The Family Meeting

2021 ◽  
pp. 578-586
Author(s):  
Stefanie N. Mooney ◽  
Marinel Olivares
Keyword(s):  
Psychosocial Support ◽  
Clinical Information ◽  
Clinical Team ◽  
Patient Centered ◽  
Family Meeting ◽  
Team Members ◽  
The Family ◽  
Centered Care ◽  
Medical Recommendations ◽  
Key Participants

Cancer is a challenging experience for the clinical team, the patient’s family, and especially the patient. Important medical decisions are often made without the patient completely understanding their condition and options, as well as without the clinical team fully appreciating the patient’s values that go into making healthcare choices. Family meetings are one way to address these concerns. This chapter will review the importance and benefits to holding a structured family meeting, explore appropriate timing to have a meeting, and discuss the key participants. A detailed discussion follows on how to prepare for the meeting, highlighting an exploration of patient and family values and goals, as well as a premeeting among clinical team members. The structure of the meeting itself is then described, including introductions between the medical team and family, gauging the patient and family’s understanding, providing clinical information and recommendations, giving psychosocial support, reconciling medical recommendations with values, and postmeeting debriefing. Throughout the text, specific advice is provided on how to ensure the family meeting is as successful as possible so that patient-centered care is the ultimate priority.

scholarly journals Harnessing COVID-Driven Technical Innovations for Improved Multi-Disciplinary Cancer Care in the Post-COVID Era: The Virtual Patient Room

2020 ◽  
Vol 27 (1) ◽  
pp. 107327482096480 ◽  
Author(s):  
Austin J. Sim ◽  
Gage Redler ◽  
Jeffrey Peacock ◽  
Cristina Naso ◽  
Stuart Wasserman ◽  
...  
Keyword(s):  
New Technology ◽  
Multidisciplinary Care ◽  
Virtual Patient ◽  
Paradigm Shifts ◽  
Patient Room ◽  
Patient Centered ◽  
Team Members ◽  
The Road ◽  
Centered Care ◽  
Virtual Visits

Emergence of the COVID-19 crisis has catalyzed rapid paradigm shifts throughout medicine. Even after the initial wave of the virus subsides, a wholesale return to the prior status quo is not prudent. As a specialty that values the proper application of new technology, radiation oncology should strive to be at the forefront of harnessing telehealth as an important tool to further optimize patient care. We remain cognizant that telehealth cannot and should not be a comprehensive replacement for in-person patient visits because it is not a one for one replacement, dependent on the intention of the visit and patient preference. However, we envision the opportunity for the virtual patient “room” where multidisciplinary care may take place from every specialty. How we adapt is not an inevitability, but instead, an opportunity to shape the ideal image of our new normal through the choices that we make. We have made great strides toward genuine multidisciplinary patient-centered care, but the continued use of telehealth and virtual visits can bring us closer to optimally arranging the spokes of the provider team members around the central hub of the patient as we progress down the road through treatment.

Best Practice for Family-Centered Health Care

2017 ◽  
Author(s):  
Joanna Sturhahn Stratton ◽  
Katherine Buck ◽  
Allison M. Heru
Keyword(s):  
Health Care ◽  
Family Involvement ◽  
Best Practice ◽  
Model Of Care ◽  
Patient Centered ◽  
Step Model ◽  
Essential Components ◽  
The Family ◽  
Centered Care ◽  
Family Centered

The patient-centered medical home is a strong model of care that can be improved by harnessing the power of the patient’s family. This chapter highlights a three-step model of family involvement in patient care: (1) family inclusion, (2) family education and support, and (3) family systems therapy. The model is grounded in evidence-based research and incorporates the essential components of integrated care. A clinical case example illustrates how to involve the family in a stepwise progression. This model of family-centered care is applicable in any health care setting.

Patients’ and Families’ Satisfaction with Visiting Policies in Cardiac Intensive Care Units

2016 ◽  
Vol 9 (1) ◽  
pp. 67 ◽  
Author(s):  
Shiva Khaleghparast ◽  
Soodabeh Joolaee ◽  
Majid Maleki ◽  
Hamid Peyrovi ◽  
Behrooz Ghanbari ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Simple Random Sampling ◽  
Vital Role ◽  
Patient Centered ◽  
Cross Sectional ◽  
The Family ◽  
Centered Care ◽  
Cardiac Intensive Care ◽  
Cross Sectional Design

