What’s the Best Way to Improve Patient- and Family-Centered Care?

One of the goals of the Johns Hopkins Medicine Strategic Plan is to be the national leader in the safety, science, teaching and provision of patient- and family centered care. What do you think is the best way to make a difference for our patients? Perhaps, 24-hour visitation, better billing information or more improved way finding? Share your response in today’s Hopkins Happenings poll and give your thoughts on other ways Johns Hopkins can improve our patient experience.

What’s the best way to improve patient- and family-centered care across JHM?

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13 Comments

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Comments

Sallyann Koontz July 25, 2014 at 3:14 pm

Start thinking about patient safety beyond the hospitals' four walls. Patients need to be safe when they are home or they may be back...soon. Ultimately, we need to start thinking of a person as our patient until they no longer need us. Isn't that our goal? Help a person until they need us for pro-active care instead of acute issues. Close the circle: from creating hope (becoming a patient) to delivering the promise (helping).

One way to do the above: create a micro-site or a special patient website or add a section into My Chart specifically geared towards the patients, and care-givers of those patients. Include content related about what to expect when you leave Hopkins or any of our entities.

This information can include what to expect in the days post-discharge, what is normal, what is not, how you will feel, how to avoid depression, what are the psychological mine fields, accurate phone numbers, emergency contacts, how to contact someone/nurse with whom you can email, how to get a home visit, what other items insurance can cover per your procedure.

If we were hit in the hospital rankings mostly because of patient safety then let's make it safer for patients to be sent home both from physiological and psychological arenas. It will help with readmitting issues.

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Peggy Medoff July 23, 2014 at 5:09 pm

Consistently ask the patient and their family what you can do to improve their stay/care,ect. This gives them the opportunity to request the information most helpful to their individual needs.

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Carolyn Harris July 22, 2014 at 2:17 pm

The best way to help Hopkins have better patient care is for staff to show empathy, a sense that you truely care what happens to the patient as another "human" and not just one more "patient." I believe showing kindness covers a multitude of sins. I was a patient in the Hopkins system for emergency galbladder surgery. I had a very bad experience with several staff members. I would have overlooked what happened but their rudeness and uncaring attitude made me take action so no other patient should experience what happened to me. It amazes me that not all persons choosing to work in this caring type of work care. How do you teach that to those who don't?

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Tianna C. Dauses July 22, 2014 at 7:59 am

The billing system is horrible, you get multiple bills for one visit that really does not give you detailed information, you pay the bill and you get another bill stating it has not been rec'd. If you set up bill payment there are multiple accounts versus using the patient's ID or one account number for all encounters. When my son was admitted I really needed to be his advocate 24/7, so many errors in care and no preparation for discharge. I have worked here for 30 years and I am still disappointed that we don't do a better job with patient care, billing and discharge planning.

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Kathy July 21, 2014 at 12:49 pm

Patients and their families tell me all the time how difficult it is to navigate through our system. Some suggestions:
Have escort/transport staff available at all entrances to take people to their appointment area, if needed;

Distribute pagers to patients who need to wait for lab results before their visit can proceed, so they're not stuck in a waiting room for hours; these could also be used when providers are behind schedule in seeing patients;

Set aside waiting areas without televisions for those who don't want to be bombarded with constant noise;

All doors that are accessible to patients should operate electronically;

Families are more often asked to be caregivers for patients with complex problems, with little or no instruction, and next to no support; they are often reluctant to call the physician on-call. We need some kind of "hot line" patients/family members can call for this type of assistance, 24/7.

I hear complaints all the time about how long it takes to be discharged from the inpatient units; this is not unique to Hopkins, although maybe we could become a leader in finding a way to expedite this process.

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Elizabeth July 21, 2014 at 12:23 pm

The use of nurses for patient education and navigation provides patients with a feeling of security and confidence. Nurses can provide a unique experience as a liaison and confidante to patients and their families. The nurse navigator position should be used throughout the hospital as an innovative move forward in providing excellent care to patients and families at Hopkins.

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Diane Becker July 21, 2014 at 11:31 am

Improved hands on comprehensive shift-based case management by nurses. The system is so complex that each inpatient needs a navigator and one person who assures communication among all staff, care providers and all staff. Hands on bedside nursing involving and educating patients and their families is the best way to centralize all responsibilities fornpatient s including transition to home and post discharge care. Too much time spent in the nurses station. Nurses on rounds would improve their understanding of the care plan too. When my family is hospitalized, I always spend the night to coordinate care and assure continuity. Far too piecemeal at present.
This should be a nursing role.
Johns Hopkins Schnof Nursing, 1964

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Cindy Huesman July 21, 2014 at 10:24 am

Suggestion: Hopkins going out into the communities to provide service. I suggest the following ideas that might help:

-House calls for very sick patients
-A van that goes out into the surrounding neighborhoods to provide health care (a mobile doctor's office)
-School visits to provide vison, hearing and general wellness assessments (When I was a child, these services were offered at my elementary school. It was during one of these visits that my parents learned that I needed glasses.)

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Bobbie July 21, 2014 at 9:52 am

My husband has been a pt many times. The most difficult thing is getting him discharged. We have been told so many times in the morning that he would be discharged but yet can wait 12 hours or more to get the discharge paperwork and get officially discharged. There has to be a better way. Poor communication in getting the discharge done in a timely fashion.

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Bonnie C July 21, 2014 at 9:44 am

Communication. Communication. Communication. Each patient's needs will be different, so there are many things that CANNOT be "standardized" - this is not a "one size fits all" industry, though many aspects can be tailored in a general way. Listen, really listen, to what the patients are trying to say, and then act accordingly. Do NOT dismiss seemingly unimportant concerns simply because they don't fit your plan of action. (I've been trying to get my personal MD to determine the cause of some chronic, though fairly minor, back pain for over 4 years. They keep telling me it's a muscle strain and that I should just go get a massage. I believe there's something a bit more significant happening, and am frustrated. I can only speculate how many other patients are out there with similar concerns.)

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Adrienne July 21, 2014 at 8:33 am

Better communication from the attendings and surgeons to the rest of the team so we can keep the patient informed about where they are in the process of their workup/diagnosis/treatment plan when attendings can't speak to patient and family every day.

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linda dunn July 21, 2014 at 7:59 am

My husband was a patient recently and it was difficult just getting admitted. I was pushing him in a wheelchair and the door to the admitting office was very difficult to open while pushing a chair. I was surprise that it's not electronic. It would be nice if the admitting office had their own escort sevice so a patient wouldn't have to wait 30-45 minutes just to go get bloodwork done. The billing system is hard to understand. Patients need to know that they will be getting bills from the University and the Hospital. Also it would be nice if you got one bill with everything listed, instead of many bills with one or two test.

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Deborah Malone July 21, 2014 at 7:25 am

As a patient - I find it difficult to navigate the system - everything operates in individual silo and very few know what the other group can do for a patient

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