Pushing BACK on Patient Centered CARE! (We knew that.)

March 18th, 2012 by Nick Jacobs Leave a reply »

In a New York Times Op-ED by Theresa Brown on March 15th entitled Hospitals Aren’t Hotels, she clearly articulated the company line regarding the new patient centered care requirements being imposed upon hospitals by previously the Bush and now the Obama administrations through CMS.   Although Ms. Brown is most probably a world class nurse, she echoes the sentiment being expressed by many healthcare leaders regarding the realities of current thinking in hospital care.  In her op-ed, she writes that “A lot of what we do in medicine, and especially in modern hospital care, adheres to this formulation.  We hurt people because it is the only way we know to make them better.” 

Having been in senior management in healthcare for over twenty years as an officer and for the last dozen years prior to my retirement as a CEO, this type of rationalizing was a constant symphony.   My experience was very different because it was from the patient’s point of view.   Almost ironically, prior to entering the healthcare field, I was the CEO of a Convention and Visitors Bureau, and I saw firsthand what could be done in healthcare.   The irony for me was that, once I was in a position to introduce a more patient centered environment in hospitals, the push back was relentless and unending.  That was until I became a CEO and took an unmovable stand on this issue.

You see, this is not a situation where patient centered care resulting in higher acceptance wouldn’t work; it is a situation as so aptly described by Ms. Brown where “We hurt people because it is the only way we know to make them better.”   Once while observing a young child being treated in the Emergency Room I heard blood curdling screams.  After the treatment was complete, we brought that team of care givers together to discuss what had happened.  During that conversation, we asked if any type of topical pain killer could have been used.  Their response was, “Yes, of course, we just never did it that way.”  It was done that way from that day forward.

What we are missing here can best be described by reading the poem “Calf Paths,” by Sam Walter Foss in which he describes a walk taken by a medieval calf that ended up being the foundation laid for what later became a road, then a primary street through a medieval town and finally a major highway.  Healthcare is based on conservative tradition, and it is well known that, as stated by a seasoned VA nurse at a presentation that I gave, “We are famous for eating our young if they don’t follow the traditional path set out for them by our healthcare ancestors.”

Our hospital offered massage, stress management, music, aroma, pet and all other types of therapy.  We had 24 hour visiting, beds for our visitors beside their loved ones and double beds in the OB suites.  We baked bread in the hallways, had popcorn machines and live music in the lobbies, but most importantly, we provided our employees classes in emotional intelligence and sensitivity.   We provided them with the knowledge that every aspect of what we did we did as a Good Samaritan.  We embraced the philosophy of “Doing unto others what we would have others do unto us,” and then we capped that with a commitment to provide unconditional love to our patients and their families.

The result?  This hospital had the lowest restraint, readmission, lengths of stay and infection rates of it 18 peer hospitals.  But most importantly, even though the patients came from the same pool of humanity, we had the lowest mortality rates. But here’s the real irony for this lesson, our employee and patient satisfaction rates were in the highest possible percentages.  Treat people with kindness, love and respect.  Explain to them when they will hurt and why and then respect their needs.  That’s not a hotel.  It is a center for healing.






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  3. Stacy Reynolds, RN says:

    “For thus such reverence is lent
    To well-established precedent.”
    Amazing analogy. This is something I will take with me into my future and pass along to those who come behind me.
    Thank you for your insight!

  4. Karla Baning says:

    Mr. Jacobs,

    I just completed my doctorate of nursing. My doctoral work focused on Patient and family-centered care in the adult ICU. “Caring” for patients and their families entails a great deal of emotional risk for healthcare providers working in the ICU. I share your opinion that one of, it not the most important interventions to facilitate change is education. Educating providers allows them to implement practices that are humane, compassionate, and medically sound while enjoying a level of enjoyment for their work that far outweighs the emotional pain it sometimes produces. When we learn what patients and their families need and have the emotional and practical resources to provide for those needs, doing so becomes a joy and a privilege rather than a burden. Thank you for the work you have done in this regard.

  5. Mark says:

    What you’ve done in your hospital reflects above all, excellent management that includes the needs of patients and staff training as well.
    Great example how to run a hospital!

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