Faced with the opportunity to promote culture change associated with Patient and Family Centered Care (PFCC), the medical center leadership opted to utilize the concepts of the Institute for Healthcare Improvement (IHI) Collaborative Model on an organizational level. It has been a tremendous success.
Fourteen teams (150 staff and managers) from every department/level of the organization were recruited to participate. PFCC involves every employee in the hospital – not just direct caregivers. This is an enormous culture change effort and the involvement of every department in this way has been a unique and effective approach to engage everyone who comes in contact with patients and their families. The teams participated in 3 learning sessions at 6 month intervals. The initial session focused on training of the concepts of PFCC, change management and the teams choosing a project for their area that supports the core concepts of PFCC. The second learning session concentrated on more advanced change management and having the teams share their “tests of change” – lessons learned and progress to date. The issues of safety and privacy emerged as issues staff needed more training on and that was addressed. The energy and momentum around PFCC has grown with each learning session. The third learning session is scheduled for later this month. The focus will be sustaining the gains and spreading best practice from each team to the entire organization. There will also be a focus on recognition and celebrating our success.
Four of the projects have an ICU focus and have resulted in impressive culture change in a traditional county, level 1, academic medical center. These projects are as follows:
Access to the ICU: Families/visitors are no longer required to call in to ask permission to enter the unit.
Inclusion in Change of Shift Report: Families are no longer asked to leave during change of shift report between nurses – in fact they are invited to stay.
Improving Communication: The Trauma/Surgery ICU group worked with the trauma surgeons to ensure optimal communication between the medical staff and patients/families. Each day the nurses ask patients/family if they have all the information they need. If they need more information, the nurse shares that need during their presentation at physician team rounds. Families are also welcome to participate/listen to rounds.
Get to Know Me and My Family: The ICUs have now utilize a “Get to Know Me and My Family” poster at the bedside of each patient.
Comfort Packs for Overnight Visitors: Our ICU liaisons have created comfort packs including toiletries, blankets and pillows for families who spend the night.
The Harborview Medical Center Family-Centered Care team includes Becky Pierce, Tracey Gooding, Sherry Steinaway, Theresa Braungart, Abby Tesfamariam, Cyndi Cutler, Carolyn Blayney, Laura nelson, Joe Cuschieri, Jon Reynolds, Corey Baxter, Nate Rozeboom and Neil Francouer.
Harborview Medical Center's staff is congratulated and commended for their efforts in providing quality care and support to critically ill patients and their families.
Honorable Mention
UC DAVIS CHILDREN'S HOSPITAL PEDIATRIC INTENSIVE CARE UNIT
Sacramento, CA 
Family-Link is a unique program which enables families and friends to see and talk from home, with loved ones who are in the hospital. This connectivity is made by using video phones and standard telephone lines.
Family-Link has made a real difference for families that live far away from the medical center and have children hospitalized for an extended period of time. Family-Link can reduce a great deal of the stress and loneliness that is normally inherent in long hospital stays.
Examples of the Family-Link program making a difference in the lives of the patients and their familes abound. From helping a 15-year-old girl reconnect with her friends at Thanksgiving after losing her leg, to allowing an 11-year-old girl hospitalized with leukemia to see her grandmother and siblings, to setting up a video-conference from 1,375 miles away in order to enable a spinal cord injury patient to virtually attend a fundraiser in his small home town which helped raise money and suppport for the patient and his family, the connectivity enabled by this program has allowed many patients to connect with their friends, families, and even entire communities from across town or across the country.
While this program utilizes low-level technology and is not considered a billable event, the attending physicians and nursing staff feel the family connection has a positive outcome in the patient's healing process. The UCDHS has received media coverage as a result of this project, as well as attention and high acclaim from Governor Schwarzenegger and his chief of staff.
The UC Davis Family-Link team members (shown above from left to right) are George Wu, Dr. Kourosh Parsapour, Janice Carpernter, Dr. Javeed Siddiqui, and Kathy Chorba.
The UC Davis staff is congratulated and commended for their efforts in providing quality care and support to critically ill patients and their families.
