Putting Patients First


Posted to Nursing, Nursing Home, Nursing News

Koszivu - Fotolia.com

Going to the hospital is just plain not fun.

But there are some hospitals who are trying new ways to make their patients’ stays as pleasant as possible. They are working with an organization called Planetree, founded by a former patient named Angelica Theiriot.

In the 1970’s, she was very ill and had to be hospitalized. The actual care she got was pretty good, she said, according to this article on the NPR website, “but she was really horrified by the human experience that she had.” She founded Planetree with the goal of changing the health care system to be more patient- and family-centered.

After more than three decades of pursuing this goal, Planetree has “designated” 30 hospitals and nursing homes in the U.S. and four other countries as meeting their criteria as someplace that provides truly patient-centered care.

One such hospital is Fauquier Hospital in Warrenton, Virginia. Its CEO, Rodger Baker, says that while he made the decision to get Planetree certification partly for business reasons, he agrees with the organizations goals and that was a primary motivation. He decries practices such as gowns with no backs on them as “stripping patients of their dignity.”

Fauquier offers services such as making all of its patient rooms private; food is cooked and delivered to order; the walls are decorated with local art; and the hallways are carpeted. They also offer massage therapy onsite, and even bake cookies!

The hospital’s concierge (it has a concierge) says that Fauquier has a “different energy about it” since it adopted the Planetree model.

Doctors and patients seem to agree.

Interventional radiologist Adam Winick admits he was a skeptic at first.

Winick says he was particularly concerned about doing away with set visiting hours, which among other things gave patients’ families open access to the intensive care unit.

“My own little area that I was most worried about was in a code setting when the patient’s heart stops. And having the family members standing there watching I felt would traumatize the patients’ families, because they don’t understand what’s going on,” he says.

But that hasn’t turned out to be a problem after all: The hospital always makes sure a staff member is on hand to explain to the family what’s going on in those situations.

Winick also says that communication has improved between patients and staff, and between doctors and nurses as a result of the changes. Poor communication in the hospital was a key complaint in the poll conducted by NPR, the Robert Wood Johnson Foundation and the Harvard School of Public Health.

“It puts everybody in the mindset that I’m doing this for the patient,” he says. “A doctor doesn’t mistreat a nurse out of anger because he’s doing it or she’s doing it — asking a question for the patient’s benefit.”

Patients also seem to appreciate what they see as more personal care.

“It’s friendly, it’s more like home,” says Marianna Traczuk, who’s been in and out of Fauquier several times being treated for ovarian cancer. She says she prefers Fauquier to the hospital where she used to get care in Maryland. “It’s nice to have someone walk in and say, ‘Hi, how are you today?’ instead of walking by and acting as if you’re invisible.”

And how much more does all this pampering cost?

Actually, unlike many hospitals, Fauquier doesn’t charge extra for private rooms or fancy food.

And Planetree President Susan Frampton says that providing the kind of care that involves patients and their families, and that patients actually want, can cut costs. She says that one hospital system that has some hospitals in the Planetree system and some that aren’t compared its orthopedic patients.

“And they found that the length of stay was actually shorter” in the Planetree hospitals, she says. “People healed quicker, they were discharged more quickly, and so the cost of care came down. So [it was] interesting to counter that misbelief that care has to be more expensive if it’s done in a patient-centered context, or in a place that’s more pleasant to be in.”

But health quality experts like Don Berwick, the former head of Medicare, warn that the most important part of places that are designated by Planetree aren’t the fancy extras like alternative therapies or fancy food — it’s the actual involvement of patients and families in their own care.

“The amenities are nice, of course,” he says. “But what really counts in patient-centered care is that the more patients and families and their loved ones participate in their own care, really play an active role in the care itself, the better the care gets. Outcomes get better, costs fall, and satisfaction increases. So this isn’t about the amenities; this is about the core of health care.”

Berwick and other quality experts also warn that being a patient-centered facility doesn’t itself guarantee high-quality care. Patients still have to make sure the medical staff is following proper guidelines for care and getting those good outcomes. But they say that keeping the patient and family highly involved in their care is one important indicator of a good hospital.