The Importance Of Patient And Family Engagement
Healthcare professionals must promote patient and family engagement and work together as a team to improve patients’ safety. For example, January 2001, 18 month old Josie King was badly burned from hot water in a bathtub. Josie was admitted to Pediatric Intensive Care Unit at Johns Hopkins Hospital in Baltimore, Maryland. Josie’s parents, Sorrel and Tony King, believed they were in good hands because Johns Hopkins is one of the best hospitals in the country. After a couple of weeks Josie was transferred out of the Intensive Care Unit. Just days before being discharged, Josie began complaining of thirst. Her parents noticed that Josie’s appearance was drastically changing overnight so they called the nurse to take a look at her. Josie’s vitals were fine so the nurses discounted the parents’ concerns and did not call for the doctor as requested by her parents. Josie died from severe dehydration, a preventable medical error.
The biggest danger is when the communication breaks down and the healthcare team doesn’t know what the other is thinking. Had the nurse shared the parents’ concerns with the healthcare team, Josie would probably be alive today. The parents knew something was wrong with their child because they saw the drastic changes in Josie’s appearance. Their voice was not heard because the family was at the bottom of the hierarchy. Hospitals need to provide care and services that are based on patient- and family-identified needs rather than the assumptions of clinicians or other hospital staff. This example illustrates that families should be a vital part of the patient’s ongoing diagnosis and treatment in order to ensure safe and effective outcomes. Patient and family engagement creates an environment in which clinicians, hospital staff, patients, and families work together as partners to improve the quality and safety of care.
Teamwork and effective communication is of critical importance in achieving safe patient care. Errors in team communication are a leading cause of adverse patient events. Hierarchy within healthcare remains a substantial barrier to the free flow of information. Where team members feel intimidated, they are prevented from speaking up and challenging seniors even in critical situations. Nurses need to be given the power to go around the hierarchy to care for the patient. Nurses and families should be included on the daily rounds when the patient care plan is being determined.
There are many advantages of this approach because it will allow every voice to be heard, and every concern be addressed, before a plan is pursued. Additionally, this process will eliminate information getting lost in the handoff. In this example, Johns Hopkins hired Hospitalists that visited patients 24 hours a day to make sure their medical care was going well. These Hospitalists interacted with the families to make sure their concerns are being met. The King family teamed up with Shady Side Hospital in Pittsburg in an effort to improve patient safety by implementing a safety system call Condition H. This system will give patients and families the power to call a Rapid Response Team.