2007 Family-Centered Care Award Summaries
At the 36th Annual Critical Care Congress, SCCM's Patient & Family Support Committee awarded the fourth annual Family-Centered Care Award to Beth Israel Medical Center, Milton and Bernice Stern Department of Pediatrics, in New York, New York. Honorable mention was given to both Harborview Medical Center, Intensive Care Unit Liaison Program, in Seattle, Washington, and Maine Medical Center, Pediatric Intensive Care Unit, Portland, Maine.
Award Recipient
BETH ISRAEL MEDICAL CENTER
NEW YORK, NY
Most patients seeking care at Beth Israel Medical Center are uninsured, are from the inner city, and depend on public transportation. Two years ago, most young critical care patients in this New York community needed to be transferred to other hospitals miles away, putting greater stress on families emotionally and financially. In August 2004, a multiprofessional team of pediatric critical care professionals saw a chance to improve the quality and level of care for these young patients and their families. They renovated a closed section of the hospital and created a state-of-the-art pediatric intensive care unit (PICU) aimed at creating a better experience for those needing such care. Among several initiatives to improve communication with patients and families was a simple plan to hang dry-erase boards on the door of each PICU room. The boards invited patient and families to list three things that would make the patient's stay better and helped sparked an open conversation.
“We have found that this simple, inexpensive technique provides us with a wealth of information and allows the patients and their parents to be involved with the design of the hospital stay. It also allows us to identify issues early and to address them,” said Edward Conway, MD, FCCM, chairman of pediatrics at Beth Israel Medical Center. It was this effort, coupled with the incorporation of several medical, spiritual and psychological approaches to care and a successful evaluation program, that helped the program stand out to receive last year's Family-Centered Care Award.
Beth Israel Medical Center's staff is congratulated and commended for their efforts in providing quality care and support to critically ill patients and their families.
2006 Family-Centered Care Award Summaries
At the 35th Annual Critical Care Congress, SCCM's Patient & Family Support Committee awarded the third annual Family-Centered Care Award to St. John Medical Center in Tulsa, Oklahoma. Honorable mention was also given to Oakwood Healthcare System (OHS): Oakwood Hospital & Medical Center in Dearborn, Michigan.
Award Recipient
ST. JOHN'S HOSPITAL
TULSA, OK
The 3rd annual Family-Centered Care Award has been presented to Dr. Gerald Plost, Medical Director, and the management team at St. John Medical Center of Tulsa, Oklahoma, for their creation and use of Family Care Specialists (FCS) and The Palliative Care Consult Service (PCCS) in their ICU setting. Since 2001, the FCS nurses have been employed to:
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Foster family comfort by creating a welcome and caring environment.
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Familiarize the ICU staff with family and the family with the ICU.
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Ensure family and patient safety and well being.
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Enhance family involvement in patient care.
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Familiarize family with support services, including pastoral care and social services.
As the FCS role has evolved from being need-based for the ICU team to being nurture-based for the family, their role has expanded to include: developing and implementing educational programs for staff as well as family members, providing leadership and direction to ICU staff in development of family care skills, advocating changes in the ICU that meet patient and family goals and needs, and providing counseling for families regarding end-of-life issues. Developed by the FCS, the PCCS is a rapid-response consulting service providing patients with access to a multidisciplinary team of palliative care specialists. The PCCS focuses on the relief of physical, psychosocial, and spiritual suffering, while attempting to maintain the best possible quality of life for a variety of end-stage diagnoses.
Team members: Gerald Plost, MD (Medical Director); Tim Hepner, MD (SICU); Kari McCracken, PharmD; Mike Zahner, RN (Director of Cardiac Services); Kimberly Vessells, RN (Manager of ICCU/MICU); Cathy Cunningham, RN (Director of Acute Inpatient Surgical Services); Connie Theys, RN (Manager of SICU); Melissa Dimick, RN (Clinical Instructor); Katie Rolston, RN (Clinical Instructor); Terri Weber, RN (Family Care Specialist); Becky Courtney, RN (Family Care Specialist); Teressa LeMaster, RN (Patient Care Coordinator); Delores Nelson, RN (ICU Data Analyst); Nancy King, RN (ICU Data Analyst); and Corkey Celcer (Critical Care Analyst).
Contact: Gerald Plost, MD, Medical Director (gplost@sjmc.org)
St. John Medical Center's staff is congratulated and commended for their efforts in providing quality care and support to critically ill patients and their families.
