Johns Hopkins Medicine
Baltimore, Maryland
Headquartered in Baltimore, Maryland, Johns Hopkins Medicine (JHM) unites physicians and scientists of the Johns Hopkins University School of Medicine with the organizations, health professionals and facilities of The Johns Hopkins Hospital and Health System. Johns Hopkins Medicine has six academic and community hospitals, four suburban health care and surgery centers, over 40 patient care locations, a home care group and an international division, and it offers an array of health care services.
JHM is proud of its rich person-centered history, with one of its founding physicians, Dr. William Osler, attributed to having said “It is much more important to know what sort of a patient has a disease than what sort of disease a patient has.”
Early on, JHM’s strategic plan emphasized patient- and family-centered care: "To be the national leader in the safety, science, teaching and provision of patient- and family-centered care." While the wording has evolved over time, the focus on person-centered care remains a pillar and guiding principle to this day.
In 2013, the system established Patient and Family Advisory Councils (PFACs) across all JHM affiliates and began including PFAC members on select entity councils and committees, with an ongoing commitment to continue to do so as new groups form. There are currently over 20 PFACs meeting regularly across the health system, connected through a JHM Collaborative PFAC. The Collaborative consists of representation from each PFAC and comes together to discuss initiatives impacting patients and families across the health system. JHM also relies on focus groups, typically called Patient and Family Cafes, for areas that do not have a need for an ongoing PFAC or are interested in starting one. To expand reach when warranted, there is also a Virtual Advisors group of over 3,000 members that provide feedback via email outreach.
In 2014 the health system announced its first Chief Patient Experience Officer to lead service excellence and patient- and family- centered care efforts and by early 2015, each hospital introduced a 24/7 visitation policy for families and guests, establishing a “health buddy” program through which patients were encouraged to select a family member or friend to provide added support during recovery and follow up care.
Upon the declaration of the COVID-19 pandemic, JHM visitation policies were drastically adjusted from open, 24/7 visitation to no visitation, or visitation by exception only. The organization quickly realized the disadvantages of not having the support of loved ones at the bedside and, in concert with patient and family advisors, established a tiered visitation policy permitting care partners for all patients, including those with coronavirus. JHM defines a care partner as “any adult the patient/parent or legal guardian wishes to have at the patient’s side. The care partner may provide support and/or can be included in the patient’s care decisions, but may not override the legally authorized health care decision-maker (LAHD). Care partners and parents/legal guardians are welcome 24/7.”
Former nurse Katharine Seltz shared a story about the impact a care partner had on both staff and the patient: “[The care partner] was a very devoted spouse who understood the demands of nursing staff. He would take her to the bathroom and keep track of the output. He told me, ‘Go take care of the other patients.’ He updated me every time I came into the room to give medication. This seemingly small gesture was a huge help to the patient and to me. The patient did not have to wait for the nurse to arrive to take her to the bathroom, which helped me, as the nurse, be more attentive to the clinical needs for her and other patients … His help was so much appreciated.”
Upon the end of the public health emergency in 2023, in continued concert with patient and family advisors, JHM developed a health systemwide Care Partner and Visitor policy that continues to delineate between care partners and visitors and encourages the presence of both for the well-being of the patient.
“Recognizing and involving care partners in the support system can lead to significant benefits …. This teamwork not only empowers care partners but also improves the care experience. Embracing care partners contributes to better outcomes and a nurturing atmosphere, ultimately benefiting patients during challenging times,” stated Clinical Customer Service Coordinator, LaMeeca Foushe-Sharpe.
A patient’s family member conveyed, “The way they … welcomed our participation and communicated with us truly spoke volumes to the talent and experience these amazing women possessed and their dedication to their patients. We genuinely felt a part of the team.”
The Johns Hopkins Hospital, JHM’s flagship location, currently has a visitor welcoming system – intentionally named “welcoming” as opposed to “management” to keep the experiences of guests to the campus at top of mind. All guests to The Johns Hopkins Hospital buildings receive a badge with a photo, partial name and expiration date. Badges also have barcodes which are assigned access to their patient’s location for secured units. They are placed on color-coded backings to help staff recognize the appropriate location to assist wayfinding, and also identify the visitor type (care partner, visitor, parent/guardian, etc.) for care team member reference. A patient and family advisory council visitor welcoming system subgroup consisting of representation from The Johns Hopkins Hospital PFACs was created to help co-design and guide that project. Members of the subgroup were included from the beginning of the project, attending site visits to other health systems, evaluating vendors, developing the workflow and design, etc. and continue to be consulted on enhancements post-implementation. Weapons detection is also in the process of being implemented across the institution. PFAC members were included in this selection as well.
The visitor policy, badging system and weapons detection are just examples of how JHM incorporates the voices of patients and families. Over the course of many years, new developments and evolving policies, the importance of patient and family involvement in decision-making and co-designing has remained a consistent priority. Care partners and patient and family advisors are vital in making sure that JHM achieves its strategic goal of being patient- and family-centered. The concepts of PFCC are incorporated into orientation for all new employees, with PFAs assisting specifically with new nurse orientation. Most recently The Johns Hopkins University School of Nursing has made it a priority for students to engage with PFAC members and includes advisors in the development and delivery of course curriculums. Per one syllabus, “Patients and their families must be at the center of the health system to effectively deliver care in a person-centered manner. Our students are excited to learn directly from patients and families about how to partner with patients to deliver person-centered care.”
JHM looks forward to continuing to find creative and innovative ways to live up to its proud legacy of patient- and family- centered care.