Patients and carers have an important role to play in the safe delivery of health care. There is strong evidence that a patient centred focus can lead to improvements in health care quality and outcomes by increasing safety, cost effectiveness and patient, family and staff satisfaction. Patient or consumer centred care is health care that is respectful of, and responsive to, the preferences, needs and values of patients and consumers (AQSCHC 2011).
Australian Commission of Quality and Safety in HealthCare (ACQSHC) has undertaken work in a number of areas to support patients and carers in receiving safe and quality care and patient-centred care is commonly found throughout the new national standards. One aim of the reforms enables healthcare organisations to improve the way they listen to, respond to and learn from people’s experiences.
The Australian Charter of HealthRights (endorsed 2008) underpins the provision of safe and high-quality care to access, safety, respect, communication, participation, privacy – central to patient centred care. These aspects support a shared understanding of the rights of patients and consumers ie: those seeking health care and those providing health care. As a partner with their healthcare providers, patients and carers can participate in making decisions about their own health care and treatment decisions.
Health care can be provided when patients and carers share – with their health care provider – issues that may impact on their compliance with treatment plans.
Environment of Care
Patients often enter the doors of a hospital with heightened feelings of stress, anxiety and vulnerability. The environment that meets them has the potential to profoundly exacerbate, or conversely, to profoundly ease these states of mind, either way often leaving an indelible impression that persists long after the patient has left the hospital. The environment of care is not limited to physical surroundings and aesthetics. It encompasses the totality of the atmosphere of the organisation – the sights, sounds, smells, but also the attitudes, human interactions and accommodations made around patient privacy, dignity, comfort and peace of mind.
Communication Effectively with Patients and Families
Communication effectively with patients and families is a cornerstone of providing quality health care. The manner in which a health care provider communicates information to a patient can be equally as important as the information being conveyed. Patients, who understand their providers are more likely to accept their health problems, understand their treatment options, modify their behaviours and adhere to follow-up instructions. If the single most important criterion by which patients judge us is by the way we interact with them, it stands to reason that effective communication is at the core of providing patient-centred care.
Elimination of Medical Jargon
Health care has a language all of its own. It becomes “second nature” for healthcare staff to be well-versed in the multitude of acronyms, multi-syllabic terms and abbreviations; but for patients unfamiliar with these terms, the confusing language of health care can exacerbate feelings of stress and anxiety. Furthermore, if patients do not understand the instructions for taking care of themselves in such a way that it makes sense to them, they will be far less able to ask informed questions and, ultimately, will be less likely to adhere to their treatment regimen.
Patient-centred care at ALWYN
At Alwyn, we are dedicated to providing a high quality, effective and efficient rehabilitation service by:
- Promoting a culture of partnership with patients, carers, general practitioners/other healthcare and community agencies and,
- Maintaining optimal levels of patient and staff experiences through a multidisciplinary process of continuous improvement.
Key principles of patient-centred approaches at Alwyn include:
- Providing a multi-disciplinary and holistic approach in delivery of care and services, with patient and carers at the centre of the process.
- Treating patients and carers with dignity and respect and encouraging and supporting their participation in decision-making.
- Providing a welcoming environment for patients and families from the first interaction on admission
- Ensure that complaints are resolved with a personal and responsive approach – ie: we listen, respond appropriately and learn from patient’s complaints and experiences.
- Fostering collaboration with patients, carers, visitors and health professionals in policy development, communicating and sharing of information, and evaluation of our services.
- As stated in our philosophy. “we recognise the commitment of our team members as the primary strength in the achievement of our objectives” and we actively encourage and support staff participation in on-going staff development.
Examples of how we involve patients in their care:
- Providing support and training for self-care and self-management eg medications
- Eliciting and taking account of patient preferences eg catering, hygiene, medication management
- Guiding patients to appropriate sources of information on health and wellbeing egInternet, journals, information brochures
- Communication information on risks identified and management plans to plans to prevent further events eg falls, pressure injuries, skin tears
- Sharing treatment decisions – discussing and giving explanations for choice of wound dressing; providing information on modern management of wounds; exercise programs
- Family conferences convened by Social Worker with team members, patients and family in attendance
- Patient pathway for rehabilitation program detailed in Patient Handbook
- Patients sign off on discharge care plan – a copy is provided to the patient and their GP/other agency who may be continuing patient management following discharge.
- Provide a current Medication List and supply of medications to take home.
- Where required, make telephone contact with patient’s own pharmacist/GP to inform them of any changes.
- Wallet card with CEO’s name and hospital telephone number provided to each patient on discharge for contact if experiencing problems after discharge.
- Provision of health information – fact sheets, brochures, copies in other languages available.
- Interpreter services available when required.
- Actively seeking their involvement in focus groups, satisfaction surveys, review of patient information documents, hospital brochure.
Patient-centred care also has a focus on staff. To succeed, a patient-centred approach should also address the staff experiences, because the staff’s ability and inclination to care effectively for patients is compromised if they do not feel cared for themselves. At Alwyn we aim to create and nurture an environment in which our most important asset – our staff – is valued and treated with the same level of dignity and respect that the management expects to be provided to patients and families (Alwyn’s Philosophy GP Manual-Section C1-page 3)
- Provision of inservice education and other opportunities for staff development
- Visibly celebrate staff success and special events in their lives eg birthdays, length of service, new babies
- Provision of complimentary meals and beverages to all staff during their work shift
- Staff and Patient BBQs; Yum Cha; Christmas party; accreditation certifications
- Staff satisfaction surveys;focus groups; meetings
- Orientation programs for all staff – covers patient-centred care
- Flexible shifts and staff leave
- Health and wellness education progrmas
- Staff vaccination program
- Include in performance reviews – that employee behaviour constantly reflects the organisations values
Patient-centred values is a scheduled item on the education program eg:
- Use of the Charter of Patient Rights to promote a culture of respectful, safe and quality care to ensure the best possible outcomes for our patients
- Understanding of the patient/carer’s perspective, expressing empathy and providing appropriate support
- Acknowledge patients by their name. Introduce yourself and who you are.
- Always tell a patient why you are in their room
- Determine specific practices or restrictions that we need to know about dietary, blood practices, chaplain referrals
- Their role in education patients/carers about falls and pressure injury prevention, wound management plans, minimising risks by following basic hand hygiene, respiratory hygiene and cough etiquette etc
- Ensure that their patients understand why certain practices are being undertaken, eg the wearing of PPE such as gowns, masks and gloves is a routine part of infection prevention and control in healthcare – it is used for everybody’s safety
- Make every interaction with patients a learning one for the patient eg bedside medication verification is an important patient safety strategy and also enhances patients’ knowledge of their medications, falls prevention strategies in hospital and at home and in the community.