Partners in Care: Working with families/whaanau to encourage participation Background: A proposed change to our admission documentation, included questions about which people are key to the patients well being and who is to be involved in decision making. Aims: •Define partners in care •Identify barriers to working in partnership with patients, family/whaanau members •Develop strategy to address key barriers •Contribute to the continued review of the current documentation •Identify training and/or information requirements to support patients, families/whaanau and staff to work as ‘partners in care’ Method: •Focused on two surgical wards at Middlemore Hospital. •Surveyed surgical inpatients & family/whaanau members and staff over 1 week •Conducted interviews with staff who had been patients or family/whaanau of patients over 4 weeks •Reviewed surgical patient satisfaction survey narrative responses for last quarter •Recruited patients and family/whaanau members for attendance at workshop event Partners in Care Forum: Full day event attended by •Patients •Family/whaanau members •Ward Nurses •Health Care Assistants •Ward Clerk •Physiotherapist •ICU Consultant Survey Feedback: Patients are asked who are key family./whaanau members: •60% Staff say – always/mostly •33% Patients/family/whaanau say they were asked Family/whaanau members are encouraged to be at doctors rounds •76% Staff say – always/mostly •28% Patients/family/whaanau say they were encouraged Opinions of family/whaanau members are listened to and respected •84% Staff say – always/mostly •85% Patients/family/whaanau say they were satisfied Patients & family/whaanau say: Staff say: Staff would be taught how to use the document, but how do we prepare patients, family/whaanau and staff for working in partnership? Partners in Care Definition: ‘anyone named by the patient that they want to work with them (the patient) and the healthcare team to help make decisions and be involved in care’ Key concepts: partners are patient defined; members of healthcare team can support the patient to find a partner (Whaanau Support Workers, for instance) Initial area of focus: •Who is involved in my care? •What facilities are available? •What are the routines and general processes? *The charge nurse had already extended the times the ward was ‘unlocked’ from 2pm-8pm to 8am–8pm What we tried: 1. Patient (family/whaanau) will know the name of the nurse looking after them. nurse name displayed on bedside information board •Tested in 4 bed spaces •Difficult to find a good place to hang the board so it could be seen •Nurses sometimes forgot to update (only few boards on ward) •Patients, family/whaanau really liked the board and could say who was looking after them 2. Bed space telephone number included on information board so family/whaanau could call patient direct •Soon identified that only 46% of bed spaces had a telephone at the bedside •Phones purchased to ensure all patients had access to phone 3. Develop process to update board at start of shift •Boards to be placed at each bedside • updating process to be standardised 4. Patients will be aware of facilities and ward routines •Work continues to evolve pictorial information sheet for the bedside Next Steps: Develop training resources that ‘script’ key conversations and demonstrate these in action (via video scenarios, for example) to address the staff support/guidance needs as identified in the staff survey. Work to be adopted by the newly formed Patient & Whaanau Centered Care Programme Lessons: •Forum was a big commitment from patients & family/whaanau members •Partnership working is about changing attitudes – requires leadership •Stories are a powerful means to engage staff Partners in Care Workgroup: Denise Kivell; David Hughes; Joye Rowlands; Lynne Kane; Melanie Olliff; Ian Kaihe-Wetting; Adrienne Batterton; Maika Veikune; Soli Henare; Sue Cotton; Maggie Spencer