Honorable Mention
OAKWOOD HEALTHCARE SYSTEM (OHS): OAKWOOD HOSPITAL & MEDICAL CENTER
DEARBORN, MI 
Paul Haydon, MD and the team at Oakwood Healthcare System (OHS): Oakwood Hospital & Medical Center in Dearborn, Michigan received honorable mention for their Family Matters Support System (FMSS) that works in collaboration with Critical Care Services to “support patients and those who love them.” Since 1998, FMSS has provided consults to clarify treatment preferences, prepare advance directives, incorporate values, beliefs, and needs into the care plan, facilitate communication, and obtain access to resources. Several initiatives are used to recognize family and patient needs including the JCAHO-best practice process of inquiring about advance directives and patient preferences upon admission, using the nationally recognized program, “My Voice-My Choice” to write advance directives, and participation in patient safety and quality initiatives to identify patient and family needs. Family education and communication are emphasized through educational materials, innovative documentation of family-provider meetings, and multi-line conference phone calls to include distant family members and to provide interpretative services. The FMSS has also added a bi-lingual nurse in order to facilitate culturally competent care. Additional programs include making arrangements for patients to attend special family events, a personal pet visit program, and providing blankets made by staff and community members to comfort seriously ill or dying patients.
Team members: Family Matters Support Service: Gail Daly, RN, PhD (Director); Christine Westphal, RN, MSN, CCRN (Clinical Nurse Specialist); Moe Rustom, RN, BSN (Nurse Clinician); Martha Hnatiuk, BSN, MA (Educator). Additional Members: Bette Fitz, RN, MBA (Patient Care Services Director); Kathryn Hester, RN (Critical Care Nursing Director and Coronary Care Unit Staff Manager); Joy Gornick, RN (Intensive Care Unit Staff Manager); Terri Destrampe, RN (3 North and East Staff Manager); Kristine LaPointe, RN (3 South and West Staff); Loraine Crechiolo, RN APRN (Nurse Practitioner); Mary Lynn McKee, RN (Clinical Manager); Arthur Riba, MD (Cardiology Education/ Research Director); Cathy Jo Ponzi, RRT (Respiratory and Rehab Director); Neha Desai, PharmD (Critical Care Rounding Pharmacist); Moe Rustom, RN (Interpretive Services Manager); Sue Ryskamp, MS, RD (Medical Nutrition Therapy Director); Critical Care Medicine Associates: Paul Haydon, MD; Adeeb Atassi, MD; Dolly Bondarian, MD; Roderick Boyes, MD; Angela DeSanti,s MD; Samer Kheirbek, MD; Zaid Tahawi, MD; Critical Care Medicine Partners PC: James T. Love, MD, FCCM; Asif Munir, MD; Mona Obeidy, MD; Asker Asmi, MD; Narendra Khanchandani, MD; Case Managers: David Cooley, RN (Director); Christine Frudzinsk, RN; Kelli Markarian, RN; Social Workers: Geriann Brock (Director); Janet Connelly, MSW; Dan Kummer, MSW; Heather Casagrande, MSW; Spiritual Support: Rev. Richard Leliaert, PhD (Director); Rev. George Jarrell; Beverly Beltramo, CPM; Rev. Tony Marshall; and Rev. Nicola Parravano.
Contact: Christine Westphal, RN, MSN (westphac@oakwood.org)
Oakwood Healthcare System's staff is congratulated and commended for their efforts in providing quality care and support to critically ill patients and their families.
2005 Family-Centered Care Award Summaries
At the 34th Annual Critical Care Congress, SCCM's Patient & Family Committee awarded the second annual Family-Centered Care Award to Children's Hospital and Regional Medical Center, Seattle Washington. Two honorable mentions were also given to Bristol-Myers Squibb Children's Hospital at Robert Wood Johnson University Hospital, New Brunswick, New Jersey and Pediatric Intensive Care Unit University Medical Center Tucson, Arizona.
