Access to care

A gap still exists between the kind of care patients receive, and the kind of care they should be receiving. Provincial averages are still well below the benchmarks released in January 2012. The Table below demonstrates the benchmarks and provincial averages, as well as shows where there has been progress as reported in the 2014-2015 Quality Improvement Plans.

Call to Action

The Excellent Care for All Act in Ontario requires every hospital to have a patient relations process that reflects the content of their patient declaration of values.⁴ In addition, hospitals are to conduct annual patient/caregiver experience surveys and make reference to both the patient relations process and the results from the survey(s) in the development of their annual Quality Improvement Plan to address patient experience issues. Although the Act was established in 2010, the 2012 Quality Monitor has reported that about one in three hospital patients does not get answers to questions he or she can understand.⁵

There are exciting opportunities for improving patient and family experience around communication, engagement in decisions, and coordination of care. Enhancing patient health care experiences will ensure the Ontario health care system can provide the best care possible for the province.

How is the patient experience in your organization?

Read on to see how you can get started.

Johnson B, Abraham M, Conway J, Simmons L, Edgman-Levitan S, Sodomka P, Schlucter J, Ford D. Partnering with Patients and Families to Design a Patient- and Family-Centered Health Care System: Recommendations and Promising Practices.

Bethesda (MD): Institute for Family-Centred Care and the Institute for Healthcare Improvement; 2008 Apr [cited 2012 Dec 18]
Available from: http://www.ipfcc.org/pdf/PartneringwithPatientsandFamilies.pdf
Governance Centre of Excellence (Ontario Hospital Association), Health Quality Ontario. Quality and Patient Safety Governance Toolkit.

Governance Centre of Excellence (Ontario Hospital Association) and Health Quality Ontario; Section 4.0, Empowering Patients and Families.
Available from: https://www.oha.com/KNOWLEDGECENTRE/LIBRARY/QPSGT/Pages/QualityandPatientSafety.aspx
Picker Institute. Principles of Patient Centred Care

[cited 2015 Oct 27]
Available from: http://pickerinstitute.org/about/picker-principles/
Excellent Care for All Act, 2010. Ontario Regulation 188/15.

Patient Relations Process.
Available at: http://canlii.ca/t/52hqm
Health Quality Ontario. Quality Monitor 2012.

Toronto: Health Quality Ontario; 2012 Sept [cited 2015 Oct 27], p. 30.
Available from: http://www.hqontario.ca/portals/0/Documents/pr/qmonitor-full-report-2012-en.pdf

Best Practices

Updated on October 27, 2015

“Insanity is doing things the way we’ve always done them and expecting different results”

Albert Einstein

Evidence-informed best practices are based on quality evidence and should be implemented into practice to optimize outcomes.⁸ Listed below you will find best practices graded according to the type of evidence. To view a description of the types of evidence, click here.

To help you move from best evidence to best practice, click on the + button next to each best practice to find details on how to implement, as well as change ideas to test using a PDSA approach.

Change ideas are specific and practical changes informed by experience and research that focus on improving specific aspects of a system, process or behaviour. To learn more about change ideas see the QI: Getting Started tab.

EVIDENCE-INFORMED BEST PRACTICESType of Evidence

Consult patients and families in health care redesign and quality improvementIV (Expert Opinion)

Make Change

Evidence-Informed
Best Practice

How To Implement

Toolbox

Consult patients and families in health care redesign and quality improvement

In its Recommendations and Promising Practices on designing a patient and family-centred health care system, the Institute for Patient- and Family-Centred Care suggests consulting patients and families in health care redesign and in quality improvement projects. A sample of specific recommendations from this organization and others include:

Inform and convince policymakers, administrators, health care providers, educators, and patients and family members of the importance and value of partnerships with patients and families
Offer opportunities for health care administrators, educators, and providers to learn practical strategies for implementing and sustaining patient- and family-centered care
Employ patient and family leaders in meaningful positions in the health care system Utilize patient and family advisory councils
Conduct focus groups of emergency department and other program area users to identify patient recommendations for improvement

More recommendations and information can be found in the Institute for Patient-and Family-Centred Care’s Recommendations and Promising Practices

Hospital Quality Improvement Plans 2014-2015. Change Ideas (p. 13). Health Quality Ontario.
Partnering with Patients and Families to Design a Patient-and Family-Centered Health Care System: Recommendations and Promising Practices, Institute for Patient-and Family-Centred Care
Working with Patient and Families as Advisors. Implementation Handbook. June 2013. Agency for Healthcare Research and Quality, Rockville, MD.

References

Consult patients and families in health care redesign and quality improvement

Type of Evidence: IV (Expert Opinion)*

REFERENCES:

Systematic Reviews:

Promoting engagement by patients and families to reduce adverse events in acute care settings: a systematic review. Berger Z, Flickinger TE, Pfoh E, Martinez KA, Dy SM. BMJ Quality & Safety. 2014 Jul;23(7):548-55. Full-text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4079036/

Toward patient-centered care: a systematic review of older adults' views of quality emergency care. Shankar KN, Bhatia BK, Schuur JD. Annals of Emergency Medicine. 63(5):529-550.e1, 2014 May. Abstract only: http://www.ncbi.nlm.nih.gov/pubmed/?term=24051211

Toward patient-centered care: a systematic review of how to ask questions that matter to patients. Rosenzveig A; Kuspinar A; Daskalopoulou SS; Mayo NE. Medicine. 93(22):e120, 2014 Nov. Full-text: http://journals.lww.com/md-journal/Fulltext/2014/11020/Toward_Patient_Centered_Care___A_Systematic_Review.7.aspx

Toolkits, Handbooks, & Guides:

Striving for Excellence in Patient Relations. Processes in Ontario’s Hospitals. A Guide to Responding to Ontario Regulation 188/15. Health Quality Ontario. 2015. Available at: http://www.hqontario.ca/Portals/0/Documents/qi/patient-relations-best-practices-improving-pr-en.pdf

Engaging with Patients and Caregivers about Patient Relations: A Guide for Hospitals. Health Quality Ontario. 2015. Available at: http://www.hqontario.ca/Portals/0/Documents/qi/guide-engaging-patients-caregivers-en.pdf

A Resource Toolkit for Engaging Patient and Families at the Planning Table. April 2014. Alberta Health Services Engagement and Patient Experience Department. Available at: http://www.albertahealthservices.ca/PatientsFamilies/if-pf-pe-engage-toolkit.pdf

Empowering Patients and Families. Quality and Patient Safety Governance Toolkit, Section 4.0. Governance Centre of Excellence (Ontario Hospital Association) and Health Quality Ontario. Available at: https://www.oha.com/KnowledgeCentre/Library/QPSGT/Documents/Section%204%20-%20Empowering%20Patients%20and%20Families.pdf

Leading Practices in Emergency Department Patient Experience. Ontario Health Association; 2010/11. Available at: http://www.oha.com/KnowledgeCentre/Library/Documents/Leading Practices in Emergency Department Patient Experience.pdf

Patient-Centered Care Improvement Guide. Planetree and Picker Institute; 2008 Oct. Frampton S, Guastello S, Brady C, Hale M, Horowitz S, Bennett Smith S, Stone S. Available at: http://www.hqontario.ca/portals/0/Modals/qi/en/processmap_pdfs/tools/Patient-Centered Care Improvement Guide.pdf

Partnering with Patients and Families to Enhance Safety and Quality: A Mini Toolkit. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2011 Feb. Available at: http://www.hqontario.ca/portals/0/Modals/qi/en/processmap_pdfs/tools/Partnering with Patients and Families to Enhance Safety and Quality - A Mini Toolkit.pdf

Working with Patient and Families as Advisors. Implementation Handbook. June 2013. Agency for Healthcare Research and Quality, Rockville, MD. Available at: http://www.ahrq.gov/professionals/systems/hospital/engagingfamilies/strategy1/index.html

Supporting Resources:

Advancing the Practice of Patient- and Family-Centered Care: How to Get Started. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2010 Oct. Institute for Patient- and Family-Centered Care. Available from: http://www.ipfcc.org/pdf/getting_started.pdf

Changing Hospital “Visiting” Policies and Practices: Supporting Family Presence and Participation. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2011 Apr. Available from: http://www.ipfcc.org/visiting.pdf

Nursing Best Practice Guideline: Client Centred Care. Registered Nurses’ Association of Ontario; 2002 Jul [revised 2006]. Available at: http://rnao.ca/sites/rnao-ca/files/Client_Centred_Care.pdf

Improving the Emergency Department Patient Experience: A Guide to Developing Rapid Improvement Surveys. Ontario Hospital Association; 2011 Oct. Available from: http://www.oha.com/CurrentIssues/Issues/Documents/Improving the ED Expierience Survey Guide.pdf

Your Health Care – Be Involved [Internet]. Ontario Hospital Association. Available from: http://www.oha.com/KnowledgeCentre/Library/PatientSafety/Documents/1838_OHA_PSTpamphlet_ENG.pdf

Websites:

Patient Relations. Health Quality Ontario. Available at: http://www.hqontario.ca/Quality-Improvement/Patient-Relations

Institute for Patient- and Family-Centered Care. Home Page [Internet]. Bethesda (MD): Institute for Patient- and Family-Centred Care. Available at: http://www.ipfcc.org

HCAHPS Frequently Asked Questions [Internet]. National Research Corporation (NRC) Picker. Available at: http://www.nationalresearch.com/products-and-solutions/cahps/hcahps/faq/

Patients for Patient Safety Canada. Home Page [Internet]. Patients for Patient Safety Canada; Available from: http://www.patientsforpatientsafety.ca/English/Pages/default.aspx
TOP OF TAB

Empower patients and families to be involved in their health care journeyIV (Expert Opinion)

Make Change

Evidence-Informed
Best Practice

How To Implement

Toolbox

Empower patients and families to be involved in their health care journey

The Ontario Hospital Association developed the “Your Health Care – Be Involved” initiative (supported by the Ontario Ministry of Health and Long-Term care). This initiative encourages hospitals to empower patients and families to be involved with their health care journeys by encouraging patients to:

