PUTTING PATIENTS AT THE CENTER HEALS MANY ILLS

In 1977, 32-year-old Angelica Thieriot was hospitalized with a life-threatening condition. The clinical treatment she received was excellent, but the overall experience was not. Glaring fluorescent lighting. A lack of privacy. Limits on visits from loved ones. And perhaps, most important, the absence of simple, basic, humanizing care.1


Her experiences would have a profound impact on the healthcare industry that has continued to influence care delivery to this day. Thieriot decided there must be a better way, one that was more respectful of patients and their loved ones. In 1978, she founded an organization called Planetree. Its goal: To “reclaim for patients the holistic, patient-centered focus that medicine had lost.”


As Dr. James Merlino, wrote in an article in Health Catalyst: “If health systems want to improve the patient experience, they need to put the patients first and at the center of everything they do. The ‘soft stuff’ counts to patients, and patients will continue to gauge their quality of care on their own proxy measures (like being treated respectfully) because that’s what they understand.”8


What if small things, such as bringing in trusted brands that patients use and prefer in their own homes, could help to create a healing environment and support the core principles of patient-centered care? 

In fact, a survey has found that 64 percent of patients say they feel more cared for and more at home when they see familiar brands.

 

Planetree set about evaluating everything in the hospital setting from the perspective of the patient and “whether it enhanced or detracted from personalizing, demystifying and humanizing the patient experience.”


Its impact on care delivery – and on patient satisfaction – has been profound. Beginning with the opening of the first Planetree model hospital unit in San Francisco in the 1980s to partnering with the U.S. Department of Veterans Affairs to develop the Office of Patient Centered Care to hosting conferences of the World Health Organization, it continues to lead to this day.


And healthcare facilities that have embraced its philosophy and put its tenets into action are finding that patient-centered care benefits institutions as well as patients. For example, Planetree-designated hospitals consistently outperform the national average on HCAHPS surveys since public reporting of scores began.2

 


 What Is Patient-Centeredness?

Patient-centeredness is defined as encompassing “qualities of compassion, empathy and responsiveness to the needs, values and expressed preferences of the individual patient.”3

Patient-centered approaches to care have been shown to improve patients’ health, lessen patients’ symptom burdens, increase compliance with treatment regimens, and reduce the chance of misdiagnosis due to poor communication.4 They have also been shown to reduce both underuse and overuse of medical care, reduce the strain on system resources and save money by reducing the number of diagnostic tests and referrals.5

The Business Case for Patient Centeredness

According to the Institute for Patient and Family-Centered Care (IPFCC), patient-centered care has become the business model for the Medical College of Georgia (MCG) Health System in Augusta, because it positively affects each of the MCG’s business metrics (finances, quality, safety, satisfaction and market share).

Three years of quality improvement data supports this:

• Patient satisfaction increased from the 10th to 95th percentile

• Volume of discharges increased by 15.5 percent

• Length of stay in neurosurgery decreased by 50 percent

• Medical errors decreased by 62 percent

• Staff vacancy rates decreased from 7.5 percent to 0 percent

• Perception of the unit by doctors and staff underwent a positive change6


Such findings led Patrick A. Charmel, president and CEO of Griffin Hospital, and Susan Frampton, president of Planetree, to conclude that patient-centered care is not merely philosophical.7 It is sound business practice.


The Role of Environmental Services in Caregiving

In a truly patient-centered healthcare environment, everyone is a caregiver–from physicians and nurses to environmental services (EVS) professionals. As caretakers of the hospital environment, EVS professionals and their chosen solutions can also make a difference.


According to Planetree’s 10 tenets of patient-centered care, “physical environments can enhance healing, health and well-being.”


A hospital stay can be a jarring experience. A patient is placed, often suddenly, in an unfamiliar institutional setting—without many of the comforts of home. But that doesn’t have to be the case. What if you could make an impact on patient care through the “little things” that can help to turn your healthcare facility into a “healing home”?