Award Recipient
CHILDREN'S HOSPITAL AND REGIONAL MEDICAL CENTER
SEATTLE, WA
The 2nd annual Family-Centered Care Award has been presented to Debra Ann Ridling, Clinical Nurse Specialist and the team at the Children's Hospital and Regional Medical Center. This outstanding center was chosen for demonstrating exemplary strategies in integration of families into the PICU team. Over the last seven years, team members at the Children's Hospital and Regional Medical Center have been developing principles and guidelines for family-centered care and working constantly to integrate them into unit culture and routine. Parents are welcome to stay at the bedside 24 hours a day and participate in the care of their children. They are encouraged to attend rounds and other multiprofessional team meetings, stay during unplanned emergencies such as resuscitation, and are provided with support if they wish. Parents have unlimited access to their child's medical record any time. A built-in parent sleep and day space is a part of every patient room and includes storage, individual lighting, and a phone. Upon admission parents are provided with a pager so they can be reached at any time during their child's hospitalization. A palliative care service is able to provide timely coordination of care in the ICU during crucial decision points and is able to facilitate discussion utilizing a structured decision-making tool, which considers medical indications and family/patient priorities. The staff recognize death as a journey and strive to make the dying process for the child as comfortable as possible while providing support for the family. End-of-life care is a priority and supported by a PICU-based Bereavement Committee that provides a number of tools including individualized books that can be given to families, supplies for creating mementos, and well-trained, experienced staff. Processes are delineated in written Guidelines of Care. Additionally, a hospital-wide follow-up program makes contact with all families who have experienced a death of a child and provide support and services individualized according to the needs of families.
*Team Members: Parents, family members, and patients; Jerry Zimmerman, MD (Medical Director, PICU); attending, fellow, and resident physicians; Harris Baden, MD (Director, Pediatric CVICU Service); attending and resident surgeons; Howard Jeffries, MD (Director, Quality for ICU); quality assurance RNs; Cathie Rea, RN (Director, Division of Critical Care); bedside and charge RNs; Jenina Deshler, LCSW, PICU; program/ population-based social workers; Jenny Stevens (Dietitian); program/population-based dieticians; Cindy Sloan, RN (Chair, Bereavement Committee); committee members; hospital-wide “Journey” program; Wendy Paul (ICU Lead Pharmacist); all ICU-based pharmacists; multiple other team members: respiratory therapists, child life specialists, occupational therapists, physical therapists, care coordinators, infection control practitioners, unit support staff.
* It is difficult to delineate the team because it is fluid depending on the needs of the individual patients and families. We have named a couple of key members, but there are numerous units as well as hospital-based staff that contribute to the care of our patients.
Contact: Debra Ann Ridling, MS, CCRN, Clinical Nurse Specialist (debra_ann.ridling@seattlechildrens.org)
Children's Hospital and Regional Medical Center's staff is congratulated and commended for their efforts in providing quality care and support to critical care patients and their families.
Honorable Mention
BRISTOL-MYERS SQUIBB CHILDREN'S HOSPITAL AT ROBERT WOOD JOHNSON
NEW BRUNSWICK, NJ
Vicki Craig, MD and the team at Bristol-Myers Squibb Children's hospital at Robert Wood Johnson, New Brunswick, New Jersey received honorable mention for their strong commitment to multiprofessional care in the Pediatric Intensive Care Unit (PICU) focusing on care of the entire family of a critically ill child. The commitment to this philosophy from the entire PICU team and hospital administration resulted in increased resources to improve physical facilities and hire the trained individuals needed to attain the goal of providing comprehensive family-centered critical care to patients admitted to the PICU. Pediatric Critical Care Nurse Practitioners were incorporated into unit practice in 2002, which improves continuity of care for the patient and family and increases the family's understanding of the patient care plan. A Child Life Specialist (CLS) is available and uses age appropriate interventions including art and recreational therapy, guided imagery, medical play and procedural preparation to help the child and family cope with any fear or anxiety associated with a critical care hospitalization or post-traumatic events. A bereavement program is an important part of the care that is provided to families suffering from the tragic loss of their child. Family support begins in the hospital and includes a pastoral care team. A yearly memorial service for children who have died is held at the Children's Hospital and is open to all families, friends, and staff.
