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14 - Actively Caring for Patient-Centered Healthcare

from INTRODUCTION TO PART II - APPLICATIONS OF AC4P PRINCIPLES

Published online by Cambridge University Press:  05 March 2016

E. Scott Geller
Affiliation:
Virginia Polytechnic Institute and State University
Dave Johnson
Affiliation:
Industrial Safety and Hygiene News
E. Scott Geller
Affiliation:
Virginia Tech Blacksburg, VA
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Summary

Only by changing how we think about kindness at the bedside, in the workplace and in our community can we deliver world-class care to our patients.

– Gary Greensweig

What could be more fertile ground for the AC4P Movement than healthcare? The aims of AC4P parallel what healthcare has been recently attempting to accomplish with patient-centered care – creating cultures of empathy, compassion, and interdependence.

The roots of patient-centered healthcare date back to 2000, when a landmark Institute of Medicine study estimated medical errors contributed to 44,000–98,000 preventable deaths and 1,000,000 excessive injuries each year in the United States. The impact of these medical mistakes was widespread, extending beyond fatalities and permanent disabilities to include hospital-acquired infections, hospital readmissions, wrong-site surgeries, wrong medications and incorrect dosages given to patients, and emotional trauma for both patients and their families.

Subsequent to this awareness of healthcare errors, a paradigm shift has begun to slowly emerge: from physician-centered care to patient-centered care. From physician knows all to patients know best how well their healthcare providers are meeting their needs. The traditional physician-centered approach to healthcare is humorously depicted in the illustration on the next page and is seemingly still the perception of many benefactors and beneficiaries of healthcare.

PHYSICIAN–PATIENT EMPATHY

One of the tenets of patient-centered care is a positive relationship between the recipient of healthcare and the caregiver, whether a surgeon, hospitalist, resident, nurse, X-ray technician, MRI operator, primary-care physician, or the technician who draws blood and takes blood pressure readings in a patient's hospital room. Some healthcare facilities have taken this paradigm shift a step further by teaching the AC4P principles of patient-centered care to almost all new hires, from housekeepers and receptionists to maintenance workers and those who bring patients their meals.

Patient-centered care has a long way to go before it becomes institutionalized in healthcare facilities and throughout the medical community. But the healthcare industry is now aware, if not always accepting, of the truism that patients want personal connections with their physicians, nurses, and other caregivers. This requires physician-to-patient communication that includes empathic listening and relationship-building conversations, as discussed in Chapter 5.

Furthermore, some medical schools are teaching their students how to practice empathy. Why? Empirical research has demonstrated substantial benefits of physician empathy.

Type
Chapter
Information
Applied Psychology
Actively Caring for People
, pp. 451 - 468
Publisher: Cambridge University Press
Print publication year: 2016

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References

1. Institute of Medicine (2000). To err is human: Building a safer health system. Washington, DC:National Academies Press.
2. Richert, J. (2012, January 24). Patient-centered care: What it means and how to get there. Health Affairs Blog. Retrieved May 21, 2014 from http://healthaffairs.org/blog/2012/01/24/patient-centered-what-it-means-and-how-to-get-there/.
3. Rodak, S. (2012, October 18). Ten guiding principles for patient-centered care. Becker's Hospital Review. Retrieved May 21, 2014 from www.beckershospitalreview.com/quality/10-guiding-principles-for-patient-centered-care.htm.
4. WMCN, “Dawn,” Interview with Mohammadreza Hojat, Ph.D., Thomas Jefferson Medical College research professor (February, 2014).
5. Block, L., Hutzler, L., Habicht, R., Wu, A. W., Desai, S. V., Silva, K. N., et al. (2013). Do internal medicine interns practice etiquette-based communication? A critical look at the inpatient encounter. Journal of Hospital Medicine, 8(11), 631–634.Google Scholar
6. Gregory, G. C., Gotto, J. L., Mangione, S., West, S., & Hojat, M. (2007) Jefferson scale of patients’ perceptions of physician empathy: Preliminary psychometric data. Croatian Medical Journal, 48(1), 81–86.Google Scholar
7. Hojat, M., Axelrod, D., Spandorfer, J., & Mangione, S. (2013). Enhancing and sustaining empathy in medical students. Medical Teacher, 35(12) 996–1001.Google Scholar
8. Geller, E. S. (2014). Living with cancer: The survival power of AC4P. In Geller, E. S. (Ed.). Actively caring for people: Cultivating a culture of compassion (4th ed.) (pp. 311–318). Newport, VA: Make-A-Difference, LLC.
9. Geller, E. S., & Johnson, D. (2007). People-based patient safety: Enriching your culture to prevent medical error. Virginia Beach, VA: Coastal Training Technologies.
10. Greensweig, G. (2011). Recognizing the value of kindness in healthcare. posted online March 13, 2014 at www.hhnmag.com, Hospitals & Health Networks magazine.
11. Cooper, M. D. (2003). Behavior-based safety: Still a viable strategy. Safety & Health, 4, 46–48; Daniels, A. C. (1989) Performance management. Tucker, GA: Performance Management Publications; Fellner, D. J., & Sulzer-Azaroff, B. (1984). Increasing industrial safety practices and conditions through posted feedback. Journal of Safety Research, 15, 7–21; Geller, E. S., & Williams, J. H. (2001). Keys to behavior-based safety from Safety Performance Solutions. Rockville, MD: Government Institutes; Geller, E. S. (1998). Understanding behavior-based safety: Step-by-step methods to improve your workplace (2nd ed.). Neenah, WI: J. J. Keller & Associates; Geller, E. S. (1999).Behavior-based safety: Confusion, controversy, and clarification. Occupational Health and Safety, 68(1), 40–49; Krause, T. R., Hidley, J. H., & Hodson, S. J. (1996). The behavior-based safety process: Managing involvement for an injury-free culture (2nd ed.). New York: Van Nostrand Reinhold; McSween, T. E. (1995). The value-based safety process: Improving your safety culture with a behavioral approach. New York: Van Nostrand Reinhold; Sulzer-Azaroff, B., & de Santamaria, M. C. (1980). Industrial safety hazard reduction through performance feedback. Journal of Applied Behavior Analysis, 13, 287–297; Williams, J. H., & Geller, E. S. (2000) Behavior-based interventions for occupational safety: Critical impact of social comparison feedback. Journal of Safety Research, 31, 135–142; Zohar, D., Cohen, A., & Azar, N. (1980) Promoting increased use of ear protectors in noise through information feedback. Human Factors, 22(1), 69–79.
12. People-based patient safety: A skills-building and life-changing process. (2007). Virginia Beach, VA: Coastal Training Technologies. A videotape and DVD program with a workbook for each of five videotapes and DVDs designed to teach healthcare workers strategies for reducing errors in hospitals and medical centers in order to keep their patients out of harm's way.

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