Patient and Family Engagement is defined by the Institute of Medicine as “providing care that is respectful of, and responsive to, individual patient preferences, needs, and values; and ensuring that patient values guide all clinical decisions.”
Nationally, hospitals, clinics and other healthcare settings strive to operationalize this concept in an effort to provide safer, more compassionate and patient-centered care. While these efforts are not uncommon, they are challenging to implement, especially in the face of many competing priorities.
The following menu includes the primary trainings designed to support healthcare organizations and individuals working with Patient and Family Advisors, Patient Activation, Co-Design Models, and in the area of PFE at the Bedside.
For all topics/programming noted, private consulting is available. Fees based on PFE Team Member hourly rate. Please contact Dean Higgins for quotes.
Monthly Events (at No Fee)
PFE Coordinator Webinar
Webinar only, offered 1 hour format
This quarterly webinar series is for PFA and PFAC Coordinators across North Carolina looking to learn and share best practices regarding how to best structure their PFAC program and better utilize their PFAs.
If you would like to be added to the listserv to receive updates on the Monthly Webinars, please contact Sarah Roberts
For information about the upcoming PFE Coordinator Webinar, please click here
Saturday Speaker’s Workshop
Once a month, patients, family members and healthcare professionals come together in Cary to workshop their personal healthcare stories. These workshops are casual in format but provide a wealth of sophisticated feedback geared to take a story to the next level no matter where the storyteller might be in their process. In addition to having the chance to be coached by peers, participants have the opportunity to be coached by a nationally recognized patient speaker, Tiffany Christensen. Participants are welcome to share their story, prepare for a specific presentation or just listen and learn.
Please RSVP at least 1 day prior to the workshop. All workshops take place at the North Carolina Hospital Center at 2400 Weston Parkway in Cary, NC.
Tiffany Christensen’s Keynote Presentations:
Tiffany Christensen brings the unique perspective of both a lifelong patient and a healthcare professional. Using the 4 guiding principals of Patient and Family Centered Care, Christensen uses her extensive patient story as a backdrop to explore the world of a patient navigating our complicated healthcare systems. In addition to her personal story, Christensen addresses why Patient and Family Engagement doesn’t always work, the power of patient activation and the approach to creating authentic healthcare teams through shared language. Participants walk away ready to take action.
Growing Up Dying: A Bed’s Eye View
In this keynote, Christensen uses her reflections of a life filled with illness to provide a rare glimpse into the heart and mind of a pediatric patient navigating our complicated healthcare systems. Christensen deconstructs misconceptions about authentic partnership in healthcare and inspires participants to take new approaches in caring for young patients and their loved ones. Learning more about the internal life of a child growing up “dying” may just change the way you practice.
Strength in the Storm: Using PFE Strategies to Reduce Burnout
This presentation presentation can be done in a 1-hour keynote but, for maximum benefit, is recommended in a 2 – 3 hour workshop format
Burnout is a serious issue effecting safety, cost and patient satisfaction. In this session, Tiffany Christensen shares her patient story woven together with the 4 Guiding Principles of Patient and Family Centered Care. Along with her experiences in the bed, Tiffany explores her recent experiences as a professional patient advocate. Tiffany opens the topic of burnout by sharing her struggle to connect with the patients she served while also lacking the sense that her work was meaningful.
This begins the conversation about the primary contributors of burnout in healthcare. Tiffany then explores three “turn-arounds” of burnout consisting of concrete strategies based in PFE best practices. In the workshop portion of this presentation, Tiffany leads groups through activities to help them reconnect with the enjoyment in patient care, find new strategies for self-care and understand new ways to use PFE to combat burnout. Participants will find they are refreshed, energized and challenged to look at the role of the patient and family differently as well as the ways in which they facilitate their own personal healing.
Patient Family Advisor Engagement
PFAC and PFA Programming
Through their unique perspectives, they give input on issues that impact care, ensuring that the next patient or family member’s journey is easier.”
~Meghan West and Laurie Brown, BJC Healthcare
Operationalizing Your PFAC: 7 Steps to Sustainability®
This 8-hour training is recommended for organizations looking to build a solid foundation and long-term plan for their PFAC Program. Whether an organization has yet to create a PFAC or has encountered challenges in working with a PFAC, this workshop addresses the “nuts and bolts” of successfully developing, launching, and sustaining a PFAC.
For more information regarding our next offering of this course, please click here
Train-the-Trainer: Orienting Your PFAC
4 hour training for staff and established PFAs
This training can be stand-alone or combined with Part 1 or 2 of “Operationalizing Your PFAC: 7 Steps to Sustainability” to best meet the needs of your organization(s)
This training is for those who have already built a solid foundation for PFA engagement and now are ready to improve the qualities of partnership.
A comprehensive training program for staff and PFAs (that goes beyond the standard volunteer training) is a vital component of any highly functional PFAC program. In order to provide focused, entity-sensitive and valuable feedback, PFAs need to understand their roles, as well as how to communicate effectively in the unique world of healthcare. Having completed this training, PFAs will have more confidence and can more effectively partner within any healthcare environment.
