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Put Patients First

At the risk of being redundant in my blog posts, I must write once again about the critical importance of person-centered care. If I’ve heard it once, I’ve heard it a thousand times: “The CMS strategy will be built on one main goal: Put Patients First.” At the ESRD Network 16 Quality Conference in October, Dr. Ann O’Hare outlined her approach to person-centered care based on her article in the American Journal of Kidney Disease titled Patient-Centered Care in Renal Medicine: Five Strategies to Meet the Challenge.

In the article, Dr. O’Hare refers to some basic areas where we should concentrate our focus. I have considered broadening the definition of patient-centered care to all persons inside and outside of the walls of our health care system:

outcome domains x mean difference in rating score chart
Evangelidis N. AJKD 2017
  • Listening: What do I really know about those with whom I interact? Do I know the name of their dog? That is a symbolic question to reinforce the core question asking what I really know about those for whom I provide care. Am I systematically and consistently including the voice of those most deeply impacted in the strategy of my organization?
  • Making Time: A largely incorrect assumption in health care states that patients, if asked an open-ended question, will talk well beyond their allotted appointment time. Studies show that when asked an open-ended question such as, “How do you feel,” patient responses averaged a mere 90 seconds.
  • Willingness to go beyond your job description: What could make a difference in the lives of those for whom we care? How can we stretch a little outside our comfort zone? Do I know where those around me are spending the holidays? Could I set out an extra plate?
  • Rethink what we mean by good care: In the medical context, this is huge. On a recent webinar, I was again reminded that the patient’s health care goals may differ, or be completely opposite, from the provider’s goals. Take a look at the graph below to see this dichotomy, then ask yourself how well do we really know those closest to us? What is important to my family? Is what is important to me different from what is important to them? Perhaps a conversation with all stakeholders at the table is worthwhile.
  • See the value in relationship-building: So how does that happen? It involves reaching out when least expected and, in some cases, with no particular agenda. It is about consistency, adding value and being credible, vulnerable and present.

Person-centered care realized, in health care and in life.

I cannot end this post without a shoutout for everything I am grateful for during this season of giving thanks. Gratitude, as we have seen research prove time and time again, reduces stress and burnout. I am grateful for my staff and colleagues who make my work life meaningful; for the promise of a newly merged organization and the positive impact it will have in reimagining health care and for my friends and family including my newly married daughter and son-in-law who began their own journey in person-centered care as physicians in New York City this year. I am grateful and very proud.

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