Category Archives: Videos

Always Events: Dartmouth-Hitchcock


Dartmouth-Hitchcock Medical Center

Principal Investigator(s): Jonathan T. Huntington, MD, PhD & Sandra G. Dickau, RN, MS
Project Title: Implementation of a set of Always Events that will increase communication


Always Event(s):
Always communicate with, inform and respect the patient through the following behaviors in every patient/family encounter:
• Introducing yourself and describing the reason you are there at each encounter
• Addressing and referring to patients by the name that they choose; not by their disease
• Displaying your name badge at all times
• Treating those whom you serve with the same respect you would wish them to show you
• Encouraging patients and families involvement in decision making
• Welcoming and being respectful to those defined by the patient as “family”

Overview: Develop and implement a educational practice intervention and improvement program to promote and evaluate the competency of frontline clinical nurses with a set of observable and behavioral Always Events. Intervention is based on experiential learning provided with simulation and fully integrating Patient Family Advisors who will serve as Standardized Patients in a clinical scenario. The efforts will build from a foundation of pre-existing resources and educational infrastructure. Specific Aims include: To operationally define measurable behaviors that demonstrate competence in specific PFCC Always Events involving communication. To Enhance a nationally recognized experiential education program targeting recently hired nurses to create immersive learning experiences utilizing SPs that will serve as a pilot for the evaluation and practice of these Always Events. To provide education to SPs regarding the importance of these behaviors and how to provide targeted feedback to learners. To Develop a novel evaluation method to measure the effects of this intervention on the clinical practice of recently hired nurses.

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Always Events: MGH

Massachusetts General Hospital
Principal Investigator: Gaurdia Banister, RN, PhD
Project Title: Always Know Your Caregiver/Always Responsive

Always Event(s): Ensure that our patients always know who is in charge of their care, and that providers are always responsive to the needs of our patients and their families and that our patients always get help when they need it.

Overview: The strategy that will be adopted will be a multi-factorial one, and will consist of a variety of approaches and tactics. These strategies will be piloted on a single, or a small number of homogeneous patient care unit(s) – using a similar unit(s) as a control. The specific strategies will be developed and deployed by staff, adjusted as they are deployed and then rolled out to the entire organization over the balance of the year remaining. It is expected that these strategies will be overseen and directed by the existing Communication and Responsiveness Council that reports to the Patient Care Services Committee – and will be influenced by the newly formed centralized Patient Family Advisory Council (PFAC). Strategies will include but will not be limited to: 1) A variety of rounding strategies to support and model the importance of timely responses to patients’ needs and their requests, 2) The production of a video that will welcome the patient and their family to the MGH, explain the environment, introduce the team that will be taking care of them and explain what they can expect in terms of our commitment to their care and well being, 3) The use of “face sheets” — The sheet describes who is taking care of them, what their role is on the team and what they should expect from them. The face sheet contains actual photographs, names and pager numbers and descriptions of each team members roles and responsibilities, 4) White boards – in each patient room that detail who is taking care of the patient, their nurse, their doctor and other pertinent information that might help the patient better communicate with the right people, 5) Communication Boards – similar to the boards for patient rooms but designed for the nurse’s stations to communicate the monthly, quarterly and year to date patient satisfaction scores – especially “Staff Responsiveness.”

Click here to view the MGH Interventions

Click here to download the Whiteboard Guidelines

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Always Events: Yale-New Haven Hospital

Organization/Institution: Yale-New Haven Children’s Hospital
Principal Investigator(s): Janet Parkosewich, DNSc, RN, CCRN, FAHA

Project Title: Premature Life Transitions: A Patient- and Family- Centered End of Life Care Program for Neonates

Always Event(s): Our proposal for the Always Event TM Grant is aimed at the consistent use of an innovative, systematically applied end-of-life program by all members of our neonatal interdisciplinary team to support patients and families during the transition from curative to palliative care, infant demise, and bereavement.


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Always Events: UPMC — Care Team Twittering

Organization/Institution: PFCC Innovation Center at University of Pittsburgh Medical Center
Principal Investigator(s): Anthony M. DiGioia, III, M.D.
Project Title: Trauma Team Texting and Guardian Angels

Always Event(s):

  • Always let the patient be the center of the care team… Care Team Twittering
  • Always keep patients and family members informed… “Guardian Angels”
  • Always know the discharge plan and beyond… Transitions in Care Experiences

Overview: Trauma Services and the Transplant Programs at UPMC have incorporated the PFCC Methodology and Practice (PFCC M/P) in their care delivery approach. The PFCC M/P approach enables Care Givers to deliver truly exceptional care experiences by refocusing existing resources through a six step process that brings patients and families directly into co-designing care delivery improvement. PFCC M/P will serve as the means by which the 2 always events will be incorporated, monitored, evaluated, disseminated, and accelerated locally and nationally so that accurate communication takes place in real time and transitions in care are seamless.

Guardian Angel Brochure

 Transplant Guardian Angel PickUp Sheet (Blank)

Transplant Guardian Angel Handoff Report (Blank)

Angel Hand- OFF Sheet Info

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Always Events: St. Jude

Organization/Institution: St. Jude Children’s Research Hospital
Principal Investigator(s): Alicia Huettel, MSN and Patricia Aiken
Project Title: Parent Mentor Program


Always Event(s):
The  Always Eventis proposed as having four goals: 1) to offer each newly diagnosed family at St. Jude a trained parent-mentor, offering support and encouragement throughout the trajectory of the child’s treatment including the transition into survivorship or bereavement, 2) to provide the family the opportunity of acceptance, while facilitating coping mechanisms and hope, 3) empowering providers and the family as a partner and in their communication with St. Jude staff in their child’s treatment, and 4) providing a resource of services offered by St. Jude and the community.   

