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Heed patient, industry calls for compassionate care

Posted Apr 11 2013 8:54am

by Thomas Dahlborg

Mr. Roberts was in the hospital being prepped for an angiogram. When Sally (the hospital chaplain) met with Mr. Roberts, he shared that his wife had passed away two months earlier; he was struggling to cope and recently had a heart attack.

Sally was fully present and attentive to the patient; she was supportive and listened and empathized with Mr. Roberts' struggles, pain and fear. And she asked whether he had shared this information with his doctor, and learned he had not.

Shortly after this powerful sharing, Mr. Roberts' doctor walked in and Sally asked the patient if he wanted to share their discussion with the doctor. So Mr. Roberts proceeded to tell his doctor about his wife passing away, and his struggles and fear.

His doctor's response?

"Sorry to hear that Mr. Roberts. So, about your angiogram ... "

Does this response align with patient-centered care? Does this response lead to an optimal patient experience? Is this response relationship-centered or heart-centered? Does this response represent the "care" in healthcare?

The Hippocratic Oath states: "I will remember that there is art to medicine as well as science, and that warmth, sympathy, and understanding may outweigh the surgeon's knife or the chemist's drug."

Yes ... warmth, sympathy and understanding in healing (i.e., compassionate care) are as essential to an improved healthcare system as a new building or a new technological advancement--and far less expensive.

And patients want more from their doctor than a diagnosis, a treatment recommendation and a referral.

In fact, according to a study published in the Annals of Family Medicine, 83 percent of patients want physicians to ask about spiritual beliefs and more than 60 percent believe information concerning their spiritual beliefs would improve the physicians' ability to provide care, as well as encourage realistic hope.

Even clinical experts agree.

In her article , "The role of spirituality in health care," Christina M. Puchalski, M.D., highlighted that a group of experts convened by the Association of American Medical Colleges listed the following as the number one essential physician attribute: "Physicians must be compassionate and empathic in caring for patients. ... In all of their interactions with patients, they must seek to understand the meaning of the patients' stories in the context of the patients' beliefs and family and cultural values."

Clearly this did not happen for Mr. Roberts in his interaction with his physician. Though, it did occur in his connection with Sally (his chaplain).

Interestingly, Puchalski also noted even The Joint Commission recognizes the importance of focusing beyond just clinical care in its policy/standard: "For many patients, pastoral care and other spiritual services are an integral part of health care and daily life. The hospital is able to provide for pastoral care and other spiritual services for patients who request them."
Compassionate care is patient-centered.

Compassionate care is desired by patients and thus improves the patient experience.

Compassionate care is recognized as important by those within the traditional healthcare sector, e.g., AAMC and TJC.

Compassionate care is an inexpensive innovation in healing.

And compassionate care leads to better care and health outcomes ...

Compassionate care has been shown to benefit patients with regard to protocol adherence, wound healing, patient satisfaction, and well-being.

Compassionate care has also been shown to benefit physicians, e.g., lower depression rates, elevated meaning, less burnout, and more diligent technical care.

Compassionate care benefits medical students with regard to diminished complaints of abusive clinical environments and maladaptive team interactions.

And it also benefits healthcare systems through improved reputational gains.

And yet compassionate care is often not set as an organizational value. Nor is it the norm to identify compassionate care as a key strategy to improve health outcomes or to ensure efficient and effective care.

But much can be done.

As healthcare leaders we can recognize the importance of compassionate care and we can adapt. We can identify the great work of those who are living the value of compassionate care throughout the system (pastoral care services and others).

We can categorize the best practices of these individuals, we can measure their impacts and we can learn. We can honor the importance of this focus and we can integrate compassionate care into our workflows and into our hearts.

Mr. Roberts' story was diminished ... and he was too.

Let's adapt, let's learn and let's grow from his story and agree to never ever allow another patient to feel as he did.

Thomas H. Dahlborg, M.S.M., is chief financial officer and vice president of strategy for the National Initiative for Children's Healthcare Quality ( NICHQ ), where he focuses on improving child health and well-being.

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