The Value of Family Advisors as Coleaders in Pediatric Quality Improvement Efforts: A Qualitative Theme Analysis

Abstract

<jats:p> Engaging family advisors in pediatric quality improvement (QI) efforts is well-studied in intensive care but less understood in other settings. The purpose of this study was to assess the perceived impact of including a family advisor as a colead on a QI initiative that successfully improved the family-centered timing of routine morning blood tests performed on pediatric inpatients. Five structured written reflections from core QI team members were analyzed using inductive thematic analysis and 3 major themes were identified. The first found that a family advisor’s presence from the beginning of a QI initiative helps inform project design. The second determined that family partners working with residents fostered a better shared understanding of the role of trainees and caregivers in improving the quality of care. The third found that a family partner is an effective change agent to enact practice improvement, support professional development, and enhance resident education. Our qualitative analysis showed that engaging a family advisor as a colead influenced the design, implementation, and post-intervention impact of the initiative and improved family-centered outcomes. </jats:p>

Interdisciplinary Approach and Patient/Family Partners to Improve Serious Illness Conversations in Outpatient Oncology

“…Our decision to embed a family partner into the QI team on a weekly basis was based on emerging consensus that these partnerships improve health outcomes and better align care delivery to patient preferences. 9,19,20 Given our focus on SIC, an explicit goal of which is to find out what matters most to patients, this partnership seemed especially salient. We found this partnership mutually beneficial: clinicians made fewer assumptions about patient and family preferences, and the partner gained insight into care processes.…”

Partnering With Patients in a Quality Improvement Curriculum for Internal Medicine Residents

“…We believe partnering with PFAs in curricula is an opportunity to actively engage residents in the patient experience while also gaining first-hand appreciation for the insights that patients and families bring to solving problems, in accordance with the framework proposed by the Institute for PFCC for including PFA in QI teams (12). The aforementioned themes of recognizing the patient and/or family perspective and opportunities that PFA collaboration can bring to solving QI problems that have been recently described in a qualitative analysis of an effort to include PFAs as co-leaders in pediatric QI initiatives (13), and others have described successful incorporation of PFAs into the design and implementation multidisciplinary QI initiatives (14). However, to our knowledge, this is the first description integrating PFAs as teammates and learners alongside resident physicians in a QI curriculum seeking to address real-word patient experience problems.…”

Pediatric Surgery Rounding Checklists

“…Interestingly, prior studies found that the incorporation of intraoperative/perioperative checklists improved all types of postoperative complications, not only those related directly to the procedure or the content of the checklist (Birkmeyer, 2010; de Vries et al, 2010). This finding suggests that checklists create and promote a culture of safety, particularly if interdisciplinary team members including a family advisor (i.e., a family member of a former patient) are included in the design and implementation of the list (Czulada et al, 2016; Ramazani et al, 2020). This notion is also supported by the studies we reviewed, as surveyed health team members consistently reported that they believed that checklists improved patient safety.…”