Co-Designing Exceptional Health Care Experiences Using the Patient and Family Centered Care Methodology and Practice (PFCC M/P)
We want to create a paradigm shift in the way healthcare is provided. The PFCC M/P uses Design Science and Experience-based Design (EBD) to focus on real-time observation of health care experiences through the eyes of patients and families. This focus allows us to discover, implement, sustain, and spread transformational changes in care delivery. Co-designing health care experiences with patients, families, and care givers provides exactly what patients and families want, while improving patient safety and clinical outcomes and decreasing waste and cost. The PFCC M/P, already proven successful locally, has the potential to transform healthcare delivery nationally and globally.
About You
About You
First Name
Tony
Last Name
DiGioia
http://twitter.com/#!/PFCC_
Facebook Profile
http://www.facebook.com/#!/pages/Patient-and-Family-Centered-Care/176450858618
About Your Organization
Organization Name
PFCC Partners @ The Innovation Center of UPMC
Organization Website
pfcc.org
Organization Phone
412-641-8683
Organization Address
3380 Blvd. of the Allies, Suite 270 Pittsburgh PA 15213
Organization Country
United States, PA, Allegheny County
Country where this project is creating social impact
United States
Is your organization a
Non‐profit/NGO/citizen sector organization
How long has your organization been operating?
1‐5 years
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Innovation
Entry Form title
Co-Designing Exceptional Health Care Experiences Using the Patient and Family Centered Care Methodology and Practice (PFCC M/P)
What change do you want to bring to the world?
We want to create a paradigm shift in the way healthcare is provided. The PFCC M/P uses Design Science and Experience-based Design (EBD) to focus on real-time observation of health care experiences through the eyes of patients and families. This focus allows us to discover, implement, sustain, and spread transformational changes in care delivery. Co-designing health care experiences with patients, families, and care givers provides exactly what patients and families want, while improving patient safety and clinical outcomes and decreasing waste and cost. The PFCC M/P, already proven successful locally, has the potential to transform healthcare delivery nationally and globally.
What are the primary activities of your project?
Our project involves implementing a simple 6-step methodology (the Patient and Family Centered Care Methodology and Practice or PFCC M/P) that identifies key patient and family encounters throughout their health care experience by repeated, direct observation (Shadowing) and Care Experience Flow Mapping. The true patient and family experience is deeply understood through this methodology, creating an urgency among care givers to improve the patient and family experience. Improvement projects are then co-designed by patients, families, and caregivers to close the gap between the current and ideal experience. Profoundly understanding patient and family experiences creates a sensory and emotional connection that brings the patient and family experience to life. Our experience has shown this methodology to improve not only patient satisfaction but patient safety, clinical outcomes, waste and cost. The PFCC M/P can be used in any care setting at any current state with very little lead time and no incremental costs. We are building a broad PFCC Community Practice to help accelerate widespread adoption of the methodology and best practices.
What is innovative about your initiative? How is it a new contribution to the field?
The only performance improvement tool developed specifically for health care, the PFCC M/P uses Design Science and Experience-based design (EBD) as the third science for health care improvement, building on traditional clinical and process improvement methods. The PFCC M/P is a framework that allows caregivers to transform care delivery from any current state to the ideal state through co-design with patients and families. The grass roots nature of the PFCC M/P has the potential for “viral” spread. Through PFCC M/P, the functional and bureaucratic silos that serve as barriers to improving care delivery are eliminated, allowing widespread adoption of improvements.
The six steps of PFCC involve:
1. Selecting a care experience for improvement;
2. Establishing a Guiding Council;
3. Evaluating the current state;
4. Developing a Working Group;
5. Creating a shared vision of the ideal patient and family care experience;
6. Identifying PFCC Projects and Project Improvement Teams to close the gap between the current and ideal states.
Guiding Councils help remove barriers, Working Groups are permanent which supports raising the bar over time for what is ideal, and Project Teams have beginnings and endings as ideals are reached, as Shadowing is repeated and new ideals are identified.
What stage is your project in?
Operating for 1‐5 years
Tell us about the community that you engage? eg. economic conditions, political structures, norms and values, demographic trends, history, and experience with engagement efforts.
The PFCC M/P engages all constituencies involved in health care delivery – patients, families, caregivers, hospital leaders, thought leaders, and academia.
1) Co-design and elimination of silos within organizations engages patients, families and caregivers (defined as anyone who touches a patient or family’s care experience – doctors, nurses, therapists, technicians, parking and admissions staff, schedulers, janitors, financial representatives…) as well as hospital leaders, all working together toward creating ideal care experiences.
2) Embracing Design Science and EBD as the third method of care delivery improvement to develop, sustain, and accelerate the spread of the PFCC M/P also engages those concerned with health care reform (e.g., politicians, economists, thought leaders).
3) Adopting The PFCC M/P as the implementation tool specifically for health care improvement can fulfill the Triple Aim (improving the health of the population, enhancing the patient experience, and reducing cost of care) recently adopted by the Centers for Medicare and Medicaid Services (CMS), engaging health reform leaders.