Ask questions and speak up if there are concerns about care
Tell health care teams about past illnesses, allergies or prior reactions to medications
Bring all medicines to the hospital or medical appointment
Ensure patients are discharged from hospital with clear information about what to do and about medications

To read more about the Your Health Care – Be Involved initiative go to: Ontario Hospital Association

Quality and Patient Safety Governance Toolkit. Section 4.0: Empowering Patients and Families, Governance Centre of Excellence (Ontario Hospital Association) and Health Quality Ontario
Your Health Care – Be Involved, Ontario Hospital Association

References

Empower patients and families to be involved in their health care journey

Type of Evidence: IV (Expert Opinion)*

REFERENCES:

Promoting engagement by patients and families to reduce adverse events in acute care settings: a systematic review. Berger Z, Flickinger TE, Pfoh E, Martinez KA, Dy SM. BMJ Quality & Safety. 2014 Jul;23(7):548-55. Full-text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4079036/

Toward patient-centered care: a systematic review of older adults' views of quality emergency care. Shankar KN, Bhatia BK, Schuur JD. Annals of Emergency Medicine. 63(5):529-550.e1, 2014 May. Abstract only: http://www.ncbi.nlm.nih.gov/pubmed/?term=24051211

Toward patient-centered care: a systematic review of how to ask questions that matter to patients. Rosenzveig A; Kuspinar A; Daskalopoulou SS; Mayo NE. Medicine. 93(22):e120, 2014 Nov. Full-text: http://journals.lww.com/md-journal/Fulltext/2014/11020/Toward_Patient_Centered_Care___A_Systematic_Review.7.aspx

Toolkits, Handbooks, & Guides:

Striving for Excellence in Patient Relations. Processes in Ontario’s Hospitals. A Guide to Responding to Ontario Regulation 188/15. Health Quality Ontario. 2015. Available at: http://www.hqontario.ca/Portals/0/Documents/qi/patient-relations-best-practices-improving-pr-en.pdf

Engaging with Patients and Caregivers about Patient Relations: A Guide for Hospitals. Health Quality Ontario. 2015. Available at: http://www.hqontario.ca/Portals/0/Documents/qi/guide-engaging-patients-caregivers-en.pdf

A Resource Toolkit for Engaging Patient and Families at the Planning Table. April 2014. Alberta Health Services Engagement and Patient Experience Department. Available at: http://www.albertahealthservices.ca/PatientsFamilies/if-pf-pe-engage-toolkit.pdf

Empowering Patients and Families. Quality and Patient Safety Governance Toolkit, Section 4.0. Governance Centre of Excellence (Ontario Hospital Association) and Health Quality Ontario. Available at: https://www.oha.com/KnowledgeCentre/Library/QPSGT/Documents/Section%204%20-%20Empowering%20Patients%20and%20Families.pdf

Leading Practices in Emergency Department Patient Experience. Ontario Health Association; 2010/11. Available at: http://www.oha.com/KnowledgeCentre/Library/Documents/Leading Practices in Emergency Department Patient Experience.pdf

Patient-Centered Care Improvement Guide. Planetree and Picker Institute; 2008 Oct. Frampton S, Guastello S, Brady C, Hale M, Horowitz S, Bennett Smith S, Stone S. Available at: http://www.hqontario.ca/portals/0/Modals/qi/en/processmap_pdfs/tools/Patient-Centered Care Improvement Guide.pdf

Partnering with Patients and Families to Enhance Safety and Quality: A Mini Toolkit. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2011 Feb. Available at: http://www.hqontario.ca/portals/0/Modals/qi/en/processmap_pdfs/tools/Partnering with Patients and Families to Enhance Safety and Quality - A Mini Toolkit.pdf

Working with Patient and Families as Advisors. Implementation Handbook. June 2013. Agency for Healthcare Research and Quality, Rockville, MD. Available at: http://www.ahrq.gov/professionals/systems/hospital/engagingfamilies/strategy1/index.html

Supporting Resources:

Advancing the Practice of Patient- and Family-Centered Care: How to Get Started. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2010 Oct. Institute for Patient- and Family-Centered Care. Available from: http://www.ipfcc.org/pdf/getting_started.pdf

Changing Hospital “Visiting” Policies and Practices: Supporting Family Presence and Participation. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2011 Apr. Available from: http://www.ipfcc.org/visiting.pdf

Nursing Best Practice Guideline: Client Centred Care. Registered Nurses’ Association of Ontario; 2002 Jul [revised 2006]. Available at: http://rnao.ca/sites/rnao-ca/files/Client_Centred_Care.pdf

Improving the Emergency Department Patient Experience: A Guide to Developing Rapid Improvement Surveys. Ontario Hospital Association; 2011 Oct. Available from: http://www.oha.com/CurrentIssues/Issues/Documents/Improving the ED Expierience Survey Guide.pdf

Your Health Care – Be Involved [Internet]. Ontario Hospital Association. Available from: http://www.oha.com/KnowledgeCentre/Library/PatientSafety/Documents/1838_OHA_PSTpamphlet_ENG.pdf

Websites:

Patient Relations. Health Quality Ontario. Available at: http://www.hqontario.ca/Quality-Improvement/Patient-Relations

Institute for Patient- and Family-Centered Care. Home Page [Internet]. Bethesda (MD): Institute for Patient- and Family-Centred Care. Available at: http://www.ipfcc.org

HCAHPS Frequently Asked Questions [Internet]. National Research Corporation (NRC) Picker. Available at: http://www.nationalresearch.com/products-and-solutions/cahps/hcahps/faq/

Patients for Patient Safety Canada. Home Page [Internet]. Patients for Patient Safety Canada; Available from: http://www.patientsforpatientsafety.ca/English/Pages/default.aspx
TOP OF TAB

Engage patients and families and keep them informedIV (Expert Opinion)

Make Change

Evidence-Informed
Best Practice

How To Implement

Toolbox

Engage patients and families and keep them informed

Encourage patient participate in self-management by actively setting and contributing to their own treatment goals.
Encourage patients to ask questions about their treatment or raise concerns about safety. See Toolbox: It’s Safe To Ask
Use “teach back” to confirm that patients understand what was explained and instructions by asking them to repeat them back. To learn about the teach back method, see Toolbox: The Teach-Back Method
Use simple language or graphical displays to explain instructions to those with low literacy. Use a “nothing about me without me” approach. This is done in leading hospitals where they conduct rounds and discuss treatment issues in front of the patient and/or family. See Toolbox: Healthcare Culture and the Challenge of Preventing Healthcare-Associated Infections
Use white boards in patient rooms for communication to keep patients informed about who is looking after them, names of providers, upcoming tests, expected discharge date, or other key information.
Keep patients informed about the cause of delay and expected resolution.
Provide patients and families with clear, written discharge instructions and frequently-asked questions (FAQ) sheets regarding medication, aftercare and instructions for follow-up plans.

To read more about change ideas to improve patient experience in hospitals, see Hospital Quality Improvement Plans 2014-2015. Change Ideas (p. 13). Health Quality Ontario.

It's Safe to Ask, Manitoba Institute for Patient Safety
The Teach-Back Method, North Carolina Program on Health Literacy
Healthcare Culture and the Challenge of Preventing Healthcare-Associated Infections, Gardam M, Reason P, Rykert L
Hospital Quality Improvement Plans 2014-2015. Change Ideas (p. 13), Health Quality Ontario
Quality and Patient Safety Governance Toolkit. Section 4.0: Empowering Patients and Families, Governance Centre of Excellence (Ontario Hospital Association) and Health Quality Ontario
Your Health Care – Be Involved, Ontario Hospital Association

References

Engage Patients and families and keep them informed

Type of Evidence: IV (Expert Opinion)*

REFERENCES:

Systematic Reviews:

Promoting engagement by patients and families to reduce adverse events in acute care settings: a systematic review. Berger Z, Flickinger TE, Pfoh E, Martinez KA, Dy SM. BMJ Quality & Safety. 2014 Jul;23(7):548-55. Full-text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4079036/

Toward patient-centered care: a systematic review of older adults' views of quality emergency care. Shankar KN, Bhatia BK, Schuur JD. Annals of Emergency Medicine. 63(5):529-550.e1, 2014 May. Abstract only: http://www.ncbi.nlm.nih.gov/pubmed/?term=24051211

Toward patient-centered care: a systematic review of how to ask questions that matter to patients. Rosenzveig A; Kuspinar A; Daskalopoulou SS; Mayo NE. Medicine. 93(22):e120, 2014 Nov. Full-text: http://journals.lww.com/md-journal/Fulltext/2014/11020/Toward_Patient_Centered_Care___A_Systematic_Review.7.aspx

Toolkits, Handbooks, & Guides:

Striving for Excellence in Patient Relations. Processes in Ontario’s Hospitals. A Guide to Responding to Ontario Regulation 188/15. Health Quality Ontario. 2015. Available at: http://www.hqontario.ca/Portals/0/Documents/qi/patient-relations-best-practices-improving-pr-en.pdf

Engaging with Patients and Caregivers about Patient Relations: A Guide for Hospitals. Health Quality Ontario. 2015. Available at: http://www.hqontario.ca/Portals/0/Documents/qi/guide-engaging-patients-caregivers-en.pdf

A Resource Toolkit for Engaging Patient and Families at the Planning Table. April 2014. Alberta Health Services Engagement and Patient Experience Department. Available at: http://www.albertahealthservices.ca/PatientsFamilies/if-pf-pe-engage-toolkit.pdf

Empowering Patients and Families. Quality and Patient Safety Governance Toolkit, Section 4.0. Governance Centre of Excellence (Ontario Hospital Association) and Health Quality Ontario. Available at: https://www.oha.com/KnowledgeCentre/Library/QPSGT/Documents/Section%204%20-%20Empowering%20Patients%20and%20Families.pdf

Leading Practices in Emergency Department Patient Experience. Ontario Health Association; 2010/11. Available at: http://www.oha.com/KnowledgeCentre/Library/Documents/Leading Practices in Emergency Department Patient Experience.pdf

