Walking down a hallway at Children’s Hospital of Georgia past a room that used to be her office and past decorations and features that she and her late son Daniel advocated for, the memories came flooding back for Julie Ginn Moretz.
“This has been almost an emotional comeback for me because I’ve had to sit down and think about how far we’ve really come here,” said Moretz, the associate vice chancellor for patient- and family-centered care at the University of Arkansas for Medical Sciences.
She was the keynote speaker Thursday at the 10th annual Patient- and Family-Centered Care Conference at AU Medical Center, which continues today.
She formerly was the director of Family Services Development at the Medical College of Georgia before joining the Institute of Patient- and Family-Centered Care. Former MCG President Daniel W. Rahn, now chancellor at UAMS, lured her there with a newly created position in 2013.
Becoming an advocate for patients and families was not a career path she chose, but her experience with Daniel, born with congenital heart problems that required surgery just days after he was born and eventually a heart transplant, and how her family was initially treated prompted her to act against things such as restrictive visiting hours and unresponsive staff.
A patient and family advisory council that was to help with the design of the children’s hospital became a permanent fixture that helped change policies within the health system and led Moretz and the late hospital administrator Patricia Sodomka to become recognized leaders in the field and to be featured in part of the 2006 PBS series Remaking American Medicine.
Much has changed even since then, but a lot has not, Moretz said.
“Some of us having been doing this work for 20 years or more and you would like to think, ‘We’re getting there, we’re getting there,’” she said. “But in reality there is still a lot of work to do across the country.”
One thing that is helping is many patient- and family-friendly provisions were built into the Affordable Care Act in 2010, Moretz said. Hospitals now to have to report patient satisfaction scores to the federal government, and those scores could affect reimbursement. While conceding they are not perfect measures, Moretz said they are important beyond just making sure patients are satisfied with their care.
“At the very least it is getting people to think about involving the voices of the patients and trying to engage them in the right way, involving them in their own care,” she said. “Patient- and family-centered care, it is about safety and quality. It is about quality outcomes.”
Those principles are being built into medical education at places such as UAMS as part of interprofessional education, and health systems are starting to put greater emphasis on health literacy for staff and providers, Moretz said. It is asking the question, “Am I explaining it correctly?” she said. “It takes the onus off the patient and puts it back on to the clinician and the staff members. And that is a huge piece of patient- and family-centered care, providing information in ways patients and families can understand.”
One way of doing that is the “teach-back method” in which patients are asked or encouraged to repeat the medical information they have just been given back to the provider or staff member, Moretz said.
This tells patients, “I want to make sure that I communicated correctly,” she said. “I want to make sure that I explained this procedure correctly. When you go home tonight and you tell your spouse what we talked about, what are you going to tell them?”
It is an attempt to address a major problem – only 12 percent of people in the U.S. would be considered proficient in measures of health literacy, according to the National Assessment of Adult Literacy.
“Nine out of 10 adults may lack the skills needed to manage their health and prevent disease,” Moretz said. “That’s huge.”