<p><strong>BACKGROUND: </strong>Families play a vital role in the recovery of patients admitted to Intensive Care Units. They can help patients to adapt themselves to the crisis and feel more satisfied.</p><p><strong>OBJECTIVE: </strong>In this study, we examined the patients’ and families’ satisfaction with the current visiting policies in Cardiac Intensive Care Units in the largest Cardiovascular Medical and Research Center of Iran.</p><p><strong>METHOD:</strong> This research used<strong> </strong>a cross-sectional design with a simple random sampling. To do so, 303 patients admitted to those Cardiac Intensive Care Units and their families responded to a two-part questionnaire between September 2014 and March 2015. The inclusion criteria for patients were aged between 18 and 85, acceptable general status to respond to the questions of the questionnaire, and having one of the cardiac diseases symptoms. Intention to attend was the only inclusion criterion for the family members.</p><p><strong>RESULTS:</strong> The results showed that 167(55.1%) of the participants were dissatisfied with the limited visiting policies of the Cardiac Intensive Care Units, while the satisfaction rate was 43(14.2%). The remaining participants (30.7%) were slightly satisfied with the visiting policies in Cardiac Intensive Care Units.</p><p><strong>CONCLUSIONS: </strong>Patient-centered care is an expectation among patients and their families in the Cardiac Intensive Care Units. It seems that a change in visiting policies is necessary.</p>

scholarly journals Investigating the Use of Telemedicine for Digitally Mediated Delegation in Team-based Primary Care: A Mixed-method Study (Preprint)

2021 ◽  
Author(s):  
Michael Knop ◽  
Marius Mueller ◽  
Bjoern Niehaves
Keyword(s):  
Primary Care ◽  
Technology Use ◽  
Online Survey ◽  
Cost Effective ◽  
Innovative Technology ◽  
Patient Centered ◽  
Team Members ◽  
Innovative Technologies ◽  
Daily Work ◽  
Centered Care

BACKGROUND Due to shortages of medical professionals, as well as demographic and structural challenges, new care models have emerged for finding innovative solutions to counter medical undersupply. Team-based primary care utilizing medical delegation appears to be a promising approach to address these challenges, but demands efficient communication structures and mechanisms to reinsure patients and caregivers receiving a delegated, treatment-related task. Here, digital healthcare technologies hold the potential to render these novel processes effective and demand-driven. OBJECTIVE The goal of this study is to recreate the daily work routines of general practitioners (GPs) and medical assistants (MAs) in order to explore promising approaches for the digital moderation of delegation processes and to deepen the understanding of subjective and perceptual factors that influence their technology assessment and use. METHODS In total, 19 interviews with 12 GPs and 14 MAs were conducted, seeking to identify relevant technologies for delegation purposes as well as the stakeholders’ perceptions of their effectiveness. Further, an online survey was conducted asking the interviewees to order identified technologies by their assessed applicability in multi-actor patient care. Interview data was analyzed using a three-fold inductive coding procedure. Multidimensional scaling was applied to analyze and visualize survey data, leading to a triangulation of results. RESULTS Our results suggest that digital mediation of delegation underlies complex, reciprocal processes and biases that need to be identified and analyzed in order to improve the development and distribution of innovative technologies, as well as to improve our understanding of technology use in team-based primary care. Nevertheless, medical delegation enhanced by digital technologies, such as video consultation, portable electrocardiograms (ECGs), or telemedical stethoscopes, is able to counteract current challenges in primary care due to its unique ability to ensure both personal, patient-centered care for patients and create efficient and needs-based treatment processes. CONCLUSIONS Technology-mediated delegation appears to be a promising approach to implement innovative, case-sensitive, and cost-effective ways to treat patients within the paradigm of primary care. The relevance for such innovative approaches increases at times of tremendous need for differentiated and effective care, like during the ongoing COVID-19 pandemic. For successful and sustainable adoption of innovative technologies, MAs represent essential team members. In their role of mediators between GPs and patients, MAs are potentially able to counteract resistance towards using innovative technology on both sides and compensate for patients’ limited access to technology and care facilities.

scholarly journals Workforce Readiness Training: A Comprehensive Training Model That Equips Community Health Workers to Work at the Top of Their Practice and Profession

2021 ◽  
Vol 9 ◽  
Author(s):  
Lily K. Lee ◽  
Elizabeth Ruano ◽  
Pamela Fernández ◽  
Silvia Ortega ◽  
Carlos Lucas ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Community Health ◽  
Training Program ◽  
Health Workers ◽  
Training Model ◽  
Organizational Readiness ◽  
Workforce Readiness ◽  
Patient Centered ◽  
Team Members ◽  
Centered Care