And an article in the New England Journal of Medicine about the role of amenities in hospital care posited: “If amenities create environments that patients, providers and staff members prefer, then providers and staff members may give better care and service in those environments, and patients may have better health outcomes.”9


 

“Hospitals as Hotels: The Role of Patient Amenities in Hospital Demand,” a paper published by the National Bureau of Economic Research, also supports this theory. It cites a 1994 study by J.P. Newhouse,10 who compared the hospital enterprise to that of an airline, “for which good food, attentive staff and pleasant surroundings are plausibly important aspects of the overall service,” adding: “Yet good measures of such amenities have been lacking for hospitals. Thus, findings of substantial productive inefficiency among American hospitals may in fact point to a substantial role for amenities.”11 


Patient Satisfaction

While patients are hospitalized for medical reasons, that doesn’t change their status as consumers. In many cases, they have a range of options available to them and can often choose where they want to receive care. In addition, a negative experience in a hospital may not only cause a patient not to return there but may have a ripple effect with family members and friends through word of mouth. All this can affect a hospital’s bottom line, through HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores and reduced occupancy levels.


In fact, research from the Gallup Management Journal Online, as reported by Becker Hospital Review, has shown that patient and family engagement obtained through a more patient-centered care system consistently improves hospital performance and business outcomes, including long-term earnings.12


For these reasons, it’s essential to make the physical environment as appealing as possible and to find solutions that enable EVS professionals to do their jobs efficiently, so they have more time to spend with patients to provide those caring moments that can truly make a difference.


The familiar can play a role here as well. Trusted, reliable brands that are known to patients and staff use at home can improve efficiencies. For example, time spent refilling dispensers is time that could be better spent on something else—like sharing a moment with someone in need. By reducing the risk of product run-out or dispenser malfunctions, these systems give EVS professionals and other caregivers more time to care.


Smart investments in towel, tissue and skincare solutions can not only improve staff efficiencies and reduce costs, but may help create a healing environment that improves the patient experience and HCAHPS scores by:

• Enhancing hygiene and cleanliness

• Improving quality of service

• Minimizing run-out to maximize hand hygiene

• Minimizing environmental stresses by reducing noise and disruptions

• Giving EVS workers more time for a caring touch


An EVS staff that is empowered to deliver compassionate care can help to accelerate healing and improve patient satisfaction, too. Given the importance of the patient experience–84 percent of healthcare leaders rank it as a top priority13 –it’s essential to do all you can to deliver the best possible experience. And it’s also good business too.


There is actually a bottom-line pragmatism in this, supported by empirical studies linking emotional and physical well-being, according to Lloyd H. Dean, president and CEO of Dignity Health. “Where there’s kindness and compassion, the probability and quickness of healing rises exponentially.”14

1 http://www.healthy.net/Health/Article/Planetree_The_Homey_Hospital/1036
http://archive.boston.com/bostonglobe/editorial_opinion/oped/articles/2010/01/11/providing_quality_care_and_a_human_touch/
2 http://planetree.org/reputation/
3 National Healthcare Quality Report. 2010. Chapter 5. “Patient Centeredness.”
https://archive.ahrq.gov/research/findings/nhqrdr/nhdr10/Chap5.html
4 Ibid.
5 Ibid.

6 The Commonwealth Fund. 2007. “Patient-Centered Care: What Does it Take?”
http://www.commonwealthfund.org/usr_doc/Shaller_patient-centeredcarewhatdoesittake_1067.pdf
7 Healthcare financial management : Journal of the Healthcare Financial Management Association 62:3 2008 Mar pg 80-5
8 Health Catalyst. “How to Improve Patient Satisfaction Scores By Using Data.”
https://www.healthcatalyst.com/how-cleveland-clinic-improve-patient-satisfaction-scores-data-analytics
9 New England Journal of Medicine 2010; 363(23): 2185-2187; Dec 2010. “The Emerging Importance of Patient Amenities in Hospital Care.”
http://www.nejm.org/doi/pdf/10.1056/NEJMp1009501

10 Newhouse, J. P. (1994). “Frontier Estimation: How Useful a Tool for Health Economics?” Journal of Health Economics 13(3):317-322.
11 National Bureau of Economic Research. December 2008. “Hospitals As Hotels: The Role of Patient Amenities in Hospital Demand.”
12 Becker Hospital Review. May 2015. “5 ways your hospital can benefit from patient-centered care.”
13 Kirkland, A. Healthcare Finance News. July 25, 2015. “The Culture of Patient Experience”
14 Forbes. March 2014. “The Power of Compassion to Drive Your Bottom Line.”

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