Putting the Patients and Families First
Phil Hassen, President of the Canadian Network for International Surgery; ISQua Fellowship Forum Moderator.
As we approach this subject, it is recommended that you put it in context with the care and service provided to patients and their families. Begin this Forum by reflecting in how you and your organization are currently putting patients and families first and consider where there are opportunities for improvement.
Patient-centered care is best defined as “providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions”. (Institute of Medicine)
Patient-centred care ensures that patients and families are in the forefront of care, and that patients and families make choices based on informed decisions. You as the healthcare givers/team need to develop a partnership with the patients, their families and the healthcare team. Essentially patients are integral members of the healthcare team and in collaboration with caregivers make important clinical decisions.
There are some core values which are vitally important in forming the basis of patient centred care –
• Patients and families must necessarily participate in their care. Care decisions need to be put before them so they can comfortably make them with you such that they (with you) clearly are making choices for themselves.
• Caregivers actively listen to patients ensuring that families and patients and families have clearly heard what you are saying about the care to be given and that you both validate your respective understanding of each other.
• Caregivers honour the choices of the patients and families and the care plan needs to reflect the basic values of the patients. Patient engagement follows the International Association of Public Participation and the steps to inform, consult, involve collaborate and to empower the patient and family.
On a broader perspective healthcare leaders and providers need to engage families and patients from time to time in quality improvement, patient safety and other programs as they are developed and introduced into your healthcare organization. For example advanced healthcare organizations actually involve patients and families in facilities design and the processes of health care delivery.
Leaders demonstrate their commitment to patient-centred care through words and actions. Further in this important change in care, leaders ultimately engage staff at the nursing unit level in developing the principles of patient-centred care at the nursing unit level. Leaders in partnership with the staff ultimately engage the patients and families in the care processes.
The Kingston General Hospital (www.kgh.on.ca) located in Kingston, Ontario, Canada is a leading example for acute and specialty care and has extensively focused on engaging patients. Partnering with patients and families is embedded into their organizational culture and demonstrated through a strategy and ranges of approaches such as patient and family forums and patient and family advisory councils.
The goal is to create a culture incorporating patient-centered care values. Thus with the physicians the organization realigns the traditional ‘medical model’ with the values outlined herein. Providers – nurses, physicians and other caregivers- will be required to create opportunities for balancing the needs and expectations of the patients and families with the needs of the care delivery team to achieve successful health care outcomes.
In summary, patient-centred care is a long term and challenging journey requiring significant leadership commitment and full involvement of nurses, physicians and other care givers. Your ability to evolve your teams’ care to focus more on the patients and family will ultimately demonstrate higher levels of patients and families satisfaction. When in place patient-centred care affirms the patients’ belief that you as a team are committed to improving their health. In fact where it has been implemented it does reduce concerns, discomfort and stress for the patient, and has also demonstrated increased efficiency and effectiveness for the team and health care organization.
1. What is your perspective on patient-centred care?
2. Have you or your organization adopted this approach to care?
• If so, please give your assessment of its benefits.
• If not, would you consider taking a few steps to move in this direction, and what steps will work in your organization.
3. Can developing countries adopt this practice, and if so what do you recommend as the first steps?
4. With respect to your behaviours in providing care –
• If your organization has adopted patient-centred care, what works for you personally in relation to the patient and family, and why?
• If your organization has not adopted patient-centred care, are you willing to implement some of the principles and which ones, and why?
5. Have you or one of your family members been in hospital and thought that this approach to care would have been beneficial to you or one of your family’s benefit?