ABSTRACT
OBJECTIVE: Present and discuss the development and basic structure of a multilevel approach to strengthen patient and family engaged care, "The New Haven Recommendations on partnering with patients, families and citizens to enhance performance and quality in health promoting hospitals and health services". METHODS: A generic literature review was conducted followed by a Delphi procedure to prepare the New Haven Recommendations. From systems theory perspective, three conceptual levels are used to map action areas to enhance patient and family engaged care. RESULTS: The recommendations propose a multilevel approach to enable patient, family, (and citizen representatives') involvement (a) within direct service provision; (b) among hospitals and health services; (c) in planning healthcare delivery systems and policy. CONCLUSION: The New Haven Recommendations provide a strategic tool and practical recommendations, which can be used for reflection on current practices or generating new ways of thinking about patient and family engaged care. They support the development of patient and family engaged care as core aspect of high quality healthcare, and can contribute to achieving the Ottawa Charter's claim of reorienting health services. PRACTICE IMPLICATIONS: The potential benefit of the multilevel approach is to reorient the basic culture of healthcare towards patient- and health-centered care.
Subject(s)
Family , Health Promotion , Patient Participation , Patient-Centered Care/organization & administration , Delphi Technique , Humans , Quality ImprovementABSTRACT
The Institute of Medicine defines patient-centered care 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." What is missing in this definition is an explicit emphasis on compassion. This perspective article draws on the experience of Planetree (CT, USA), a not-for-profit organization that partners with healthcare establishments to drive adoption of patient-centered care principles and practices by connecting healthcare professionals with the voices and perspectives of the patients and family members who utilize their services. Across hundreds of focus groups facilitated by Planetree, patients and their loved ones emphasize that paramount among their needs, preferences and values are compassionate human interactions. For care to be truly patient-centered, a foundation of compassion is essential. Reports from patients and the media, and research from healthcare systems around the world demonstrate the fallacy of assuming that compassion is a current or prevalent feature of the care experience. Concurrently, a growing evidence base highlights the supreme importance of compassion in driving high-quality, high-value care. However, good intentions are not sufficient for delivering compassionate care. Drawing on the experiences of exemplary patient-centered hospitals (recognized as such following a rigorous culture audit to determine fulfillment of the criteria for formal recognition as a Designated® Patient-Centered Hospital [Planetree]), this paper explores practical approaches for embedding compassion in healthcare delivery and organizational culture to meet patients' expressed desires for empathic and respectful human interactions.
Subject(s)
Empathy , Patient-Centered Care/organization & administration , Humans , Inpatients , Organizational Culture , Patient Satisfaction , Professional-Patient Relations , United StatesABSTRACT
This article describes the history and findings of the Epidaurus Project, a Uniformed Services University-affiliated project to bring holistic care and evidence-based design into the Military Health System (MHS). A distinguished group of civilian thought leaders contributed. The 2005 Base Realignment and Closure process offered a chance to implement the Epidaurus agenda. A new integrated healthcare delivery system, centered around the Walter Reed National Military Medical Center at Bethesda, Maryland, was the result. These facilities will be templates for a new generation of MHS "healing environments" and a model for innovative systems of healthcare nationwide. The Epidaurus Project represents a significant collaboration between civilian medicine and the military in times of war.
Este artículo describe la historia y los hallazgos del Proyecto Epidaurus, un proyecto en colaboración con la Uniformed Services University (Universidad de Servicios Uniformados), para incorporar la medicina holística y el diseño basado en la evidencia en el Military Health System (Sistema de Salud Militar). A ello contribuyó un grupo distinguido de líderes intelectuales civiles. El proceso de Realineamiento y Cierre de Bases del 2005 ofreció una oportunidad para implementar el programa Epidaurus. El resultado fue un sistema nuevo e integrado de asistencia sanitaria, centrado alrededor del Walter Reed National Military Medical Center de Bethesda. Estas instalaciones serán el modelo para una nueva generación de "entornos de salud" MHS y para sistemas de asistencia sanitaria innovadores a nivel nacional. El Proyecto Epidaurus representa una colaboración destacada entre la medicina civil y los militares en tiempos de guerra.
