Deck 11: Person- and Family-Centered Leadership

Question 1

In the person- and family-centered care (PFCC) approach, the definition of family, as well as the degree of the family's involvement in health care, is determined by the person, provided that he or she is a legal adult and legally competent to do so.

Answer 1

True

Question 2

These four core concepts comprise patient- and family-centered care, according to the Institute for Patient- and Family-Centered Care are:

A) Health, Partnership, Family, Patient
B) Respect and Dignity, Information Sharing, Participation, Collaboration
C) Respect and Dignity, Empowerment, Participation, Collaboration
D) Partnership, Outcomes, Empowerment, Collaboration

Answer 2

B

Question 3

The Crossing the Quality Chasm: A New Health System for the 21st Century report offers "10 Rules to Redesign and Improve Care." The 5 most relevant approaches are:

A) Care based in continuous healing relationships, customization based on patient needs and values, patient as the source of control, shared knowledge and free flow of information, need for transparency
B) Care based on partnerships, customization based on family needs and values, family as source of control, shared knowledge and free flow of information, need for transparency
C) Primary treatment, individualized care, partnerships, shared mental model, need for redundancy
D) Advanced care planning, custom treatment regimens, controlling patients and families, knowledgeable providers, need for healthcare reform

Answer 3

A

Question 4

Contemporary organizations that influence health policy in the United States are making person- and family-centered care a priority in their long-term strategic agendas, validating the essential role these core concepts play in healthcare design and improvement. These include:

A) Institute for Healthcare Improvement (IHI), Center for Medicare and Medicaid Services (CMS), and The Joint Commission
D) Institute of Medicine, Institute for Patient- and Family-Centered Care
C) Agency for Healthcare Research and Quality (AHRQ) and National Quality Forum
D) All of the above

Question 5

In 2017, Dr. Anthony Digioia and Eve Shapiro published a book about transforming healthcare through co-design. The most important component of this performance improvement technique is:

A) Patient- and Family-Centered Care Methodology
B) Shadowing
C) Time-Driven Activity-Based Costing

Question 6

There is no need to formulate a comprehensive PFCC-oriented community needs assessment, as the tools used in the hospital will suffice.

Question 7

According to Donald Nelson, a physician and expert on quality, an organization will transform the culture only when it moves from improvement projects to improving systems. What is the correct order in which to effect systems change?
M) Project or intervention, macrosystem change, mesosystem change, microsystem change

A) Project or intervention, macrosystem change, mesosystem change, microsystem change
B) Project or intervention, microsystem change, mesosystem change, macrosystem change
C) Microsystem change, mesosystem change, macrosystem change, ongoing projects or interventions
D) Microsystem change, macrosystem change, mesosystem change, project or intervention

Question 8

The Picker Institute's Eight Dimensions of Care Measurement (Access, Respect for patients' values and preferences, Coordination of Care, Information, Communication, and Education, Physical Comfort, Emotional Support, Involvement of Friends and Family, and Preparation for Discharge and Transitions in Care) were chosen by enlightened administrators to measure critical aspects of hospital patients' experiences.

Question 9

There are numerous examples in the literature showing that improved health outcomes, better allocation of resources, and greater satisfaction with the healthcare experience for the patient and family are achieved with PFCC.

Question 10

Assessing organizational culture for PFCC readiness involves:

A) Reviewing internal policies
B) Focusing on organizational functioning
C) Understanding the culture and composition of the community
D) All of the above

Question 11

According to a 2006 study conducted by the Economic and Social Research Institute for the W. K. Kellogg Foundation, certain populations face greater barriers to PFCC. Which population group was not identified as experiencing barriers to PFCC according to this study?

A) Individuals with low income and the uninsured
B) Immigrants and persons with racial or ethnic minorities
C) Persons with mental illness and disabled individuals
D) The elderly

Question 12

Which of the following are not organizational barriers to implementing person- [and family-] centered care?

A) Recruiting and retaining culturally competent healthcare professionals, lack of defined boundaries for outreach staff, and hiring policies that restrict hiring staff from the neighborhood
B) Bureaucratic organizations, lack of planning, and shortage of space
C) Fatigue and burnout, traditional "old school" attitudes toward cultural and socioeconomic issues or patient/provider relationships
D) Competing priorities, lack of tools to measure and reward PFCC behaviors, and financial constraints

Question 13

PFCC implementation challenges for clinicians may include:

A) The shift from pay-for-service to pay-for-performance
B) The inability to make necessary changes due to declining reimbursement and dwindling net revenue with fewer liquid resources available to hire staff, fund marketing, and maintain practice operations
C) Higher reliance on evidence-based care and regulatory and healthcare reform requirements for PFCC, such as the Joint Commission, Centers for Medicare and Medicaid Services, and the federal government
D) All of the above

Question 14

When orienting new clinicians, physicians, and administrators it is not necessary to reinforce that all aspects of communication and decision-making should include the person (and with the person's approval) the family.

Question 15

Patient Family Advisors (PFAs) are specially trained former patients and/or family members who can partner with hospital leadership and counsel hospital leaders on subjects such as equipment, supplies, electronic health records, signage, policies and educational materials to name few. There are core competencies for PFAs, including:

A) Establishing Partnerships, Constructive Collaboration, and Solution-Focused
B) Open Dialogue, Critical Feedback, and Sharing Stories
C) Representative Voice and Teachable Spirit
D) A & C

Question 16

Core competencies for PFCC leadership and management are the same.

Question 17

One of the essential precepts in PFCC is the tenet that persons and families (as determined by the person) are true partners in care, decision-making, and setting policy. This partnership may take the following forms:

A) Partnership in the processes of patient assessment and in planning patient care and treatment
B) Partnership via organizational advisory roles
C) Partnership by providing input on hiring, educating, and evaluating clinicians
D) Partnership in leading local and larger-scale advocacy efforts
E) All of the above

Question 18

For faith-based organizations, the concept of stewardship and serving others for the better good of the patients/families is called Servant Leadership.

Question 19

Implementing the concept of managing by values can enhance organizational effectiveness for healthcare organizations that face the following challenges except:

A) Increasing complexity
B) Competitive challenge
C) A high rate of change
D) Raising reimbursements

Question 20

Healthcare leaders working with persons and their families have begun to address social determinants of health to improve healthcare outcomes for individuals, families, and communities. Thus for care to be truly person-centered, it is imperative to truly know one's population.