EPIC Podcast: Eileen MacFarlane

Join Yessi Cubillo, a Quality Insights ESRD Network 3 Patient Engagement Specialist, and Eileen MacFarlane, Facility Manager at Satellite WellBound Cherry Hill in New Jersey, as they discuss patient engagement experiences in their facility's monthly QAPI meeting.

Learn more about Quality Insights End-Stage Renal Disease (ESRD) Network 3.

This material was prepared by Quality Insights Renal Network 3, an End Stage Renal Disease (ESRD) Network under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS). Views expressed in this material do not necessarily reflect the official views or policy of CMS or HHS, and any reference to a specific product or entity herein does not constitute endorsement of that product or entity by CMS or HHS. Publication No. ESRD3-101123-GK-A

Transcript

welcome to the very first episode of the

empowering partners for improved care

epic podcast each month you will learn

and hear informative information about

patients family and staff engagement

initiatives including barriers and

proven practices that may impact your

own interventions at the dialysis center

um i yes patient engagement specialist

for esrd network 3 will be your host for

today and we will be talking about a

facility's first patient engagement

experience in their monthly cooper

meetings

um with our with us today we have a

guest uh her name is eileen mcfarland

she is the facility administrator at

well-bound cherry hill hi elaine and

thank you for joining us

oh thank you for inviting me it's a

pleasure

eileen how long have you been a facility

administrator wellbound

i've been with

satellite healthcare wellbeing of

of mercer and cherry hill for 15 years

now wow that's a wealth of uh knowledge

that you could uh share with many uh so

it's a it's an honor to have you here

with us today and a pleasure to share on

this first conversation i know they it

started with you reaching out and kind

of talking about the topic of fish and

engagement in kwapi um and so i said hey

how about we uh bring you to the podcast

and share some of those initiatives so

today we will actually be covering three

areas uh and those three areas will be

uh the recruitment of the patients and

family members that you had participate

in your coop meeting uh your first time

experience this is the first time you

shared haven't haven't haven't had

patients participating in your

facilities cooperative meetings and some

of the takeaways that um that happen

from that meeting and the impact to

future meetings that you will be having

uh or the work not just the meetings but

the work that you'll be doing at your

facility as well uh so with that being

said eileen let's get started with our

first topic and that would be

uh share a little bit about the

recruitment process or how did it go

about how do you guys want about

recruiting those patients and family

members to participate in your cooper

meeting

well originally when i had received your

email

i had reached out to the nurses and

asked them if they could recruit a

couple of patients hopefully

from both modalities i have home hemo

and i have peritoneal dialysis patients

and so they picked one of each and they

were able to

uh recruit

a pd patient along with his caregiver

and

the caregiver of one of the home hemo

patients she solely takes care of her

her husband who is a teacher

right he doesn't participate in his care

at all except to give her um

instructions but other than that she

does everything so i was glad to have

the both of them at the meeting

i mean yeah that's it's amazing that not

only were you able to recruit the

patient but also their caregiver um and

have that active participation of those

caregivers in in this meeting i i think

oftentimes facility kind of struggle

between who can i have in my meetings uh

is it is it going to be a patient um how

can we have that engagement and and

of that patient in the meeting but you

guys went above and beyond and not only

reached out to the patient now you have

family members who are very active

participants in their in the patients

care as well their family members care

be a part of these uh of this meeting so

that's i think great and having the

not just one person

leading the recruitment but you have

multiple staff working on this and kind

of coming together and say hey we got to

do this as a team let's come up and and

recruit somebody to be a part of that

meeting

um

and adding a little bit to that

how do you

do you know how the staff kind of share

the participation in the meetings like

did they provide them any insight as to

what were their expectations in the

meeting and things like that

well i believe they spoke to the fact

they wanted to discuss

uh the quality at the center

and they wanted to have feedback from

both patients and caregivers

where we

could improve or where we were doing

well

and both of these

individuals are very verbal okay so they

jumped right on the bandwagon to come

and participate

in the crappy meeting my thoughts are if

i had to as i go forward as i have to do

it again

um

i would i'm going to send out the

recruitment letter to all the patients

now okay including the whoever has a

caregiver and see who would like to

attend

and rotate people coming into the

meetings because you know i found it to

be very beneficial

with their their suggestions and

recommendations