4) Embedding the PFCC M/P into health care academia (physicians, nurses, therapists…) engages those who come into the health care system when resources are scarce and the need for methods that will transform care delivery with short lead-times and no incremental cost is great.
Share the story of the founder and what inspired the founder to start this project
Trained as an engineer, orthopaedic surgeon, and social entrepreneur, Anthony M. DiGioia, III, MD is Medical Director of the Innovation Center at the University of Pittsburgh Medical Center (UPMC), one of the first applied research centers that focuses on merging the art and science of performance in health care. Dr. DiGioia has long studied process improvement approaches such as Lean and Six Sigma. However, when he set out to exceed the needs and desires of patients in his own practice, he created the Patient and Family Centered Care Methodology and Practice to be specific to health care rather than using strategies developed for industry that needed to be translated to health care. As the PFCC M/P showed excellent results in patient satisfaction, safety, clinical outcomes and cost in the Hip and Knee Arthritis Program, he has led an effort to export the PFCC M/P to nearly three dozen clinical and non-clinical settings throughout UPMC, with equally promising results. PFCC M/P is not just a process-improvement tool; it is a performance improvement tool focused on care experiences. PFCC M/P is not standard patient care, but standardized care delivered with the patient and family at the center.
Social Impact
This Entry is about (Issues)
Please describe how your project has been successful and how that success is measured
Created in 2006, the PFCC M/P showed positive results in the Hip and Knee Arthritis Program including patient satisfaction in the 99th percentile nationally, and mortality rates, hospital length of stay, infection rates, and discharge directly home all significantly better than the national average. These positive results have been sustained for over five years. The program ranks 42nd in the U.S News & World Report‘s Top 100 Hospitals.
Over the past five years, the PFCC M/P has been exported to nearly three dozen clinical and non-clinical areas throughout UPMC including trauma, rheumatology, oncology, home care, and human resources, with equally promising results. For example, in Trauma Services patient satisfaction has increased by 14%, staff turnover has decreased by 66%, the time patients spend in cervical spine collars has decreased by 50%, and lost patient belongings has been eliminated. Each of these improvements significantly reduces the cost of care and has been accomplished without additional resources by refocusing current resources. Two UPMC hospitals are set to become “PFCC Hospitals” in the near future, and the PFCC M/P has been recognized nationally by the Institute for Healthcare Improvement (IHI), the Picker Institute, the Joint Commission, and policy and academic leaders.
How many people have been impacted by your project?
More than 10,000
How many people could be impacted by your project in the next three years?
More than 10,000
Winning entries present a strong plan for how they will achieve growth. Identify your six-month milestone for growing your impact
Education and training will be expanded to all levels of the health care system – front line staff, clinical leaders, academia, and policy makers.
Task 1
Development of a PFCC Community of Practice
Task 2
Development of an educational program for students in the schools of pharmacy, medicine, nursing and social work.
Task 3
Accelerated outreach to caregivers, patients, families, policy makers, national, and international organizations – word of mouth has the potential to go “viral.”
Identify your 12-month impact milestone
Community of Practice and project data-base
PFCC courses for academia
Collaboration with 3 additional health care universities
Participation in 3 additional national forums
Task 1
Identify members of PFCC Community of Practice, develop communication media for PFCC Community of Practice, and create PFCC Community of Practice project data-base.
Task 2
Develop educational curriculum for health care academia, develop PFCC M/P internship program, enroll three PFCC M/P interns.
Task 3
Identify and reach out to key policy holders and national organizations; participate in 5-8 activities at a national level to promote the PFCC M/P.
How will your project evolve over the next three years?
With several years of successful experience spreading the PFCC M/P locally, it is time to accelerate the spread regionally, nationally, and globally. PFCC M/P can play a major role in supporting new health care delivery platforms and the Triple Aim because it has been shown to improve quality and safety while decreasing waste and cost. Accelerating its spread will require 1) expanding our education and training, 2) building a PFCC Community of Practice and project data base, and 3) continuing to increase exposure at national forums and through publications.
Sustainability
What barriers might hinder the success of your project and how do you plan to overcome them?
Unlike other process or performance improvement methods, the PFCC M/P is self-sustaining because of the stepped (and looped) process as well as the grass-roots nature of the methodology that creates energy, excitement, commitment, and spread. The PFCC M/P is also self-supporting in that there are no associated incremental costs. The Working Groups and project teams meet for only 1 hour/weekly and all care delivery improvements can be achieved by refocusing existing resources.
It is important that hospital administrators and physician leaders support the cultural transformation that results from the spread of PFCC M/P. Without top-down commitment, the significant progress made from grass roots efforts will begin to flatten out. Two UPMC hospitals are set to become PFCC Hospitals with the support of administrators and physician leaders; these efforts will be key to demonstrating that PFCC M/P is easy to implement on a broader organizational scale and will have positive clinical, operational, and financial outcomes.
Creating the PFCC M/P Community of Practice and project data base, expanding our education and training activities, and continuing our outreach to policy makers and health care professionals will allow us to effectively bridge the quality gap on a large (national and global) scale.
