Institute for Patient- and Family-Centered Care
Transforming health care through partnerships

Stanford Health Care Peer 2 Peer Program

Stanford Health Care

As of FY 2013, Stanford Health Care has 613 licensed beds, 49 Operating Rooms and completes 520,000 ambulatory visits/year. The organization has 7,689 employees, 1,070 volunteers, and 22 Nobel Laureates. It is an Academic Medical Center, Level 1 Trauma Center, and Magnet and Niche designated.

Stanford has a network of care with primary care offices throughout the Bay Area, outpatient clinics in Redwood City and Palo Alto, Stanford South Bay Cancer Center, and Valley Care in the Tri-Valley region.

The Peer 2 Peer (P2P) Program is closely aligned to the organizational goals of patient- and family-centered care. The initial members of the program planning team included: an administrator in patient experience, a cystic fibrosis patient, a cancer patient, the wife of a chronic cancer patient, a research advance practice nurse in cardiology, social workers in solid organ transplant and pulmonary service lines, and members of the heart transplant Patient and Family Advisory Council (PFAC), including patients and a family member, heart transplant social workers, and a psychiatrist.

Structure

The Peer 2 Peer program reports to the Administrative Director of Patient and Community Engagement and to a Care Coordination Manager in the Department of Social Work and Case Management. Peer 2 Peer Program is staffed @ 0.6 FTE dedicated to the P2P and Woman to Woman programs. The current Program Coordinator has a Masters in Social Work (MSW), State of California licensure (LCSW), and a Masters in Public Health (MPH). The specific educational requirement is a MSW, with LCSW preferred. The salary range is: $37-53/hour.

P2P program is part of the Patient and Family Partner Program. It is co-supported by the Department of Social Work and Case Management and the Patient Experience Departments. Expansion into women's cancer and the establishment of the Woman to Woman Program initially was funded by a seed grant from the Ovarian Cancer Research Foundation. After that grant expired, Stanford Health Care Administration continued to support the program and anticipates continued growth into other clinical areas.

Stanford Health Care started providing peer mentors in late 2012 using the model of one-to-one match. Unique aspects of the program include extended mentor training, social work support, supervision of mentors, and peer mentor support meetings. Mentors can be provided for all health care settings, with disease and treatment specific matching and mentoring. Currently the program has patient mentors in Heart Transplant, Liver Transplant, Cystic Fibrosis, Pulmonary Hypertension and GYN Oncology. Caregiver mentors are also provided for Heart Transplant and Pulmonary Hypertension. Mentors are able to go to both hospital and clinic locations.

Coordination

Currently the program has 33 active mentors. Recruitment and training of mentors is continuous. Peer mentors are recruited via social workers, nurses, physicians, and other staff. Mentors then complete an application and a phone interview with the program coordinator. Mentors are required to complete the standard hospital volunteer training program via computer. This program includes training in HIPPA, confidentiality, infection control, and safety. Volunteers attend an orientation to the Patient and Family Partner Program, which includes information on patient- and family-centered care concepts, information about the hospital and working with staff and physicians, as well as conflict resolution and parameters of the partnership. Volunteers are also required to attend a mentor specific five hour training course that reviews active listening skills (utilizing interactive role play techniques), discusses the scope, limits and boundaries of mentor services, emergency situations, and the support available for the mentors.

The goal is to provide educational presentations for the mentors on a regular basis. Periodic meetings are held for the peer mentors to connect with each other. Support and advice is provided to them via the program coordinator. After a volunteer completes his or her first contact with each mentee, the program coordinator calls the mentor. The coordinator reviews the interaction with the mentee, and provides guidance and support. Mentors can also call the program coordinator at any time to obtain support or advice. If the coordinator is not available, mentors can call the hospital social work department, (staffed 24/7) if immediate assistance is needed.

The program coordinator completes a match once a written authorization is obtained. The coordinator attains as much information as possible on the mentee from the social worker on the service. The coordinator then reviews with the social worker who may be the most appropriate mentor, considering disease status, treatment plan, gender, life circumstances, cultural background, and available mentors. The program coordinator may also contact the mentee to get further information that will help in the matching process. Mentors usually have an active connection with no more than two mentees at a time. After each contact, the mentor completes a form to report time spent and services provided.

Mentors are recognized and celebrated in the annual hospital volunteer recognition awards program. The program coordinator writes an e-mail thank you to the mentor once each match is made. Feedback from mentors often indicates that mentors also benefit from their volunteer mentoring. They gain listening skills and the psychological benefit of helping others, which enhances their own quality of life. This is consistent with the research literature.

A variety of sources of data provide information about the program. The program coordinator sends evaluations to the mentees after 1-2 months of mentor contacts. The coordinator evaluates matches, with feedback from social workers or other staff, and also at the mentee or mentor's request. Mentors complete a program evaluation. The program coordinator collects and collates statistics on volunteer hours and services provided by this program to help improve support to patients and caregivers.

Currently the program has IRB approval to conduct psychosocial research in the GYN Oncology area on the effects of this mentoring program on the quality of life of mentees that participate in it. This research may extend to other treatment service areas in the future.

The plan is to strategically grow the program and improve its quality, based on the collected metrics. Currently the program is recruiting mentors for solid organ transplant (liver, lung and kidney), aplastic anemia, bone marrow transplant (BMT), and the Adolescent and Young Adult Cancer programs. The program coordinator has attended meetings with the social work staff, GYN oncology staff, various PFACs, and BMT physician and nursing groups to further advertise the program and to recruit more mentors and mentees. A brochure with program information is in development to better advertise the program to patients, caregivers, and heath care personnel.

Stanford Health Care Administration, Department of Social Work and Case Management, and the Department of Patient Experience have all committed to sustain this program. There is strong clinical support for the program and demand to further expand. Additional growth based on the outcome measures of the research study and evaluations is anticipated. The program has been presented nationally and internationally at seminars and conferences, and provides guidance and consultation for centers starting similar peer mentor programs.

Anne Heideck LCSW, MPH
Program Coordinator
Peer to Peer and Woman to Woman Programs
300 Pasteur Drive, HC029, Stanford, CA 94305
Cell 650.474-1011 fax 650.725-3589
aheideck@stanfordhealthcare.org