“CARE”

I (William) had an experience that illustrates the transformative power of healthcare professionals who truly listen and respond to patient needs. Following an aortic valve replacement at 23, I encountered health issues a few months later. My first cardiologist dismissed my symptoms as mere anxiety, advising me to “toughen up.” This brush-off could have been fatal, but with my wife’s strong advocacy, we got a second opinion. This cardiologist valued my thoughts and feelings and worked with us to identify and address a potentially life-threatening condition. 

Adopting a patient-centered care model, healthcare professionals combine their knowledge with clinical evidence, guidelines, and patients’ individual preferences and values. This strategy includes a two-way exchange of information, personalized feedback, and patient engagement.  Advocated for by many international institutions, such active patient participation is essential for optimized health outcomes and for codesigning the healthcare system, including quality improvement and evaluation. Some positive impacts include: 

1. Reducing disputes.
Informed patients are more engaged and less inclined to give negative feedback. 

2. Improving patient  follow-through.
Understanding medical advice promotes patient follow-through with the care plan.

3. Enhancing perceptions.
Shared decision-making improves how patients view their care and builds trust in the patient-healthcare professional relationship.

4. Better health outcomes.
Knowledgeable patients can contribute more effectively to their recovery. 

What clinicians can do:

Shift the question from “What’s the matter with you? What’s your chief complaint?” to “What matters to you?” as championed by Dr. Michael Barry and Susan Edgman-Levitan. Consider using the acronym CARE as a mnemonic for steps that can aid in comprehension and communication in patient interactions. 

C:
Create an environment for open communication, acknowledging diverse communication styles and practicing empathy, compassion, and trauma-informed care. For example, what factors might make it difficult for patients to discuss treatment? What can you do to provide a supportive environment for that conversation?  

A:
Articulate facts clearly, using plain language and visual aids to ensure understanding. Ask the patient to share what they understood from your conversation and what questions they still have.

R:
Receive feedback actively, allowing adequate time for patient responses to questions. Consider inviting the patient to share more. For example, if the patient says, “I’m fine,” ask “What does great look and feel like to you?” 

E:
Evaluate the interaction, seeking feedback to refine care. Ask “Is there anything that could have made this visit better?”  

Encouraging system-wide feedback: 

1. Utilize a team approach.
Who else can assist with this effort? 

2. Ask patients to share experiences and contribute to the healthcare setting’s evolution.  

3. Use various methods, for example surveys and focus groups, to gather feedback from multiple sources, including patients, loved ones, and others in the care team.

4. Review feedback to identify insights and opportunities for improvement.

5. Share findings with stakeholders to show how their input facilitated quality improvement. 

The global acknowledgment of the need for patients to be active participants in their healthcare journey is blending their voice with clinical expertise to enhance outcomes and satisfaction. By adopting this approach, together we build a more responsive, empathetic, and effective healthcare system. 

What is one small action you can take this week to foster this approach? 

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