Healthcare improvement starts with putting the patient at the center

She was shocked. ‘How could it be?’” Thomas Dahlborg

As I sipped my iced green tea the other morning, an incredible woman who has now become a good friend shared with me the following story:

“To say that Dr. Jankowski [name changed] was absolutely floored when the findings were shared would be an understatement. She was also disheartened and hurt and asked me, ‘how could this be?’”

My good friend continued:

“Dr. J had been charged with instilling a patient-centered care culture within the large healthcare system. She had been working day and night with her team to manifest the needed change and the new focus. She felt good about the effort, and yet the progress was not what she had hoped for or expected. Yes, the healthcare system’s marketing and communications highlighted patient-centered care, and yet she knew if you pulled back the curtain the reality was not congruent with the branding.”


Unfortunately, this revelation was not new to me. Having had the opportunity to speak with many CEOs, CFOs and others in healthcare leadership positions in this country and beyond, I have heard such things as, “My job is to ensure the hospital’s doors remain open. I do not have time for anything else.” And, “It is all about market share. And the most direct way to achieve the goal is through merger and acquisition.” As well as, “A new service line is critical to the hospital remaining financially solvent. And that is where our resources will be focused.”

So I asked my good friend to share with me if she knew what barriers Dr. J. was facing in achieving the manifestation of patient-centered care within her healthcare system.

“Tom, consultants were brought in to assess just that--the progress and the barriers to instilling patient-centered care within her system--and after what appears to be a thorough review what they found was ‘the lack of leadership buy-in to the need for patient-centered care was the greatest barrier to success in this space.’”

And again, unfortunately, this additional revelation was not new to me.

Now, is keeping the doors of an essential hospital open to ensure patient access vitally important? Unquestionably.
Is keeping a healthcare system’s financial standing in good order important so that it is well positioned to fund key initiatives to improve care, safety, health outcomes and value, such as appropriate nurse to patient staffing ratios? Of course.

Is adding new service lines that better meet the needs of patients, families and communities also essential to optimizing care, safety, outcomes and value? Most definitely.

And should healthcare leaders be focused in these very important areas? Without a doubt.

But are patient-centered care (note: I prefer the person centered care and relationship centered care perspective but that is for another post) and these other aims mutually exclusive? Absolutely not. And in fact, more and more data is highlighting the direct link between patient-centered care and optimal care, safety, health outcomes and value.

So does this mean health system leaders are bad and don’t care about patients and families? Not at all.
It means that we have a profoundly broken healthcare system with multiple improvement and innovation needs and requirements. It also means we need to lean in, support one another, understand others’ perspectives and goals, and together improve the system while never losing sight of the people actively engaged within the system.

Each and every healthcare system stakeholder is facing profound challenges, and only with a multi-relational and multi-lens view will we truly move away from a place of blame and move to a place of improvement and innovation--together.

There are many solutions before us, and only collaboratively can we truly honor our missions and all those we work with and serve.

It is time.

Thomas H. Dahlborg, M.S.H.S.M., is an industry voice for relationship-centered compassionate care and servant leadership. He is a keynote speaker, author, consultant and adviser and is the president of the Dahlborg Healthcare Leadership Group.