C L O S L E R
Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

Patient-Centeredness in The Hospital

How can we make hospital care even more patient-centered?

Takeaway

One way to demonstrate patient-centered care is creating spaces in which patients feel less vulnerable. A space that is safe, calm, and private is ideal for healing.

Patient-centered care is a buzzword in modern healthcare. It’s the idea that we shift care from being driven by clinicians and institutions to being driven by the needs of the people whom clinicians and institutions serve—our patients and their community of support.

 

Long-gone are the days of healthcare professionals independently dictating the care plan and expecting patients and their families to unquestionably “fall in line.” Now, we know that patients are leaders and partners in care. However, we’re still developing our ability to consistently and optimally create processes and resources that genuinely place patients and their families at the center of care.

 

The real issue

Clinics and hospitals seek to be places of healing, but they can also cause much disruption in the lives of patients and their families. It could be argued that a measure of disruption is necessary, but how can we minimize this? Shouldn’t we be continually asking ourselves and colleagues how we can make care even more patient- centered?

 

Patients come to us in vulnerable states, often for things out of their control. Once they’re admitted to the hospital, their control their environment and schedule is even more limited. We dictate when they eat, rest, get their medications, and much more. As a nurse, I see how patients interact with many facets of hospital life, from nutrition services delivering food to scheduling and transportation for diagnostic testing and procedures.

 

“This isn’t the time I take this medication at home,” is a common comment I hear in the pre-dawn hours when I give medication. Another is, “I didn’t sleep well.” Some might assert that “hospitals are just busy,” but is that thinking from a truly patient-centered perspective? We can’t avoid all disruptive aspects of care that occurs. However, we can pause to think about how to minimize the disruptive and intrusive aspects of healthcare in the hospital.

 

3 things we can do to create truly patient-centered care in the hospital:

 

1. Avoid creating overwhelming situations or those that exacerbate a patient’s vulnerable position.

When rounding, think about how entering the room with numerous people could make patients feel exposed. This is particularly critical when their body will be touched, examined, or on display in some way.

 

2. Get to know patients as people.

Ask patients about their life at home—their family, friends, neighbors, hobbies, passions, and favorite foods.

 

3. Take time to communicate effectively. 

Ask what you can do to improve their stay in the hospital.

 

 

This piece expresses the views solely of the author. It does not represent the views of any organization, including Johns Hopkins Medicine.