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This week my intention was to follow up my recent post highlighting kindness, compassion and patient-centered care with additional positive signs of a healthcare transformation where patients and families are engaged, care teams are healthy and whole and positioned to honor their patients, and patient preferences, patient safety and healthcare outcomes are all being optimized.
And then two things happened.
The first was a discussion within the Robert Wood Johnson Foundation (RWFJ) Leadership Network LinkedIn forum. I asked a question relative to patient engagement, tools, lessons learned and best practices, and during the ensuing interchange an individual with much passion and who is also part of a team doing great work in this area used the phrase "... engagement and activation and collaboration have definitely reached buzzword status." That got me thinking. A buzzword--could it be that patient-centered care was simply "fashionable" at this particular time and that in actuality there is no longevity to this movement? Is patient-centered care simply another flavor of the month?
Consumer choice is the new frontier of the healthcare marketplace. While I haven't found anyone that challenges that fact, I encounter many that still resist this reality in their actions and efforts. In the simplest of terms, consumers are people that select a product and pay for it, and we see this happen in significant ways in healthcare today.
With higher deductibles, a broader range of care options and more, healthcare organizations have to work harder to attract the customer to their door (and keep them) at all points on the care continuum, from physician practices and outpatient centers, to acute and post acute settings. The realities are clear as organizations report lower volumes and patients and families are more intentional in their healthcare choices.
While we will never take away the idea of patient or resident at the core of our healthcare dialogue, we do need to remember that in almost all but the most extreme cases, these individuals--and we as family members, friends and patients as well--make choices. We are all consumers. And one thing all consumers have regardless of the setting, and more so in the emotionally charged environment of healthcare, is an experience. We all have one whether planned for or not. It is this very reality on which I want to challenge the misinterpretation of patient experience as satisfaction.
Recently, I sat in on an interview for a vice president of nursing position at a community hospital. During the interview, the chief hospitalist asked the candidate with a sense of fervor, "Who do you think should be running the hospital, the nurses or the doctors?"
I have to admit I was stunned, given the changes in healthcare and the presence of more nurses in hospital leadership roles. However, he was serious.
The New England Journal of Medicine raised the issue in "The Doctor-Nurse Game Revisited" some 24-years ago. Clearly, we still haven't moved forward. This rigid hierarchy that places physicians firmly in charge, even though nurses regularly offer expert advice about patient care, should be extinct. By engaging in this characteristic behavior, hospitals sacrifice communication, and nurses feel frustrated and dissatisfied with working relationships that devalue their professional worth.
by Barry Ronan
Last month a Hospital Impact blogger raised the questions: What is a hospital's obligation to promote and model healthy eating and sustainability habits to both staff and patients.
The Western Maryland Health System (WMHS) is a member of the Maryland Hospitals for a Healthy Environment (MD H2E) and has been since the inception of the organization in 2005. MD H2E advances a culture of environmental health and sustainability in Maryland's healthcare community. WMHS is one of twenty eight Maryland hospitals and health systems participating in MD H2E's latest initiative idea: The Buy Local Challenge.
Simply put, we agreed to support farms by serving and eating local during Buy Local Week, which is this week, July 19 through July 27. We pledged through our food and nutrition service at WMHS to serve at least one local food item each day during Buy Local Week.
Recently, we received a large number of inquiries about our last several blogs here at Hospital Impact. In particular, people are interested in how they can create a culture of innovation in their organization. They're also interested in why it's so hard to get people to become more innovative, creative and capable problem solvers. Times are changing, and to make new ideas actually happen, people need to see, feel and think in new ways those elusive innovations.
Healthcare changes push hospitals and providers to rethink their core values, beliefs and behaviors: the essential elements of their culture.
Indeed, the movement from volume to value sounds cool, but what does it really mean and how do we actually do it? Keeping people out of the hospital sounds easy. Yet the trends suggest that as Baby Boomers age, their in-patient needs will accelerate, not diminish. What is the right direction? When will we know we are making strides? What are the key metrics that show progress, and when do we have to pivot and rethink the new processes or programs we have put into place?
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