Patient-Centered Care Improvement Guide. Planetree and Picker Institute; 2008 Oct. Frampton S, Guastello S, Brady C, Hale M, Horowitz S, Bennett Smith S, Stone S. Available at: http://www.hqontario.ca/portals/0/Modals/qi/en/processmap_pdfs/tools/Patient-Centered Care Improvement Guide.pdf

Partnering with Patients and Families to Enhance Safety and Quality: A Mini Toolkit. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2011 Feb. Available at: http://www.hqontario.ca/portals/0/Modals/qi/en/processmap_pdfs/tools/Partnering with Patients and Families to Enhance Safety and Quality - A Mini Toolkit.pdf

Working with Patient and Families as Advisors. Implementation Handbook. June 2013. Agency for Healthcare Research and Quality, Rockville, MD. Available at: http://www.ahrq.gov/professionals/systems/hospital/engagingfamilies/strategy1/index.html

Supporting Resources:

Advancing the Practice of Patient- and Family-Centered Care: How to Get Started. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2010 Oct. Institute for Patient- and Family-Centered Care. Available from: http://www.ipfcc.org/pdf/getting_started.pdf

Changing Hospital “Visiting” Policies and Practices: Supporting Family Presence and Participation. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2011 Apr. Available from: http://www.ipfcc.org/visiting.pdf

Nursing Best Practice Guideline: Client Centred Care. Registered Nurses’ Association of Ontario; 2002 Jul [revised 2006]. Available at: http://rnao.ca/sites/rnao-ca/files/Client_Centred_Care.pdf

Improving the Emergency Department Patient Experience: A Guide to Developing Rapid Improvement Surveys. Ontario Hospital Association; 2011 Oct. Available from: http://www.oha.com/CurrentIssues/Issues/Documents/Improving the ED Expierience Survey Guide.pdf

Your Health Care – Be Involved [Internet]. Ontario Hospital Association. Available from: http://www.oha.com/KnowledgeCentre/Library/PatientSafety/Documents/1838_OHA_PSTpamphlet_ENG.pdf

Websites:

Patient Relations. Health Quality Ontario. Available at: http://www.hqontario.ca/Quality-Improvement/Patient-Relations

Institute for Patient- and Family-Centered Care. Home Page [Internet]. Bethesda (MD): Institute for Patient- and Family-Centred Care. Available at: http://www.ipfcc.org

HCAHPS Frequently Asked Questions [Internet]. National Research Corporation (NRC) Picker. Available at: http://www.nationalresearch.com/products-and-solutions/cahps/hcahps/faq/

Patients for Patient Safety Canada. Home Page [Internet]. Patients for Patient Safety Canada; Available from: http://www.patientsforpatientsafety.ca/English/Pages/default.aspx
TOP OF TAB

Create an environment of careIV (Expert Opinion)

Make Change

Evidence-Informed
Best Practice

How To Implement

Toolbox

Create an environment of care

Respect for patients’ values, preferences and expressed needs
Coordination and integration of care
Information, communication and education
Physical comfort
Emotional support and alleviation of fear and anxiety
Involvement of family and friends
Transition and continuity
Access to care

In order to create an environment of care, consider the patient and family needs and values. Services that enhance their hospital stay can create an optimal experience. Some examples include:

Access to spiritual and prayer services
Concealing medical equipment
Quiet rooms
Family accommodations
Health resource centres
Hospital greeters
Interpreter services
Patient care associates/advocates
Pet therapy
Valet parking
Windows and views outside

The Ontario Hospital Association’s Leading Practices in Emergency Department Patient Experience 2010/11 provides useful information on enhancing patient experience through leading practices, improving access, reducing waiting times, providing a responsive environment, improving communication, and improving customer service as key ideas.

Leading Practices in Emergency Department Patient Experience 2010/11, Ontario Hospital Association
Principles of Patient-Centred Care, Picker Institute

References

Create an environment of care

Type of Evidence: IV (Expert Opinion)*

REFERENCES:

Systematic Reviews:

Promoting engagement by patients and families to reduce adverse events in acute care settings: a systematic review. Berger Z, Flickinger TE, Pfoh E, Martinez KA, Dy SM. BMJ Quality & Safety. 2014 Jul;23(7):548-55. Full-text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4079036/

Toward patient-centered care: a systematic review of older adults' views of quality emergency care. Shankar KN, Bhatia BK, Schuur JD. Annals of Emergency Medicine. 63(5):529-550.e1, 2014 May. Abstract only: http://www.ncbi.nlm.nih.gov/pubmed/?term=24051211

Toward patient-centered care: a systematic review of how to ask questions that matter to patients. Rosenzveig A; Kuspinar A; Daskalopoulou SS; Mayo NE. Medicine. 93(22):e120, 2014 Nov. Full-text: http://journals.lww.com/md-journal/Fulltext/2014/11020/Toward_Patient_Centered_Care___A_Systematic_Review.7.aspx

Toolkits, Handbooks, & Guides:

Striving for Excellence in Patient Relations. Processes in Ontario’s Hospitals. A Guide to Responding to Ontario Regulation 188/15. Health Quality Ontario. 2015. Available at: http://www.hqontario.ca/Portals/0/Documents/qi/patient-relations-best-practices-improving-pr-en.pdf

Engaging with Patients and Caregivers about Patient Relations: A Guide for Hospitals. Health Quality Ontario. 2015. Available at: http://www.hqontario.ca/Portals/0/Documents/qi/guide-engaging-patients-caregivers-en.pdf

A Resource Toolkit for Engaging Patient and Families at the Planning Table. April 2014. Alberta Health Services Engagement and Patient Experience Department. Available at: http://www.albertahealthservices.ca/PatientsFamilies/if-pf-pe-engage-toolkit.pdf

Empowering Patients and Families. Quality and Patient Safety Governance Toolkit, Section 4.0. Governance Centre of Excellence (Ontario Hospital Association) and Health Quality Ontario. Available at: https://www.oha.com/KnowledgeCentre/Library/QPSGT/Documents/Section%204%20-%20Empowering%20Patients%20and%20Families.pdf

Leading Practices in Emergency Department Patient Experience. Ontario Health Association; 2010/11. Available at: http://www.oha.com/KnowledgeCentre/Library/Documents/Leading Practices in Emergency Department Patient Experience.pdf

Patient-Centered Care Improvement Guide. Planetree and Picker Institute; 2008 Oct. Frampton S, Guastello S, Brady C, Hale M, Horowitz S, Bennett Smith S, Stone S. Available at: http://www.hqontario.ca/portals/0/Modals/qi/en/processmap_pdfs/tools/Patient-Centered Care Improvement Guide.pdf

Partnering with Patients and Families to Enhance Safety and Quality: A Mini Toolkit. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2011 Feb. Available at: http://www.hqontario.ca/portals/0/Modals/qi/en/processmap_pdfs/tools/Partnering with Patients and Families to Enhance Safety and Quality - A Mini Toolkit.pdf

Working with Patient and Families as Advisors. Implementation Handbook. June 2013. Agency for Healthcare Research and Quality, Rockville, MD. Available at: http://www.ahrq.gov/professionals/systems/hospital/engagingfamilies/strategy1/index.html

Supporting Resources:

Advancing the Practice of Patient- and Family-Centered Care: How to Get Started. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2010 Oct. Institute for Patient- and Family-Centered Care. Available from: http://www.ipfcc.org/pdf/getting_started.pdf

Changing Hospital “Visiting” Policies and Practices: Supporting Family Presence and Participation. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2011 Apr. Available from: http://www.ipfcc.org/visiting.pdf

Nursing Best Practice Guideline: Client Centred Care. Registered Nurses’ Association of Ontario; 2002 Jul [revised 2006]. Available at: http://rnao.ca/sites/rnao-ca/files/Client_Centred_Care.pdf

Improving the Emergency Department Patient Experience: A Guide to Developing Rapid Improvement Surveys. Ontario Hospital Association; 2011 Oct. Available from: http://www.oha.com/CurrentIssues/Issues/Documents/Improving the ED Expierience Survey Guide.pdf

Your Health Care – Be Involved [Internet]. Ontario Hospital Association. Available from: http://www.oha.com/KnowledgeCentre/Library/PatientSafety/Documents/1838_OHA_PSTpamphlet_ENG.pdf

Websites:

Patient Relations. Health Quality Ontario. Available at: http://www.hqontario.ca/Quality-Improvement/Patient-Relations

Institute for Patient- and Family-Centered Care. Home Page [Internet]. Bethesda (MD): Institute for Patient- and Family-Centred Care. Available at: http://www.ipfcc.org

HCAHPS Frequently Asked Questions [Internet]. National Research Corporation (NRC) Picker. Available at: http://www.nationalresearch.com/products-and-solutions/cahps/hcahps/faq/

Patients for Patient Safety Canada. Home Page [Internet]. Patients for Patient Safety Canada; Available from: http://www.patientsforpatientsafety.ca/English/Pages/default.aspx
TOP OF TAB

Create partnerships in hospital settingsIV (Expert Opinion)

Make Change

Evidence-Informed
Best Practice

How to Implement

Toolbox

Create partnerships in hospital settings

In its Recommendations and Promising Practices on designing a patient and family-centred health care system, the Institute for Patient- and Family-Centred Care suggests creating partnerships in ambulatory settings. A sample of specific change ideas include:

Provide incentives and rewards for hospitals and affiliated long-term care facilities implementing patient- and family-centered care to encourage its development and to assure that it is a recognized value in the marketplace.
Assure involvement of patients and families at all levels in the health care system.
Ensure that patient and family perspectives, including their experience of care, are key drivers in improving care processes and structures.
Bring patient experiences to the Hospital Board/Leadership Team

More change ideas and information can be found in the Institute for Patient- and Family-Centred Care’s Recommendations and Promising Practices

