UHC: Implementation of patient- and family-centered care improves quality of care for patients

Understanding the needs of patients and their families has several advantages for health care providers, including enhancing safety and helping to stem the increasing costs of medical errors and malpractice litigation. In fact, many academic medical centers are turning to implementation of patient- and family-centered care (PFCC) to improve the quality of care for patients.

The Institute for Family-Centered Care defines PFCC as "an innovative approach to the planning, delivery, and evaluation of health care that is grounded in mutually beneficial partnerships among health care patients, families, and providers." The core concepts of PFCC are dignity and respect, information sharing, participation, and collaboration.

Senior leaders at University HealthSystem Consortium (UHC) member organizations are placing a greater emphasis on PFCC because the perceptions and experiences of patients and families are at the core of health care improvements. The experiences of patients and families affect the hospital's quality, safety, financial performance, and staff and customer satisfaction.

"Health care providers that want to successfully implement PFCC concepts must be committed to a true paradigm shift," said Kathy Vermoch, project manager in UHC's Benchmarking & Improvement Services program. "Within this paradigm shift, patients and families must be viewed as equal and important members of the health care team. Collaborative partnerships with patients and families are needed to improve safety, quality of care, and operational efficiency," she added.

Continuing its commitment to improve the quality of health care in the United States, UHC enlisted the help of 26 organizations to participate in a survey and assessment about PFCC practices and initiatives. The goals of this benchmarking project included helping UHC members:

• Pinpoint their PFCC strengths and improvement opportunities
• Identify useful metrics for monitoring progress toward PFCC goals
• Develop an aggregate database of PFCC practices in academic medical centers
• Discover how organizations are successfully implementing PFCC's core concepts to address the principles of quality care as outlined by the Institute of Medicine

The majority of academic medical centers participating in this UHC benchmarking project indicated that PFCC is part of the organizational mission. However, in a 2007 survey, 68% responded that the budget to support this initiative was "none" or "unknown." Only 36% of responding organizations included PFCC in job descriptions and performance evaluations.

MCG Health, Inc., the health system of the Medical College of Georgia, experienced dramatic improvements in patient safety, length of stay, and patient satisfaction by implementing PFCC. In fact, Press Ganey satisfaction scores for neurosciences, the first adult service line to implement PFCC, increased from the 10th percentile to the 95th percentile in less than a year. Improvement in patient satisfaction has also helped dramatically reduce costly malpractice litigation for MCG.

The UHC benchmarking project also identified several leadership strategies that can help facilitate implementation of PFCC core concepts in health care organizations:

• Organizations must collaborate with patient and family advisers to incorporate PFCC concepts into the organizational culture.
• Leaders and providers--including outsourced service and equipment vendors, administrative leaders, caregivers, and medical staff--must subscribe to and practice PFCC concepts.
• Staff and providers must be held accountable for achieving and maintaining PFCC goals.