A reminder for health leaders to emphasize relationship-centered care

Originally published by Hospital Impact

In my last post, I mentioned the recent opportunity I had to visit a number of well-respected healthcare organizations and meet with amazing servant leaders who are all striving to bring healthCARING back into the healthcare system.

I shared in that post the insights from a chief nursing officer relative to the importance of empathy in healthcare. Today I would like to highlight another discussion, this time with a brilliant physician and chief experience officer (who I will refer to as Dr. Jane Sloan) at a large healthcare institution with reach and impact both nationally and internationally.

It did not take long for Dr. Sloan and me to realize we shared not only many philosophies and a vision for healthCARING, but also a common language.

Many folks talk of patient experience, patient engagement and patient activation, but Dr. Sloan and I honed in on our shared focus on “relationship-centered care” and the importance of:

  • Each member of the care team developing authentic relationships with their patients and families
  • Healthcare leaders developing care models (healthCARING models) that position the care team, i.e., physicians, nurses, physician assistants, etc., to be whole and healthy themselves
  • Structures, learnings, processes and financial drivers to enhance the relationship between care team and patient and family, rather than to create barriers.

Together we also noted that patient-centered care in and of itself is not enough.

One explanation of relationship-centered care (RCC) comes from Mary Catherine Beach, M.D., Thomas Inui, M.D., and the Relationship-Centered Care Research Network:

“Relationship-centered care is health enhancing. It is founded upon, proceeds within and is significantly influenced by the web of relationships that promote the well-being and full functioning of patients. In RCC, the patient is often our central concern, but is not considered in isolation from all others. Instead, while the clinicians’ first responsibility is to prevent and alleviate illness, we do this work mindful of the contributions of the family, our team, our organizations and our community to what can be accomplished. Similarly, we must be mindful of the impact of what we do with patients on the well-being of all others involved, including their integrity, functional capacity, resilience and financial stability. Finally, we do this work in full knowledge that our own well-being and function need to be sustained if we are to continue to serve others vigorously.”

Now all this said, it was actually a story that this caring physician shared that really caught my attention:

“Truly embracing the concept of relationship-centered care, I try to honor this philosophy and approach in all of my encounters with patients.

One day I saw on my schedule that I would be meeting with Mrs. Smith (name changed). She is a 54-year-old, Caucasian woman who had seen members of my care team for 10 or so years but this was my first appointment with her.

I reviewed her file, her previous test results, her most recent test results, her MRIs over time, and I was so very excited to meet with her.

I walked in and introduced myself. I sat across from Mrs. Smith. We made and held eye contact, and we began to talk.

I learned more about Mrs. Smith and she learned more about me. And after a good amount of sharing, I excitedly said,

‘Mrs. Smith, I have reviewed all of your tests and I have great news. You do not have MS (multiple sclerosis).’

Well Tom, here I am thinking I am delivering wonderful news. But no.

Mrs. Smith was furious and was adamant that she had MS.

‘Dr. Michaels said I have a touch of MS. He has been treating me for years. You must be wrong. I want to see MY doctor again!’

I couldn’t believe it. I thought I had done the right thing. I researched her file. I ensured I introduced myself. I began to connect with Mrs. Smith. I was transparent. I assumed this would be good news. And that was one of my mistakes. I assumed.

As I said, this was my first time meeting Mrs. Smith. I had not established a relationship with her to date. I tried to connect during our (albeit limited) time together, but it was not enough. We did not have years of continuous learning and sharing together. I did not understand the emotional and mental aspects of her ‘illness’ and how they were being impacted. I did not realize her very identity was now so thoroughly connected to her illness (MS) that my news was actually devastating to her. I did not know.

Tom, this incident serves as a reminder to me that relationships cannot be hurried. Relationships take time. This situation also serves to remind me that the emotional, mental and spiritual dimensions of health and healing must be embraced by the care team. Only focusing on the physical aspect of health will inadvertently cause harm … like I did.

Looking back, if I could ‘do-over’ my visit with Mrs. Smith I would have discussed her history with her in a far different way. We would have discussed the various dimensions of her health and healing. I would have sought deeper understanding. I would have leveraged my training, skills, intuition and wisdom and developed with Mrs. Smith a pathway that would have helped rather than harmed.

This is how I practice now. This is how I teach and this is how I lead. And as a healthcare leader it is my responsibility to build care models that promote this sort of approach to healing.”

Needless to say, this sharing was passion fueled, from the heart, and a ripple for this chief experience officer to create a wave inside and outside of her healthcare institution.

It is also a reminder for me that we must evolve past patient-centered care and move toward relationship-centered care. We healthcare leaders must stop seeing our world with the blinders of what is and innovate to what should be.

“There are those who look at things the way they are, and ask why … I dream of things that never were, and ask why not?” ~ RFK

Thank you, Dr. Sloan, for being vulnerable and sharing from your heart. You are an inspiration.

Please join us as together we create the healthCARING model of the future … today.

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