Pediatric Asthma Person and Family Engagement (PPFE) Learning Network

Pediatric Asthma Person and Family Engagement (PPFE) Learning Network

Overall Aim: PCPCC's Pediatric Asthma Person and Family Engagement (PPFE) Learning Network examined how to use person and family engagement strategies to improve pediatric asthma care and reduce emergency visits for asthma. The PCPCC SAN hosted 5 learning network calls lead by a pediatric quality improvement expert, showcasing pediatric practices that have improved asthma care quality. Participants were provided with specific ideas for using person and family engagement strategies to improve patient activation and overall asthma care quality. The Learning Network offered targeted strategies, tools, and resources aligned with clinical objectives and metrics from the Transforming Clinical Practice Initiative.

Target Audience: Clinicians and quality improvement staff from pediatric practices, Practice Coaches/Facilitators with PTNS

Format: Each Learning Network webinar included: 

  • A PTN Pediatric Practice Highlight - a pediatric primary care team’s sharing of a successful PFE experience (5-10 minutes) 
  • Topic presentation/discussion with suggested strategies, tools, and resources woven in; to provide concrete, actionable steps to share with practice teams to test/implement (30 minutes) 
  • Facilitated Discussion – Coaches/Facilitators/QI Advisors will be asked to share any PFE-related successes during the previous month along with issues/challenges.  Our seasoned pediatric quality improvement facilitator will help to identify practical quality improvement strategies to overcome challenges.

Overview of Topics and Objectives

Lesson 1: Including the voice of the person and family 

Objectives: 

  • To identify and discuss different levels and types of PFE relevant to pediatric practices participating in the TCPI, using American Academy of Pediatrics PFE concepts and the TCPI PFE measures as the framework 
  • To briefly define the 6 TCPI PFE measures, focusing on concrete examples demonstrating adoption of the ‘patient and family voices’ metric 
  • Discuss the goal of this learning network, to support practices in implementing PFE strategies to improve pediatric asthma care and reduce use of emergency care 
  • To share resources to help support pediatric practice teams testing various types of PFE strategies 
  • To discuss reasons and ways to identify a practice’s patient population with asthma 

Lesson 2: Engaging the patient/family in asthma care visits (Part 1) 

Objectives: 

  • To briefly review the 6 TCPI PFE measures, focusing on concrete examples demonstrating adoption of related measures addressing shared decision-making, assessment of patient activation, health literacy assessment, and collaborative medication management
  • To identify and discuss standardized assessment tools for practice teams to consider testing as part of initial and/or follow-up asthma visits.

  • To discuss “Teach Back,” as a strategy for practice teams to consider testing to engage patients/families in medication techniques and use.

  • To share resources and strategies to help support pediatric practice teams engage patients/caregivers in their own/child’s asthma management.

Lesson 3: Engaging the patient/family in asthma care visits (Part 2)

Objectives:

  • To briefly review the 6 TCPI PFE measures, focusing on concrete examples demonstrating adoption of related measures addressing shared decision-making, assessment of patient activation, health literacy assessment, and collaborative medication management
  • To discuss shared decision-making techniques effective for asthma treatment planning and follow up
  • To share resources to help support pediatric practice teams testing shared decision-making strategies to engage patients/caregivers in their own/child’s asthma management.
  • To discuss strategies to share with practice teams to identify supports and services in their community(ies) for patients/families with asthma.

Lesson 4: Engaging the patient/family in asthma care visits (Part 3)

Objectives:

  • To briefly review the 6 TCPI PFE measures, focusing on concrete examples demonstrating adoption of related measures use of e-tools
  • To discuss how to develop/maintain a patient registry (high or low tech), as a tool to help practice teams coordinate care with their patients/families with asthma.
  • To discuss steps and share lessons learned for practice teams to consider as they work to engage patients/families in the use of a patient portal (for current asthma action plan, scheduling, pre-visit assessments, concerns, questions).

Lesson 5: Connecting patients/families with appropriate supports and services

Objectives:

• To briefly review the 6 TCPI PFE measures and discuss how they operate synergistically to activate patients and families as partners in asthma care
• To discuss strategies for practice teams to test to engage and partner with identified community-based organizations and agencies who could help patients/families with asthma.
• To share best practices and lessons learned regarding coordinating care with family supports and services and patients/families with asthma.'

Something to keep in mind…

These opportunities to improve PFE in the pediatric primary care setting involve the use of QI methodology, to test changes and implement/sustain and spread improvements, AND include actual “voices” of patients/families early and often, as team members at various levels of partnership to improve their own/child’s care and practice-based care systems.

Lesson Resource Materials

Lesson 2: Webinar Recording

 

Health Literacy

North Carolina Program on Health Literacy Health Literacy Universal Precautions Toolkit

Agency for Healthcare Research and Quality Health Literacy Universal Precautions Toolkit

Teach-back

The Teach-Back Method - Tool #5 from the NC Health Literacy Universal Precautions Toolkit

The Guide to Improving Patient Safety in Primary Care Settings by Engaging Patients and Families Implementation Quick Guide - Teach-Back

Activation of Patients for Successful Self-Management  - 2009 article with discussion and assessment tool

Assessment of Activation

My Health Confidence Ruler - AAFP

Patient Activation Measure is copyrighted by Insignia Health 

What The Evidence Shows About Patient Activation: Better Health Outcomes And Care Experiences; Fewer Data On Costs - 2014 article

Quality Improvement

Institute for Healthcare Improvement - PDSA tutorial

 

Lesson 3 Slides: Engaging the patient/family in asthma care visits (Part 2)
 


 

SHARE approach for shared decision-making (AHRQ) - https://www.ahrq.gov/professionals/education/curriculum-tools/shareddecisionmaking/index.html

Asthma Treatment Plans - PediatricAdult Asthma Coalition of NJ (PACNJ) - http://pacnj.org/pacnj-asthma-treatment-plan/

Minnesota Department of Health interactive Asthma Action Plan (iAAP)

National Patient Safety Foundation - Words to Watch Fact Sheet (Health Literacy)

Article: Butz, A. M., Walker, J. M., Pulsifer,M. and Winkelstein, M.  Shared Decision Making In School Age Children with Asthma. Pediatr Nurs. 2007 ; 33(2): 111–116. 

Session 5 Recording: Adopting PFE Strategies to Improve Pediatric Asthma Care

 

Lesson 5 Slideset: Connecting patients/families with appropriate supports and services

Recommended Resources

American Academy of Pediatrics (AAP):  Connecting Families to Community Resources - Basic Needs Referral Template

AAP National Center for Medical Home Implementation: Care Co-Management Among Patient/Family, Pediatric Medical Home and Specialists 

AAP Council on School Health: Making the Grade: Working with Families and Schools for Academic Success

University of Massachusetts: New Patient Referral / Consultation Form - Sample

National Institute for Children's Health Quality:  Family Engagement Guide

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