A Call to Action: It’s Time to Break Another Glass Ceiling
By Lisa Freeman, Member, Planetree Patient and Family Partnership Council and Executive Director, Connecticut Center for Patient Safety
Patient-centeredness crystalizes around the patient/family member being a full and equal member of the patient’s care team. Everything is done with the patient rather than for the patient. This concept is what differentiates patient-centered care from patient-focused care, and has been correlated to better outcomes, higher patient satisfaction and lower costs.
For many patients and family members like myself, we accept patent-centeredness as a given, the only way that it should be. And yet, as I have become more familiar with the healthcare system, it has become clear that patient-centered care represents a stark departure from business as usual. It often requires significant changes involving new ways of thinking and new ways of doing things.
These days, discussing and debating patient-centered care as a solution for bringing about safe, high quality care while reducing the overall cost of healthcare is a hot topic among healthcare governing boards. But when it comes to role modeling the new ways of thinking and new ways of doing things in this new paradigm of patient partnership, most healthcare boards are falling short.
Today, in most healthcare organizations—even those celebrated as among the most patient-centered—boards and governing committees lack the pivotal patient/family member perspective. In other words, the typical board make-up has remained more or less unchanged even as expectations about the role patients will play as partners in achieving a high quality, high value healthcare system have been radically upended. At most healthcare organizations, the boards are often made up of community business leaders (lay people) and perhaps some physicians and other healthcare stakeholders who bring their related experience to board-level discussions. But where are the patients and family members?
Patients and family members are among the most underutilized resources in healthcare. To not include them on hospital and other healthcare boards and committees is a great missed opportunity. After all, these boards have the highest decision-making authority. It is also at this governing board level where the essence of the organization’s culture is being created and disseminated. It is from the top leadership of each facility that the expectations surrounding the meaning of quality of care are established.
Patient-centeredness, in the truest and broadest sense of the word, needs to be not only embraced, but reflected at this highest level of governing. A hospital or other healthcare facility would simply be a purposeless structure if it were without patients. We are essential to the purpose and meaning of what healthcare providers are there to do. Every decision within the organization’s walls will directly or indirectly impact patients and their families—be it a decision about signage, staffing levels or about quality standards such as physician credentialing. As patients and family members, we have a unique perspective that adds value to these conversations.
Some might argue that patients do not have the level of medical expertise that a physician board member has to inform their thinking on these important decisions. However, the chief of medicine, who has not yet been a patient in a hospital, may not have the level of expertise on the patient experience that the patient brings. Additionally, a physician board member may not have the business expertise that a community business leader might have and vice versa. It is important for the board to have full representation and participation of those who are impacted by the decisions made—decisions that, in turn, affect the care that is provided to the community that the facility is in place to serve.
As a first step in acknowledging the value of the patient/family voice, a growing number of hospitals, long-term care communities and physician practices have established patient and family partnership councils. This is an important and commendable first step, but it is only a first step. The natural next step is to invite patients/family members onto the governing boards where their voice is not only heard, but is part of the top level decision-making process that is there for the purpose of providing care to no one else but the patient.
When hospitals and other healthcare facilities embrace patients and family members on their boards they have now enhanced and elevated the meaning of shared decision making – bringing it to the governing level. By true leadership through example, each healthcare organization that embraces patients and family members in this way is not only taking important steps to assuring the highest level of quality care, but they are demonstrating their commitment to true patient-centeredness.
As a patient, there is nothing that is more important to me than seeing this top-down leadership through example occur in every healthcare organization across our country.