Defining and Evaluating Excellence in Patient-Centered Care

Abstract

INTRODUCTION Griffin Hospital is a 160-bed acute care hospital located in the highly competitive healthcare market of the northeastern United States. Despite the number of larger and betterknown healthcare institutions in adjacent communities, Griffin has gained a reputation as a hospital of choice through a focused effort to satisfy the full range of patient and family needs. Griffin's approach to patient-centered care is guided by the Planetree philosophy, which promotes patient-provider partnerships through access to information and family involvement and emphasizes caring for and supporting staff so that they can better care for and support patients. At the core of this model is the patient and responsiveness to the patient's needs, expectations, and preferences. A MULTIPRONGED APPROACH TO UNDERSTANDING THE PATIENT EXPERIENCE As illustrated in the articles by Taylor and Rutherford and Steiger and Balog, any undertaking to be responsive to patient needs must be founded on an effort to understand the patient experience - not from the vantage point of a CEO, physician, or nurse, but from the patient's perspective. For those of us who work in hospitals, the language and processes of healthcare are familiar and routine. For patients and their families, they are anything but. Engaging patients to share their experiences and communicate what is most important to them ensures that, despite our fluency in hospital operations, day-today routines and improvement efforts are grounded in the revealing perspectives of those who come to us for care. Griffin Hospital's approach to this work is multipronged. It includes focus groups, telephone and mail surveys, community image surveys, rounding, and the establishment of a patient and family advisory council. Collectively, these methods have amplified the voice of patients and family members and have recast the traditionally passive recipients of care as agents of organizational change. These processes have illuminated opportunities for improvement and have resulted in the implementation of varied strategies to enhance the patient experience. Changes to discharge teaching and billing communications, patient education about the hospitalist program, efforts to reduce noise levels, and the design and services of the recently opened Center for Cancer Care are just a few of the improvements and enhancements driven by patient feedback. Though multifaceted, Griffin's approach to engaging patients and family members is hardly all-inclusive. Inspired by Rutherford and Taylor's recommendation that executives spend hour per month observing patients' experiences, I carved out some time during a recent week to do just that. Admittedly, it was not easy to find the time with so many competing demands jockeying for the top priority. Nonetheless, the true priority was indisputable, and my time connecting with patients and family members proved to be well spent. It was gratifying to hear patients and their loved ones commend the kindness, friendliness, and responsiveness of staff. While much of my discussion with patients and family members was distinctly positive, their personal stories also powerfully convey the persistent challenges of navigating a complex healthcare system even in an organization like Griffin Hospital with a 20-year history of working to demystify the healthcare experience. The son of an 86-year-old patient with emphysema struggled to make sense of the case management process, wanting to do what would be best and safest for his father but unsure of how to maneuver through the logistical and emotional maze of placing his father in a nursing home. Another patient awaiting the results of a biopsy casually mentioned the she has never met her primary care physician, but hoped to, one day. And another family who took turns at the bedside of their loved with a broken knee and wrist from two falls in two days wrestled with her helplessness and with how to make sure all of her needs were met when they couldn't be there. …