Always Events®: Creating an Optimal Patient Experience – Tool Box (2011), Picker Institute
Partnering with Patients and Families to Design a Patient- and Family-Centered Health Care System: Recommendations and Promising Practices, Institute for Patient- and Family-Centred Care
Quality and Patient Safety Governance Toolkit. Section 4.0: Empowering Patients and Families, Governance Centre of Excellence (Ontario Hospital Association) and Health Quality Ontario
Your Health Care – Be Involved, Ontario Hospital Association

References

Create partnerships in hospital settings

Type of Evidence: IV (Expert Opinion)*

REFERENCES:

Systematic Reviews:

Promoting engagement by patients and families to reduce adverse events in acute care settings: a systematic review. Berger Z, Flickinger TE, Pfoh E, Martinez KA, Dy SM. BMJ Quality & Safety. 2014 Jul;23(7):548-55. Full-text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4079036/

Toward patient-centered care: a systematic review of older adults' views of quality emergency care. Shankar KN, Bhatia BK, Schuur JD. Annals of Emergency Medicine. 63(5):529-550.e1, 2014 May. Abstract only: http://www.ncbi.nlm.nih.gov/pubmed/?term=24051211

Toward patient-centered care: a systematic review of how to ask questions that matter to patients. Rosenzveig A; Kuspinar A; Daskalopoulou SS; Mayo NE. Medicine. 93(22):e120, 2014 Nov. Full-text: http://journals.lww.com/md-journal/Fulltext/2014/11020/Toward_Patient_Centered_Care___A_Systematic_Review.7.aspx

Toolkits, Handbooks, & Guides:

Striving for Excellence in Patient Relations. Processes in Ontario’s Hospitals. A Guide to Responding to Ontario Regulation 188/15. Health Quality Ontario. 2015. Available at: http://www.hqontario.ca/Portals/0/Documents/qi/patient-relations-best-practices-improving-pr-en.pdf

Engaging with Patients and Caregivers about Patient Relations: A Guide for Hospitals. Health Quality Ontario. 2015. Available at: http://www.hqontario.ca/Portals/0/Documents/qi/guide-engaging-patients-caregivers-en.pdf

A Resource Toolkit for Engaging Patient and Families at the Planning Table. April 2014. Alberta Health Services Engagement and Patient Experience Department. Available at: http://www.albertahealthservices.ca/PatientsFamilies/if-pf-pe-engage-toolkit.pdf

Empowering Patients and Families. Quality and Patient Safety Governance Toolkit, Section 4.0. Governance Centre of Excellence (Ontario Hospital Association) and Health Quality Ontario. Available at: https://www.oha.com/KnowledgeCentre/Library/QPSGT/Documents/Section%204%20-%20Empowering%20Patients%20and%20Families.pdf

Leading Practices in Emergency Department Patient Experience. Ontario Health Association; 2010/11. Available at: http://www.oha.com/KnowledgeCentre/Library/Documents/Leading Practices in Emergency Department Patient Experience.pdf

Patient-Centered Care Improvement Guide. Planetree and Picker Institute; 2008 Oct. Frampton S, Guastello S, Brady C, Hale M, Horowitz S, Bennett Smith S, Stone S. Available at: http://www.hqontario.ca/portals/0/Modals/qi/en/processmap_pdfs/tools/Patient-Centered Care Improvement Guide.pdf

Partnering with Patients and Families to Enhance Safety and Quality: A Mini Toolkit. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2011 Feb. Available at: http://www.hqontario.ca/portals/0/Modals/qi/en/processmap_pdfs/tools/Partnering with Patients and Families to Enhance Safety and Quality - A Mini Toolkit.pdf

Working with Patient and Families as Advisors. Implementation Handbook. June 2013. Agency for Healthcare Research and Quality, Rockville, MD. Available at: http://www.ahrq.gov/professionals/systems/hospital/engagingfamilies/strategy1/index.html

Supporting Resources:

Advancing the Practice of Patient- and Family-Centered Care: How to Get Started. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2010 Oct. Institute for Patient- and Family-Centered Care. Available from: http://www.ipfcc.org/pdf/getting_started.pdf

Changing Hospital “Visiting” Policies and Practices: Supporting Family Presence and Participation. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2011 Apr. Available from: http://www.ipfcc.org/visiting.pdf

Nursing Best Practice Guideline: Client Centred Care. Registered Nurses’ Association of Ontario; 2002 Jul [revised 2006]. Available at: http://rnao.ca/sites/rnao-ca/files/Client_Centred_Care.pdf

Improving the Emergency Department Patient Experience: A Guide to Developing Rapid Improvement Surveys. Ontario Hospital Association; 2011 Oct. Available from: http://www.oha.com/CurrentIssues/Issues/Documents/Improving the ED Expierience Survey Guide.pdf

Your Health Care – Be Involved [Internet]. Ontario Hospital Association. Available from: http://www.oha.com/KnowledgeCentre/Library/PatientSafety/Documents/1838_OHA_PSTpamphlet_ENG.pdf

Websites:

Patient Relations. Health Quality Ontario. Available at: http://www.hqontario.ca/Quality-Improvement/Patient-Relations

Institute for Patient- and Family-Centered Care. Home Page [Internet]. Bethesda (MD): Institute for Patient- and Family-Centred Care. Available at: http://www.ipfcc.org

HCAHPS Frequently Asked Questions [Internet]. National Research Corporation (NRC) Picker. Available at: http://www.nationalresearch.com/products-and-solutions/cahps/hcahps/faq/

Patients for Patient Safety Canada. Home Page [Internet]. Patients for Patient Safety Canada; Available from: http://www.patientsforpatientsafety.ca/English/Pages/default.aspx
TOP OF TAB

Create partnerships in ambulatory settingsIV (Expert Opinion)

Make Change

Evidence-Informed
Best Practice

How To Implement

Toolbox

Create partnerships in ambulatory settings

In its Recommendations and Promising Practices on designing a patient and family-centred health care system, the Institute for Patient-and Family-Centred Care suggests creating partnerships in ambulatory settings. A sample of specific change ideas include:

Develop and support partnerships among administrators, providers, patients, and families to improve quality and safety in ambulatory care.
Assure that patterns of care in ambulatory settings are patient- and family-centered, encouraging patients and families to be partners in their care. Develop and disseminate approaches to education and training to advance partnerships with patients and families in ambulatory care.

More change ideas and information can be found in the Institute for Patient- and Family-Centred Care’s Recommendations and Promising Practices

Partnering with Patients and Families to Design a Patient- and Family-Centered Health Care System: Recommendations and Promising Practices, Institute for Patient- and Family-Centred Care
Quality and Patient Safety Governance Toolkit. Section 4.0: Empowering Patients and Families, Governance Centre of Excellence (Ontario Hospital Association) and Health Quality Ontario

References

Create partnerships in ambulatory settings

Type of Evidence: IV (Expert Opinion)*

REFERENCES:

Systematic Reviews:

Promoting engagement by patients and families to reduce adverse events in acute care settings: a systematic review. Berger Z, Flickinger TE, Pfoh E, Martinez KA, Dy SM. BMJ Quality & Safety. 2014 Jul;23(7):548-55. Full-text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4079036/

Toward patient-centered care: a systematic review of older adults' views of quality emergency care. Shankar KN, Bhatia BK, Schuur JD. Annals of Emergency Medicine. 63(5):529-550.e1, 2014 May. Abstract only: http://www.ncbi.nlm.nih.gov/pubmed/?term=24051211

Toward patient-centered care: a systematic review of how to ask questions that matter to patients. Rosenzveig A; Kuspinar A; Daskalopoulou SS; Mayo NE. Medicine. 93(22):e120, 2014 Nov. Full-text: http://journals.lww.com/md-journal/Fulltext/2014/11020/Toward_Patient_Centered_Care___A_Systematic_Review.7.aspx

Toolkits, Handbooks, & Guides:

Striving for Excellence in Patient Relations. Processes in Ontario’s Hospitals. A Guide to Responding to Ontario Regulation 188/15. Health Quality Ontario. 2015. Available at: http://www.hqontario.ca/Portals/0/Documents/qi/patient-relations-best-practices-improving-pr-en.pdf

Engaging with Patients and Caregivers about Patient Relations: A Guide for Hospitals. Health Quality Ontario. 2015. Available at: http://www.hqontario.ca/Portals/0/Documents/qi/guide-engaging-patients-caregivers-en.pdf

A Resource Toolkit for Engaging Patient and Families at the Planning Table. April 2014. Alberta Health Services Engagement and Patient Experience Department. Available at: http://www.albertahealthservices.ca/PatientsFamilies/if-pf-pe-engage-toolkit.pdf

Empowering Patients and Families. Quality and Patient Safety Governance Toolkit, Section 4.0. Governance Centre of Excellence (Ontario Hospital Association) and Health Quality Ontario. Available at: https://www.oha.com/KnowledgeCentre/Library/QPSGT/Documents/Section%204%20-%20Empowering%20Patients%20and%20Families.pdf

Leading Practices in Emergency Department Patient Experience. Ontario Health Association; 2010/11. Available at: http://www.oha.com/KnowledgeCentre/Library/Documents/Leading Practices in Emergency Department Patient Experience.pdf

Patient-Centered Care Improvement Guide. Planetree and Picker Institute; 2008 Oct. Frampton S, Guastello S, Brady C, Hale M, Horowitz S, Bennett Smith S, Stone S. Available at: http://www.hqontario.ca/portals/0/Modals/qi/en/processmap_pdfs/tools/Patient-Centered Care Improvement Guide.pdf

Partnering with Patients and Families to Enhance Safety and Quality: A Mini Toolkit. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2011 Feb. Available at: http://www.hqontario.ca/portals/0/Modals/qi/en/processmap_pdfs/tools/Partnering with Patients and Families to Enhance Safety and Quality - A Mini Toolkit.pdf

Working with Patient and Families as Advisors. Implementation Handbook. June 2013. Agency for Healthcare Research and Quality, Rockville, MD. Available at: http://www.ahrq.gov/professionals/systems/hospital/engagingfamilies/strategy1/index.html

Supporting Resources:

