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Project PARIS- Parents and Residents in Session 
               Teaching family-centered care in a training
                                program
            Christine Low,   L.C.S.W. 1, 2,
                                          Rachel A. Annunziato,     Ph.D. 1,4,
                                                                         Melissa Rubes,                                 B.A. 4,   Eyal Shemesh,
                                   M.D.1, Dana Wyles, B.S.N., M.L.S.3, Joel Forman, M.D.1
             Mount Sinai Medical Center, New York, Departments of Pediatrics1, Social Work Services2, and Child Life and
                           Creative Arts Therapy3, and Fordham University, Department of Psychology4



AIM:                                                                  MEASUREMENT of IMPROVEMENT:
The aims of this research were to (1) improve the                     Trainees knowledge of family centered care principles
knowledge and attitudes of medical trainees regarding                 Trainees attitude regarding family centered care practices
the practice of patient and family centered care (PFCC),              Family faculty experience of participation in teaching efforts
and (2) to ascertain if there is an ideal time to offer PFCC
education to medical trainees for maximal impact.
                                                                      RESULTS:

STRATEGY for CHANGE:                                                  In phase 1 (2010-2011) 29 pediatric residents participated in
                                                                      training sessions with 7 family faculty members. Mean scores
Accreditation bodies (including The Joint Commission,                 on the Attitudes measure given to the residents showed
the Accreditation Council for Graduate Medical                        significant improvement after the session . Similarly,
Education , Magnet and the American Academy of                        Knowledge scores also significantly improved.
Pediatrics) have embraced the need to incorporate
patient and family centered principles into training                  In phase 2 (2011-2012) 52 medical students participated in
methodologies and hospital operations. Patient and                    training sessions with 5 family faculty members. Mean scores
family centered care has also has become a training                   on the Attitudes measure given to the medical students
requirement for pediatric residency programs in the                   showed significant improvement after the session but there
United States. The Department of Pediatrics at Mount                  was no significant improvement in the knowledge scores for
Sinai School of Medicine has embarked on a multi-year                 this group.
strategic effort to improve the provision of family
centered care in inpatient and outpatient settings. The                                                                    Attitude Mean Score

Parents and Residents in Session (PARIS) initiative was               30            P - Value < .01
                                                                                    (Significant)



launched as part of this effort in October 2010 with input                                                     25.84                                      P - Value < .01
                                                                                                                                                          (Significant)
                                                                      25

from physicians, psychologists , nursing, social work, and                         22.71
                                                                                                                                                                             22.15


child life. Project PARIS calls for a supervised meeting              20
                                                                                                                                                     20.26




between a family member of a previously hospitalized                                                                                                                                 Pre    Post
                                                                      15

child and a medical trainee. The meeting addresses the
perspective of the family during the childs hospital stay            10


and encourages communication between family
                                                                       5
members and physicians when making healthcare
decisions.                                                             0
                                                                                               Residents                                                         Students



                                                                                                                        Knowledge Score: % Correct
CHANGES MADE:                                                         100%


                                                                       90%



8 family faculty volunteer to use their own family's                  80%



healthcare experiences to highlight core tenets of family              70%
                                                                                            P - Value = .026
                                                                                            (Significant)

centered care to medical trainees.                                     60%
                                                                                                                52.4%                                P - Value = .699


Hospital staff write a manual outlining the session
                                                                       50%                                                                           (Not Significant)
                                                                                                                                                                                     Pre
                                                                                                                                                                                     Post
                                                                       40%                                                                                                   38.1%

content.
                                                                                                                                                      35.7%
                                                                                     32.5%
                                                                       30%

The patient and family centered care coordinator trains               20%


family faculty participants for 2 hours regarding the                  10%


purpose of the study and the session content.                          0%


Family faculty discuss 10 standardized topics related to
                                                                                                 Residents                                                        Students



family centered care, using the manualized approach, in
one hour meetings with the trainees.                                   LESSONS LEARNED:
Pre and Post session questionnaires are given to
participant trainees.                                                  As patient and family centered care has been embraced as a
Trainees acceptance of patient centered care is                      preferred method of practice and as a requirement in
evaluated via a Likert scale with 6 questions, with a range            pediatric training programs project PARIS seems to be a
of scores of 6-30.                                                     feasible and highly promising way to incorporate patient and
 Pre and post evaluations scale scores compared using T               family centered care practices into training curricula. This
tests.                                                                 training methodology requires investment in the recruitment,
Family faculty experience is also captured using a 9 item             training and coordination of family faculty but then can be
questionnaire designed for the study.                                  easily incorporated into existing training rotations.

