While looking for more ways to have staff partner with patients and families to support the best patient experience, we came upon an article on the Advisory Board Company's website. The article laid out a basic framework for having patients and families provide feedback on a recent hospitalization.

Patient led feedback forums are a vehicle by which patients and/or family members return to a unit/clinic/practice where they have recently had an experience to share that experience directly with staff. They share things that went well from a patient/family perspective and things that could have been better.

To support the sharing of the experience, the patient/family takes part in a preliminary meeting with the manager and director of the area where the experience took place along with a facilitator. The patient/family shares their experience and the manager, director and facilitator listen for things that will provide the greatest learning for staff. The patient/family is asked to begin the forum with something positive, to speak about things needing attention and to end with something positive. The patient/family is given a "Tip Sheet" which was created to help them best articulate their experience.

A date and time for the forum are determined, advance notice is provided to staff for the up-coming forum and as many staff as possible are freed up to attend. A "Tip Sheet" for staff was also created to prepare them for the forum.

The facilitator begins the forum by stating the purpose of the forum as a learning tool where-by patients and families can share their experience face to face with staff and improvements plans can be developed and implemented.

After the patient/family has shared their experience, there is time for general comments before the patient/family leave the room. Staff must then list all the things that made for a great patient experience and those that took away from a great experience. Staff then choose one or two processes or behaviours that have positively impacted the patient experience which need to be supported or things which need to be remedied. The staff then engage in improvement cycles to discover how to support the best patient experience.

The director sends out a thank-you letter to the patient and family listing all the things they heard at the forum and the one or two behaviours/processes which they are addressing through the improvement cycles.

Examples of improvements from the Forums:
• Acquiring longer call bells
• Improving patient discharge sheet
• Increasing frequency of cardiac patients referred to rehabilitation
• Ensuring availability of the correct blood pressure cuff size in the Emergency Department
• Improving the process by which Emergency Department caregivers are engaged in Patient Safety, Quality and Risk
• Design and implementation of an end-of-life guide for families when their loved one is dying.
• Improving medication reconciliation
• Re-designing the charge nurse form to assist with assigning staff to patients that require full continuity of care, especially at the end of life, with little disruption to routines.
• Improving the triage process in the Emergency department.
• Providing education and support resources to float staff.
• Raising awareness and re-educating staff regarding the need to respect, support and advocate for the care decisions made by patients.
• Reviewing and Improving Pain Assessments in patients with cognitive impairment
• Reviewing and Improving Communication strategies with patient with cognitive impairment.

Patients and families are integral partners at every stage of the development of the Forums. They remain active partners through each individual forum and in the improvement cycles arising from the forums. The patient/family is central in bringing opportunities to light to create the best patient experience for future patients and families.

Contact Information:

Title: Lead for Patient- and Family-Centred Care

Contact information: belld@kgh.kari.net

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