Originating in the 1950s, patient-centered care has made leaps since the turn of this century, both in terms of its development and its implementation into practice.^[i] It takes a philosophically different approach to healthcare, changing the practitioner-patient dynamics and viewing the patient (and, in some circumstances, their family members) as a partner. Patient-centered care goes beyond being simply a mindset and a promise made to patients, but requires taking action and consistent follow-through.

The Institute of Medicine’s publication, Crossing the Quality Chasm: A New Health Care System for the 21^st Century, acknowledges patient-centered care as a fundamental component of the future of healthcare.^[ii] The Institute For Patient And Family Centered Care builds on this by identifying four critical pillars of patient-centered care:

1. Respect & Dignity: Practitioners listen and incorporate the patient’s points of view. The uniqueness of the patient, including their values, beliefs, and cultural background, is incorporated into the planning and delivery of care.
2. Information Sharing: Practitioners are communicative, sharing timely, complete, objective, and up-to-date information that enables patients to take an active role in decision-making.
3. Participation: Patients are encouraged to take an active role in participating with practitioners in the decision-making process.
4. Collaboration: All parties, including patients, play a role in collaborating on things like policy & program development, engagement on facility design and delivery of care, etc.

Taking Action

At Level5, our work often incorporates Customer Centricity — a foundational mindset and methodology we use to help organizations engage, attract, and retain customers, donors, or, in this case, patients, while establishing a compelling differentiation. Keeping this in mind, there are several steps that can be taken toward becoming a more patient-centered organization — spanning from how you think about planning through to how you execute a transformation. In other words, making promises and consistently keeping them.

Promises…

We often start by aligning the organization around clear statements of strategic direction (informed by a robust fast base). As a starting point, try to answer that existential question of ‘why does our organization exist?’ to determine your purpose. Next, think about what you want the organization to embody in 5+ years and use that to craft a vision statement. Finally, develop a mission statement that defines how to get there and values that provide guidelines for expected behaviours and ways of working.

For example, consider the corporate statements of Sinai Health, a Toronto-based healthcare system:

• Purpose: We care, create possibilities and offer hope.
• Vision: We discover and deliver life-changing care.
• Mission: Sinai Health delivers excellent and compassionate care in hospital, community and home. Focusing on the comprehensive needs of people, we push boundaries for health solutions and innovative models that connect care across the continuum, and the lifespan. We discover and translate scientific breakthroughs, and educate future clinical and scientific leaders.
• Values: Service, Humanity, Inclusivity, and Discovery.

These can act as your ‘promise,’ or a guiding light for identifying initiatives that help the organization take incremental steps toward change. For example, in Sinai Health’s case, this comes to life via implementing a policy on patient-centered care that creates day-to-day processes for the organization and its employees to uphold. In addition to this, benchmarks and metrics should be built to ensure progress is made.

…Consistently Kept

We then work with our clients to form and execute tangible transformations that help turn these aspirational strategic statements into a reality. Utilizing Level5’s Customer Centricity Framework, examples of bringing to life patient-centered care could include:

• Developing an understanding of the patient’s journey, and along that journey, where ‘moments of truth’ and ‘pain points’ exist. If the long, seemingly never-ending wait times distort patient reviews, consider a software that could increase wait-time transparency or better expedite minimal-risk, low-effort processes.
• Identifying what is driving patients’ decision-making from both a rational and emotional context. These insights give perspective into what patients really want out of their relationship with their practitioners. For example, consider Doctors Ezekiel and Linda Emanuel’s study, Four Models of Physician-Patient Relationship, which outlines doctors who take a paternalistic approach versus an informative, interpretive, or deliberative view.^[x] Patients are not a one-size-fits-all, and developing processes to better understand these rational and emotional drivers can help nurture stronger relationships between practitioners and patients.

Becoming patient-centered not only provides tremendous value to patients, but to all parties involved. To institute proper patient-centeredness, it is not enough to simply make promises. To see real change, it is vital to follow through and keep them.

References:

^[i] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5728618/

^[ii] https://pubmed.ncbi.nlm.nih.gov/25057539/

^[iii] https://pubmed.ncbi.nlm.nih.gov/23894060/

^[iv] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3589960/

^[v] https://www.researchgate.net/profile/Wayne-Weston/publication/12292586_The_Impact_of_Patient-Centered_Care_on_Outcomes/links/004635260327e8a432000000/The-Impact-of-Patient-Centered-Care-on-Outcomes.pdf

^[vi] https://catalyst.nejm.org/doi/full/10.1056/CAT.17.0559

^[vii] https://pubmed.ncbi.nlm.nih.gov/21551394/

^[viii] https://www.researchgate.net/profile/Wayne-Weston/publication/12292586_The_Impact_of_Patient-Centered_Care_on_Outcomes/links/004635260327e8a432000000/The-Impact-of-Patient-Centered-Care-on-Outcomes.pdf

^[ix] http://pqcnc-documents.s3.amazonaws.com/fpe/fperesources/BuildingBusinessCasePCCCharmelFrampton2008.pdf

^[x] https://www.unlv.edu/sites/default/files/story_attachments/1111/11.08.18%20SOM%20Journal%20Club%20Article.pdf