Tell us about your partnerships
While our most important partnerships are between patients, families, and caregivers, we have also created strong partnerships with the IHI, the Picker Institute, professional societies, and several universities providing training for health care professionals. These partnerships are the foundation of a PFCC Community of Practice and are critical to our effort to spread and accelerate the adoption of Design Science and EBD as the new third pillar of performance improvement and the PFCC M/P as the implementation tool that will bring about transformations in care delivery.
Our non-profit partners provide a variety of opportunities for us to spread the word about the PFCC M/P – we host webinars, teach courses, lead workshops, and give formal presentations. For example, we are presenting at IHI’s 22nd Annual National Forum on Quality Improvement in Healthcare in December, 2011 – with an anticipated attendance of over 5,000 people – an excellent forum for disseminating information about PFCC M/P.
We also consider scholarly and professional journals as partners in bringing the PFCC M/P to thousands of readers, demonstrating not only the approach but the significant positive outcomes for patients, families, and caregivers.
Current annual budget of project, in US dollars
$500,001‐1 million
Explain your selections
Our primary funding comes from the University of Pittsburgh Medical Center (UPMC), which supports the development of new models of patient-centered care and the PFCC M/P. Other organizations (IHI, Picker Institute, etc.) have assisted and supported our effort to spread and accelerate the adoption of the PFCC M/P, as well.
How do you plan to strengthen your project in the next three years?
Creating a PFCC Community of Practice and maintaining visibility through national organizations and forums is vital to spreading the word about PFCC M/P and supporting its acceleration. It is important that we continue to reach hospital administrators, physicians, academicians, and policy makers to demonstrate the simplicity of PFCC M/P and its clinical and financial outcomes.
Development of a robust on-line database is also important for growing the PFCC M/P initiative so that: 1) Successes can be qualified and quantified, 2) Working Groups and project teams can access best practices, and 3) Duplication of efforts can be avoided.
Educating new PFCC Working Groups and health care students will assure that the PFCC M/P approach of understanding care experiences through the eyes of patients and families, through Shadowing and Care Experience Flow Mapping, will continue to spread. Through this approach, the sense of urgency among caregivers is created and sustained. The cyclical nature of PFCC M/P creates ever higher levels of performance and expectations as ideals are reached and new ones are identified, resulting in cultural transformation.
Continued publication in news media and peer-reviewed scholarly journals will help us reach a broad, national and international audience so that best practices can be replicated.
Challenges
Which barriers to health and well-being does your innovation address?
Please select up to three in order of relevancy to your project.
PRIMARY
Other (Specify Below)
SECONDARY
Other (Specify Below)
TERTIARY
Other (Specify Below)
Please describe how your innovation specifically tackles the barriers listed above.
1. Addressing the significant need to improve care delivery quality outcomes, including patient satisfaction, patient safety, clinical indicators, waste and cost.
2. Training health care professionals to deliver exceptional care experiences and to transform the culture of health care delivery – how it is delivered and how it is received.
3. Addressing CMS’s Triple Aim - improving the health of the population, enhancing the patient experience, and reducing cost of care
Co-design gives patients exactly what they want/need – no more/less, making best use of scarce resources.
Education is critical in teaching health professionals about PFCC M/P and Design Science/EBD.
Cultural transformation occurs as PFCC M/P spreads through bottom-up/top-down efforts.
How are you growing the impact of your organization or initiative?
Please select up to three potential pathways in order of relevancy to you.
PRIMARY
Grown geographic reach: Multi-country
SECONDARY
Influenced other organizations and institutions through the spread of best practices
TERTIARY
Repurposed your model for other sectors/development needs
Please describe which of your growth activities are current or planned for the immediate future.
Primary - Grow Geographic Reach: Multi-Country The PFCC M/P is scalable to any health system of any size in any country with any payment system (e.g., U.S., U.K., Africa, India, Canada, etc.). With the focus on making things better for the end user through co-design, there are no site- or system-specific limits to its efficacy.
Secondary - Influence Other Organizations through the Spread of Best Practices PFCC M/P allows us to change the current state of care delivery no matter what the current state is through broad participation and the spread of best practices.
Tertiary - Repurpose Model for Other Sector Needs: Sets the stage for CMS’s Triple Aim
All of our actives are current and planned.
Do you collaborate with any of the following: (Check all that apply)
NGOs/Nonprofits, Academia/universities.
If yes, how have these collaborations helped your innovation to succeed?
Our most important partnerships are between patients, families, and care givers. These partnerships are new to health care. Through collaboration with doctors’ offices, hospitals, outpatient centers, etc. we are able to spread the PFCC M/P and its transformative power to achieve excellent care outcomes while decreasing waste and cost. Our collaboration with non-profit groups (e.g., IHI, the Picker Institute, professional societies, health care professionals, etc.) and academia are critical to our effort to accelerate the adoption of the PFCC M/P by exposing greater numbers of people, including new health care professionals and health care thought leaders, to the methodology.
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| 87 weeks ago Michelle Giarrusso updated this Competition Entry. |
| 87 weeks ago Michelle Giarrusso updated this Competition Entry. |
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