the other thing after the meeting and i

had given some thought to

was

you have action items and

there are quite a few of them

i think the next time going forward what

i'll try to do is focus on one or two

action items that the network recommends

us discussing

and bring that into the mix because as

you know

quality meetings can be cumbersome and

and i don't think they knew exactly what

we were talking about i think i'm going

to take a little more time going forward

and explain a little bit more

about the process and what's happening

in in in each area we're discussing at

that time hemoglobin's care plans

transplant a lot of the stuff that you

had on your list oh that's awesome i i i

like the idea of how you mentioned kind

of rotating that participation of the

patients and family members as well

since you have that engagement

on a monthly basis and kind of giving

that opportunity to someone who may also

want to continue their engagement in the

future say hey i would like to come back

maybe follow up on those action items as

you mentioned that they suggested during

the meeting and providing feedback to

them of what happened with those action

items but i one thing that we shared

with um as a best practice last year

that we learned from last year is that a

facility said we're going to follow that

process and call them guest of honors in

our in our in our cooper meetings

that way they don't feel intimidated by

any other terms such as maybe a subject

matter expert or a facility

representative or something like that so

saying saying to them that they are our

patient or family member guest of honor

in our meetings kind of gives them that

opportunity to just it's not a

commitment that they're making it's just

a one-time kind of deal

and if they want to continue

participating after that they can

continue doing so and i also like the

concept of you kind of explaining to

them in detail um maybe not focusing on

not not going through all the topics

that you have to cover with or that you

would like to cover with them but rather

focusing on a few of them and getting

more in-depth so that they have a better

understanding of maybe the goals the

outcomes that you're having with those

with those uh measures so i think that's

a great great um

uh great feedback and great initiative

that you can move forward with

well i think it's also important that

the patients

um there's transparency

and they have a better understanding

beside what they're all going through

um personally but that you know that

there's

a greater good happening here by their

participation

um this might generate you know uh

they might be more proactive with their

care knowing that there's certain

measures that we're trying to achieve

for them

and the rationale behind all that

yeah yeah definitely that's a that's a

great uh point i i appreciate that now

our second topic that we wanted to get a

little more deeper into is the first

time experience for all participants i

think this is the most intimidating part

for for facilities and even for patients

just being a part of these meetings and

and not knowing what to expect how

things are going to turn out to be so

can you share a little bit about that

first time experience for your for your

participants

well

for the the staff i think that they when

i spoke to them

they they wanted the patients to see how

good our quality is

and

you know that we're all working towards

um a better place for

everybody and it's it's not just um you

know you give them their report cards

and you you tell them what they need to

fix

but there's a greater good going on so

my staff actually enjoyed having the

patients present wow now the patients

when i gave them the opportunity to

speak at the end to see if they could

add anything in um

what they offered was more about you

know how grateful

they felt being in a facility

that

was so caring

and it wasn't they they weren't just a

number they both came back with with

pretty much the same

um statements uh as for myself

i actually like you said i found it very

empowering because now i feel like

by having the patients and their

caregivers participate

um

we're taking it a step further you know

this is uh an engagement of of when you

talk about a whole interdisciplinary

team you're engaging

everyone it's just not a care plan

meeting it's trying to bring higher

standards to the state the the center

and

for the patients and and and i think

they really appreciated being part of

something greater than just treatments

at home

that's that's great thank you so much i

think i i i

i can attest to that as well because i

just recently had a

patient meeting our pfac the patient and

family advisory council um and we had

the discussion of patients participation

in the coop meetings and one of the

things they they said um

just being a participant in our meeting

in that call is it provides us

we have a purpose it provides us

additional purpose um to be a part of

something that's not not just our daily

routines and so being a part of that

group being a part of those discussions

provides them an additional purpose and

an opportunity for them to share their

own experiences the things that they're

seeing

and the wealth of information that they

can bring to the table so

i think that's uh that's great and i i

appreciate also the fact that uh your