Advancing the Practice of Patient- and Family-Centered Care: How to Get Started. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2010 Oct. Institute for Patient- and Family-Centered Care. Available from: http://www.ipfcc.org/pdf/getting_started.pdf

Changing Hospital “Visiting” Policies and Practices: Supporting Family Presence and Participation. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2011 Apr. Available from: http://www.ipfcc.org/visiting.pdf

Nursing Best Practice Guideline: Client Centred Care. Registered Nurses’ Association of Ontario; 2002 Jul [revised 2006]. Available at: http://rnao.ca/sites/rnao-ca/files/Client_Centred_Care.pdf

Improving the Emergency Department Patient Experience: A Guide to Developing Rapid Improvement Surveys. Ontario Hospital Association; 2011 Oct. Available from: http://www.oha.com/CurrentIssues/Issues/Documents/Improving the ED Expierience Survey Guide.pdf

Your Health Care – Be Involved [Internet]. Ontario Hospital Association. Available from: http://www.oha.com/KnowledgeCentre/Library/PatientSafety/Documents/1838_OHA_PSTpamphlet_ENG.pdf

Websites:

Patient Relations. Health Quality Ontario. Available at: http://www.hqontario.ca/Quality-Improvement/Patient-Relations

Institute for Patient- and Family-Centered Care. Home Page [Internet]. Bethesda (MD): Institute for Patient- and Family-Centred Care. Available at: http://www.ipfcc.org

HCAHPS Frequently Asked Questions [Internet]. National Research Corporation (NRC) Picker. Available at: http://www.nationalresearch.com/products-and-solutions/cahps/hcahps/faq/

Patients for Patient Safety Canada. Home Page [Internet]. Patients for Patient Safety Canada; Available from: http://www.patientsforpatientsafety.ca/English/Pages/default.aspx
TOP OF TAB

Educate health care professionalsIV (Expert Opinion)

Make Change

Evidence-Informed
Best Practice

How To Implement

Toolbox

Educate health care professionals

The Registered Nurses’ Association of Ontario (RNAO) recommends as a core principal that all nursing staff embrace as foundational to client centred care a set of values and beliefs in all aspects of their practice:

respect;
human dignity;
clients are experts for their own lives;
clients as leaders;
clients’ goals coordinate care of the heath care team;
continuity and consistency of care and caregiver;
timeliness;
responsiveness; and
universal access to care.

The RNAO also recommends that education of client-centred principles be part of standard education/core curriculum of nursing staff. To read more go to The Registered Nurses’ of Ontario’s Client Centred Care Best Practice Guidelines.

In its Recommendations and Promising Practices on designing a patient and family-centred health care system, the Institute for Patient- and Family-Centred Care suggests educating health care professionals in patient-centred care. A sample of specific change ideas include:

Envision the education of health professionals as intrinsically patient- and family-centered, and develop and support efforts to realize this vision.
Integrate patient- and family-centered competencies into all course work and clinical experiences, from the basic sciences and early clinical didactic aspects of education to internships and residencies.
Ensure active patient and family involvement in the education of future health care professionals.

More change ideas and information can be found in the Institute for Patient- and Family-Centred Care’s Recommendations and Promising Practices.

Some additional ideas for education and training of health care staff include:

Provide customer service training including skills around greetings, use of eye contact, simplified language, strategies for de-escalating conflict, and active listening.

Nursing Best Practice Guideline: Client Centred Care (2002 July; revised 2006), Registered Nurses’ Association of Ontario (RNAO)
Partnering with Patients and Families to Design a Patient- and Family-Centered Health Care System: Recommendations and Promising Practices, Institute for Family-Centred Care
Hospital Quality Improvement Plans 2014-2015. Change Ideas (p. 13). , Health Quality Ontario
Always Events®: Creating an Optimal Patient Experience – Tool Box (2011), Picker Institute.

References

Educate health care professionals

Type of Evidence: IV (Expert Opinion)*

REFERENCES:

Systematic Reviews:

Promoting engagement by patients and families to reduce adverse events in acute care settings: a systematic review. Berger Z, Flickinger TE, Pfoh E, Martinez KA, Dy SM. BMJ Quality & Safety. 2014 Jul;23(7):548-55. Full-text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4079036/

Toward patient-centered care: a systematic review of older adults' views of quality emergency care. Shankar KN, Bhatia BK, Schuur JD. Annals of Emergency Medicine. 63(5):529-550.e1, 2014 May. Abstract only: http://www.ncbi.nlm.nih.gov/pubmed/?term=24051211

Toward patient-centered care: a systematic review of how to ask questions that matter to patients. Rosenzveig A; Kuspinar A; Daskalopoulou SS; Mayo NE. Medicine. 93(22):e120, 2014 Nov. Full-text: http://journals.lww.com/md-journal/Fulltext/2014/11020/Toward_Patient_Centered_Care___A_Systematic_Review.7.aspx

Toolkits, Handbooks, & Guides:

Striving for Excellence in Patient Relations. Processes in Ontario’s Hospitals. A Guide to Responding to Ontario Regulation 188/15. Health Quality Ontario. 2015. Available at: http://www.hqontario.ca/Portals/0/Documents/qi/patient-relations-best-practices-improving-pr-en.pdf

Engaging with Patients and Caregivers about Patient Relations: A Guide for Hospitals. Health Quality Ontario. 2015. Available at: http://www.hqontario.ca/Portals/0/Documents/qi/guide-engaging-patients-caregivers-en.pdf

A Resource Toolkit for Engaging Patient and Families at the Planning Table. April 2014. Alberta Health Services Engagement and Patient Experience Department. Available at: http://www.albertahealthservices.ca/PatientsFamilies/if-pf-pe-engage-toolkit.pdf

Empowering Patients and Families. Quality and Patient Safety Governance Toolkit, Section 4.0. Governance Centre of Excellence (Ontario Hospital Association) and Health Quality Ontario. Available at: https://www.oha.com/KnowledgeCentre/Library/QPSGT/Documents/Section%204%20-%20Empowering%20Patients%20and%20Families.pdf

Leading Practices in Emergency Department Patient Experience. Ontario Health Association; 2010/11. Available at: http://www.oha.com/KnowledgeCentre/Library/Documents/Leading Practices in Emergency Department Patient Experience.pdf

Patient-Centered Care Improvement Guide. Planetree and Picker Institute; 2008 Oct. Frampton S, Guastello S, Brady C, Hale M, Horowitz S, Bennett Smith S, Stone S. Available at: http://www.hqontario.ca/portals/0/Modals/qi/en/processmap_pdfs/tools/Patient-Centered Care Improvement Guide.pdf

Partnering with Patients and Families to Enhance Safety and Quality: A Mini Toolkit. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2011 Feb. Available at: http://www.hqontario.ca/portals/0/Modals/qi/en/processmap_pdfs/tools/Partnering with Patients and Families to Enhance Safety and Quality - A Mini Toolkit.pdf

Working with Patient and Families as Advisors. Implementation Handbook. June 2013. Agency for Healthcare Research and Quality, Rockville, MD. Available at: http://www.ahrq.gov/professionals/systems/hospital/engagingfamilies/strategy1/index.html

Supporting Resources:

Advancing the Practice of Patient- and Family-Centered Care: How to Get Started. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2010 Oct. Institute for Patient- and Family-Centered Care. Available from: http://www.ipfcc.org/pdf/getting_started.pdf

Changing Hospital “Visiting” Policies and Practices: Supporting Family Presence and Participation. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2011 Apr. Available from: http://www.ipfcc.org/visiting.pdf

Nursing Best Practice Guideline: Client Centred Care. Registered Nurses’ Association of Ontario; 2002 Jul [revised 2006]. Available at: http://rnao.ca/sites/rnao-ca/files/Client_Centred_Care.pdf

Improving the Emergency Department Patient Experience: A Guide to Developing Rapid Improvement Surveys. Ontario Hospital Association; 2011 Oct. Available from: http://www.oha.com/CurrentIssues/Issues/Documents/Improving the ED Expierience Survey Guide.pdf

Your Health Care – Be Involved [Internet]. Ontario Hospital Association. Available from: http://www.oha.com/KnowledgeCentre/Library/PatientSafety/Documents/1838_OHA_PSTpamphlet_ENG.pdf

Websites:

Patient Relations. Health Quality Ontario. Available at: http://www.hqontario.ca/Quality-Improvement/Patient-Relations

Institute for Patient- and Family-Centered Care. Home Page [Internet]. Bethesda (MD): Institute for Patient- and Family-Centred Care. Available at: http://www.ipfcc.org

HCAHPS Frequently Asked Questions [Internet]. National Research Corporation (NRC) Picker. Available at: http://www.nationalresearch.com/products-and-solutions/cahps/hcahps/faq/

Patients for Patient Safety Canada. Home Page [Internet]. Patients for Patient Safety Canada; Available from: http://www.patientsforpatientsafety.ca/English/Pages/default.aspx
TOP OF TAB

Educating health care leadersIV (Expert Opinion)

Make Change

Evidence-Informed
Best Practice

How To Implement

Toolbox

Educating health care leaders

In its Recommendations and Promising Practices on designing a patient and family-centred health care system, the Institute for Patient-and Family-Centred Care suggests educating health care leaders in patient-centred care. A sample of specific change ideas include:

Articulate and define key patient-and family-centered skills, competencies, and attitudes needed by leaders and integrate them into all applicable undergraduate and graduate training programs for health care administrators, managers, and leaders.
Develop and disseminate a core curriculum on patient-and family-centered concepts that faculty can teach in health care management and health services master of business administration programs, master of public administration programs, and master of health care administration programs.
Integrate patient- and family-centered concepts into the review criteria of organizations that accredit and certify health administration, management, and leadership training programs.

More change ideas and information can be found in the Institute for Patient- and Family-Centred Care’s Recommendations and Promising Practices.

Change ideas can also be found in the Hospital Quality Improvement Plans 2014-2015. Change Ideas (p. 13), Health Quality Ontario.

