Imagine that you are going to launch a new program, like patient access to their medical record online, and a visitor from another institution asks for a tour of the work in progress. Then imagine that it isn’t a member of the staff that does the demo – it is one of your patients. I think this idea would sound foreign to most organizations. It’s pretty normal here, and Christine did a great job, on her own, without any oversight or hand holding. This is the level of trust that exists here.
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I have actually never had a patient demonstrate their own access to the electronic health record to me. This was the first time in my career. I am so used to doing the demos and describing what patients want, and this was so different because it included the things that worked best, but also the hopes and dreams for using this tool to be involved in care. Christine not only did the demonstration for me, but also 3 Medical College of Georgia Students, and part of the research team on a funded project to introduce patient access into hypertension care.
In the hopes and dreams part, Christine talked about uses of the system that we might consider concerning as medical professionals, such as writing messages that conveyed a significant level of concern about her condition (she lives with MS), but when she explained it, it made sense, and it became not so concerning.
This was a theme throughout the visit – the normalcy of patient and family involvement in care. This was very evident in the 3W Neurosciences unit and Ambulatory clinic. Countertops are reduced or eliminated. The layout is open. There is no such thing as “visiting hours.” Signage is welcoming and participation is encouraged. There are alcoves for family conferences, and even computers set up for families to use. There is guest wireless throughout the hospital.
As you watch the Remaking of American Medicine show and look at the data associated with this tranformation, it’s very clear this is not only good for families and patients (and society), it’s good for business. Quality is up, mortality is down, patient satisfaction is up, profits are up – all the right trends for a hospital serving a vital population like this.
This organization of course is part of a health care system with many challenges – physicians and nurses have significant time challenges, and even the physicians in training here are at risk in terms of their future enjoyment of the profession. I casually ran my idea of a 4th year rotation on patient-centered care (which would include elements of LEAN such as process flow, physician leadership, and service and access methods) with our student hosts, and they provided a little balance to the concept and assistance with messaging. Matt, Kim, and Brandi reminded me about the immediate needs of physicians in training and the way that they learn about and commit to new training experiences. I’d therefore like to propose a rotation on success in practice beyond the diagnosis – enjoying work, life, and balancing both successfully. Being patient centered guarantees that this is the outcome for any physician, in my opinion.
The thing I am super interested whenever I meet people who have done exceptional things is, “Why?” I noticed that in the PBS show, Medical College of Georgia was an institution in which their transformation was not set off by a patient tragedy. So I asked Pat about this and here’s what she said:
What started this and kept it going and I may have told you this in a way is that we developed a value around the inclusion of the patients voice in our work from the beginning of the design process for the new childrens hospital. I personally was a senior executive back then and I was utterly transformed by the power of the patient’s (in this case, parents and children) perspective on what mattered most in care and I could see that this was a strength that we were denying ourselves as executive leadership. We also had very good mentors way back then in Bev Johnson and the Institute for Family Centered Care and I think we were just open to learning. Because I became so committed and over time could show the hard results in terms of outcomes so did the rest of our leadership. I think it is really that simple….just persistence over many years, Ted.
I think this is very remarkable – Pat and the Medical College of Georgia did not wait for a patient to be hurt to transform their system. I keep reading and hearing about organizations that transform only after a tragedy. We’re health care, we cannot wait for a tragedy, right?
When we were touring 3West, Pat, Roslyn, and Bernard showed me a plaque, signed by every staff member that represents their commitment to patient and family centered care. The first thing I did was look at the date that it was first signed, and of course wondered if it was up to date. As I did that Roslyn said, “Whenever we get new staff, they add their signatures, too. We haven’t had new staff in a long time, though, because people stay here.”
I can’t wait to see the innovation that will come from Medical College of Georgia in the launch of their patient access system. This will take Patient and Family Centered Care beyond their physical buildings and wherever patients and families live, work, and play.
With thanks again to the patients, families, staff, physician and leadership at MCG for being great teachers, so that every patient and family can be involved in their care, whether or not they are fortunate to be supported by the MCG Health System.
And, I am not going to consider patient access to their medical record successful until a patient does the demo.
