Patient Centeredness

On the American Hospital Association's Quality web page, the real business of health care is about:
1. preventing ill-health
2. caring for people who are sick
3. meeting the needs of people with chronic disease or disability
4. making people in communities healthier.
The Institute of Medicine's Crossing the Quality Chasm report defined patient centeredness as focusing "on the patient's experience of illness and health care and on the systems that work or fail to work to meet individual patients' needs".
Several characteristics of patient-centered care have been identified based on work done by The Picker Institute:
1. respect for patients' values, preference and expressed needs;
2. coordination and integration of care;
3. information, communication and education;
4. physical comfort;
5. emotional support;
6. involvement of family and friends;
7. access.
Patients vary on their desire to be involved in their health care. Patients today are made to feel excluded as partners in the discussion and decisions that affect them and the health care they receive. As a consequence, patients and their families find the health care they receive to be impersonal and incomplete.
At our family health center and in the hospital at Nature Coast, we strive to be all inclusive with patients and family members concerning decisions about choices related to health care needs. It does not take any longer to have a meaningful discussion with a patient and with their family about what to do. I am a big believer in having an open dialogue about the risks and benefits of treatments. I see myself as a coach who guides my patients through the maze of what has become one of the largest bureaucracies in the world, the U.S. healthcare delivery system.
What do I believe is the critical success factor for patient-centeredness? The clinician must develop the skills of being a good listener. When an open-ended question is posed to the patient at the beginning of the encounter, "What can I help you with today?" or "What brings you in to see me today?", when left alone the patient will talk about their issues for around 2 minutes and stop. It is this uninterrupted time that makes the patient feel as though they have had the opportunity to become a partner in their care. This is the most critical time period that begins the cascade of patient-centered decisions and activities.
The number one reason that malpractice suits are brought against most physicians is the perception that there was a significant failure to communicate with the patient.
Making the patient the center of the healthcare universe should be our number one priority as our nation attempts to rebuild the healthcare delivery system.
The patient is the center of our universe at Nature Coast. In just a short while, patient care surveys will be done to check my perception.
Dr. Dale