Healthy World, Healthy Nation, Healthy You

Effectively Communicating with Family Caregivers-Patient and Family Centered Care at the Hospital of the University of Pennsylvania

Dr. Mary Walton-Nurse Ethicist-Hospital of the University of PA

Mrs. Anita McGinn Natali-Artist, wife, mother, care giver, and advisor, Hospital of the University of Pennsylvania. Philadelphia, PA, Volunteer, National Oral Cancer Foundation


WaltonMary K. Walton has practiced in academic health care settings for over 35 years and has a progressive history of leadership. Roles of staff nurse, clinical nurse specialist and nurse manager included responsibility for clinical ethics committees and ethics consultation services, cultural competency training and establishing evidence-based practice standards.  Currently she is responsible for organizational initiatives focused on clinical ethics and improving the patient and family experience of care. She is a frequent guest lecturer in nursing programs and hospitals on nursing practice issues and has presented her work at national professional meetings.

Ms. Walton holds a Bachelor of Science Degree and a Master of Science Degree from the University of Pennsylvania School Of Nursing and a Master of Bioethics Degree and a Certificate in Clinical Ethics Mediation from the University of Pennsylvania, School of Medicine.  She has published in the areas of advocacy, collaboration, ethics, healthy work environment, patient-centered care and nursing history.

AnitaAnita is a wife, mother, grandmother, and a professionally trained Fine Art Painter, with a BFA from Temple University’s Tyler School of Art. She was a single Mom to two teenage sons working as an Art Director when she met Clark Natali in 1993. Five years later, in 1998, Anita and Clark married on a gorgeous October day surrounded by their family and friends. Throughout their relationship, Anita and Clark enjoyed skiing, traveling, boating, golfing, and spending summers at the shore. In 2003, Anita retired from pharmaceutical advertising to pursue painting full time. In 2007, when Clark was diagnosed with oral cancer, Anita became her husband’s caregiver, helping him through a serious health crisis that would last more than 5 years.

Today, Anita is a volunteer and Co-Chair on the Patient and Family Advisory Council at the Hospital of the University of Pennsylvania. Additionally, she donates her oil paintings to The Oral Cancer Foundation to help raise funds for awareness, prevention, and education. Anita is profoundly grateful to the people of HUP and OCF for their continued care and support for her husband and herself.


Patient and Family Centered Care at the Hospital of the University of Pennsylvania is a program that invites selected former patients and family members to get involved as volunteers advising senior executives, clinical staff and the entire organizational community in how to take better care of patients. This direct consumer input has been vital in improving services for all patients. The program was started by the nurse leaders and was quickly embraced by all key leaders and physicians. Mary Walton is the manager of the program and Anita McGinn Natali is a volunteer in the program. Their discussion of how the program works will allow viewers to see an example of how consumer feedback improves a healthcare organization and will provide an example of how all hospitals can adopt such an approach in order to provide excellence in care.

Anita writes the following about her experience with her husband’s illness:

In 2007, my husband was diagnosed with oral cancer and I immediately became his caregiver and advocate, a role I willingly embraced. Navigating the health care system for my husband became my full-time job. I am a hands-on erson who enjoys being actively involved rather than being an observer.

My husband had a resection from ear to chin, tracheotomy, and free flap from his thigh for reconstruction during his initial hospitalization at HUP. He received his nutrition and medications from an NG tube.

The nursing staff encouraged and taught me to: clean and suction the trach; administer meds and tube feed; manage wound care; observe and recognize changes; and, know when to call for help. I felt included and an integral part of his care.

It is empowering to be an important part of his health care team. In the months and years following, he has had return visits for radiation, infection and numerous surgeries for reconstruction. He always refers to his appointments or scans as, “we have a PET scan…” As challenging as those years were, I can’t imagine not being involved.

Today, my husband is healthy and active. I am so grateful for the care he

received that I wanted to volunteer at HUP to give back. Last year, I met with Mary and joined the Patient and Family Centered Care group as an Advisor. At our monthly meetings, we review special projects, that are submitted by various departments in the hospital who are looking for participation from our group. Having gone through a serious health challenge with my husband reinforced the importance of a caregiver in the treatment and recovery of a patient both physically and emotionally.

I am honored to share my experience with others and I hope that my participation will mean positive change for patients and caregivers alike.

3 Key Points:

  1. Active involvement in care vs. just observing, releases stress for family members.
  2. Nurses are key in inviting family to assist in care in order not to feel helpless.
  3. Volunteering as a follow-up is an outlet for passion and giving back to an institution.


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