All of these are necessary for establishing an environment of mutual respect and for making your PFAC program a valued component of your quality improvement efforts. Upon completion of this training, participants will be ready to return to their organization, customize the materials provided and plan the implementation of this PFAC orientation.
Partners in Quality: Engaging Patients in QI Efforts
4 hour or 1 day training designed for organizations seeking concrete best practices for engaging patients in quality improvement (QI) efforts while utilizing core QI methodology to design programs and measure impact.
This program explores foundations of Quality Improvement Methodology and weaves these concepts into best practices for partnering with patients on quality improvement. This workshop will provide concrete guidelines on utilizing patient as storytellers to reduce burnout, interviewing potential hires, and for peer rounding. Participants will work to apply the PDSA model to engage patients as “Secret Shoppers,” as a part of Root Cause Analysis, during Rapid Improvement Events and as Patient Activation Coaches. Participants will sketch a plan for utilizing a PDSA with patients as partners.
For more information regarding our next offering of this course, please click here
Coach-the-Coach: PFA Storytelling Workshop
This is 4-hour training developed for staff, providers, patients and families. One of the best ways to inspire and motivate culture change and understanding of Patient-Centered Care is through the patient/family story. This program is a “Coach the Coach” workshop equipping healthcare professionals and peers with concrete strategies for crafting the story and tailoring for healthcare audiences. Participants will be able to help PFAs take their story to a place of maximum impact. The workshop will provide tools to shape the story while ensuring it is infused with key messages that help leadership hardwire their mission into the hearts and minds of staff and providers.
PFE at the Bedside Programming
Institute of Medicine defines Patient Family Engagement as “Providing care that is respectful of, and responsive to, individual patient preferences, needs, and values; and ensuring that patient values guide all clinical decisions”
TeamSTEPPS for Patients
In “TeamSTEPPS for PFE,” Tiffany Christensen lays the groundwork by sharing her extensive patient history as a backdrop to weave together themes of partnership, patient safety and patient satisfaction. Participants will explore decreasing medical error through partnership using concrete strategies from TeamSTEPPS. By translating TeamSTEPPS tools into communication skills for patients and families, Tiffany sketches out several ways in which we can better incorporate patients into the team, operationalize PFE and guide patients and families to be more activated in their care.
Patient Activation Programming
According to the PAM (Patient Activation Measure), activation appears in 4 measures:
- Believing the patient role is important
- Having the confidence and knowledge necessary to take action
- Actually taking action to maintain and improve one’s health
- Staying the course even under stress
The following “New Change Team” trainings have been designed to help healthcare teams operationalize Patient and Family Engagement while simultaneously increasing patient activation. By pulling in PFAs as a part of the team, these programs utilize all resources known to PFE for the benefit of the patient, family and provider
Creating the New Change Team
Today, it is becoming more understood that the healthcare “team” includes the patient and family. As we seek to determine how to create authentic partnerships, we must look to Patient Family Engagement best practices. We also acknowledge that we still struggle with operationalizing these concepts.
This unique workshop requires an organization bring a team ready to work on a PDSA for care improvement. The team must include patients, family members, physicians and other front-line care providers.
This workshop brings together the following concepts with the right people to co-design a PDSA and pilot program that will be tracked and supported throughout the duration of the HIIN:
Patient Activation coaching provides the skills to be able to “meet people where they are” and focuses on how patients and families can best become partners in their care.
TeamSTEPPS® is an evidence-based teamwork system aimed at optimizing patient care by improving communication and teamwork skills. It includes a comprehensive set of ready-to-use materials and a training curriculum to successfully integrate teamwork principles into a variety of settings. This workshop utilizes these same tools for bedside engagement with the understanding that shared language is one of the fastest ways to instill a sense of teamwork and increase efficacy of communication.
The 5 CMS PFE Criteria represent core PFE best practices that are most successful when explored/implemented in collaboration with patients and families. This workshop brings all of these elements together to “Create the New Change Team” with concrete action plans and results.
This program trains staff, providers and select PFAs in specific TeamSTEPPS tools and Motivational Interviewing Coaching techniques. The goal is to form several layers of strategy around building an authentic team while maintaining a close coaching relationship with the NCQC PFE Experts.
This model brings together more PFE Best Practices because Patient and Family Advisors (PFAs) take on an integral role in supporting actual patients in using TeamSTEPPS strategies in clinical settings. In combination with TeamSTEPPS Tools for the purpose of shared language, PFAs will coach their peers in an effort to advance their level of Patient Activation as measured by PAM.
When planning the implementation of this model, the contracting organization’s leadership will choose a population and focus area to measure. The focus areas will likely be one of the following: improve adherence and outcomes, reduce readmissions and/or decrease ER visits.
