“The introduction of “What Matters to You”: a quality improvement initiative to enhance compassionate person-centered care in hospitals in Ireland

Abstract

Rationale for this initiative: On admission and throughout the acute hospital stay, the main focus of the healthcare professional is the medical model of care, which revolves around the physical status of the patient (Dewar & Nolan 2013). Hospital staff work in a system where patient flow and lengths of stay are indicators of effective organisations (Shahin & Mahood 2007). The emphasis appears to centre on “What’s the matter with you” (Doyle et al. 2010). While the presenting health issue is a concern to the patient, their experience of hospital care is measured by the level of dignity, compassion and respect with which they are treated (HSE & Age Friendly Ireland 2015). The Service Plan explicitly emphasises that people’s experience of the health service must be “safe, of high quality, but also caring and compassionate” (HSE 2015 p. 3). Compassionate care involves knowing the patient as a person (Lown et al. 2011) and developing a relationship of equals where the carer conveys an understanding of the patient’s suffering in a way that alleviates some of that suffering (von Dietze & Orb 2000). There is a critical link between services who regard the patient as an equal contributor to their care, where their opinions are sought and valued, and the provision of compassionate care (NHS 2014). The “What Matters to You” (WMTY) initiative supports this concept. It is a process that seeks to identify the concerns of the individual admitted to hospital and, thereby, facilitates the delivery of person-centered, compassionate care. Description of the initiative: WMTY is an approach to care that promotes compassionate relationship-centred care (Dewar & Nolan 2013). It involves introducing a change in practice, whereby, nursing staff ask about what is important to the patient, rather than simply concentrating on their diagnosis and past medical history. The literature suggests that to provide compassionate care we need to know the details of care that matter to the person (Burnell & Agan 2013, Health Foundation 2014). Information captured through WMTY provides staff with a unique knowledge of the person, which then informs the plan of care for that patient. It is recorded on the WMTY board, which is kept at the bedside, or as determined by the patient, for ease of access by all healthcare professionals. The IHF “What Matters to Me” education programme has been adapted for use in the acute hospital to support this initiative. A suite of documents were developed to provide guidance and information, thus supporting the project’s implementation.