Putting Patients First:
Patient and Family Centered Care

An Overview

What is patient and family centered care (PFCC)?

• It is a term in search of a meaning . . .
• From a Hospital’s and Provider’s Perspectives – PFCC is the redesign of patient care so that hospital resources and personnel are organized around the needs of patients and families rather than around various specialized hospital departments

What is the problem?

• The traditional operating approach in hospitals is broken and can’t be fixed by simply working harder and faster 
• Fundamental structural problems of the current system over-compartmentalize, over-specialize and rely on only one operating approach for all patients
• A majority of hospitals center operations on meeting the needs of departments and disciplines rather than patients

The Principles of Patient and Family Centered Care (PFCC)

• Examine all processes from the patient’s perspective
• Reorganize treatment around patient care
• Focus on specific patient populations, disease processes, medical conditions and the full cycle of care
• Create value-based competition
• Decentralize routine activities to the point of care
• Cross train staff to minimize hand offs
• Have the right level of staff expertise matched to the right job
• Seek “low tech” solutions, simplify and streamline processes to eliminate unnecessary complexity
• Empower staff to support accountability at lower levels, and ideally, at the point of care
• Foster teamwork beyond departmental walls

The Expected Outcomes and Benefits of PFCC

• Seamless patient care experiences and improved continuity of care (i.e. minimize “hand offs” within the hospital but also when the patient returns to the community).
• Cross train healthcare professionals to enrich jobs, increase productivity, enhance accountability and decrease the number of care givers that interact with the patient
• Improve vertical and horizontal collaboration
• Regroup patients into similar case types (i.e. disease or problem-specific processes from the patients’ perspective)
• Revamped documentation and IT infrastructure to enable efficiencies and support PFCC
• Streamline and simplify processes by reduced documentation; improve coordination, scheduling and communication
• Integration of continuous quality improvement into everyday life

What can be achieved and expected efficiencies

• Decreased costs and increase productivity
• Reduced staff turnover, employee error and patient length of stay averages
• Reduced waiting times for activities such as outpatient registration and the process time for services such as pharmacy and lab
• Improved delivery systems in their respective institutions while increasing physician, staff and patient satisfaction

Re-defining services and work

• The guiding principles of patient-focused care are based on first putting as many services as possible as close to the patient as possible
• Involve redefining work by appropriately desegregating job tasks and providing staff with the necessary support, skills, education and training

Hospitals Must Support PFCC because:

• Patient focused care aims to revamp these old systems so patients are placed at the top of hospital agendas.
• New methods are needed for deploying staff, reconfiguring jobs and restructuring facilities. 
• Basic tenets include decentralization of services, cross-training of employees, work redesign, and physical and geographical reorganization of delivery systems as they are brought closer to the bedside.
• Horizontal and vertical collaboration among nurses, physicians and technicians must be intensified
• Operational elements are merged to meet the single common goal of providing the most effective and efficient care to patients.

Expected Benefits to the Patient and Organization:

• Reduction in “non-value added” steps
• Reduction in the number of caregivers a patient encounters
• Cross trained staff
• Improved patient, physician and staff satisfaction
• Improved direct care time performed by the clinical staff
• Indirect cost savings by reduced turnover, better staffing, higher productivity, increased patient and physician satisfaction
• Direct operating cost reduction

A Vision . . . A Passion . . . and Teamwork!

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