Team Members: Division of Pediatric Critical Care, UMDNJ-Robert Wood Johnson Medical School - Thomas Bojko, MD, MS, FCCM; Steven Choi, MD; Vicki Craig, MD; Lisanne Hauck, MD; Kelly Keefe-Marcoux, MSN, PCCNP; Michael Kelly, MD; Maureen Madden, MSN, PCCNP, FCCM; Daniel Notterman, MD, FCCM; Michelle Sorscher, MSN, CPNP; Jacqueline Williams-Phillips, MD; Pediatric Intensive Care Unit nurses; Linda Palkoski, RN, MPH (Director, Pediatric and Critical Care and Transport, Nursing and Patient Care Services); Child Life Team: Barbara Gursky (Director), Tammy Moin (Bereavement Counselor); Social Services/Discharge planning; Respiratory Care Team; Patient Care Technicians/Hostess Team; Pastoral Care Team.
Contact: Vicki Craig, MD (craigvl@umdnj.edu)
Bristol-Myers Squibb Children's hospital's staff is congratulated and commended for their efforts in providing quality care and support to critical care patients and their families.
Honorable Mention
UNIVERSITY MEDICAL CENTER, PEDIATRIC INTENSIVE CARE UNIT
TUCSON, AZ
Also receiving honorable mention is Andreas A. Theodorou, MD, and the team of University Medical Center in Tucson, Arizona. For 7 years, the team at UMC has been working at developing and improving family-centered care by addressing the needs and satisfaction of their pediatric patients and their families. Their two main goals are to develop strategies to improve communication with patients/families and to improve coordination of care. A Pediatric Family-Centered Care Advisory Committee, made up of parents, teenage patients, nurses, doctors, social workers, pastoral care, respiratory therapists, case managers, and community supporters, developed the following vision and mission as a working team.
- Be the leader in providing family-centered care for infants, children, adolescents, and their families during hospitalization and discharge from UMC.
- Collaborate with families in planning, delivering, and evaluating pediatric care.
- Ensure continuity of care and improve patient and family outcomes by providing an optimum environment for health, wellness, and caring.
- Provide care that honors the racial, ethnic, cultural, religious, and socioeconomic diversity of families.
The UMC is located close to the US/Mexico Border as well as several Native American Reservations. Because many patients and families often come from far away, a Family Host position was created. The role of this position is unique and requires an assertive, yet accommodating person that can understand critical care issues and is able to support a family without ongoing direction from the health care staff. The host is the family representative throughout the admitting process and the hospital stay. Parents have reported they felt safe and secure with the knowledge that someone would be their representative.
Team Members: Megan Acker, RN (Case Management); Vicki Began, RN, MN (Director, Women & Children's Services); Claire Bianchi, MSW (Pediatrics); Darlene Blair, RN (Case Management); Julie Brown (Family Member); Laurel Burnham, (Family Member); Leah Burnham (Family Member); Dagmar Cushing, MSW, NICU; Katie Desiato (Family Member); Tim Downes (Child Life Specialist); Jeanne Fenn, RN, CNS (Pediatrics); Donna Gonzalez, RN (Infant Toddler Unit); Anne Miros, RCP (Respiratory Care); Teresa Higgins-Wallice (Family Member); Laurel Hizer (Administrative Coordinator); Nematollabi Hooshang, RN (Operating Room); Sandy Jackson (Family Member); Mica Kinder, (Family Member); Lisa Ouellette, RN (Infant Toddler Unit); Penny Ratzan, RN (Developmental Coordinator); Andreas Theodorou, MD, (PICU); Lori Throne, RN (Nurse Manager, PICU); Deanna White, RN (NICU); Annie Wilkinson, RN (PICU); Pat Williams (Ronald McDonald House Charities); Kathy Zillman (Family Member)
Chairpersons: Katie Desiato (Family Member); Lisa Ouellette, RN; Jeanne Fenn, RN, CNS
Contact: Andreas A. Theodorou, MD, Chief, Pediatric Critical Care Medicine (aat@peds.arizona.edu)
University Medical Center's staff is congratulated and commended for their efforts in providing quality care and support to critical care patients and their families.
2004 Family-Centered Care Award Summaries
At the 33rd Annual Critical Care Congress, SCCM's Patient & Family Committee awarded the first annual Family-Centered Care Award to Saint Vincent's Medical Center in Worcester, Massachusetts. Two honorable mentions were also given to Harborview Medical Center at the University of Washington in Seattle, Washington and St. John's Hospital in Tulsa, Oklahoma.
