Forming a Family Advisory Committee in a Small Pediatric Practice

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Forming a Family Advisory Committee in a Small
Pediatric Practice

• Andrea B Lowe MD PhD
• Skagit Pediatrics
• Mount Vernon, WA

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Learning Objectives

• Understanding a working-model of a practice
  advisory committee, and its importance in
  creating family-professional partnerships
• Identify strategies for developing and sustaining
  a practice advisory committee
• Acknowledge possible barriers for developing and
  sustaining a practice advisory committee.

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Why Skagit Pediatrics wanted a Family Advisory
Committee

• Inspired by presentation at Medical Home meeting
  four years ago
• Formal way for families to contribute to the
  mission of the clinic
• Advice for administration and medical leadership
  on patient needs and clinic priorities from a
  family perspective
• Help with resource info for families

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About Skagit Pediatrics

• One of three pediatric practices in Skagit County
• Ten clinicians--doubled the number of doctors in
  a three year period
• Changed from managed care to fee for service
  could no longer afford to have a dedicated triage
  nurse.
• Moved into a new building

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Physicians and Parents Ranking of Services
Ranking Service
Physicians Parents   -Respite
care 1
9 -Day care
2
21 -Parent support groups
3 3 -Help with behavior
problems 4
10 -Financial information or help
5 2 -After-school child
care 6
20 -Assistance with physical household
changes 7
15 -Vocational counseling
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6 -Psychological services
9 5 -Homemaker services
10
22 -Recreational opportunities
13 4 -Information about
community resources 14
1 -Dental treatment
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8 -Summer camp
19 7
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What is a Medical Home?

• A Medical Home is not a structure but an approach
  to providing health care services involving
  physicians, families, allied care professionals
  as partners.

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This includes medical and non-medical services
needed to help children and their families
achieve their maximum potential.
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Elements of a Medical Home
Care that is

• Accessible
• Family-Centered
• Comprehensive
• Continuous
• Coordinated
• Compassionate
• Culturally-competent

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How to Create Family-Professional Collaboration

• Intake forms
• Suggestion box
• Office setting is reflective of various cultures
  and traditions
• Use of individuals names
• Questions at the beginning end of visit
• Extra time for CYSHCN visits
• Family-friendly written information
• Family Advisory Committee

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Where to Begin?

• Developing and Sustaining a Patient and Family
  Advisory Council by Patty Devine Webster and
  Beverly H. Johnson
• Kate Orville at University of Washington
• Brainstorming help
• Sent out e-mails to find people with experience
• Lyn Kratz
• Discussed Seattle Childrens
• Hospital council
• Helped work out details
• Portland Family Advisory Council

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Structure of Group

• 10-12 family and staff
• Rotating membership with 2-3 year terms
• Parents with children of various ages, special
  needs, former patients
• Quarterly meetings
• Start in the Fall

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Enticements

• Food at each meeting
• Gift certificate
• Annual gift
• Name on plaque
• 10-25 per official meeting

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How to fund

• Practice pays as investment into practice
• Grants
• Volunteer

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Recruiting Members

• Ran search for patients with chronic disease
  diagnosis.
• Gave lists to all providers and had them star
  parents or patients they thought would be
  interested and positive
• Went through shortened list at an office meeting
  and picked 8 people to send invitations to.

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Invitation Letter
(see handouts)
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The Results Current Members

• Pediatrician
• Front office staff member with pre-school
  children
• Lead FRC with special needs children
• Public Health nurse with middle school twins
• 3 Mothers of children with and without special
  needs

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First Meeting

• Discussed concept of Family Advisory Council
• Toured clinic
• Began brainstorming project ideas

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Second Meeting

• One month later - to maintain momentum
• Continued to brainstorm
• Made a list of ideas for the staff to review at
  next office meeting
• Decided to start with family satisfaction survey

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Ideas Discussed

• Getting feedback from parents (survey)
• Providing info for families
• Patient Education TV
• Bulletin Board
• Web Pages
• Resource Library
• Ask a Pediatrician night
• Supporting families
• Being a parent first, enjoying your child
• Transitioning of Adolescents

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Family Satisfaction Survey
(see handout)
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Results of Questionnaire

• "How well were all of you questions answered?"
  4.66 out of 5
• "Did you have any trouble scheduling your
  appointment?", 100 said no.
• "friendliness of staff" 4.75 out of 5
• "Is there anything we can do to improve our
  services" 97 said no

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Comments
-I so appreciate the opportunity to ask all my
questions and never feel like I'm being
rushed -Always greeted and sent off with a
smile. -Appreciate Sat hours -Knowledgeable
staff -Very friendly staff -Always wonderful
about getting us in
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-Thank you -Your staff is always nice, and
wonderful at making/canceling appointments. -Only
once in the many years an appointment was
scheduled wrong and that was fixed when we came
in -It was last minute and I still got to see my
child's doctor-what a relief -They are always
nice -You are the best Pediatric Office.
Everyone here is so kind, friendly and
compassionate. Thank you for all being so great!
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Next Project

• Provide up-to-date resource info for families
• Calendar of Events
• Flyers of local agencies and support
  organizations
• Seasonal information

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Comparing Display Options

• Bulletin Boards
• Expensive
• Involve dangerous tacks
• Easy destroyed by ADHD patients
• Unable to reuse
• Can have tear off flyers with information
  families can bring home

• Posters in Frames
• Less expensive
• No tacks
• Children cant destroy
• Can be reused or lent to other clinics
• Cant have flyers families can take home

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Calendar of Local Events

• Poster dedicated to calendar listing community
  events and meetings of interest to local families
• Updated every quarter

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Resources

• Poster dedicated to resources in the community
  and how to tap into them

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Seasonal Info

• Poster dedicated to seasonal topics
• Can be saved for next year or loaned to other
  offices if interested
• Topics Dental Health, Summer Safety, Flu Shot,
  etc

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Other Roles for FAC

• Sounding board for clinic, e.g.
• Should clinic have products available for
  patients if we can supply them at a better price?
• Would families be willing to pay for a triage
  call if it meant not having to come in?

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Next Step Recruiting New Members

• Poster in Waiting Room
• Notice in Parent to Parent newsletter
• Develop Flyer

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Could You Say No?
e
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Current Projects

• Update Web site
• Compile a list of References for
  Children with Special Health Care Needs
• Continuing the Posters

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Thank you
Jennifer Sass-Walton, Cynthia Hubert, Carol
Hamre, Angelique Kissas, Heather
Swenson and Susan Hirst
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Contact Information

• Andrea B Smith [phone]
  andreabsmith_at_yahoo.com

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Family-Centered Care Resources

• Medical Home information for families
• Medical Home tools for families
• Brochures for families
• Presentations for families
• Located at www.medicalhomeinfo.org