ABSTRACT
This is the seventh and last in a series of articles from Planetree, an international non profit organization founded in 1978 that's "committed to improving medical care from the patient's perspective." For more information, go to www.planetree.org. To register for a free Webinar based on this series that starts on September 21, go to http://bit.ly/aezmEu.
Subject(s)
Patient-Centered Care/standards , Quality Assurance, Health Care/methods , Benchmarking , Health Plan Implementation , Humans , North America , Nurse's Role , Organizational CultureABSTRACT
This is the sixth in a series of articles from Planetree, an international nonprofit organization founded in 1978 that's "committed to improving medical care from the patient's perspective." For more information, go to www.planetree.org.
Subject(s)
Cooperative Behavior , Nurse's Role/psychology , Patient Advocacy , Patient-Centered Care/organization & administration , Professional-Family Relations , Caregivers/education , Caregivers/psychology , Family/psychology , Hospital Rapid Response Team/organization & administration , Humans , Nebraska , Nursing Staff, Hospital/education , Nursing Staff, Hospital/organization & administration , Nursing Staff, Hospital/psychology , Organizations, Nonprofit/organization & administration , Patient Education as Topic , Pilot Projects , Program Development , ResuscitationABSTRACT
When a nurse at the Celilo Cancer Center at the Mid-Columbia Medical Center in The Dalles, Oregon, found out that his patient was scheduled to receive chemotherapy on her wedding anniversary, he asked the woman and her husband what song they'd first danced to on their wedding day. It was "Save the Last Dance For Me," and the next day, when the couple rose from their chairs after the patient's six-hour infusion, the song began playing. Right there in the infusion area, with their arms around each other, they danced. This story illustrates the kind of care that has become the norm at the 10 hospitals in North America recognized since 2007 as patient-centred hospitals by Planetree's Patient-Centred Hospital Designation Program. At these hospitals "patient-centred care" is more than a buzzword. Rather, it's reflected in their mission statements, strategic plans, models of nursing care, and day-to-day operations. While many organizations, including the Institute of Medicine, the Institute for Healthcare Improvement, and Planetree, have endeavored to define patient-centred care, no definition conveys its essence as well as the patients at these hospitals can. "This place has a special character," one patient said in a focus group. Others have said, "You can tell the nurses here care about you as a person," "They are a special breed of people here," and "I don't think it's just a job for them; they're here for a reason." Over the past year, this series, Putting Patients First, has explored several aspects of the patient-centered approach--encouraging patients to review their medical records, lifting restrictions on family involvement in care, and lowering noise levels in hospitals, among others. We believe they show that, ultimately, patient-centered care is more than the sum of its parts.
Subject(s)
Cancer Care Facilities/organization & administration , Patient-Centered Care/methods , Quality of Health Care , Benchmarking , Humans , Nurse's Role , Patient Satisfaction , Patient-Centered Care/organization & administration , United StatesABSTRACT
This is the third in a series of articles from Planetree, an international nonprofit organization founded in 1978 that's "committed to improving medical care from the patient's perspective." For more information, go to www.planetree.org.
Subject(s)
Nursing Care/organization & administration , Patient Access to Records , Patient-Centered Care/organization & administration , Attitude to Health , Connecticut , Counseling , Hospitals, Community , Humans , Medical Records Systems, Computerized , Patient Access to Records/legislation & jurisprudence , Program Development , United StatesSubject(s)
Benchmarking/organization & administration , Health Facility Environment/organization & administration , Holistic Health , Hospital Design and Construction/methods , Models, Organizational , Patient-Centered Care/organization & administration , Family/psychology , Health Services Research , Humans , Interior Design and Furnishings , Patient Satisfaction , Pilot Projects , Total Quality Management , United StatesABSTRACT
Hospitals that provide patient-centered care reap a number of financial benefits, including: Reduced length of stay. Lower cost per case. Decreased adverse events. Higher employee retention rates. Reduced operating costs. Decreased malpractice claims. Increased market share.
