It seems everyone is talking about their commitment to patient-centered care. The problem is, so many of our processes and systems were put into place to create efficiencies for the people delivering the care rather than those receiving the care. In fact, we have created so many of these systems that when we do things that are truly patient-centered, we stand out. At least until our competition catches up. And they will catch up.
Think about it. Scheduled meals have nothing to do with the patient’s hunger cycle, but everything to do with the efficiency of preparing and delivering food to a large number of people. Physician rounds are most often done when the physician has time, not necessarily when the patient feels ready to engage in conversation and the care plan. Yet we may look at a tray of uneaten food and assume the patient isn’t feeling well because he hasn’t eaten when in fact he prefers to be awake for a few hours before eating breakfast. Or we think that a patient isn’t engaged if she doesn’t ask questions or seem conversational during rounds. But the truth is that the patient was sleeping just before the doctor entered and needs time to wake up before she can think clearly.
Of course many hospitals have shifted to room service in order to meet the patients’ dietary needs with a more individualized approach. But we still have a long way to go in adopting the mindset needed to be truly patient centered in other areas. What if the patient dictated when she’d like the doctor to make rounds to discuss the care plan? What if the patient could call the care team together when he had questions that involved multiple disciplines? What if the patient could order a post discharge follow up home visit with the nurse, doctor and pharmacist?
Being patient centered requires that we know what they want and are delivering it. It starts with a conversation and one that may not be as complex as the hypothetical situations I mentioned above. The best way that I know to start the shift to becoming more patient centered is by simply asking, “What can we do for you to make your care the best it can be?” It may not solve everything, but it’s a start.