Background: Recent reports have recognized that only 20 percent of health outcomes are attributed to clinical care. Environmental conditions, behaviors, and social determinants of health account for 80 percent of overall health outcomes. With shortages of clinical providers stressing an already burdened healthcare system, Community Health Workers (CHWs) can bridge healthcare gaps by addressing these nonmedical factors influencing health. This paper details how a comprehensive training model equips CHWs for workforce readiness so they can perform at the top of their practice and profession and deliver well-coordinated client/patient-centered care.Methods: Literature reviews and studies revealed that training CHWs alone is not sufficient for successful workforce readiness, rather CHW integration within the workforce is needed. Consequently, this comprehensive training model is developed for CHWs with varying skill levels and work settings, and supervisors to support organizational readiness and CHW integration efforts. A systematic training program development approach along with detailed implementation methods are presented. Continuing education sessions to support CHW practice and Organizational Readiness Training for supervisors, leadership and team members directly engaged with CHWs in the workplace are also discussed. CHWs were involved in all phases of the research, development, implementation, and actively serve in evaluations and curriculum review committees.Results: Components of the comprehensive training model are presented with an emphasis on the core CHW training. Two CHW training tracks are offered using three delivery modalities. Process measures with student learning objectives, outcome measures developed using the Kirkpatrick model to capture attitude, perceptions, knowledge acquisition, confidence, behavior, and overall experience, and impact stories by two CHWs are presented. Lessons learned from the implementation of the training program are discussed in three categories: Practice-driven curricula, student-centered training implementation, and adaptations in response to COVID-19 pandemic.Conclusion: This comprehensive training model recognizes that training CHWs in a robust training program is key as the demand for well-rounded CHWs increases. Furthermore, a comprehensive training program must include training for supervisors, leadership, and team members working directly with CHWs. Such efforts strengthen the CHW practice and profession to support the delivery of well-coordinated and holistic client/patient-centered care.

The Dying Patient in the Intensive Care Unit: Assisting the Family in Crisis

1993 ◽  
Vol 4 (3) ◽  
pp. 550-557
Author(s):  
Brian E. Mendyka
Keyword(s):  
Practical Experience ◽  
Positive Outcomes ◽  
Patient Centered ◽  
The Core ◽  
Clinical Events ◽  
The Family ◽  
Centered Care ◽  
Family Centered ◽  
Dying Patient

Critically ill patients belong to larger phenomenologic systems, their families. What affects one member affects other system members. Nursing care requires meticulous observation and assessment of family concerns, understanding of clinical events, and practical experience to achieve positive outcomes even if a death occurs. It seems easy to dismiss the family from the clinical and technical matters of the critical care unit, especially when much nursing energy goes into operating peripheral machinery, performing tasks, and pursuing ever-changing patient-centered goals. The following case study attempts to redefine and redirect the focus of what “patient-centered” means to include the nurse, the patient, and the family in the meaning of the core of family-centered care

Flexible implementation and integration of new team members to support patient-centered care

Healthcare ◽  
2014 ◽  
Vol 2 (2) ◽  
pp. 145-151 ◽  
Author(s):  
Sherry M. Grace ◽  
Jeremy Rich ◽  
William Chin ◽  
Hector P. Rodriguez
Keyword(s):  
Patient Centered Care ◽  
Patient Centered ◽  
Team Members ◽  
Centered Care

scholarly journals The Family and Safety of the Hospitalized Patient: An Integrative Literature Review

2020 ◽  
pp. 1-12
Author(s):  
Tânia Sofia Pereira Correia ◽  
Maria Manuela Ferreira Pereira da Silva Martins ◽  
Fernando Fausto Margalho Barroso
Keyword(s):  
Health Care ◽  
Literature Review ◽  
Health Professionals ◽  
Current Data ◽  
Hospitalized Patients ◽  
Care Process ◽  
Patient Centered ◽  
The Family ◽  
Centered Care ◽  
Hospitalized Patient

<b><i>Framework:</i></b> Considering that the current data on health care safety remain alarming, there is an overwhelming urge for the ongoing study of this topic and for recommendations and differentiated strategies which aim to promote health and which prove effective. Some recommendations have been taken into consideration, such as patient-centered care, and consequently the need for greater involvement of patient and family in this process. However, we have identified arguments for and against the involvement of family in the care process, and consequently a greater or lesser openness towards hospital visits. <b><i>Objective:</i></b> What are the implications of the presence of family for the safety of hospitalized patients? What does the science say about these implications? <b><i>Methods:</i></b> We conducted an integrative literature review by referring to the Web of Science, CINAHL, Medline, and Scopus databases, according to the recommendations of the Joanna Briggs Institute for scoping review. <b><i>Results:</i></b> We found 115 articles. After selection, 13 articles were included in this review. There were 6 qualitative studies, 5 quantitative studies, and 2 literature reviews. Data were grouped according to: the perspective of patients and their families, the health professionals’ perspective, and statistical evidence. <b><i>Conclusion:</i></b> Families take efforts to protect the safety of hospitalized patients but feel unprepared; a lack of follow-up was reported. Some health professionals claim that the presence of the family can increase the risks for patient safety and the fear of an increased workload. The evidence of the presence of the family and its link to the safety of the hospitalized patient demonstrated that this relationship is not yet well understood. There were limited findings about this in the current literature. <b><i>Relevance to Clinical Practice:</i></b> Structured interventions about family integration in ensuring the safety of hospitalized patients may have the potential to contribute to the safety of health care.

