Now Reading: Integrating Patient- and Family-Centered Care With Health Policy

As Regina Holliday (@ReginaHolliday) and I discussed in our TEDx Talk (“Embrace of Failure” – Henry Ford Innovation Institute), health care is addicted to not involving patients and families in the design of the system that’s built for their benefit. Multiple reasons, including fear, lack of self-confidence, and also not knowing how to do it. That’s where Tony DiGioia, MD’s (@PFCC_) work comes in. It’s not that hard and it’s possible in every specialty of medicine, every one of the health professions – Tony’s an accomplished orthopedic surgeon at one of the most prestigious institutions in the United States.

This paper includes tidbits including a description of the first mention of the term “patient-centered care”:

Balint introduced the term in 1969, referring to the need for physicians to build a physician-patient relationship by seeing each patient as having a unique experience of illness.

Isn’t it interesting that 1969 is also the birth year of the specialty of family medicine – a lot of innovation was going on in the 1969.

I digress, though. Tony and I think very much the same way when it comes to involving patients and families in the design of the health system. This paper takes that passion and applies it to requirements of the Accountable Care Act and vice versa, connecting what should be done to what needs to be done. Easy!

Actually, the easy part is that Tony’s methodology doesn’t take a lot of resources, just the ability and interest in listening and observing. He discusses the limitations of data (I am also in agreement, when I talk about data versus facts – Getting the Facts about patient and family experience: Shadowing (presentation) | Ted Eytan, MD).

When patient satisfaction benchmarks are exceeded, we tout the results; when they are not, we variously (1) attribute the results to comparing “apples to oranges”; (2) are frustrated by the fact that the data is necessarily dated because of the time it takes to distribute, collect, collate, and disseminate it; (3) are frustrated by the difficulty of identifying root causes for both positive and negative patient satisfaction data, and (4) redouble and reprioritize our efforts to achieve better outcomes and scores despite the inevitable shortcomings of the data.

One great aspect of the PFCC methodology is that Tony’s view of what the care team is is much broader – innovation and caring comes from everyone on the team:

The PFCC M/P defines caregivers broadly, as any person within the health care setting whose work touches a patient’s or family’s experience (eg, doctors, nurses, therapists, technicians, appointment schedulers, parking attendants, medical records clerks, etc).

He involves all of them in the process to produce a healthy, cost-effective, high quality care experience. Want to practice how it’s done and you’re close to Washington, DC? Come to VisionQuest on May 10, 2013 at The Center for Total Health (@kptotalhealth). We’re hosting this with Tony because we want to build a base in Washington, DC for this approach as a norm rather than an exception in health care here. There are a limited number of scholarships available – contact me in the comments or tweet me @tedeytan and we’ll set you up. If every health system did this there would be a lot less unnecessary un-health.

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