In a recent blog post from Joe Montano “A COVID 19 silver lining: Family-centered care”, he talked about our recent study (Ekberg, Schuetz, Timmer and Hickson, 2020) in which we describe barriers and facilitators to implementing family-centered care (FCC) for adult clients in clinical practice. I thought it might be useful to expand on what we learnt from that study in the hope that is helpful for others to consider in their own clinics.
First of all let me say that interviewing practice managers, clinicians and front-of-house staff about FCC was absolutely enlightening and might be something you want to do in your own practices!!! FCC runs the risk of seeming simple and super easy to bring into the clinical world. In fact, that is what audiologists have said to me time and again in workshops. This is not what we found.
When the 13 staff in the study were interviewed in an open-ended way and assured that their opinions would be anonymized and their statements would not affect employment (ethical considerations in any research) they said things like:
- “I think there’s a lot of research evidence that family-centred care is the way forward and it’s really what we should be trying to do. (…) I don’t really know that we know how to do it sometimes. The research seems to suggest that this is best, and it works from our own little bits of experience too. But how do we implement it? How do we make these best practice appointments?” [Clinician]
- “I know obviously tools exist, but I don’t really find that they’re used often at [name of the hearing care company].” [Clinician]
- “In training they didn’t say anything about family members coming to appointments and stuff. (…) when you mentioned like family care, I was like what? What is that?” (Front-of-house)
Some staff expressed concerns about the real reason FCC is being promoted:
- “Some audiologists just see management as supporting family-centered care as a sales tactic. (…) some would argue that from a sales perspective it’s easier when you have all the decision-makers in the room when they’re making a big investment. The sales process is quicker because they don’t have to go home and first discuss this decision with their husband or wife and then come in again. So some audiologists have some resistance to involving the family because they don’t want to be perceived as being ‘salesy.’” (Front-of-house)
A very positive finding was that all staff could articulate numerous potential benefits of family attending appointments. But, they really wanted more education about the HOW of FCC (which was good news for us since that is the next phase of our research):
- “There’s always usually a research piece on family-centered care, so it’s definitely on the radar. But in terms of practical training or practical tools, maybe not a lot.” (Clinician)
- “In terms of giving people strategies when it goes wrong, I’d like to be a bit more confident in that.” (Manager and clinician)
This is akin to the typical dilemma of knowing something is right and actually doing it. I am sure we can all think of things in our daily lives that we intend to do because we know are very good for us (exercising daily, not drinking alcohol, eating vegetables, less screen time, meditating, etc.) but in reality we find it hard to take action. We need support, education and encouragement to build confidence.
Our main finding is that for FCC to work a whole-of-clinic approach is needed – it’s everyone’s business!
In case you want to try this ‘research’ in your own clinic, some examples of questions we asked were:
What is your current understanding of family-centered care in hearing rehabilitation for adult clients?
How important do you feel it is to involve family members in hearing rehabilitation as part of your job?
What do you think other colleagues think about involving family in appointments?
The full list of questions is in the article but the above would be a good start. With answers to these questions you would gain a lot of insight into how to implement FCC in your practice….and in so doing improve outcomes for adult clients, their families and for clinicians.
Ekberg, K., Schuetz, S., Timmer, B., & Hickson, L. (2020). Identifying barriers and facilitators to implementing family-centred care in adult audiology practices: a COM-B interview study exploring staff perspectives. International Journal of Audiology, 59:6, 464-474
To learn more about Family-Centered Care, including resources to help you implement this approach into your practice, please visit our website.