Children's Mercy Kansas City includes two state-of-the-art hospitals in downtown Kansas City, Missouri, and suburban Overland Park, Kansas. When patients, families, and visitors enter Children's Mercy, they are greeted with a sign that says, "The children of Missouri and Kansas welcome you to their hospital." This simple sign describes the patient- and family-centered environment at the hospitals and outpatient clinics. As CEO Dr. Rand O'Donnell says, "The children are our bosses!" The patients and their families are at the heart of everything that happens at Children's Mercy in Kansas City.
Children's Mercy was founded in 1897 when two sisters, Dr. Alice Berry Graham, a dentist, and Dr. Katharine Berry Richardson, a physician, found a young girl who was abandoned, undernourished, and crippled. Their act of compassion and medical expertise was the beginning of what has become Children's Mercy Kansas City.
The mission of Children's Mercy is to "improve the health and well-being of children by providing comprehensive, family-centered health care and committing to the highest level of clinical and psychosocial care, and to research, academic and service excellence."
As the only free-standing children's hospital between St. Louis and Denver, Children's Mercy provides comprehensive care for patients from birth to 21. Children's Mercy is the first hospital in Missouri or Kansas to earn the prestigious Magnet designation for excellence in patient care from the American Nurses Credentialing Center.
Patient and Family Advisory Boards
In 1999, Children's Mercy established its first Patient and Family Advisory Board. Hospital leadership recognized the value of collaborating with patients and families on an institution-wide basis after realizing, over time, the value of involving them — on an ad hoc basis — on various committees and projects. The creation of these boards facilitated a formal process for ongoing partnership among patients, families, and hospital leadership and staff.
The Family Advisory Board includes family members, as well as hospital staff and leadership such as the Executive Vice President and Co-Chief Operating Officer, and leaders from Quality and Safety, Service Excellence, and the Department of Pediatrics. The Board meets monthly to provide an opportunity for families and staff to collaborate in efforts to improve the care experience.
Each of the boards described below has its own unique structure and process, depending on the needs of the group. For example, El Consejo is conducted in Spanish, meets in the evenings at an off-site location, and the ratio of community members to staff is higher than on some other boards. Learn more...
- Teen Advisory Board (TAB). In 1999, a group of patients between the ages of 13 and 19 years who receive care at Children's Mercy formed the first Teen Advisory Board. The TAB provides valuable insight regarding educational materials and support services for the teenage population. These young adults also partner in research projects and education for staff.
- Family Advisory Board (FAB). Started in 2003, the FAB has 21 parents and guardians of children with a wide variety of diagnoses and experiences who receive services at Children's Mercy. Members review policies, participate on hospital committees, and provide feedback on an array of programs. Additionally, FAB partnered with staff to create educational materials for families such as the New Journeys handbook, Visitor Tip Cards, and Nurse Advice Line magnets.
- El Consejo de Familias Latinas/Hispanas. Created in 2008, this Council ensures that Spanish-speaking families have an active role in hospital improvement. The members are integral in linking Children's Mercy with the Hispanic community through participation in health fairs and the initiation of health education through Spanish radio and television spots. Members of El Consejo collaborate with staff to ensure that the needs of non-English speaking families are supported through projects such as inclusive signage with English, Spanish, and universal symbols.
- Intensive Care Nursery Family Staff Advisory Council (ICN FSAC). In 2012, ICN FSAC was formed to represent the voice of the families of our tiniest patients. The ICN FSAC provides guidance on the selection and implementation of ICN Family Support programs and activities, reviews information for families, and collaborates with staff on a variety of topics.
Since 2008, family advisors have been involved in 138 committees and projects hospital-wide.
Parents Hired As Staff
In 2008, the hospital hired two parents as Family-Centered Care (FCC) Coordinators to represent the voice of patients and families throughout the hospitals and clinics. Coordinators share information with appropriate staff and hospital committee members about issues raised by patients and families, identify opportunities to increase engagement, create educational tools, and educate staff. Working in collaboration with staff to create successful outcomes, the coordinators' responsibilities encompass three main areas: providing the family perspective on committees, managing the Family as Faculty program, and designing support programs for families.
In addition to serving on hospital committees, such as Ethics, Health Literacy, Equity and Diversity, and many Quality and Safety committees, the FCC Coordinators partner with staff from all disciplines on a variety of projects such as the re-design of the website, lab reconciliation, Family Activated Rapid Response, and Sensory Friendly Environment.
In 2012, Children's Mercy formalized a PFCC Policy to ensure that the patient and family perspective is represented on hospital committees, workgroups, and projects. The PFCC Policy quotes the Institute for Patient- and Family-Centered Care definition for patient- and family-centered care and outlines the process for partnering with Patient/Family Advisors (PFAs). PFAs include members of the formal Advisory Boards as well as other parents who have unique experiences beneficial to specific committees and projects. The FCC Coordinators recruit, train, and manage the PFAs. They also provide training to staff on how to effectively integrate PFAs into committees and projects. The FCC Coordinators increased the utilization of PFAs by over 400% since the program's inception.
Family as Faculty Program
Family as Faculty Program recognizes the patient and family expertise and strengths, encourages input, and acknowledges the value of patient and family observations and perceptions across all disciplines of care. Parents are uniquely qualified to educate health care providers about integrating the principles of patient- and family-centered care into their daily practice. Sharing their real life experiences, Family Educators impart vital information that enables clinicians to better understand the health care experience from the family's perspective.
- Patient Care Services Orientation—FCC Coordinators introduce the patient- and family- centered care culture of Children's Mercy to new employees during orientation.
- Graduate Nurse Orientation—FCC Coordinators converse with newly hired nurses about the core concepts of patient- and family-centered care and partnering with patients and families during their health care experiences.