Hospital Quality Improvement Plans 2014-2015. Change Ideas (p. 13), Health Quality Ontario.
Partnering with Patients and Families to Design a Patient- and Family-Centered Health Care System: Recommendations and Promising Practices, Institute for Patient- and Family-Centred Care

References

Educating health care leaders

Type of Evidence: IV (Expert Opinion)*

REFERENCES:

Systematic Reviews:

Promoting engagement by patients and families to reduce adverse events in acute care settings: a systematic review. Berger Z, Flickinger TE, Pfoh E, Martinez KA, Dy SM. BMJ Quality & Safety. 2014 Jul;23(7):548-55. Full-text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4079036/

Toward patient-centered care: a systematic review of older adults' views of quality emergency care. Shankar KN, Bhatia BK, Schuur JD. Annals of Emergency Medicine. 63(5):529-550.e1, 2014 May. Abstract only: http://www.ncbi.nlm.nih.gov/pubmed/?term=24051211

Toward patient-centered care: a systematic review of how to ask questions that matter to patients. Rosenzveig A; Kuspinar A; Daskalopoulou SS; Mayo NE. Medicine. 93(22):e120, 2014 Nov. Full-text: http://journals.lww.com/md-journal/Fulltext/2014/11020/Toward_Patient_Centered_Care___A_Systematic_Review.7.aspx

Toolkits, Handbooks, & Guides:

Striving for Excellence in Patient Relations. Processes in Ontario’s Hospitals. A Guide to Responding to Ontario Regulation 188/15. Health Quality Ontario. 2015. Available at: http://www.hqontario.ca/Portals/0/Documents/qi/patient-relations-best-practices-improving-pr-en.pdf

Engaging with Patients and Caregivers about Patient Relations: A Guide for Hospitals. Health Quality Ontario. 2015. Available at: http://www.hqontario.ca/Portals/0/Documents/qi/guide-engaging-patients-caregivers-en.pdf

A Resource Toolkit for Engaging Patient and Families at the Planning Table. April 2014. Alberta Health Services Engagement and Patient Experience Department. Available at: http://www.albertahealthservices.ca/PatientsFamilies/if-pf-pe-engage-toolkit.pdf

Empowering Patients and Families. Quality and Patient Safety Governance Toolkit, Section 4.0. Governance Centre of Excellence (Ontario Hospital Association) and Health Quality Ontario. Available at: https://www.oha.com/KnowledgeCentre/Library/QPSGT/Documents/Section%204%20-%20Empowering%20Patients%20and%20Families.pdf

Leading Practices in Emergency Department Patient Experience. Ontario Health Association; 2010/11. Available at: http://www.oha.com/KnowledgeCentre/Library/Documents/Leading Practices in Emergency Department Patient Experience.pdf

Patient-Centered Care Improvement Guide. Planetree and Picker Institute; 2008 Oct. Frampton S, Guastello S, Brady C, Hale M, Horowitz S, Bennett Smith S, Stone S. Available at: http://www.hqontario.ca/portals/0/Modals/qi/en/processmap_pdfs/tools/Patient-Centered Care Improvement Guide.pdf

Partnering with Patients and Families to Enhance Safety and Quality: A Mini Toolkit. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2011 Feb. Available at: http://www.hqontario.ca/portals/0/Modals/qi/en/processmap_pdfs/tools/Partnering with Patients and Families to Enhance Safety and Quality - A Mini Toolkit.pdf

Working with Patient and Families as Advisors. Implementation Handbook. June 2013. Agency for Healthcare Research and Quality, Rockville, MD. Available at: http://www.ahrq.gov/professionals/systems/hospital/engagingfamilies/strategy1/index.html

Supporting Resources:

Advancing the Practice of Patient- and Family-Centered Care: How to Get Started. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2010 Oct. Institute for Patient- and Family-Centered Care. Available from: http://www.ipfcc.org/pdf/getting_started.pdf

Changing Hospital “Visiting” Policies and Practices: Supporting Family Presence and Participation. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2011 Apr. Available from: http://www.ipfcc.org/visiting.pdf

Nursing Best Practice Guideline: Client Centred Care. Registered Nurses’ Association of Ontario; 2002 Jul [revised 2006]. Available at: http://rnao.ca/sites/rnao-ca/files/Client_Centred_Care.pdf

Improving the Emergency Department Patient Experience: A Guide to Developing Rapid Improvement Surveys. Ontario Hospital Association; 2011 Oct. Available from: http://www.oha.com/CurrentIssues/Issues/Documents/Improving the ED Expierience Survey Guide.pdf

Your Health Care – Be Involved [Internet]. Ontario Hospital Association. Available from: http://www.oha.com/KnowledgeCentre/Library/PatientSafety/Documents/1838_OHA_PSTpamphlet_ENG.pdf

Websites:

Patient Relations. Health Quality Ontario. Available at: http://www.hqontario.ca/Quality-Improvement/Patient-Relations

Institute for Patient- and Family-Centered Care. Home Page [Internet]. Bethesda (MD): Institute for Patient- and Family-Centred Care. Available at: http://www.ipfcc.org

HCAHPS Frequently Asked Questions [Internet]. National Research Corporation (NRC) Picker. Available at: http://www.nationalresearch.com/products-and-solutions/cahps/hcahps/faq/

Patients for Patient Safety Canada. Home Page [Internet]. Patients for Patient Safety Canada; Available from: http://www.patientsforpatientsafety.ca/English/Pages/default.aspx
TOP OF TAB

Evaluate and research patient-centred health careIV (Expert Opinion)

Make Change

Evidence-Informed
Best Practice

How To Implement

Toolbox

Evaluate and research patient-centred health care

In its Recommendations and Promising Practices on designing a patient and family-centred health care system, the Institute for Patient-and Family-Centred Care suggests evaluating and researching patient-centred health care. A sample of specific change ideas include:

Support research and evaluation to document the contribution of partnerships with patients and families to safe, effective health care.
Encourage partnerships with patients and families in research processes.
Develop collaborative projects to investigate outcome measures, study designs, and research and evaluation processes for patient- and family-centered care.

More change ideas and information can be found in the Institute for Patient- and Family-Centred Care’s Recommendations and Promising Practices

Partnering with Patients and Families to Design a Patient- and Family-Centered Health Care System: Recommendations and Promising Practices, Institute for Patient- and Family-Centred Care

References

Evaluate and research patient-centred health care

Type of Evidence: IV (Expert Opinion)*

REFERENCES:

Systematic Reviews:

Promoting engagement by patients and families to reduce adverse events in acute care settings: a systematic review. Berger Z, Flickinger TE, Pfoh E, Martinez KA, Dy SM. BMJ Quality & Safety. 2014 Jul;23(7):548-55. Full-text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4079036/

Toward patient-centered care: a systematic review of older adults' views of quality emergency care. Shankar KN, Bhatia BK, Schuur JD. Annals of Emergency Medicine. 63(5):529-550.e1, 2014 May. Abstract only: http://www.ncbi.nlm.nih.gov/pubmed/?term=24051211

Toward patient-centered care: a systematic review of how to ask questions that matter to patients. Rosenzveig A; Kuspinar A; Daskalopoulou SS; Mayo NE. Medicine. 93(22):e120, 2014 Nov. Full-text: http://journals.lww.com/md-journal/Fulltext/2014/11020/Toward_Patient_Centered_Care___A_Systematic_Review.7.aspx

Toolkits, Handbooks, & Guides:

Striving for Excellence in Patient Relations. Processes in Ontario’s Hospitals. A Guide to Responding to Ontario Regulation 188/15. Health Quality Ontario. 2015. Available at: http://www.hqontario.ca/Portals/0/Documents/qi/patient-relations-best-practices-improving-pr-en.pdf

Engaging with Patients and Caregivers about Patient Relations: A Guide for Hospitals. Health Quality Ontario. 2015. Available at: http://www.hqontario.ca/Portals/0/Documents/qi/guide-engaging-patients-caregivers-en.pdf

A Resource Toolkit for Engaging Patient and Families at the Planning Table. April 2014. Alberta Health Services Engagement and Patient Experience Department. Available at: http://www.albertahealthservices.ca/PatientsFamilies/if-pf-pe-engage-toolkit.pdf

Empowering Patients and Families. Quality and Patient Safety Governance Toolkit, Section 4.0. Governance Centre of Excellence (Ontario Hospital Association) and Health Quality Ontario. Available at: https://www.oha.com/KnowledgeCentre/Library/QPSGT/Documents/Section%204%20-%20Empowering%20Patients%20and%20Families.pdf

Leading Practices in Emergency Department Patient Experience. Ontario Health Association; 2010/11. Available at: http://www.oha.com/KnowledgeCentre/Library/Documents/Leading Practices in Emergency Department Patient Experience.pdf

Patient-Centered Care Improvement Guide. Planetree and Picker Institute; 2008 Oct. Frampton S, Guastello S, Brady C, Hale M, Horowitz S, Bennett Smith S, Stone S. Available at: http://www.hqontario.ca/portals/0/Modals/qi/en/processmap_pdfs/tools/Patient-Centered Care Improvement Guide.pdf

Partnering with Patients and Families to Enhance Safety and Quality: A Mini Toolkit. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2011 Feb. Available at: http://www.hqontario.ca/portals/0/Modals/qi/en/processmap_pdfs/tools/Partnering with Patients and Families to Enhance Safety and Quality - A Mini Toolkit.pdf

Working with Patient and Families as Advisors. Implementation Handbook. June 2013. Agency for Healthcare Research and Quality, Rockville, MD. Available at: http://www.ahrq.gov/professionals/systems/hospital/engagingfamilies/strategy1/index.html

Supporting Resources:

Advancing the Practice of Patient- and Family-Centered Care: How to Get Started. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2010 Oct. Institute for Patient- and Family-Centered Care. Available from: http://www.ipfcc.org/pdf/getting_started.pdf

Changing Hospital “Visiting” Policies and Practices: Supporting Family Presence and Participation. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2011 Apr. Available from: http://www.ipfcc.org/visiting.pdf

