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The Case for Integrating Patient-Centered Care in Healthcare Organizations

Posted 7:17 PM by

Patient-Centered Healthcare

The best healthcare is patient centered. That concept is easy to verbalize but difficult to put into practice. "Integrating the Principles of Patient-Centered Care" and turning those words into deeds was the focus of the recent Healthcare Leaders of New York panel discussion, hosted by New York Medical College (NYMC) in Hawthorne, N.Y.

Dr. Denise C. Tahara, acting chair of NYMC’s Department of Health Policy and Management, moderated a panel that included:

  • Deborah Neuendorf, vice president of administration, New York-Presbyterian/Hudson Valley Hospital (NYP/HVH)
  • Dr. Maria Lyn Quintos-Alagheband, physician quality officer, The Children’s Medical Center at Winthrop-University Hospital
  • Lauren W. Johnston, assistant vice president for the Office of Patient Centered Care and corporate chief nurse executive, New York City Health and Hospitals Corporation (HHC)

Key takeaway: The principles of patient-centered care must be a part of the very fabric of, and aligned with, each healthcare organization’s mission and values. Otherwise, it is just talk.

Make Patient-Centered Care a Reality

According to Dr. Tahara, it starts at the very top of an organization – with the CEOs, CFOs, COOs, CNOs – and everyone must buy into, actively support and insist on patient-centered care at every touch point. “Senior management," she says, "must drink the Kool-Aid.”

Dr. Tahara advocates leveraging the Centers for Medicare and Medicaid Services incentive programs, which rewards healthcare teams and administrators who understand and live the concepts. The benefit to institutions and departments can be enormous. She says, you will see the benefits – from the patient, from financials and from quality scores and reputation. Simply “broadcasting” – telling the patient what to do – and not actively listening makes it impossible to address patients’ concerns, and that lack of attention will be reflected in institutional and individual quality scores, financials and health outcomes.

Drink the Kool-Aid

Make sure everyone is on board, insists Neuendorf. Senior management, she notes, must be prepared to accept a system-wide change and be encouraged to move from a position of "denial, excuses and blame" to a forward-thinking, action plan for healthcare teams. It is about developing a culture that "won't tolerate" deviations from patient-centered care practices.

And at HHC, says Johnston, doctors and professionals tackled the common problem of patients skipping out on medications, since it was too difficult for them to manage, by turning the problem around and simply asking patients how many medications they could take daily? Senior management and staff then worked with payers and formularies to eliminate red tape by combining multiple drug prescriptions into one pill to cut down on the number of daily medications. As a result, patients took their medications, medical outcomes improved and costs declined.

"Build" Business, Raise Quality Scores Through Incentives

“It’s not what’s the matter with the patient," says Johnston, who banned the phrase "non-compliant patient" at staff meetings. "It’s what matters to the patient.”

According to Neuendorf, prior to bringing on, and implementing incentives, NYP/HVH's predecessor had been failing all quality measures (6% patient satisfaction scores) and losing money. It was not a viable road to travel. 

Financial incentives, she explains, bind high performers to patient-centered care practices hospital-wide and weed out lower-performing workers. She advocates exploring low-cost and no-cost improvements before hiring consultants or other third parties, including weekly staff "book clubs" that study patient-centered care. 

Include the Patient and Their Family – It Will Make Your Job Easier

By listening to patient demands, says Neuendorf, NYP/HVH came up with its acclaimed "no-wait” emergency room, where patients see doctors before filling out paperwork. Paperwork is completed later via a computer-on-wheels workstation. The result: rising quality scores and revenue growth that helped fund a new hospital building – and free parking.

Dr. Quintos-Alagheband of Winthrop agrees, especially when it comes to pediatrics that typically involve a patient's family and relies heavily on two-way communication. She so strongly advocates "putting yourself in the patient's shoes" that Winthrop launched a "patient shadowing" program, which permitted staff to look at, and experience, care from a patient’s point-of-view. 

Johnston also backs enlisting the support of, and educating, the family in patient care. The home hospital model initiative at HHC (which cares for patients speaking more than 120 different languages) works closely with each patient's family to improve the care and outcomes for children with complex medical needs as they transition home. 

Johnston believes that patient-centered care is at the very heart of healthcare reform. “We can’t fix healthcare without involving and listening to the patient.”

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Katz, Sapper & Miller’s Healthcare Resources Group serves healthcare providers, including physicians, hospitals and health systems, surgery centers, and long-term care facilities. Our team of healthcare professionals has the scope and depth to meet client needs. Learn more.

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Comments (1)
Wendy Haas wrote
Thanks for sharing Mike. It's disheartening to this industry lifer that THE primary tenet of healthcare remains an issue. While the industry has been distracted by decades of consolidation and increased regulation with unfunded mandates, providers must focus on their mission of caring for patients and their families. Engaging their target market in this process is not only good business, it's also best practice clinically. In this era of reform, where patient engagement matters and patient outcomes will drive reimbursement rates, this golden rule of patient care remains relevant to all stakeholders.
Posted May 26 2015 11:38 PM
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