Utilization of Family as Faculty: A Patient Directed Simulation Education to Improve Patient and Family Communication during Patient-Family Centered Rounds (PFCR)

Abstract

Introduction: Patient-family-centered care (PFCC) is based on the understanding that the family is the child’s source of strength and support. Effective communication between families and providers is an essential component of PFCC. Our interprofessional team designed an initiative to improve medical providers’ communication in partnership with the Patient and Family Advisory Council (PFAC). Strategies included the creation of a competency rubric and simulation curriculum using the family as faculty. The SMART aim was to improve the percentage of respondents who answered “Always” to doctor communication domains from 72% to 75.6% in Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) by December 2020. Methods: Pediatric residents, medical students, faculty, nurses, and PFAC members formed a Quality Improvement (QI) team to address PFCR competency. The team created a PFCC checklist to address competency. PFAC volunteers served as standardized parents in an in situ simulation of PFCR scenarios involving interprofessional in-patient teams. Evaluators observed rounds for the pre and postintervention assessment using the checklist. The outcome measure was the percentage of respondents who answered “Always” in the HCAPHS domain for physician communication. The process measure was the PFCR pre and postintervention, using Fisher’s exact test for analysis. Results: Using a statistical process chart (SPC), HCAHPS data from 2018 to 2020 showed that we exceeded our aim of >5% increase in the physician communication performance. Pre-post intervention data showed improvement in PFCR competency. Conclusion: Family as faculty simulation led to improved physician communication, translating to improved performance in the HCAHPS score and PFCR competency communication domains.

Educational programmes for paediatric healthcare professionals in patient- and family-centred care. A scoping review

“…The most applied term was family-centred care. Only 10 of the 49 reports applied the term patient- and family-centred care [ 26 , 28 , 30 , 44 , 47 , 49 , 52 , 56 , 60 , 68 ].…”

“…The participants mainly completed them, but in some studies the parents did, while the children only did so in one study, where the questionnaire did not cover the healthcare professional’s communication skills, but children rated their mental illness symptoms [ 67 ]. Fourteen of the studies used various validated questionnaires [ 26 , 33 , 37 , 38 , 45 , 46 , 50 , 51 , 54 , 56 , 60 , 63 , 67 , 68 ]. Only the Measure of Process of Care for Service Providers questionnaire (MPOC-SP), was used in more than one study [ 38 , 50 , 68 ].…”

“…Several studies evaluated the education at more than one level (Table 1 ), but most of them were evaluated on level two (learning) and assessed for whether the programme caused changes in knowledge, skills, attitude, confidence, and commitment (Tables 1 and 2 ). The least frequent level of evaluation was level 4 (results), which we found in 11 of 49 reports, with intended outcomes described on an organisational level, such as feedback from parents about satisfaction with the communication or quality of care, parent- and youth-rated mental illness symptoms, and functioning or medical errors [ 21 , 23 – 26 , 47 , 48 , 51 , 63 , 66 , 67 ]. Table 2 describes which assessment methods we identified within the identified six groups of educational strategies, and which we classified in accordance with Kirkpatrick levels.…”