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Obtaining Evidence From Families: Family-Centered Care in Action at the Unit Level

Tuesday, 14 July 2009

Linda A. Lewandowski, PhD, RN
Nursing Administration/College of Nursing, Children's Hospital of Michigan/Wayne State University, Detroit, MI
Janice Cottrell, MSN, RN
Patient Care Services, Children's Hospital of Michigan, Detroit, MI

Learning Objective 1: discuss the importance of "obtaining evidence" from patients and families to improve global health care.

Learning Objective 2: describe an organized approach to obtaining and using family input, involvement, and feedback to make improvements in clinical settings.

Purpose: In today’s global world, it is increasingly recognized that changes in clinical practice must be based on evidence.  Evidence regarding patient and family preferences is emphasized as important (e.g., Melnyk, et. al ), yet may be overlooked as it can be challenging to obtain in a systematic manner.  We will share a successful model to gain evidence from families -- a unit-based Family Advisory Council (FAC) on a pediatric neurosurgical unit (5-West) at the Children’s Hospital of Michigan.

Methods: Family members were recruited to the 5-West FAC and met monthly with a small group of interdisciplinary staff led by the nurse manager (Cottrell).  Other staff were invited as needed to resolve a particular issue. The most active ongoing members were parents whose children had frequent admissions while feedback and suggestions from less experienced parents were obtained via “impromptu” family meetings held on the unit several times a month. Family members offered unique points of view and practical, invaluable suggestions regarding issues discussed by the group.  Issues could be brought to the group for discussion by either a staff member or a family member.

Results: Of the many contributions of this FAC, two will be used to illustrate the importance of evidence obtained from family member involvement:  reducing noise bothersome to the children on this neurosurgical unit and a protocol for interdisciplinary patient care conferences (IPCC) to improve communication. Before the advent of the hospital-wide FAC, a number of the accomplishments of this unit-based FAC –brought forth due to evidence from families--spread to the rest of the hospital.

Conclusion: Unit-based FACs are a very effective and efficient method of obtaining data regarding family preferences and perspectives. Practical “lessons learned” and suggestions will be shared.

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