scholarly journals Empowering Patients during Hospitalization: Perspectives on Inpatient Portal Use

2019 ◽  
Vol 10 (01) ◽  
pp. 103-112 ◽  
Author(s):  
Ann McAlearney ◽  
Naleef Fareed ◽  
Alice Gaughan ◽  
Sarah MacEwan ◽  
Jaclyn Volney ◽  
...  
Keyword(s):  
Health Information ◽  
Care Team ◽  
Care Providers ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Secure Messaging ◽  
Team Members ◽  
Centered Care ◽  
Adult Inpatient

Background Patients have demonstrated an eagerness to use portals to access their health information and connect with care providers. While outpatient portals have been extensively studied, there is a recognized need for research that examines inpatient portals. Objective We conducted this study to improve our understanding about the role of a portal in the context of inpatient care. Our study focused on a large sample of the general adult inpatient population and obtained perspectives from both patients and care team members about inpatient portal use. Methods We interviewed patients (n = 120) who used an inpatient portal during their hospitalization at 15 days or 6 months after discharge to learn about their portal use. We also interviewed care team members (n = 331) 4 weeks, 6 months, and 12 months after inpatient portal implementation to collect information about their ongoing perspectives about patients' use of the portal. Results The perspectives of patients and care team members generally converged on their views of the inpatient portal. Three features—(1) ordering meals, (2) looking up health information, and (3) viewing the care team—were most commonly used; the secure messaging feature was less commonly used and of some concern to care team members. The inpatient portal benefited patients in four main ways: (1) promoted independence, (2) reduced anxiety, (3) informed families, and (4) increased empowerment. Conclusion Inpatient portals are recognized as a tool that can enhance the delivery of patient-centered care. In addition to empowering patients by increasing their sense of control, inpatient portals can support family members and caregivers throughout the hospital stay. Given the consistency of perspectives about portal use across patients and care team members, our findings suggest that inpatient portals may facilitate shifts in organizational culture that increase the patient centeredness of care and improve patient experience in the hospital context.

scholarly journals A Qualitative Analysis of Attending Physicians' Use of Shared Decision-Making: Implications for Resident Education

2018 ◽  
Vol 10 (1) ◽  
pp. 43-50 ◽  
Author(s):  
Elizabeth M. Schoenfeld ◽  
Sarah L. Goff ◽  
Tala R. Elia ◽  
Errel R. Khordipour ◽  
Kye E. Poronsky ◽  
...  
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Resident Education ◽  
Shared Decision ◽  
Patient Centered ◽  
Skill Levels ◽  
Team Members ◽  
Centered Care ◽  
Complex Relationships ◽  
Attending Physicians

ABSTRACT Background  Physicians need to rapidly and effectively facilitate patient-centered, shared decision-making (SDM) conversations, but little is known about how residents or attending physicians acquire this skill. Objective  We explored emergency medicine (EM) attending physicians' use of SDM in the context of their experience as former residents and current educators and assessed the implications of these findings on learning opportunities for residents. Methods  We used semistructured interviews with a purposeful sample of EM physicians. Interviews were transcribed verbatim, and 3 research team members performed iterative, open coding of transcripts, building a provisional codebook as work progressed. We analyzed the data with a focus on participants' acquisition and use of skills required for SDM and their use of SDM in the context of resident education. Results  Fifteen EM physicians from academic and community practices were interviewed. All reported using SDM techniques to some degree. Multiple themes noted had negative implications for resident acquisition of this skill: (1) the complex relationships among patients, residents, and attending physicians; (2) residents' skill levels; (3) the setting of busy emergency departments; and (4) individual attending factors. One theme was noted to facilitate resident education: the changing culture—with a cultural shift toward patient-centered care. Conclusions  A constellation of factors may diminish opportunities for residents to acquire and practice SDM skills. Further research should explore residents' perspectives, address the modifiable obstacles identified, and examine whether these issues generalize to other specialties.

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