The Expert In The Room:
Engaging Family in Direct Care
The Johns Hopkins
Armstrong Institute for Patient Safety and Quality
Rhonda Malone Wyskiel
[email protected]
© The Johns Hopkins University and The Johns
Hopkins Health System Corporation, 2011
• How many of you have been a patient or had
a loved one in the hospital?
• What kinds of things did you do while you
were visiting?
– Likely watched T.v, read newspaper, computer
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Armstrong Institute for Patient Safety and Quality
What could have improved the
experience?
• What if the nurse had invited you to help?
• What if you built a relationship where you
were a trusted member of the healthcare
team?
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Armstrong Institute for Patient Safety and Quality
Why are you doing this?
Exercise: Imagine your mother, father, loved one in
this ICU. What would you want for them? For you as
a family member?
Clinical practice guidelines for support of the
family in the patient-centered intensive care unit:
American College of Critical Care Medicine Task
Force 2004–2005
“endorsement of a shared decision-making model, early
and repeated care conferencing to reduce family stress
and improve consistency in communication, honoring
culturally appropriate requests for truth-telling and
informed refusal, spiritual support, staff education and
debriefing to minimize the impact of family interactions
on staff health, family presence at both rounds and
resuscitation, open flexible visitation, way-finding and
family-friendly signage, and family support before,
during, and after a death.”
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What do we have in place currently?
• What are current patient-centered care
practices?
– what patient-centered care practices or
behaviors have you witnessed or participated
in?
– practices/behaviors as either active or passive
engagement.
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Armstrong Institute for Patient Safety and Quality
Family Involvement Menu
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Rhonda Wyskiel, RN, BSN
Development of Menu
• Developed the Family Involvement Menu using results from nurse
exercise and family survey.
• Educated nursing staff on the availability and intended uses of the
Menu
• Displayed the Family Involvement Menu on a reusable white board
in each patient room and encouraged its use.
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Armstrong Institute for Patient Safety and Quality
Development of Menu
• Engaged staff and family members in the concept of the Family
Involvement Menu
• Educated nursing staff on the value and intended uses of the Menu
• Executed the Family Involvement Menu on a reusable white board
in each patient room and encouraged its use.
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Barriers and Early Wins
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Early adopters vs late adopters (never users).
Nursing Perspective
Patient-Provider relationships
Documentation
Sharing
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Armstrong Institute for Patient Safety and Quality
Next Steps
• Evaluation Process/Research
• National Recognition
• Betty and Gordon Moore Foundation Support
– Project Emerge
• Development of toolkit for implementation
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Armstrong Institute for Patient Safety and Quality
Remember your experience
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Armstrong Institute for Patient Safety and Quality
Making families part
of patient-centered
care
An example: Family
involvement menu
(developed by Rhonda
Wyskiel, RN)
Implementation
strategies: What might
your team put on the
menu?
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References
Mahoney D. Nurturing a collaborative culture. Partners 2014 Oct/Nov: 20-23.
Wyskiel RM, Weeks, K, Marsteller, JA. Inviting Families to Participate in Care: A
Family Involvement Menu. The Joint Commission Journal on Quality Improvement.
2015. 41(1):43-46
Wyskiel RM, Chang BH, Alday AA et. Al. Towards Expanding the Acute Care Team:
Learning how to involve families in care processes, in preparation to be submitted to
Families, Systems, and Health.
Mitchell ML, Chaboyer W. Family Centered Care—A way to connect patients
families and nurses in critical care: A qualitative study using telephone interviews.
Intensive and Critical Care Nursing. 2010;26:154-160.
Davidson JE. Family-Centered Care: Meeting the needs of patients’ families and
helping families adapt to critical illness. Critical Care Nurse. 2009;29(3): 28-34
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