Over a year and half later, Covid-19 is still finding new ways to disrupt patient lives and their health. Despite the clouds that hang over our heads, Covid-19 is the shock to the system that the healthcare industry has needed. In just over a year and half, healthcare organizations have had to really listen to patient and staff voices, which have become the driving force for change in the industry. Using their voices, we’ve made considerable operational changes to keep providers and staff safe while still being able to offer quality care for our patients through rapidly virtualizing care and sharpening our communications for us to quickly adapt to a fluid situation.
20 years after the publication of “Crossing the Quality Chasm” by the Institute of Medicine (IOM), the search for an operationalized model of Patient Centered Care is becoming more tangible. Although Covid-19 opened the doors for organizations to restructure and rethink how they were going to deliver care, in the quest for a true patient-centered model, organizations need to actually care for their patients. In an NEJM Catalyst article, author Adrienne Boissy, Chief Experience Officer at the Cleveland Clinic, suggests that although clinical teams work hard daily to ensure that patients are as comfortable as possible, we have not yet achieved the goal of “caring for the patient” in health care. Healthcare is eager to identify patient stories and highlight moments of kindness. However, according to Boissy, in order for patients to feel like they are truly cared for, patients need to be at the center of consideration for changes to the following 5 areas:
1) Ease - How can we improve the overall ease of patients’ access to data, appointments, costs and timely care?
If you can imagine calling a company to have a question answered, being on hold for 30 minutes, finding out the person on the line can’t help you, getting transferred, being put on hold again only to end up in a dead end. That is a glimpse into the world of healthcare scheduling. If this is your experience before you even have an appointment on the calendar, it goes without saying that you are going to show up at that appointment already feeling uncared for. It is the prerogative of patients to have easy access to their care, data and appointments.
2) Safety - What can we do to make patients feel like we care? Feel safe? Feel like they can express themselves about aspects of their care?
The number 1 mission of any healthcare organization is to make patients feel safe and well-taken care of. In most cases, top quality care is just one way to create that feeling. The other piece is meaningful communication through bed-side manner and simply asking questions like “What Matters to You” in order to gain insights into what the patient’s goals are and what safety means to each individual.
3) Teamwork - How do we include patients as part of the care team?
Boissy highlights the importance of shared-decision making (SDM) to bring patients into the fold when it comes to clinical decisions. The old antiquated model of providers dictating to patients what their care plan is, must be phased out for the new operationalized patient-centered model. Boissy also highlights the importance of differentiating patient engagement from patient experiences, how to measure both, how to use that data and what their goals are. Needless to say, teamwork within providers and staff are also essential to delivering positive patient experiences.
4) Empathy - Treat patients like a high-end consumer. How do we constantly improve our services? Develop trust? Customize our care? Transform end-of-life care?
An increasing number of healthcare professionals are adopting the idea that patients are high-end consumers. As high-end consumers they expect quality services, customized care, low-costs and capacity to develop loyalty to a brand. It is up to organizations to earn that consumer’s loyalty by developing the quality services they expect, anticipate what their needs are, and develop trusting relationships. One aspect of healthcare that can be considerably improved with this idea is planning for and talking about end-of-life care.
5) Reimagine how we measure experiences - How do we change the way we think about experiential data?
The way qualitative data is collected and used today results in a bombardment of surveys to patients who are tired of filling them out. Surveys that ultimately never ask the question that really matters, “Did you feel cared for?.” At the Cleveland Clinic, Boissy inventoried the number of surveys they were mailing and discovered they were asking patients an astounding 543 unique questions across 20 different surveys. Along with the retrospective nature of surveys, like the HCAHPS survey, narrow focus towards inpatient care and focusing on provider input from only nurses and physicians, all together this should signify the need for an overhaul of the system to be more all encompassing and standardized.
There is no question that the healthcare system is in need of a huge update, where patients need to be centrally integrated, using their experiences as the springboard for change. Boissy and other experts in this field have outlined a path that organizations will need to take in order to reach the long sought goal of revolutionizing healthcare to make good on the timeless promise of caring about our patients.
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Boissy, A. (2020). Getting toPatient-Centered Care in a Post-Covid-19 Digital World: A Proposal for NovelSurveys, Methodology, and Patient Experience Maturity Assessment. NEJMCatalyst Innovations in Care Delivery, 1(4), 1–26.https://doi.org/10.1056/CAT.19.1106
August 27, 2021