The first step in implementation is a daylong training similar to the workshop outlined in model 1. In model 2, the patients and families will be replaced by seasoned and hand-selected PFAs. Upon implementation, PFAs will follow standard Peer Rounding protocols (as found in the training developed by Chrestensen and Christensen) within clinical areas. The roles and responsibilities are as follows:
- PFAs will share responsibility with our PFE Team to teach TeamSTEPPS tools to patients/families in a defined clinical setting
- PFAs will schedule follow up conversations with the patients/families they have enrolled in the program at an established frequency
- PFAs will gather data about TeamSTEPPS tools used/not used along with indicators for improved patient activation
The New Change Team: Train the Trainer
Today, it is becoming more understood that the healthcare “team” includes the patient and family. As we seek to determine how to create authentic partnerships, we must look to Patient Family Engagement best practices. We also acknowledge that we still struggle with operationalizing these concepts. “The New Change Team” approach brings together mastery level best practices from the areas of patient engagement, patient safety, quality improvement and patient activation in order to build a structure for authentic partnership for relevant improvement.
When holding a “New Change Team” event, participating teams must include patients, family members, physicians and other front-line care providers. After going through this “train the trainer” workshop, New Change Team (NCT) Facilitators will have a solid understanding of the necessary framework for the initial education, evaluation of teamwork and co-design of a PDSA for care improvement. NCT Facilitators will also explore a variety of opportunities for measurement the impact of this intervention. The New Change Team approach is valuable for out-patient, in-patient, residential retirement communities and emergency department settings.
Tiffany Christensen approaches her work from the perspective of a life-long patient and a professional patient advocate.
Tiffany is a TeamSTEPPS Master Trainer, a Respecting Choices Advance Care Planning Instructor, an APPEAL certificate recipient, and the co-creator of the training series for Patient and Family Advisory Councils and TeamSTEPPS for PFE.
Tiffany is the author of three books exploring advocacy, end of life planning and partnership strategies in healthcare. She is a board member of the Beryl Institute for improving the patient experience and is faculty for the Patient Safety Officer Training at the Institute for Healthcare Improvement. Tiffany served as a patient advocate at Duke Hospital working primarily in the area of Oncology and as the Program Coordinator for Duke Medicine’s Patient Advisory Council Expansion Program in which she was responsible for design and implementation of a standardized PFAC model and training.
Currently, Tiffany is the Performance Improvement Specialist at the NC Quality Center working on operationalizing Patient and Family Engagement across North Carolina and across the USA.
Allison Chrestensen is a licensed Occupational Therapist with over 10 years of experience.
Although she had the opportunity to work with patients of varying ages and diagnoses, she specialized in cancer rehabilitation and Complete Decongestive Therapy (CDT) for the treatment of lymphedema. As a Lymphology Association of North America certified lymphedema therapist and a faculty member for The Academy of Lymphatic Studies, she taught CDT certification courses to clinicians around the country.
After earning her Masters of Public Health degree with a Health Policy and Administration focus from The University of Georgia, Allison began working in healthcare quality improvement, leading large-scale quality improvement projects for North Carolina Medicaid waiver programs and conducted training programs for Medicaid providers.
In 2013, Allison suffered a catastrophic cardiac event and was fortunate to receive innovative medical treatment at Duke University Hospital that ultimately saved her life. Inspired by her own patient experience, she became a certified Health and Wellness Coach with the aim of helping others to reclaim control over their wellbeing following a catastrophic illness.
Drawing on both her personal and professional experience, Allison is passionate about bridging the divide between patients and families and providers by helping healthcare organizations to establish effective Patient/Family Advisory Councils to improve the healthcare experience for everyone. She also enjoys teaching providers how to improve clinical outcomes using motivational interviewing techniques to guide patient/family interactions.
Allison coordinated the PFAC Program for Duke University Health System and is a Team STEPPS Master Trainer. She currently works as a as a consultant for the North Carolina Quality Center and other healthcare organizations.
Utilizing the breakthrough improvement model developed by IHI was the foundation for the KHC PFAC Collaborative, but it was the experienced, knowledgeable and energetic faculty we found in Tiffany Christensen and Allison Chrestensen, that brought the training alive for Kansas hospitals. The integration of Tiffany and Allison’s personal stories goes straight to the “heart” of why it’s important to establish a PFAC or similar committee with patient-representation.
~ Kendra Tinsley
Executive Director, Kansas Healthcare Collaborative
Do not miss the chance to work with or learn from Tiffany. It is an experience reflective of all that is right in healthcare today.
Jason A. Wolf, Ph.D.
President of The Beryl Institute
Oregon Patient Safety Commission Conference Attendee
Tiffany is an amazing person who has given us a great gift at Duke through her unrelenting yet gracious advocacy for patients and their families. Having experienced medical errors in her own healthcare journey, she has been able to reach across the divide that sometimes separates the healthcare team and the patient/family. She has taught us what the true healthcare team really is…
Karen Frush, MD
Chief Patient Safety Officer, Duke Medicine