Patient & Family Advisory Council

Minutes of Meeting

Thursday August 28th, 10am - 2pm

ATTENDANCE – P = Present; R = Regrets

P / Penny Ericson (Pt. Advisor / Co –chair) / P / Margaret Melanson (Co-Chair) / P / Kevin Standing (Pt. Advisor)
R / Russell Whitney (Pt. Advisor) / R / Marie Innes (Pt. Advisor) / R / Karen Storey (Pt. Advisor)
P / Jane Claxton-Oldfield (Pt. Advisor) / P / John McGarry / P / Annette LeBouthillier
P / Janet Hogan / P / Elizabeth Cormier / P / Lauza Saulnier
P / Jeff Carter / P / Dr. Tom Barry / P / Paula Pickard
P / Tina Ramsay (recording)
Item # / Topic / Points of Discussion
1.1 / Welcome / Margaret Melanson and Penny Ericson welcomed all members of the Patient & Family Advisory Council.
1.2 / Approval of the agenda.
Approval of Minutes, June 5, 2014 / The Agenda and Minutes were approved as distributed.
1.3 / International PFCC Conference / Margaret and Penny attended the International PFCC Conference in Vancouver, BC from August 6-8th. This Conference was the 6th International Conference on Patient and Family Centred Care Partnerships for Quality and Safety.
Penny reported back to the group there are many ways Patient and Family Advisory Councils participate, and there is a growing track record of data that proves this works. They are a vital link to communication with the community, they focus on issues and concerns of the patient and families, which helps improve community care and they are a link for members of the community to express concerns. They help with support at a political level. They work with pilot groups to initiate change on units. They provide leadership to the CEO and unit managers to benefit institutions. Budgets need to be set up to have a support person to help make Patient and Family Advisories run smoothly from an administrative standpoint.
After attending this conference Penny had some suggestions for our Council
·  Meet with the nurse educators in Moncton, Fredericton and Saint John to explain what our focus is and help them work with us.
·  Meet with NBNU as they can help implement positive change with us.
·  Meet with physicians, include them in dialogue of our focus as we need their help and support.
·  Meet with the Health Minister and keep him apprised of changes.
Penny was thankful for the opportunity to participate in this conference.
2.0 / Guests/Presentations
2.1 / Proactive Patient Rounding / Paula Pickard attended the Patient and Family Advisory Council meeting and presented a power point to the group. Proactive patient rounding is a means to improve patient satisfaction, improve patient outcomes, prevent adverse events, and improve nurse job satisfaction. It is an evidence based structured approach used by more than 400 international healthcare systems since 2007.
Proactive patient rounding utilizes the basic nursing standard of hourly patient rounding and makes this more intentional improving patient satisfaction, reducing falls, reducing pressure ulcers and reducing the number of call bells.
Needs to be addressed in Proactive Patient Rounding follow the 4 “P’s”
Pain
·  Do you have any pain or discomfort?
·  What is your pain/discomfort on the pain scale?
Positioning
·  Are you comfortable?
·  Do you need repositioning?
·  Reposition nonverbal patients at high risk for breakdown, if required
Personal Toileting
·  Do you need to use the bathroom/bedpan/urinal?
·  Perform incontinent care, if needed
Possessions
·  Do you need any items moved closer? I.e.: call light, phone, water, bedside table, glasses, hearing aid, etc.
A bilingual welcome letter will be provided to all patients upon admission to the unit.
This initiative was introduced in the Miramichi Hospital on all nursing units except psychiatry and addictions. This is to be initiated on all inpatient units at all acute care facilities by February 2015. Implementation will begin at smaller sites.
Accountability will be to the Executive Directors, Administrative Directors and unit Managers who have been part of this initiative. A core team will be established for staff education and support. Accountability framework includes roles and responsibilities being clarified and reporting structure established. Ongoing measurement of implementation will be gathered by manager feedback and staff reviews. Outcome measurement will be six months post initiation at facility.
The group suggested the need to gather real time feedback from patients. Paula to take this suggestion back to the team to come up with a plan of action.
2.2 / Smoking cessation on Facility Property – Smoke Free Horizon / Kerrie Luck presented the group a power point on the Smoke Free Horizon Initiative. The mission of this initiative is to advocate and support leadership strategies that promote tobacco free health care environments. The vision is to have a 100% tobacco free indoors/outdoors on all healthcare campuses in New Brunswick. Kerrie shared with the group the known dangers of smoking and the reasoning behind promoting healthy choices and providing a healthier environment reflecting a hospitals health mission/vision. Many Ontario hospitals have already shown leadership and many Ontario municipalities have by-laws prohibiting smoking on hospital grounds. With a comprehensive tobacco policy, cessation supports for staff, cessation support for inpatients who want to quit, nicotine withdrawal management for inpatients and staff who are not ready/don’t want to quit and a hospital property smoking/tobacco ban it is believed Horizon Facilities could become smoke free.
To date: A small steering committee has been created. The project plan is being finalized with a phased approach and will be submitted to the Horizon Board of Directors for approval. Public and staff engagement sessions will be held with a public service announcement being released in September. Staff and members of the public will be invited to call and register to attend an evening forum which will be held in Saint John to discuss the issues and challenges to implementing a smoke free campus at the Saint John Regional Hospital.
Kerrie shared and played a link to the group about smoking:
https://www.youtube.com/watch?v=2m7-zIa6-Es
Kerrie finished off her presentation by advising the group there will be a Tobacco Free Webinar on September 9th at Noon, Atlantic Time. Kerrie invited the Council members to take part, or to listen in follow-up.