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  • 1. Project PARIS- Parents and Residents in Session Teaching family-centered care in a training program Christine Low, L.C.S.W. 1, 2, Rachel A. Annunziato, Ph.D. 1,4, Melissa Rubes, B.A. 4, Eyal Shemesh, M.D.1, Dana Wyles, B.S.N., M.L.S.3, Joel Forman, M.D.1 Mount Sinai Medical Center, New York, Departments of Pediatrics1, Social Work Services2, and Child Life and Creative Arts Therapy3, and Fordham University, Department of Psychology4 AIM: MEASUREMENT of IMPROVEMENT: The aims of this research were to (1) improve the Trainees knowledge of family centered care principles knowledge and attitudes of medical trainees regarding Trainees attitude regarding family centered care practices the practice of patient and family centered care (PFCC), Family faculty experience of participation in teaching efforts and (2) to ascertain if there is an ideal time to offer PFCC education to medical trainees for maximal impact. RESULTS: STRATEGY for CHANGE: In phase 1 (2010-2011) 29 pediatric residents participated in training sessions with 7 family faculty members. Mean scores Accreditation bodies (including The Joint Commission, on the Attitudes measure given to the residents showed the Accreditation Council for Graduate Medical significant improvement after the session . Similarly, Education , Magnet and the American Academy of Knowledge scores also significantly improved. Pediatrics) have embraced the need to incorporate patient and family centered principles into training In phase 2 (2011-2012) 52 medical students participated in methodologies and hospital operations. Patient and training sessions with 5 family faculty members. Mean scores family centered care has also has become a training on the Attitudes measure given to the medical students requirement for pediatric residency programs in the showed significant improvement after the session but there United States. The Department of Pediatrics at Mount was no significant improvement in the knowledge scores for Sinai School of Medicine has embarked on a multi-year this group. strategic effort to improve the provision of family centered care in inpatient and outpatient settings. The Attitude Mean Score Parents and Residents in Session (PARIS) initiative was 30 P - Value < .01 (Significant) launched as part of this effort in October 2010 with input 25.84 P - Value < .01 (Significant) 25 from physicians, psychologists , nursing, social work, and 22.71 22.15 child life. Project PARIS calls for a supervised meeting 20 20.26 between a family member of a previously hospitalized Pre Post 15 child and a medical trainee. The meeting addresses the perspective of the family during the childs hospital stay 10 and encourages communication between family 5 members and physicians when making healthcare decisions. 0 Residents Students Knowledge Score: % Correct CHANGES MADE: 100% 90% 8 family faculty volunteer to use their own family's 80% healthcare experiences to highlight core tenets of family 70% P - Value = .026 (Significant) centered care to medical trainees. 60% 52.4% P - Value = .699 Hospital staff write a manual outlining the session 50% (Not Significant) Pre Post 40% 38.1% content. 35.7% 32.5% 30% The patient and family centered care coordinator trains 20% family faculty participants for 2 hours regarding the 10% purpose of the study and the session content. 0% Family faculty discuss 10 standardized topics related to Residents Students family centered care, using the manualized approach, in one hour meetings with the trainees. LESSONS LEARNED: Pre and Post session questionnaires are given to participant trainees. As patient and family centered care has been embraced as a Trainees acceptance of patient centered care is preferred method of practice and as a requirement in evaluated via a Likert scale with 6 questions, with a range pediatric training programs project PARIS seems to be a of scores of 6-30. feasible and highly promising way to incorporate patient and Pre and post evaluations scale scores compared using T family centered care practices into training curricula. This tests. training methodology requires investment in the recruitment, Family faculty experience is also captured using a 9 item training and coordination of family faculty but then can be questionnaire designed for the study. easily incorporated into existing training rotations.