Family-centred care is an approach to the planning, delivery and evaluation of health care that is grounded in mutually beneficial partnerships among health-care providers, patients and families. It redefines the relationships between patients and health-care providers.
In this approach to care, family-centred practitioners value the vital role that families play in ensuring the health and well-being of patients of all ages. They acknowledge that emotional, social and developmental support is integral to providing quality health care. They promote the health and well-being of patients and families and restore dignity and control to them.
At Joseph Brant Memorial Hospital, patient-centred and family-centred care are important philosophies built on the smallest of details: placing a chair beside every stretcher in the Emergency Department; re-naming an area in the Emergency Department to “reception room” from “waiting room;” working with the hospital Foundation to commission a large, colourful mural running the length of one wall of the ER reception area, featuring scenes of Burlington’s waterfront and a diverse and happy community at play.
When working with a challenging patient, staff seeks to recognize the reason behind the patient’s concern. They use different approaches to defuse the underlying fear and anxiety and listen to what people really need. The living proof is in letters from satisfied patients and families.Consumers of our service sit on hospital advisory and planning committees as representatives. They join the monthly departmental meetings and provide very valuable insight from a different perspective.
While families have always been involved in patient care to varying degrees, last year’s SARS crisis (and its visiting restrictions) pinpointed how important families are as part of the health-care team.
“The daughter of a patient asked if she could help her mother to the bathroom,” relates Marilyn Hollick, nurse manager of the Emergency Department. “I told her ‘you are a valued member of the health-care team. We encourage you to be part of your mother’s care’.”
The renewed focus on family-centred care at Joseph Brant has been spearheaded by Hollick and fellow nurse manager Susan Burlock of Maternal Child. They were inspired by a conference in Boston last fall and will present their initiative at the Sigma Theta Tao conference in Ireland later this summer.
Patient and family-centred care plays a pivotal part in Joseph Brant’s latest strategic planning and will be integrated into all areas of the hospital. Even language has changed, moving from strict policies and procedures to guidelines, with an emphasis on how care can be improved.
“It’s about becoming partners, sharing information, collaborating and building a relationship,” says Burlock about the model.
Doing routine things in a different way is also part of the family-centred model. In Maternal Child, newborn baths were traditionally done in the nursery. Now families bathe their newborns at the mother’s bedside. The initiative “Kangaroo Mother Care” where mother and child bond skin-to-skin will follow.
When communicating with staff, Hollick and Burlock weave in the principles of family-centred care wherever and whenever possible. They believe it is an attitude rather than a policy and gentle persuasion is the key.
“It’s the power of ooze,” says Hollick. “We try to model and articulate the best features and practices of family-centred care.”
The key elements of family-centred care are respect, choice, information, collaboration, strengths, flexibility, support and empowerment. The ratings of our patient satisfaction surveys have increased since the family-centred care initiative started.
“Family-centred care provides the care that we ourselves would want if we or our family were the patients,” says Burlock. “The motto is ‘nothing about me – without me’.”