The overarching goal of the NCMHI family engagement quality improvement project (FEQIP) was to improve family engagement in pediatric primary care practices. This was accomplished by increasing knowledge of concepts and implementation strategies related to family engagement among participating practice teams and increasing the capacity of participating teams to make practice improvements related to family engagement. The FEQIP was implemented over the course of ten months with eight primary care pediatric practices participating. 

      • Participating teams reported a 77.8% increase in knowledge of family engagement.
      • All participants reported clinical improvements due to the project, such as focusing on family strengths and implementing shared plans of care.
      • Most participants reported improvements made at the practice-level, such as adding front desk staff to increase capacity and encouraging parents to speak at staff meetings.

More information about lessons learned during the FEQIP can be found in the Enhancing Family Engagement through Quality Improvement: Lessons Learned from the Family Engagement Quality Improvement Project fact sheet.

View this video tutorial for a section-by-section overview of the implementation guide. Interested individuals can learn more about how to use the resources to meet individual needs and learn brief details about various tools and resources included in the implementation guide.

All handouts from the implementation guide below have been compiled into a single document for easy viewing. The entire document can be viewed here.

Updated: April 2018

 Background and Project Overview

Overview

      • This quality improvement project implementation guide is available to assist American Academy of Pediatrics (AAP) chapters, Maternal and Child Health Title V / Children and Youth with Special Health Care Needs programs (MCH Title V / CYSHCN programs), clinical practices, and other organizations interested in implementing a quality improvement/Maintenance of Certification Part 4 project. All resources are free of charge and available for customization.

Definition

      • Family engagement is a family-centered and strengths-based approach to making decisions, setting goals, and achieving desired outcomes for children and families.
      • Family engagement is an innovative approach grounded in mutually beneficial partnerships among health care providers, patients, and families.
      • Family engagement and family-centered care improves patient and family outcomes, increases family and clinician satisfaction, decreases health care costs, and improves effective use of health care resources.

Top Resources

 Project Planning

Prerequisites for Project Planning

      • Before initiating a family engagement quality improvement project, organizations and practices should consider if they meet a few prerequisites that support successful planning and implementation, including the following:
            • Are there entities, such as practices or individuals, that are ready to make a change to enhance family engagement within your community, state, and/or organizations?
            • Are there appropriate resources available within your organization to support implementation of this project? These resources could include technology and budget to support a shared work-space and virtual meetings (conference calls, webinars) and support staff to coordinate efforts?
            • Is there a strong team leader or champion who has the interest and capacity to lead quality improvement efforts within each practice site? This individual does not have to be a pediatrician.
            • Seek feedback from stakeholders including parents and caregivers. Are there individuals within a practice who would participate in a multidisciplinary team or who would share diverse perspectives? A diverse quality improvement core improvement team facilitates improvement activities and should include representation of individuals impacted by the project.  

Project Planning

 Pre-work, Orientation, and Baseline Data Collection

 Learning Session(s)

​Learning Session(s)
Learning sessions allow participants to meet project staff, the quality improvement advisors/coaches and other participants face-to-face and discuss the project and available resources. Sample materials for these sessions are included below. To access PowerPoint slides for the presentations listed below, email medical_home@aap.org.

      • Learning Session 1
          • Agenda
          • Agenda Book
          • Presentation Topics
              • Helpful Tools for Parent Partners
              • Introduction to Family Engagement
              • Model for Improvement
              • Quality Improvement for Parent Partners
              • Shared Decision Making
              • Sustainability
          • Story Board Presentations
              • Instructions
              • Presentation Template
      • Learning Session 2
          • Presentation Topics
              • Sustain and Spread
              • Parent Panel Template Presentation

 Action Period

​Action Period
Action periods involve participants implementing interventions such as small-scale changes using the Plan, Do, Study, Act (PDSA) cycle. The action period also includes data collection, narrative progress reports, and educational webinars. Resources used for action period(s) are included below.

 Post-Implementation

Post-Implementation
Once action periods are complete, post-implementation resources can be customized to assist in evaluating successes and challenges of the project.

 Lessons Learned

​Lessons Learned

      • Family engagement is a continuum. Clinical teams and practices vary in their levels of foundational knowledge and expertise in the topic area.
      • Practices are beyond the "what" and "why" and want to focus on "how"; Maternal and Child Health Title V / Children and Youth with Special Health Care Needs programs can support practice teams in these efforts.
      • Parent/caregiver partners are important, but clear roles and responsibilities are crucial to success.
      • Small changes are key to success.
      • Quality improvement science and related methodologies take time to learn and implement.
      • Teams can be busy and it is not always possible to meet face-to-face. Innovative strategies to meet as a team are needed, such as flexible hours or meeting during nights/weekends.
      • The fact sheet, Enhancing Family Engagement through Quality Improvement: Lessons Learned from the Family Engagement Quality Improvement Project, provides more information about lessons learned during the Family Engagement Quality Improvement Project.

 Results

​Results

      • Participating teams reported a 77.8% increase in knowledge of family engagement
      • All participants reported that they made clinical improvements because of the project, including the following:
          • Focusing on family strengths
          • Communicating directly with the patient rather than just the parent
          • Incorporating shared decision-making
          • Utilizing the teach-back method for improving patient-provider communication
      • Most participants reported that they had implemented practice-level improvements as well, including the following:
          • Developing policies and procedures for referral tracking and follow-up
          • Making their patient portal and website more parent-friendly
          • Increasing the number of front desk staff to enhance patient communication
          • Creating handouts to help parents choose a specialist
          • Inviting parents to speak at staff meetings
      • Final aggregate run charts
      • Summary of Key Findings

 Acknowledgements

Acknowledgements

The National Center for Medical Home Implementation is supported by the Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) under grant number U43MC09134. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the US Government.

For more information about the Family Engagement Quality Improvement Project or materials included in this implementation resource guide, please contact us here.