staff was um very supportive of this of

this uh it is very supportive of the

initiative and everyone is looking

forward to doing it on an ongoing basis

and i think that's the goal that we want

to be able to

establish with all the facilities this

is not because we are participating in a

network project or you know it's just a

period of time that you're going to be

doing this but we want everyone to see

that there is a benefit to the

operations of the dialysis center uh in

making this happen you hear about

hospitals big hospitals big entities

having actual members participating in

their board of directors meetings and

and having uh that active membership of

patients in there because they're

serving patients they're serving

families so to have that voice in there

from that perspective i think is an

integral component of as you said of the

interdisciplinary team so thank you very

much uh i linked it for that for that uh

for that information uh our third topic

that we want to talk about is some

takeaways from the meeting that will

impact future meetings i know you

touched a little bit about this and

things that you would like to do in the

future but also the work of the facility

anything else that uh you would like to

add to that

well i think going forward um i know we

have paperwork that we initially have

the patients sign

and their agreement and and to get an

idea of what's going to happen at the

meeting

but i think i need to

initially speak to the relevance of the

quality meetings and the rationale

behind it before i proceed with that

initial crappie meeting especially to

newcomers so every time um a new group

of people

come to this to the meeting patients or

caregivers i want to really address what

how important it is to

maintain quality meetings and always

move forward and improve um i think it

was a very positive experience i think

everybody learned from it um you know

we're not all perfect

even at the center and to get feedback

from patients and have a better

understanding of what their needs are we

can address them better

um and and to bring in different people

during different meetings different

patients and caregivers for each meeting

um you know even if we there's a one

takeaway

to show some sort of improvement or make

their lives better

you know we're trying to humanize

dialysis here right so i think that's a

plus

um

we were able to recruit men peer mentors

going forward both of them said they'd

be happy to speak to patients going

forward to and and you know

what i i thought was exceptional the one

patient the peritoneal patient he goes i

was really scared when i first started

and and no one could alleviate

you know that fear

but if i could help another patient

that's coming forward he said you know

you guys are all great and i did

everything you told me and as long as i

knew the next step i was good but it's

still that fear

of the unknown if i can help another

patient get past that

he goes i'm on board

i will be a peer mentor so

i was able to recruit some peer mentors

um

or

i it gave them empowerment to

participate in the center you know that

that open transparency um we're not

hiding anything i'm always i always tell

all my patients you know if if if there

you find something that that doesn't

meet your needs or you're unhappy with

you can come to me go to the network

call the state

i don't ever find um criticism a bad

thing i find we can all learn from it

and i feel that um maybe this will

generate a feeling that feeling of

participation in the center and make

them more proactive with their care

yeah

it's interesting you bring up there's a

couple of things that i caught on your

in your feedback that you just share one

of them is being that um

you want to be able to share with the

patients and a little bit of what to

expect in those coop meetings

and understanding a little bit more of

what the cooperative meeting is really

all about

there is a resource that i have on our

website and i'll share that with

everyone as well

it's help patients understand their role

in quality assessments and performance

improvement in the cooper meetings um as

well as quality uh quality assurance

performance improvement engaging

patients in a virtual environment which

is another helpful resource but to help

you with that topic as you mentioned of

uh explaining to them or giving them a

heads up of this is what you can expect

as being being a member of our team uh

is something that that um that is

currently available but i think it could

be polished and made specifically to

what you're you're addressing so i will

work with our patient and family

advisory council

to polish uh some some materials that

could be shared with the facilities to

kind of give you an additional tool to

help you with that description of what

the cooper meeting is and what to expect

from that so i think that's a great

that's a takeaway that i can take away

from from this discussion today

um the second part is you mentioned that

during the cooper meeting you had

patients or the members that were

participating just the patient because

he had family members as well interested

in being peer mentors and that is

something that i tell the facilities uh

we are implementing three projects the

based on patient engagement we're doing

the life plan which is the plan of care

my dialysis plan uh we're doing the

