Putting Patients First: Designing and Practicing Patient‐centered Care

Abstract

This book is an anthology of patient‐centred care practices found in selected health care organizations across America. The common thread is that these organizations are all members of the Planetree Alliance. Planetree is a non‐profit membership organization which is an alliance of hospitals, health resource centres and long‐term care facilities across the USA. The Planetree mission is to ‘serve as a catalyst in the development and implementation of new models of healthcare that focus on healing and nurturing body, mind and spirit. These models integrate human caring with the best of scientific medicine and complementary healing traditions.’ The Planetree model is patient centred and is committed to improving medical care from the patient's perspective. It empowers patients and their families through information and education and encourages ‘healing partnerships’ with care givers. The history and development of the Planetree model is described from its foundation in 1978 as an educational library service, the development of the first health resource centre in 1981, its initial model hospital unit in San Francisco in 1985 to the present day. Early chapters guide us through different elements of the Planetree philosophy/model including architecture, art therapy, environmental design, massage, music and nutrition. Current examples are given plus strategies for adoption of these principles. Detailed research evidence which support the benefits to patients from the Planetree programme is described. The second part of the book reflects on future directions. This discussion obviously focuses on a health consumer environment where not only an increase in the satisfaction of patients but an increase in the number of patients is a desirable outcome. Many of these examples are relevant to health services provision in countries beyond the US, for example, tackling current issues of staff shortages and transforming the culture of health care. Chapter 10 specifically focuses on the business case for patient‐centred care and presents evidence of its effectiveness in terms of increased patient satisfaction and reduced malpractice claims. The single biggest cost associated with adoption of the Planetree model is stated to be staff training, the majority of which is directed to nursing and administrative staff. These staff champion a patient‐centred culture whereas doctors view this as a positive change without giving it the highest priority. Whilst recognizing that physicians are the least involved members of the hospital staff in the Planetree process, no suggestions are made as to how to improve this situation. The editors end by highlighting areas for attention, given the needs and desires of patients. They suggest that by continually examining the hospital policies, procedures and practices through the eyes of patients, the challenges and opportunities that exist for the future will become apparent – certainly a challenge for us all. This book provides an excellent introduction to the subject of patient‐centred care, albeit with an American focus. As a result of the many examples provided and literature references given for each subject area, a beginner to this field can follow‐up any particular area of interest in more depth.