I have seen the rise and fall of many Family Councils in pediatric health centres over the past ten years. Here is what I have learned….
- Are organic, and come from the request of families.
- Have senior leadership support – including senior leaders who come to council meetings and events.
- Report directly to senior leadership on the organizational chart.
- Are a true collaboration – this means they have an even ratio of families and staff/physician/leaders on the council.
- Consider having a ‘co-chair’ model – a family chairs with a staff champion.
- Have fixed terms for participation – so that the council membership gets renewed on a regular basis. There is a mix of ‘senior’ and ‘junior’ council members.
- The meeting time and place is carefully chosen so it is both family and staff friendly.
- There is a way to accommodate families who are from out of town (Skype, conference call, etc).
- Both families and staff are screened – they fill out an application form and go to an interview (conducted by both staff and a family representative).
- Members commit to attend meetings and participate in working groups.
- The council is supported by a dedicated staff member (not just ‘off the side of a desk’). This person should be chosen carefully for their beliefs in family centred care, their listening skills and their understanding of the family experience.
- The council should identify how they are engaging staff and families. This expectation should be made clear to the members. This includes establishing a clear sense of meaning to the council.
- There should be a fun, social element to council, so that members get to know each other as people, not just as professional roles.
- Council meetings should be inclusive and friendly – including utilizing roundtable introductions, a ‘buddy’ system for new members, co-presenting by both families and staff.
- Sharing both family and staff stories should be an element in each meeting.
Councils that have struggled:
- Are set up by the hospital, instead at the request of the families.
- Have too many family reps, or too many staff reps – the balance is off.
- Lose their senior leadership support.
- Have one staff or one family presence that is too strong.
- Have a negative tone, instead of a constructive one.
- Don’t celebrate their small wins.
- Set up meetings according to staff, not family schedules.
- Are too corporate and intimidating for families.
- Are considered ‘tokenistic’ by families – they don’t see any ‘real action’ from their ideas or work.
- Actual change is non-existent, or happens too slowly.
- The staff have a ‘no’ attitude, instead of a ‘yes, how can we make this happen?’ attitude.
- The staff reps are not truly family centred in their philosophy.
- The staff in the hospital are not open or ready to accept change suggested by council.
I have also learned:
A council is not the only way to include the family voice in your hospital.
Here are some alternatives to councils. These might be in place before a council, or while a council is set up:
- Network Model – this model emphasizes communication about family centred care with staff and interested families. It may include a newsletter that shares family centred care best practice, family stories and volunteer opportunities for families.
- Staff Engagement – even if staff need to hear the family voice, if they are not ready or open for it, things will not end well. Working with them on reflective practice about family centred care, self-care techniques, and sharing family stories to build a compassionate hospital environment is crucial.
- Family Advising/Engagement in Program Work – this is an ad-hoc engagement on different projects/opportunities – including family stories at orientations or other speaking opportunities, engaging families on committees or other meetings/events, naturally including families in activities at the hospital (social events, professional development, etc).