Nursing Best Practice Guideline: Client Centred Care. Registered Nurses’ Association of Ontario; 2002 Jul [revised 2006]. Available at: http://rnao.ca/sites/rnao-ca/files/Client_Centred_Care.pdf

Improving the Emergency Department Patient Experience: A Guide to Developing Rapid Improvement Surveys. Ontario Hospital Association; 2011 Oct. Available from: http://www.oha.com/CurrentIssues/Issues/Documents/Improving the ED Expierience Survey Guide.pdf

Your Health Care – Be Involved [Internet]. Ontario Hospital Association. Available from: http://www.oha.com/KnowledgeCentre/Library/PatientSafety/Documents/1838_OHA_PSTpamphlet_ENG.pdf

Websites:

Patient Relations. Health Quality Ontario. Available at: http://www.hqontario.ca/Quality-Improvement/Patient-Relations

Institute for Patient- and Family-Centered Care. Home Page [Internet]. Bethesda (MD): Institute for Patient- and Family-Centred Care. Available at: http://www.ipfcc.org

HCAHPS Frequently Asked Questions [Internet]. National Research Corporation (NRC) Picker. Available at: http://www.nationalresearch.com/products-and-solutions/cahps/hcahps/faq/

Patients for Patient Safety Canada. Home Page [Internet]. Patients for Patient Safety Canada; Available from: http://www.patientsforpatientsafety.ca/English/Pages/default.aspx
TOP OF TAB

Measurement and feedbackIV (Expert Opinion)

Make Change

Evidence-Informed
Best Practice

How To Implement

Toolbox

Measurement and feedback

Regular measurement with patient experience surveys with continuous sampling throughout the year.
Provision of continuous feedback to individual hospital units of patient experience survey data
Highlight positive scores from survey to staff and identify areas for improvement
Monitor patient feedback including compliments, suggestions and complaints

To learn about patient surveys to improve patient experience in Emergency Rooms, refer to the Ontario Hospital Association’s Improving the Emergency Department Patient Experience: A Guide to Developing Rapid Improvement Surveys.

Hospital Quality Improvement Plans 2014-2015. Change Ideas (p. 13), Health Quality Ontario.
Improving the Emergency Department Patient Experience: A Guide to Developing Rapid Improvement Surveys, Ontario Hospital Association

References

Measurement and Feedback

Type of Evidence: IV (Expert Opinion)*

REFERENCES:

Systematic Reviews:

Promoting engagement by patients and families to reduce adverse events in acute care settings: a systematic review. Berger Z, Flickinger TE, Pfoh E, Martinez KA, Dy SM. BMJ Quality & Safety. 2014 Jul;23(7):548-55. Full-text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4079036/

Toward patient-centered care: a systematic review of older adults' views of quality emergency care. Shankar KN, Bhatia BK, Schuur JD. Annals of Emergency Medicine. 63(5):529-550.e1, 2014 May. Abstract only: http://www.ncbi.nlm.nih.gov/pubmed/?term=24051211

Toward patient-centered care: a systematic review of how to ask questions that matter to patients. Rosenzveig A; Kuspinar A; Daskalopoulou SS; Mayo NE. Medicine. 93(22):e120, 2014 Nov. Full-text: http://journals.lww.com/md-journal/Fulltext/2014/11020/Toward_Patient_Centered_Care___A_Systematic_Review.7.aspx

Toolkits, Handbooks, & Guides:

Striving for Excellence in Patient Relations. Processes in Ontario’s Hospitals. A Guide to Responding to Ontario Regulation 188/15. Health Quality Ontario. 2015. Available at: http://www.hqontario.ca/Portals/0/Documents/qi/patient-relations-best-practices-improving-pr-en.pdf

Engaging with Patients and Caregivers about Patient Relations: A Guide for Hospitals. Health Quality Ontario. 2015. Available at: http://www.hqontario.ca/Portals/0/Documents/qi/guide-engaging-patients-caregivers-en.pdf

A Resource Toolkit for Engaging Patient and Families at the Planning Table. April 2014. Alberta Health Services Engagement and Patient Experience Department. Available at: http://www.albertahealthservices.ca/PatientsFamilies/if-pf-pe-engage-toolkit.pdf

Empowering Patients and Families. Quality and Patient Safety Governance Toolkit, Section 4.0. Governance Centre of Excellence (Ontario Hospital Association) and Health Quality Ontario. Available at: https://www.oha.com/KnowledgeCentre/Library/QPSGT/Documents/Section%204%20-%20Empowering%20Patients%20and%20Families.pdf

Leading Practices in Emergency Department Patient Experience. Ontario Health Association; 2010/11. Available at: http://www.oha.com/KnowledgeCentre/Library/Documents/Leading Practices in Emergency Department Patient Experience.pdf

Patient-Centered Care Improvement Guide. Planetree and Picker Institute; 2008 Oct. Frampton S, Guastello S, Brady C, Hale M, Horowitz S, Bennett Smith S, Stone S. Available at: http://www.hqontario.ca/portals/0/Modals/qi/en/processmap_pdfs/tools/Patient-Centered Care Improvement Guide.pdf

Partnering with Patients and Families to Enhance Safety and Quality: A Mini Toolkit. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2011 Feb. Available at: http://www.hqontario.ca/portals/0/Modals/qi/en/processmap_pdfs/tools/Partnering with Patients and Families to Enhance Safety and Quality - A Mini Toolkit.pdf

Working with Patient and Families as Advisors. Implementation Handbook. June 2013. Agency for Healthcare Research and Quality, Rockville, MD. Available at: http://www.ahrq.gov/professionals/systems/hospital/engagingfamilies/strategy1/index.html

Supporting Resources:

Advancing the Practice of Patient- and Family-Centered Care: How to Get Started. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2010 Oct. Institute for Patient- and Family-Centered Care. Available from: http://www.ipfcc.org/pdf/getting_started.pdf

Changing Hospital “Visiting” Policies and Practices: Supporting Family Presence and Participation. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2011 Apr. Available from: http://www.ipfcc.org/visiting.pdf

Nursing Best Practice Guideline: Client Centred Care. Registered Nurses’ Association of Ontario; 2002 Jul [revised 2006]. Available at: http://rnao.ca/sites/rnao-ca/files/Client_Centred_Care.pdf

Improving the Emergency Department Patient Experience: A Guide to Developing Rapid Improvement Surveys. Ontario Hospital Association; 2011 Oct. Available from: http://www.oha.com/CurrentIssues/Issues/Documents/Improving the ED Expierience Survey Guide.pdf

Your Health Care – Be Involved [Internet]. Ontario Hospital Association. Available from: http://www.oha.com/KnowledgeCentre/Library/PatientSafety/Documents/1838_OHA_PSTpamphlet_ENG.pdf

Websites:

Patient Relations. Health Quality Ontario. Available at: http://www.hqontario.ca/Quality-Improvement/Patient-Relations

Institute for Patient- and Family-Centered Care. Home Page [Internet]. Bethesda (MD): Institute for Patient- and Family-Centred Care. Available at: http://www.ipfcc.org

HCAHPS Frequently Asked Questions [Internet]. National Research Corporation (NRC) Picker. Available at: http://www.nationalresearch.com/products-and-solutions/cahps/hcahps/faq/

Patients for Patient Safety Canada. Home Page [Internet]. Patients for Patient Safety Canada; Available from: http://www.patientsforpatientsafety.ca/English/Pages/default.aspx
TOP OF TAB

Create partnerships with supporting organizationsIV (Expert Opinion)

Make Change

Evidence-Informed
Best Practice

How To Implement

Toolbox

Create partnerships with supporting organizations

Accrediting and licensing organizations
Professional associations and disease-specific organizations
Quality improvement and patient safety organizations
Foundations, government agencies, and corporations

A sample of specific change ideas include:

Enhance licensing and certification requirements relating to patient- and family-centered skills.
Assure that accrediting organizations and those that set standards for health care place a high value on requirements related to patient- and familyp-centered care, emphasizing the link to health care quality and safety.
Incorporate patient- and family-centered care requirements, patient experience-of-care surveys, patient and family involvement in quality improvement activities, and the creation of patient and family advisory councils) into pay-for-performance standards.

More change ideas and information can be found in the Institute for Patient- and Family-Centred Care’s Recommendations and Promising Practices.

Always Events®: Creating an Optimal Patient Experience – Tool Box (2011), Picker Institute
Partnering with Patients and Families to Design a Patient- and Family-Centered Health Care System: Recommendations and Promising Practices, Institute for Patient- and Family-Centred Care

References

Create partnerships with supporting organizations

Type of Evidence: IV (Expert Opinion)*

REFERENCES:

Systematic Reviews:

Promoting engagement by patients and families to reduce adverse events in acute care settings: a systematic review. Berger Z, Flickinger TE, Pfoh E, Martinez KA, Dy SM. BMJ Quality & Safety. 2014 Jul;23(7):548-55. Full-text: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4079036/

Toward patient-centered care: a systematic review of older adults' views of quality emergency care. Shankar KN, Bhatia BK, Schuur JD. Annals of Emergency Medicine. 63(5):529-550.e1, 2014 May. Abstract only: http://www.ncbi.nlm.nih.gov/pubmed/?term=24051211

Toward patient-centered care: a systematic review of how to ask questions that matter to patients. Rosenzveig A; Kuspinar A; Daskalopoulou SS; Mayo NE. Medicine. 93(22):e120, 2014 Nov. Full-text: http://journals.lww.com/md-journal/Fulltext/2014/11020/Toward_Patient_Centered_Care___A_Systematic_Review.7.aspx

Toolkits, Handbooks, & Guides:

Striving for Excellence in Patient Relations. Processes in Ontario’s Hospitals. A Guide to Responding to Ontario Regulation 188/15. Health Quality Ontario. 2015. Available at: http://www.hqontario.ca/Portals/0/Documents/qi/patient-relations-best-practices-improving-pr-en.pdf

Engaging with Patients and Caregivers about Patient Relations: A Guide for Hospitals. Health Quality Ontario. 2015. Available at: http://www.hqontario.ca/Portals/0/Documents/qi/guide-engaging-patients-caregivers-en.pdf

