Patient Family Advisors Supply the Voice of the Consumer
"We want to make Dartmouth-Hitchcock Medical Center the best hospital we can and some great ideas come from patients," says Gabbie Black, a Patient Family Advisor (PFA). That premise is at the core of DHMC’s commitment to patient- and family-centered care, an institution-wide initiative that engages patients and their family supporters in identifying and implementing health care delivery improvements.
Supporting that goal is the job of the Office of Patient and Family Centered Care which provides education and manages a group of volunteers, Patient Family Advisors, who hold positions on decision-making committees across the institution. "The PFA community is incredible in terms of experience and work history," says Licia Berry-Berard, Manager of Patient and Family Centered Care. "They are fully engaged committee members and we rely on them to provide the voice of the consumer. Through them, we understand what is working well for patients and families and where improvement is needed."
Linda Wilkinson, Coordinator of Patient and Family Centered Care and a former PFA, recruits and helps assign PFAs to committees that require their insights and skills. "PFAs are registered DHMC volunteers," says Wilkinson. "They are often inspired by their own experiences as patients or family supporter but they also consider the experiences of others. They listen well and are committed to protecting privacy. They voice their opinion. And they allow DHMC to leverage their management, financial, IT, communications or other professional skills."
Since the patient- and family-centered care initiative began, 130 PFAs have engaged in committee assignments and other activities. It’s clear that DHMC and its patients are benefitting from their talents. How do the PFAs benefit? Why would someone dedicate many hours per week to DHMC when they are already working, have family responsibilities, or finally enjoying retirement? Three current PFAs shared the inspiration behind their participation and the work they are doing.
Karen Blum
Karen Blum is a relatively new PFA but no stranger to volunteering inside hospitals. She first volunteered at a hospice and then Beth Israel Deaconess Hospital in Boston. When she and her husband (a former VP at DHMC) moved back to Hanover, it was her natural inclination to volunteer at DHMC.
Blum sits on the Nursing Practice Council where she is rapidly increasing her appreciation of the role of nurses. "There’s a lot that goes on beyond the bedside," says Blum. She also volunteers time in the ED where she gathers linens, holds hands, and does anything else she can to help. She’s also helping to create training modules for how to share bad news with patients. "I want physicians to know that what might not seem like bad news to them could be very bad news to someone else," she says.
As a PFA, Blum is able to be "highly active but cerebral" in her volunteer efforts. "PFAs aren’t encumbered by being insiders," says Blum. "We’re consumers, patients. We’re willing to stand up for our point of view and ask questions like ‘Why do I have to give my date of birth to everybody?"
When Blum tells others she’s a PFA she gets a lot of unsolicited, but welcome, "free will testimony." "People have stories they want share," says Blum. "I write them down. If the information is verifiable and when there’s a chance, I pass them along. DHMC is learning to embrace patient- and family-centered care and those stories are being heard."
Michael Oeschger
"When my wife was dying we were referred to a local agency for hospice care," says Michael Oeschger, PFA. "The experience didn’t go well. After my wife died, I wanted to be sure that no one else ever had that experience."
Oeschger wrote to Ira Byock, MD, Director of Palliative Medicine, about his concerns. Byock told him about Patient Family Advisors and asked him to join the Palliative Care Committee. "I was ecstatic to be asked," says Oeschger.
That was in 2008. Now Oeschger has added to his PFA duties a seat on the Internal Medicine Committee. While work there is just beginning, he’ll be helping to create a patient-focused "home environment" in which patients develop a relationship with a primary physician and health care team.
Having noted how PFA input was valued by the Palliative Care Committee, Oeschger has already passed along an important observation to Internal Medicine. "When there’s a snowstorm, many patients aren’t able to make it in for their appointments," says Oeschger. "As my wife and I experienced, the lines after a snowstorm can be longer than usual. Departments need to anticipate and manage a larger than normal patient load."
With a degree in accounting and many years of experience as an IT consultant to large organizations, Oeschger is ready and willing to use even more of his talents as a PFA. "Patient- and family-centered care has been a long time coming," says Oeschger. "I’ve been inspired by my wife’s death and I really believe in DHMC. I’ll do whatever I can to help."
Gabbie Black
The mother of a child with a chronic illness, Gabbie Black is very familiar with the Children’s Hospital at Dartmouth (CHaD). In 2004, she joined a task force charged with developing a Family Council through the CHaD’s Boyle Program, an initiative that introduced patient- and family-centered care to DHMC. She has continued to volunteer her services as a member of the CHaD Family Advisory Board.
"The board is dynamic and productive," says Black. "Members are parents who have used emergency services, helped their child through a single surgery or health event, or, like me, have brought a child to ChaD for years."
Black helps Meg Seely, fellow PFA and Chair of the CHaD Family Advisory Board, run Children’s Voices, an effort to continually gather feedback from pediatric patients. "Once a week we go to the pediatric floor and talk to kids who have so many good ideas," says Black. "Teenagers told us that they were hungry all the time, as teenagers often are. Younger kids wanted snacks. We worked with staff in Food and Nutrition Services to change the meal delivery schedule. They also added a snack cart that visits the ward twice a day so kids can get a healthy snack."
That’s the kind of change that makes a hospital stay much easier for patients and their parents. It’s also the kind of thing that keeps Black so energetically involved as a PFA. "Everyone at DHMC is supportive of patient- and family-centered care," says Black. "I love the people I’m working with and it’s satisfying and rewarding to point out issues and get a response."
For more information on patient- and family-centered care or becoming a Patient Family Advisor, please contact Licia Berry-Berard at 650-7248 or Linda C. Wilkinson at 650-6362.