2.3 / Horizon Dress Code Policy / Andrea Seymour presented on the Horizon Dress Code Policy.
A draft policy and a briefing note had been presented to the Executive Leadership Team. It had been discussed by the ELT whether there should be casual days or not and if it should be in the policy or not.
Casual days are varying practices in each facility across Horizon Health Network varying from automatic payroll deduction going directly to the Foundation, to proceeds going to charities and staff funds. Casual dress varies as well.
ELT felt casual days could be permissible on Fridays, but money would be for the Foundation, Auxiliary or Community fund and made directly through payroll deduction. In order to accomplish this, there needs to be specifics in the policy.
Andrea requested feedback from the Patient Experience Advisors and the Advisory Council on what they deem appropriate. After discussion, the group agrees there should not be casual days as we are a professional organization and casual days do not reflect a professional atmosphere.
2.4 / H.E.L.P. Initiative / Elizabeth Cormier spoke about the H.E.L.P. Initiative which is in the developmental stage. “H” Hello/Bonjour, “E” Explanations, “L” Listening, “P” Professionalism has been developed into a training program for staff. A group from across Horizon was brought together for a test run and feedback was gathered. Videoconferencing worked very well. A patient and Family Centred Care Participant workbook, pre evaluation survey and after evaluation survey are all in developmental stages.
3.0 / New Business
3.1 / Patient and Centred Care Priorities and Initiatives Planning / Ashley Brioux attended this council in April 2014 to begin brainstorming work. At that time it was to come up with a definition for PFCC.
Ashley will now assist the group in answering 2 questions.
1.  What will success look like for this Council?
2.  Planning, initiative, actions, priorities as to what members feel Horizon should be working on in the next 2 years.
Ashley and the Council began brainstorming by contributing to a list of the following items the Council would like to see improvements to:
Food, cleanliness, patient “retelling” of story, reduction of OR wait times, reduction of wait times for inpatient beds, family presence policy, parking (in saint john it does not take visa or debit card), patient access to test results, improvement to process of removing inaccurate information from medical records, wi-fi access at hospitals, TV’s in hospitals should be used therapeutically or educationally, relaxing music being utilized, bedside nursing reports at shift change, complimentary therapies.
Ashley will attend the next Council meeting to continue the process.
3.2 / Communications Update / Janet Hogan reported to the group, a public service announcement introducing the Patient & Family Advisory Council and its members was released. The Horizon Health Network website has posted biographies of the Patient Experience Advisors as well as the Agendas and Minutes of meetings. Recruitment of more Advisors to begin soon.
Over the last year time was spent reviewing Diagnostic Imaging, Therapeutics and Lab Services and how many patients are not attending pre booked appointments. A large number of appointments are not cancelled, patients just do not show up. This affects Horizons ability to provide timely and quality care to its patients. This has resulted in the Missed Appointment awareness initiative to encourage patients to attend their scheduled medical appointments or to call to cancel and rebook if they are unable to attend. This initiative will initially target the Fredericton area where data shows there are a number of programs with a high rate of no shows specifically in therapeutic services.
Horizon will use staff memos/meetings and skyline to communicate internally and will use posters, reminder stickers, a media champagne the website and social media to create public awareness. The campaign started in Fredericton week of August 18th, all clinics throughout the Fredericton area have a poster and they will post the number of missed appointments on them.
Automatic reminder calls are being piloted in Moncton this fall.
Automatic discharge feedback will be piloted in the future.
3.3 / Patient Advisors Engagement Tools / Elizabeth Cormier reported to the group they are working on a staff engagement toolkit for Patient & Family Centred Care so staff are aware on how to utilize Patient Experience Advisors. A Horizon toolkit will be developed to use for the working groups who will be working with the Patient Advisors.
When the Patient Advisors finish working on a team project, there needs to be a way to measure the effectiveness and if we are doing a good job. A Patient Experience Advisor Evaluation is being developed.
ACTION: Next meeting final draft of Toolkit and Evaluation to be distributed to the group
3.4 / Leslee Thompson / Mr. John McGarry shared with the group there will be a fall presentation by Leslee Thompson, CEO of Kingston General Hospital. Leslee is a preeminent voice on patient care in our country. She will be visiting to speak to several groups in NB on Tuesday October 28th. She will be speaking to all NB nurse managers and our Board of Directors on Wednesday October 29th. In attendance will be Horizon Sr. Management, Department of Health representatives, Vitalite representatives, Regional Medical Advisory Council and Mr. McGarry would like to extend the invite the Patient Advisory Council, Patient Experience Advisors, to attend as well.
ACTION: To advise members of details as they are received.
4.0 / Business Arising
4.1 / Hand Hygiene / The Hand Hygiene poster is being worked on with the communication team. Fiscal data has been prepared with an overview of Hand Hygiene within Horizon Health Network. There had been improvement in hand hygiene compliance, now up to 72%, with a target of 80%.
There have been 143 Hand Hygiene Champions trained across Horizon to provide daily reinforcement and complete audits on the unit level.
5.0 / Open Discussion
Patient Experience Advisor Handbook and Brochure / Elizabeth Cormier provided each member with a copy of the Patient Experience Handbook and brochure.
6.0 / Adjournment/Date of Next Meeting / Margaret Melanson and Penny Ericson will confer about next meeting date and members will be advised.