Family care map: Sustaining family-centered care in polytrauma rehabilitation centers

Abstract

The study assessed sustainability of the Family Care Map, a family-centered approach to providing care for Veterans with polytrauma-related injuries, in four Department of Veterans Affairs Polytrauma Rehabilitation Centers. We applied a mixed-methods approach. Staff surveys used standardized measures of sustainability, commitment to change, information, and partici­pation during implementation. Qualitative inquiry assessed Family Care Map implementation and facilitators and barriers to sustainability. Staff sustainability perceptions had a significant positive correlation with affective commitment to change, par­ticipation, and information received about the change process. Family Care Map integration into standard practices and use of its concepts with patients and families related to staff percep­tions about sustainability. The degree of use and integration of the Family Care Map in traumatic brain injury/polytrauma care varied among the Polytrauma Rehabilitation Centers. Some suc­cessful sustainability strategies included integration into daily workflow and organizational culture. Examples of sustainability barriers included staff awareness and use and outdated informa­tion. Some practices, such as measuring and documenting the use of the Family Care Map in treatment plans, may not rou­tinely occur. The focus on family-centered care will require fur­ther evaluation of organization-, staff-, and innovation-level attributes that influence sustainability of changes designed to improve family-centered care.