- Intermountain Healthcare’s program to support family engagement in patient care has resulted in improved clinical outcomes measures such as preventable hospital readmissions, according to new data.
The research, published in the journal CHEST, investigated Intermountain’s Partners in Healing pilot program. The pilot seeks to empower family members in managing certain aspects of their loved one’s care, helping to integrate those family members into the care team and prepare them for at-home care.
"The vast majority of families like to have something to do and they like to participate in patient care. They're often the most motivated member of the care team," program lead Michelle Van De Graaff, RN, said in a statement. "We've found that families not only want to promote healing, but patients benefit from someone who knows their preferences, and the result is, the rate of readmissions is reduced after patients are discharged from the hospital."
Bedside nurses first offer patients and family members participation in the program during the initial care encounter. Families who choose to participate then select lead family caregivers, who are given a badge that identifies them as a part of the care team and grants them access to certain amenities available to Intermountain Healthcare staff members.
Family caregivers are trained in certain simple tasks, such as helping with breathing exercises, assisting with activity, giving help using the bathroom, measuring urine output, or keeping track of how much a patient eats and drinks. Family caregivers record this information on a checklist kept on the back of the exam room door and nurses transcribe that information into the patient chart.
The tasks that family members learn about tend to be specific to the patient’s health needs. For example, relatives of post-surgery patients tend to focus on breathing exercises and mobility.
These tasks are aimed at giving family members a sense of autonomy during the clinical care encounter, according to Van De Graaff.
"These are simple tasks, but they give families a sense of control and knowledge about what they can and can't do," Van De Graaff explained. "By inviting them onto the healthcare team, we're also preparing them to take over care when a patient goes home."
"The program also boosts confidence and teamwork," she added. "It lets family members practice patient care with expert guidance before the patient goes home."
The care intervention proved effective in improving the quality of the care encounter for both patients and family members. The research team looked at data for patients who did and did not opt into the family engagement program, and saw that participants had improved outcomes.
The 30-day readmission rate was 65 percent lower for patients participating in the family engagement program than for non-participants, the researchers said. Ninety-two percent of patients said the program eased transitions of care from hospital to home, and 94 percent said they highly recommend the program to other families.
Participants reported that the program made them feel empowered and like a key member of the patient care team. In turn, family members experienced less anxiety and more confidence in caring for loved ones at home.
Family engagement programs are usually effective because they equip relatives with the skills and knowledge necessary for keeping a patient healthy while recovering at home. When a patient can consult with a clinician about proper at-home care before hospital discharge, it is more likely that the patient will see optimal outcomes.
Van De Graaff also noted that the family engagement program allows patients and families to experience care fit to their preferences.
The Partners in Healing program allows patients and family members to engage in simple health activities without the presence of a nurse or doctor, letting them perform some activities on their own time. Additionally, it allows patients to experience at least some of their care from the individuals who know their preferences best.
Intermountain Healthcare as piloted the program in seven of its acute care unites. The healthcare organization plans to expand the program to all of its 21 facilities. The Mayo Clinic has also adopted the program.
Expanding this program is top-of-mind for Intermountain employees who hope to see more patient satisfaction and improved care outcomes, according to Tammy Richards, assistant vice president of Patient and Clinical Engagement at Intermountain Healthcare.
"Offering the Partners in Healing program to the patients and families in all of our Intermountain hospitals is a commitment to providing the best care possible to our patients by involving their loved ones in the healing process," Richards concluded.