Resident Education—An ongoing, three-year longitudinal PFCC curriculum—developed and implemented in the 2009 pediatric residency program—is designed to help residents understand medicine from the patients' perspective, improve communication, and facilitate sharing of information and decision-making. Activities include:
- Orientation lunch with FAB and TAB members.
- In-home visit with a family whose child has special health care needs, followed by a reflection with FCC Coordinators on how this experience will impact their future practice.
- Death and dying panel discussion with parents whose child has passed away.
- Simulated patient experience about delivering difficult news.
- Child Life and Music Therapy Interns—FCC Coordinators present patient- and family- centered care modules.
- Community Nursing Schools—FCC Coordinators teach classes on patient- and family- centered care to nursing students.
Support for Families
- Parents Offering Parent Support (POPS) is a network of parent volunteers who offer guidance and encouragement to other parents going through the similar experiences with their own children.
- Family Time is an informal social time for families hosted by FCC Coordinators to provide a chance for families to take a break from the bedside and connect with other parents.
- Parent rooms are available on inpatient units to offer family members a place away from the patient rooms to use a computer, eat a meal, make a private phone call, or simply gather their thoughts. Snacks are provided regularly.
- Aftercare Program provides a compassionate support system for families experiencing a death of a child and the staff who care for the children and their families. The program provides comprehensive support and education to those experiencing a loss, including an annual memorial service, a memory book, a grief resource brochure, and quarterly support groups. Cards are also sent to families on Mother's Day, Father's Day, and the winter holidays.
Partnership with Quality and Safety
FCC Coordinators collaborate with staff and families on quality and safety initiatives throughout the institution. Examples include:
- Family Experience Tracers. FCC Coordinators randomly select a family to have an in-depth conversation about their experiences with Children's Mercy. The feedback is sent to Quality and Safety, Patient Advocacy and Service Excellence. There is a system in place with Patient Advocates to take immediate action if necessary.
- Hospital Acquired Conditions (HAC's). A PFA is a standing member of each HAC committee.
- Error Prevention Training. FCC Coordinators co-present this training with a clinician.
- Family Friendly MAR. Families are given a copy of their child's daily medications on a family friendly form to help educate them throughout their inpatient stay.
- Family Accessible Restroom. PFAs partnered with facilities management to design a restroom to accommodate patients and visitors with special needs. It includes an adjustable height-changing station for all sizes, special toileting equipment, and other amenities.
- Family-Centered Rounds. Parents and caregivers are encouraged to participate in family-centered rounds.
- Communication Boards. Children's Mercy recognizes that information sharing is a critical component of patient- and family-centered care. The FCC Coordinators partnered with staff to design communication boards for every inpatient unit to facilitate "two-way" communication.
Designed for Kids
An in-house artist creates unique murals throughout the hospitals and clinics. PFAs collaborated with staff to create a non-denominational chapel, outdoor spaces with fountains, and a 50's-themed cafeteria complete with a jukebox. Color-coded zones and bilingual signage with universal symbols make it easy for patients and families to find their way around Children's Mercy.
Family Presence Policy
Parents and guardians are considered part of the health care team and are not considered visitors. They are encouraged to be with their child 24 hours a day, seven days a week and are issued a special orange wristband to wear throughout their child's stay. This wristband allows them to pass through security without standing in line and gives them access to their child's inpatient unit.
Ten playrooms are available and provide inpatients and their families 24/7 access to safe activity spaces and materials. Seven of the playrooms offer scheduled, supervised sessions each weekday. In addition, the Hematology/Oncology inpatient floor houses a Teen Room, designed and equipped by teens.
Forty-five certified Child Life Specialists routinely cover all inpatient units, the Emergency Departments, Radiology, Same Day Surgery, Dialysis, Hematology/Oncology Clinic, and SCAN (Child Abuse and Neglect), providing consultation and support to all Children's Mercy departments and facilities.
Additional support is offered, such as:
- The Music Therapy Program;
- The Hospital Based School Teachers;
- Provision of coffee and daily snacks for families; and
- Evening programs such as Pet Pals.
Project RISE "Disabilities become opportunities"
Launched in 2007, Project RISE (Reaching for Independent Successful Employment) disability outreach initiative promotes inclusion of people with disabilities in employment, especially former patients of Children's Mercy. Support includes paid jobs within the hospital, volunteer opportunities, transition from school to work programs, and diversity/disability awareness activities. Young adults with significant disabilities are employed in a variety of roles within the hospital and job duties are combined in unique ways to meet identified business needs. Project RISE actively connects the hospital with numerous community partners and business groups to demonstrate the benefits of employing young people with disabilities, many of whom have a history of care with Children's Mercy. The program also connects current patients who are transitioning to adulthood with community resources that can help them with post-secondary education and employment-related supports.
The Beacon Program provides a patient-centered primary care medical home for children with the most complex special needs and their siblings. The medical home team includes medical specialists, nurse practitioners, social workers, clinical service coordinators, case managers, registered dietitians, and allied health providers who are experts in caring for children with complex health conditions. This team communicates with health care providers in clinics, hospitals, schools, and at home to coordinate care and assist with transition throughout the health care system.
This program streamlines the health care process for families that have one or more children with medical complexity, from birth to 21 years, and their siblings. The goal is to simplify appointment scheduling and reduce patient visits and inpatient admissions.
Children's Mercy is recognized as one of the Caregiver Action Network's "25 of the Nation's Best Practices in Patient and Family Engagement." These exemplary practices showcase how patients, caregivers, hospital staff, and hospital systems have created new and innovative programs that are helping to ensure healthier outcomes for patients. Actively listening to patients, creating genuine partnerships between providers and family caregivers and the willingness to learn from mistakes are some of the key elements common to these best practices. Learn more about Children's Mercy's awards.