March/April 2007

Person-Centered Care Expands

03-07PersonCentered1 Photo

Awareness and active implementation of person-centered care (PCC) are growing throughout Catholic Health Initiatives. “Catholic Health Initiatives’ efforts regarding person-centered care are a natural evolution in our understanding of what it means to serve patients,” said Milt Hammerly, MD, vice president of medical operations and integrative care for Catholic Health Initiatives. Hammerly and Marita Schifalacqua, RN, director of professional practice innovation for Catholic Health Initiatives, use three words to help convey the essence of person-centered care: personalized, comprehensive and collaborative. “As providers, we always strive to do what is best for the patient,” said Schifalacqua. “But, person-centered care takes that a step further by asking, ‘How can we make this care more personalized by design; more comprehensive in scope; and more collaborative in nature?’ Asking these questions helps us view the world through a different set of lenses and opens the door to new ways of delivering services.” Person-centered care is deliberately distinct from patient-centered care. “We want to see those we serve not just as our patients, but as complete persons — with their own values and preferences — who will take an active role in their own care,” said Hammerly. Partnering with Patients Person-centered care also means partnering with patients to redesign care delivery. “We survey patients to find out what they think is important and, in their eyes, how good a job we do meeting their needs,” said Hammerly. “We’ve learned that what health care providers think doesn’t necessarily match what patients think. This enables us to identify areas for improvement. To borrow from Robert Frost, ‘We dance ‘round in a ring and suppose, but the secret sits in the middle and knows.’ The secret to redesigning health care is in the middle: the patient knows. Person-centered care at its best realizes coordination between caregivers, patients and their families, with all of those individuals feeling empowered.” Hammerly said that collaborating more closely with patients can also reinvigorate providers who experience the stresses and strains of delivering health care. “Having patients who are more involved in their own care can really tap into the passion of providers to serve people in need,” said Hammerly. Contributing to Quality “Person-centered care has a direct line to several elements of the Catholic Health Initiatives strategic plan, particularly the Quality core strategy,” said Schifalacqua. “Person-centered care is more than a philosophy because it leads to actions that help actively engage patients and their family members in their care, as collaborators with their caregivers,” she said. “Care that is more collaborative naturally results in better outcomes.” To help MBOs take person-centered care from philosophy to action, Hammerly and Schifalacqua have visited more than 10 market-based organizations to provide education to leadership teams and help them educate their employees. Chief nursing officers often serve as champions of person-centered care. “We can help market-based leaders see how person-centered care extends through all areas of a hospital — everywhere that patients receive care and services,” said Schifalacqua. As person-centered care gains momentum within Catholic Health Initiatives, it is also becoming a more common topic of discussion throughout health care. “Person-centered care was the focus of a track of educational sessions at the Institute for Healthcare Improvement’s most recent conference,” said Hammerly. “However, according to what we hear from our peers, Catholic Health Initiatives has done more than other health systems to promote person-centered care.” Person-Centered Care in Action One of the best examples of person-centered care in action is patient-activated rapid response teams. Rapid response teams are made up of caregivers who respond quickly to a patient’s bedside when the patient shows signs of rapid decline. Rapid response teams that can be activated by nurses and other caregivers have been implemented in every Catholic Health Initiatives market-based organization. Now, some market-based organizations are introducing patient and family activation of rapid response teams. “Patients and their family members often are the first to recognize a change in the patient’s condition,” said Mary Osborne, director of clinical performance improvement for Catholic Health Initiatives. “Knowing they can activate a rapid response team makes them feel empowered and more in control of their care.” Our Lady of the Way Hospital, Martin, Ky., began the process of introducing patient and family activation of rapid response teams in February. “During the admission process, we will provide education to patients and families about their ability to activate a rapid response team,” said Billie Turner, RN, vice president of clinical operations and chief nursing officer for Our Lady of the Way. “We also have the information needed to activate the team in every patient room.” Turner said the hospital’s leadership had some concern that rapid response teams would be overwhelmed by patient and family activation. “But — like most other hospitals that have this program — we’ve found that patients understand the appropriate use of rapid response teams,” she said. “They also know that their nurses are watching out for their well-being, and that their nurses can summon the rapid response team, too.” Public reporting of hospital quality, cost and patient satisfaction data is another expression of person-centered care. Catholic Health Initiatives has been conducting focus groups of consumers to learn more about meaningful information about the cost of their care, particularly estimates of out-of-pocket costs, available via hospital Web sites. Focus group participants have commented that hospital pricing seems mysterious and incomprehensible, but the availability of cost information “helps bring down the wall between patients and the hospital.” “For patients to feel more in control of their care, they need more information,” said Hammerly. “Public reporting provides the type of information that will help patients make health care choices that suit their needs.” Tools and Methodologies Hammerly and Schifalacqua are ready to work with market-based organizations that are interested in expanding the influence of person-centered care in their facilities. “We can provide specific tools and methodologies to assess the status of person-centered care and identify areas for action,” said Schifalacqua. “The market-based leaders we work with develop a new understanding of how person-centered care fits with the core strategies and themes of Catholic Health Initiatives, and how it can — and should — be a part of all clinical and operational initiatives.” “We’re in a transition period of hardwiring person-centered care into the work our facilities and national offices do,” said Hammerly. “We’re progressing along a continuum that began with providing care to patients; moved through providing care for patients; and is now moving toward providing care with patients.”

03-07PersonCentered2 Photo