A Resource Toolkit for Engaging Patient and Families at the Planning Table. April 2014. Alberta Health Services Engagement and Patient Experience Department. Available at: http://www.albertahealthservices.ca/PatientsFamilies/if-pf-pe-engage-toolkit.pdf

Empowering Patients and Families. Quality and Patient Safety Governance Toolkit, Section 4.0. Governance Centre of Excellence (Ontario Hospital Association) and Health Quality Ontario. Available at: https://www.oha.com/KnowledgeCentre/Library/QPSGT/Documents/Section%204%20-%20Empowering%20Patients%20and%20Families.pdf

Leading Practices in Emergency Department Patient Experience. Ontario Health Association; 2010/11. Available at: http://www.oha.com/KnowledgeCentre/Library/Documents/Leading Practices in Emergency Department Patient Experience.pdf

Patient-Centered Care Improvement Guide. Planetree and Picker Institute; 2008 Oct. Frampton S, Guastello S, Brady C, Hale M, Horowitz S, Bennett Smith S, Stone S. Available at: http://www.hqontario.ca/portals/0/Modals/qi/en/processmap_pdfs/tools/Patient-Centered Care Improvement Guide.pdf

Partnering with Patients and Families to Enhance Safety and Quality: A Mini Toolkit. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2011 Feb. Available at: http://www.hqontario.ca/portals/0/Modals/qi/en/processmap_pdfs/tools/Partnering with Patients and Families to Enhance Safety and Quality - A Mini Toolkit.pdf

Working with Patient and Families as Advisors. Implementation Handbook. June 2013. Agency for Healthcare Research and Quality, Rockville, MD. Available at: http://www.ahrq.gov/professionals/systems/hospital/engagingfamilies/strategy1/index.html

Supporting Resources:

Advancing the Practice of Patient- and Family-Centered Care: How to Get Started. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2010 Oct. Institute for Patient- and Family-Centered Care. Available from: http://www.ipfcc.org/pdf/getting_started.pdf

Changing Hospital “Visiting” Policies and Practices: Supporting Family Presence and Participation. Bethesda (MD): Institute for Patient- and Family-Centred Care; 2011 Apr. Available from: http://www.ipfcc.org/visiting.pdf

Nursing Best Practice Guideline: Client Centred Care. Registered Nurses’ Association of Ontario; 2002 Jul [revised 2006]. Available at: http://rnao.ca/sites/rnao-ca/files/Client_Centred_Care.pdf

Improving the Emergency Department Patient Experience: A Guide to Developing Rapid Improvement Surveys. Ontario Hospital Association; 2011 Oct. Available from: http://www.oha.com/CurrentIssues/Issues/Documents/Improving the ED Expierience Survey Guide.pdf

Your Health Care – Be Involved [Internet]. Ontario Hospital Association. Available from: http://www.oha.com/KnowledgeCentre/Library/PatientSafety/Documents/1838_OHA_PSTpamphlet_ENG.pdf

Websites:

Patient Relations. Health Quality Ontario. Available at: http://www.hqontario.ca/Quality-Improvement/Patient-Relations

Institute for Patient- and Family-Centered Care. Home Page [Internet]. Bethesda (MD): Institute for Patient- and Family-Centred Care. Available at: http://www.ipfcc.org

HCAHPS Frequently Asked Questions [Internet]. National Research Corporation (NRC) Picker. Available at: http://www.nationalresearch.com/products-and-solutions/cahps/hcahps/faq/

Patients for Patient Safety Canada. Home Page [Internet]. Patients for Patient Safety Canada; Available from: http://www.patientsforpatientsafety.ca/English/Pages/default.aspx
TOP OF TAB

Grol R, Grimshaw J. From best evidence to best practice: effective implementation of change in patients' care.

Lancet. 2003 Oct 11;362(9391):1225-30.
Available from: http://www.ncbi.nlm.nih.gov/pubmed/14568747

Measurement

Updated on October 27, 2015

“Some is not a number, soon is not a time.”

Don Berwick, former CEO and President of IHI, December 2004, at launch of the 100,000 Lives Campaign

How will we know if a change is an improvement? Measurement is one of the critical steps in a quality improvement (QI) initiative that assesses the impact of your tests of change. Quality indicators are used to measure how well something is performing. There are three types of quality indicators used to measure your QI efforts: outcome (indicators that capture clinical outcomes and or system performance), process (indicators that track the processes that measure whether the system is working as planned), and balancing indicators (indicators that ensure that changing one part of the system does not cause new problems in other parts of the system).

Type of Indicator	Indicator of Quality Improvement	How to Calculate: numerator __________ denominator	Targets/ Benchmarks	How is This Indicator Used?
Outcome	Percentage of patients who would definitely recommend their hospital to friends and family: Hospital Inpatient Emergency Department	Number of patients who responded “Yes, definitely” (for NRC Canada), or “Definitely yes” (for HCAHPS) Number of patients who registered any response to this question (do not include non-respondents)	Targets: As high as possible (100%) Provincial benchmarks*: Hospital Inpatients: 81.8% Emergency Department: 70.6%	Quality improvement QIP indicator Publicly reported by HQO
Outcome	Percentage of patients who would rate the overall care and services received at the hospital as excellent, very good, or good: Hospital Inpatient Emergency Department	Number of patients who responded “Excellent”, “Very good”, and “Good” Number of patients who registered any response to this question (do not include non-respondents)	Targets: As high as possible (100%) Provincial benchmarks*: Hospital Inpatients: 96.4% Emergency Department: 91.8%	Quality improvement QIP indicator Publicly reported by HQO

*The benchmark fell on the eightieth percentile of 2010/2011 NRC Picker Canada Ontario hospital data

Run Charts

Collected measures can be presented graphically by plugging the monthly results into a run chart.

Want to know more?

Explore the Tools and Resources tab to find additional support for your QI initiative.

Tools & Resources

Updated on October 27, 2015

Tools

Patient Experience Tools

Best Practices Toolkit: Implementing and Sustaining Change in Long-Term Care Registered Nurses’ Association of Ontario (RNAO), 2008. Portal for the Long-Term Care Best Practices Initiative.
Improving the Emergency Department Patient Experience: A Guide to Developing Rapid Improvement Surveys Ontario Hospital Association (OHA), 2001.This guidance document supports hospitals in their development of a brief questionnaire to test specific emergency department change initiatives.
Nursing Best Practice Guideline: Client Centred Care Registered Nurses’ Association of Ontario (RNAO), 2006. This guideline comprises the resources necessary for the support of evidence-based practice.
Partnering with Patients and Families to Enhance Safety and Quality: A Mini Toolkit Institute for Patient- and Family-Centered Care, 2011. This toolkit helps healthcare leaders, clinicians and staff learn how to partner with patients and families to enhance safety and quality. Reprinted with permission from the Institute for Patient- and Family-Centered Care.
Patient-Centered Care Improvement GuideFrampton, S. et al., Planetree and Picker Institute, 2008. A collection of best practices and practical implementation tools for patient-centred care.

QI Tools

Communications Plan: Instructions , Tool
Fishbone Template: Instructions , Tool
Five Whys: Instructions , Tool
Measurement Plan Template: Instructions , Tool
Pareto Chart: Instructions , Tool
PDSA Template
Project Charter
Tree Diagram Worksheet

For a more comprehensive list of tools and resources, visit the following links on our HQO website:

HQO Tools and Resources

Resources

Reports

Insights into Quality Improvement: Key Observations: 2014-15 Quality Improvement Plans – Hospitals. Health Quality Ontario. 2015
Always Events®: Creating an Optimal Patient Experience Picker Institute, 2011. Always Events® is a Picker Institute initiative that is aimed at setting a new standard for the patient experience: an expectation that certain elements of the patient experience should happen for all patients all of the time.
Changing Hospital “Visiting” Policies and Practices: Supporting Family Presence and Participation Institute for Patient- and Family-Centered Care, 2010. This report discusses current visiting policies within the United States and their impact on patient-centred care, and explores how visitation policies could — and should — be changed. Reprinted with permission from the Institute for Patient- and Family-Centered Care.
Leading Practices in Emergency Department Patient Experience Ontario Hospital Association (OHA), 2011. A compilation of an English-language literature search from 2003 to 2010, providing change ideas to improve patient experience in emergency departments.

Presentations

Improving the Emergency Department Patient Experience Ontario Hospital Association (OHA), 2011. Archived presentations from a March 23, 2011, OHA conference on improving patients’ experiences in emergency departments.

QI Resources

Interpreting Run Charts
Health Quality Ontario
Model for Improvement (Clip 1)
Institute for Healthcare Improvement
Model for Improvement (Clip 2)
Institute for Healthcare Improvement
PDSA Cycle Video (Part 1)
Institute for Healthcare Improvement
PDSA Cycle Video (Part 2)
Institute for Healthcare Improvement
The run chart: a simple analytical tool for learning from variation in healthcare processes
Perla RJ, Provost LP, Murray SK. BMJ Qual Saf. 2011 Jan;20(1):46-51.

Patient Experience

Overview

Issue

Call to Action

How is the patient experience in your organization?

Johnson B, Abraham M, Conway J, Simmons L, Edgman-Levitan S, Sodomka P, Schlucter J, Ford D. Partnering with Patients and Families to Design a Patient- and Family-Centered Health Care System: Recommendations and Promising Practices.

Governance Centre of Excellence (Ontario Hospital Association), Health Quality Ontario. Quality and Patient Safety Governance Toolkit.

Picker Institute. Principles of Patient Centred Care

Excellent Care for All Act, 2010. Ontario Regulation 188/15.

Health Quality Ontario. Quality Monitor 2012.

Best Practices

Grol R, Grimshaw J. From best evidence to best practice: effective implementation of change in patients' care.

Measurement

Run Charts

Want to know more?

Tools & Resources

Tools

Patient Experience Tools

QI Tools

Resources

Reports

Presentations

Links

QI Resources