Award Recipient
SAINT VINCENT'S MEDICAL CENTER
WORCESTER, MA
The first annual Family-Centered Care Award has been presented to Dr. David Kaufman and the Saint Vincent's Critical Care Unit. This outstanding unit was chosen for demonstrating exemplary strategies in providing support and care of the critically ill patient and their families. Saint Vincent's philosophy of care places families central to the care of the critically injured patient. The waiting area was transformed into a Critical Care Family Center. The Family Care Center furnishes amenities to families in a large spacious room that contains a kitchen, storage, linens, free phones as well as alcoves for privacy. The Family Care Center is also equipped with a web-enabled computer, news, and resources to families including the SCCM-linked family information Web site at www.ICU-USA.com. Families are provided with unrestricted visiting hours, allowing them to assist in the care of the patient. Daily family-witnessed rounds welcome family involvement and participation in care and information sharing. The team includes a Critical Care Family Liaison who is available to the families to provide accurate and timely updates on patient progress. The Liaison also ensures frequent communication between the physician and the family. She attends procedures and rounds to be able to provide detailed feedback to families in a timely manner.
Saint Vincent's staff is congratulated and commended for their efforts in providing quality care and support to critical care patients and their families.
Contact: Dr. David A. Kaufman, Chief of the Department of Critical Care Medicine
(David.Kaufman@tenethealth.com)
Shown above: The Saint Vincent Critical Care Patient and Family-Focused ICU Team: (L.to R.) Mary Abelli (Family Liaison); Lynn Hedman RN (Manager of Critical Care Information Services); Wendy Lancey RN, MS, CCRN (Nurse Manager of Critical Care Center); David A. Kaufman MD, FCCM (Chief, Department of Critical Care Medicine).
Honorable Mention
HARBORVIEW MEDICAL CENTER AT THE UNIVERSITY OF WASHINGTON
SEATTLE, WA
Dr. J. Randall Curtis and the team at Harborview Medical Center in Seattle, Washington received honorable mention for their comprehensive multiprofessional palliative care program. Most notable was the complexity and depth of the quality improvement program implemented to monitor success and opportunity in a data driven manner. The Quality of Dying and Death (QODD) validated tool created by this team is used to survey the bereaved family members to grade and provide feedback regarding the end-of-life experience. This feedback is shared with staff. Staff and physicians also are surveyed routinely regarding their experiences with end-of-life care. Death rounds are held to review each case and illuminate teaching points or opportunities for improvement. Staff at all levels receive special training to ensure provision of optimal palliative care. Forms and pathways have been developed to guide the end-of-life process.
Contact: Dr. J. Randall Curtis, Co-Principal Director of IPACC and Director of the Harborview/University of Washington End-of-life Research Program
(jrc@u.washington.edu)
Shown above: Dr. J. Randall Curtis, Co-Principal Director of IPACC and Director of the Harborview/University of Washington End-of-life Research Program
Honorable Mention
ST. JOHN'S HOSPITAL
TULSA, OK
Also receiving honorable mention is Dr. Gerald Plost and the team of St. John's Hospital, Tulsa, Oklahoma. St. John's innovative strategies are based on Nancy Molter's classic research on family needs demonstrating that families prioritize their needs to be: support, comfort, proximity, assurance, and information. To meet these needs, Family Care Specialist nursing positions were developed. These specialists are ELNEC (End-of-Life Nursing Education Consortium) trained. Data was collected from surveys, problems were identified, and interventions developed to best meet family needs in the ICU setting. A family support protocol, which the team is willing to share, was developed. The team has successfully reduced family complaints over time with these strategies.
St. John's is to be commended for their continuous assessment of family needs and evaluation of their unit in order to meet the needs of patient's families.
Contact: Dr. Gerald Plost, Medical Director (gplost@sjmc.org)
Shown above: St. John Medical Center Interdisciplinary Team
First Row: Teressa LeMaster, RN (Patient Care Coordinator); Gerald Plost, MD (Medical Director of Critical Care Services). Second Row: Sr. Julie Manternach, (Chaplain); Pam Coates, RN; Mary Martin, RN (Family Care Specialist); Corkey Celcer, (Data Analyst). Third Row: Mark Mills, PharmD; James Griggs, RN; Curtis Langston, RRT.