cooper meetings and the peer mentoring

uh and what i say is you have to

cooperate and the peer mentor and could

be your same members that are

participating in your co-op meetings so

if you have a peer mentor that peer

mentor can come back and share what the

um the the interaction with the with the

other patients where um what happened

with with their experience in becoming

certified to be a peer mentor so it's

it's additional these additional topics

of discussion that you can bring back to

the

to the uh to the coop meeting discussion

and it says as the same goes you're

killing two birds one stone right you're

basically covering two areas and now

you're doing it with that same member

that's actively engaged in your co-op

meeting so i think that's that's a great

takeaway

um and then the very last topic that you

mentioned it was remind me again you you

were talking about like the future

of i should start writing this down this

is our very first time doing this so i

thought i was going to keep track of all

of them but you did mention something at

the end do you mind refreshing my

um it gave them empowerment to

participate in the center yes

transparency yes and that part as you

mentioned that you don't all only want

to hear the the like you know the

patients come to these cooperative

meetings they're going to share things

that are maybe not going right with the

center things that are negative that you

might perceive or the team may perceive

as negative

and that brought to mind something that

discussion that we had just recently uh

just yesterday with our pfac our patient

and family advisory council

that

through our meeting there was a new

member who came out and say you know i

appreciate there are many who are

sharing positive things about their

center and i have not nothing bad to say

about my center it's all great things

but then i i don't know i feel a little

i feel a little odd odds with

patients who kind of um say negative

things about their center or they're

reporting things that are not going well

well with their center and so i took

that opportunity to share it look the

way we see that

is that we don't take it as a negative

comment towards the center we see it as

this is there is an opportunity for us

as a group to kind of address those

areas of improvement i see it not as a

negative but as an area of improvement

or an area that we can kind of provide

support to that to that peer to that

peer to that meant now mentor now i got

like the word mentor and peer on my head

but the subject matter expert so being

able to kind of provide that support to

them when they're reporting hey this is

what's going on wrong in my center hey i

never heard about my dialysis plan how

come my dialysis center hasn't shared

that with me or

um i didn't know that my facility was

hosting monthly co-op meetings so those

are the type of comments that were

shared and so this one other patient is

engaged in their facility they're seeing

all of these things but the other

patients who are on these calls who are

very active uh are not seen at their

center so we use as an opportunity to

coaching one another and providing

support and saying all right this is

what you can take back to your center

and ask them how can we partner how can

we better partner to make this happen

and improve

our communication and my support towards

you guys so i think that's a great great

takeaway

so eileen before we end today any uh

additional words of wisdom or any

encouraging words that you would like to

share um uh just from your own

experience so that you would like to

share with other providers and patients

as well

the only thing that like i said in the

beginning

is before you if this is new to you

i would say

go through the paperwork

that

that network three sent to you on

empowering partners for improved care uh

make sure you read it and be prepared to

incorporate some of those action items

into your copy because we normally want

to tend to go through the quappi meeting

blah blah blah blah blah you know with

with you know you read your

you read your copy and then you have

your action plans and then it's done

i would take time like i said to focus

on one or two items that are in your

action item list and speak specifically

to it and get my input from the patient

and not wait until the end to get input

that's all that i have to add that's

great and thank you so much well this is

our time for today thank you so much

alin for joining us and sharing your

unique experiences i know every facility

has their own unique experiences and

hopefully they can benefit from this as

well as patients and family members kind

of encourage them to be a part of um

of their kwabi meeting and and have that

active engagement so to our listeners

out there uh this is our first time

doing this so i hope you enjoy our

discussion today i appreciate eileen for

being our very first guest in this epic

podcast

we're going to call it going forward so

if you have any specific topics of

interest in the future that you'd like

to hear more about or if you yourself

would like to be a guest speaker

here in our podcast please send me an

email at ycobio

qualityinsights.org well thank you all

for listening for listening today

and being a part of our epic podcast

stay tuned for next month's topic thank

you all

thank you jesse