True patient-centered care needs a personal touch

Most discussions about improving patient engagement focus on technology--specifically, on the patient portal--but healthcare organizations cannot forget the human element of the relationship they have with their patients, according to executives from two leading healthcare systems who spoke this week at the Medical Informatics World Conference in Boston.

Pamela Greenhouse, executive director of the Patient and Family Care Center (PFCC) Innovation Center at the University of Pittsburgh Medical Center (UPMC) and Adrienne Boissy, M.D., chief experience officer and director of the Cleveland Clinic's Center for Excellence in Healthcare Communication described the personal approaches their organizations take to provide more patient-centered care.

See care through patients' eyes

UPMC started what it now calls its PFCC methodology at a single bone and joint hospital in 2006. Now the process is in place in 70 clinical areas in eight of UPMC's 20 hospitals, according to Greenhouse. More than 30 other hospitals also use the program, she said.

The methodology strives to view the healthcare experience through the eyes of the patient. To that end, PFCC working groups include everyone from clinicians to parking attendants, Greenhouse said.

The program places heavy emphasis on shadowing the patient experience. Here, observers--be they medical students, new hires in the midst of orientation or middle managers--take in objective and subjective details and bring them back to the working group. The observation process, Greenhouse said, "creates empathy, which leads to inssight ... and an urgency to create change for those who are doing it."  

Changes initiated by the PFCC range from small (universal phone chargers in intensive care unit family waiting areas) to large (restructuring UPMC's Level 1 trauma teams), Greenhouse said.

Engage clinicians to engage patients

All that said, the patient experience won't improve if clinical staff don't buy into the patient engagement process. Making that happens requires a bit of a balancing act, said Boissy.

Physicians need to understand their role in building a relationship with patients, Boissy said. When patients don't give the Cleveland Clinic a patient satisfaction score of  "9" or "10," she said, it's often because they weren't treated with respected or given enough information.

At the same time, physicians need to come to that understanding in a "safe, comfortable place," Boissy said--one mindful of the fact that, while nurses receive regular feedback and training in bedside manner, physicians do not. As you work to engage physicians, be mindful of your institution's larger culture, she said.

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