Overview: Our Always Event™ proposal is the development and implementation of a parent‐mentoring program at St. Jude. During the first year we will: 1) outline the position description, recruit and train 3‐10 parent mentors with an interdisciplinary team of chaplains, social workers, psychologists, physicians, nurses, and members of the FAC and Family Centered‐Care Program, 2) formulate a program marketing plan to offer the Always Event™ to parents, 3) establish a communication process between mentors and parents, 4) create a formal documentation process, 5) establish the feedback process to interdisciplinary team including debriefing and support, 6) implement evaluation measurements, 7) assess the feasibility of program expansion within other clinics. A parent mentoring implementation team (PMIT) will be formed to assess the outlined steps and to offer feedback as the program is implemented. The PMIT will consist of members of the described interdisciplinary staff.

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Always Events: Inova Health System

 

Organization/Institution: INOVA Health Systems
Principal Investigator(s): Mary Ann Friesen, PhD, RN, CPHQ:
Project Title: Developing a Patient-Centered Approach to Handoffs

Always Event(s): Patients will always be included in the ISHAPED handoff shift-to-shift hand-off process at the bedside as this will add an additional layer of safety by allowing the patient to communicate potential safety concerns.

Overview: This project will build on previous research by the Inova Health System (IHS) to improve the quality and safety of patient care by enhancing communication and encouraging patient participation. Recent reviews of patient safety and satisfaction at Inova identified the shift-to-shift handoff as a process in need of improvement. Inova responded by convening a quality-improvement team to develop a new strategy for conducting the shift-to-shift handoff, one that standardizes procedures and incorporates a bedside component. Entitled “ISHAPED” (I=Introduce, S=Story, H=History, A=Assessment,

P=Plan, E=Error Prevention, and D=Dialogue), this strategy also provides patients and their families the opportunity to participate in the handoff process. The proposed project aims to 1) measure patient satisfaction and perceptions regarding the ISHAPED bedside handoff process, 2) use the patient feedback to optimize and standardize the bedside handoff process, and 3) develop a training video and companion toolkit to educate nurses on how to conduct a safe, effective and patient-centered bedside hand-off across multiple settings.

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Always Events: Iowa Health Systems

Organization/Institution: Iowa Health System
Principal Investigator(s): Gail A. Nielsen
Project Title: Always Use Teach Back!

Always Event(s): The Always Event is to always listen to the patient during hand-offs by encouraging teach-back opportunities—during hospitalization and upon arrival in the next care setting. Always use the Teach-back method.

Overview: IHS will develop and implement a “Always Use Teach-back!” toolkit for the three care settings encountered by patients being discharged from the hospital: hospital discharge, primary care follow-up, and home health support. The toolkit will include training modules with videos demonstrating effective use of teach-back. IHS will train and coach physicians and nurses on the “Always Use Teach-back!” approach.

The Always Events encompass Teach-Back (T-B) opportunities – during a patient’s hospitalization and upon arrival in the next care setting. Physicians and nurses will educate and discover (in a non-shaming way) what the patient or family caregiver understood using T-B. The aim is to have patients/family caregivers able to teach back in their own words:

  • danger signs and symptoms to watch for after discharge from hospital
  • action steps if signs or symptoms occur
  • key medications related to principal diagnosis
  • critical self-care activities
  • follow-up appointments

IHS has the ongoing benefit of patient and family advisors in developing appropriate T-B interventions through their HLC, partnership with the New Readers of Iowa7, and Reducing Readmissions Collaborative. IHS patient and family caregivers will be partners in developing and testing the most effective T-B learning system.

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Always Events: UPMC Innovation Center

University of Pittsburgh Medical Center Innovation Center
Principal Investigator(s): Anthony M. DiGioia, III, M.D.
Project Title: Care Team Twittering and Guardian Angels

Always Event(s):
Always let the patient be the center of the care team… Care Team Twittering
Always keep patients and family members informed… “Guardian Angels”
Always know the discharge plan and beyond… Transitions in Care Experiences

Overview: Trauma Services and the Transplant Programs at UPMC have incorporated the PFCC Methodology and Practice (PFCC M/P) in their care delivery approach. The PFCC M/P approach enables Care Givers to deliver truly exceptional care experiences by refocusing existing resources through a six step process that brings patients and families directly into co-designing care delivery improvement. PFCC M/P will serve as the means by which the 2 always events will be incorporated, monitored, evaluated, disseminated, and accelerated locally and nationally so that accurate communication takes place in real time and transitions in care are seamless.

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Always Events: Jennie Chin Hansen

Jennie Chin Hansen, RN, MS, FAAN. CEO American Geriatrics Society

In March 2011, Picker Institute launched the Always Events℠ initiative to identify experiences that should always occur when patients and families interact with the healthcare system. Leaders in patient-centered care have been deeply involved in developing the program. Jennie Chin Hansen, CEO of the American Geriatrics Society, discusses the concept here.

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Always Events: Jerod Loeb

Always Events Discussion
Jerod M. Loeb, Ph.D., Executive Vice President, Division of Healthcare Quality Evaluation, The Joint Commission

In March 2011, Picker Institute launched the Always Events℠ initiative to identify experiences that should always occur when patients and families interact with the healthcare system. Leaders in patient-centered care have been deeply involved in developing the program. Jerod M. Loeb,  Ph.D.,executive vice president for the Division of Healthcare Quality Evaluation at The Joint Commission, discusses the concept here.

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