Family Engagement In Care Bolsters Quality

Family members are a crucial part of a team approach to patient care. When a family member is serving in a health care proxy role it is critically important for care providers to work collaboratively with family members. A systems approach to family collaboration is one in which the care provider organization as a whole and each of its components, such as administration, caregivers (providing direct care in terms of activities, housekeeping, and therapy), take an interdependent approach to caregiving.

A care provider that implements a systems approach to family collaboration examines the overall structures, patterns, and cycles in systems, rather than seeing only specific events in the system. Focusing on the entire system can help care provider leaders identify solutions that address as many problems as possible in the system.

The Family’s Viewpoint
Family members see only the care provided during the part of the day they are present. While this may seem obvious, caregivers working eight or more hours a day sometimes fail to appreciate that a family member’s impression may be based on the observations of only a few moments of care. Viewing this from a systems perspective, what a person sees today at 1:00 p.m. is all he or she can know about the care provider organization as a whole. This makes every moment important, but it also helps staff understand why it is sometimes hard for family members to believe their mother or father was cheerful all week, when what they see today does not support that claim.

A systems approach means that care providers provide families with specific information about what takes place when they were not present. Documenting and sharing specific anecdotes about events, attitudes, physical and emotional changes that take place at times when they are not there.

It is also important to listen to family members questions and concerns and address these in care notes and communications. This can be very reassuring for families, especially when they feel their views have been heard. It is also helpful to understand that family members are going through their own struggles. Adjusting to the move of a mother, father, husband, wife, or other loved one into long term care is a major life transition. In meeting the challenge of appreciating a family member’s viewpoint, it is helpful to understand that the individual is someone who cares a great deal. Developing a connection with him or her will help to support the overall care.

Think Holistically
In addition to seeing only moments of the full range of care, it is important to understand that family members who visit do not usually think separately about the different care venues. For example, family members see individual caregivers, administrative staff (Human Resources, Care Managers, care team coordinators/schedulers, and agency leadership) as part of the whole organization, and the actions of one staff member in one area will affect the family member’s perception of the entire organization.

Thinking of the whole organization as part and parcel of the solution is key to successful collaboration with family members.

Mission Should Reflect Culture
Midwest Home Care has a stated vision or mission for how we expect to support our clients and their family members – “We work with our families to develop a personalized plan of care to ensure they receive comprehensive, compassionate care that fits their needs.”

We strive to fulfill this mission by welcoming family members to be engaged with their loved one’s care. All members of the Midwest Home Care organization impact the family members’ experience as does the thoroughness of staff in carrying out care plans, completeness of care notes and professionalism demonstrated by all personnel.

All of these things contribute to the family members’ positive feelings about the care we provide their loved one. A systems perspective suggests that supporting a culture that is inclusive, engaged, communicative, and upbeat will be most likely to support the best patient care and the best community for all involved.

A Midwest Home Care Adaptation of: 
A systems approach to working with family members can improve resident care and boost customer satisfaction
by Jeannette L. Gerzon, EdD

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