In the past few weeks I listened attentively to the story of a colleague about the pathway his father went through, which he followed closely… a trajectory with still room for improvement: sub-optimal communication between medical disciplines, too little information for patient and relatives, insufficient attention for medication usage, ambiguity concerning hospital discharge, etc.
Everyone can agree at this point: the patient must be the focus. However, this involves major challenges… First of all, we must learn to listen (more carefully) and involve the patient more often. Also, it is important to use a segmented approach, (better) cooperation throughout the entire healthcare chain becomes crucial, and the importance raises of hospitals / other healthcare institutions providing caregivers with a clear framework and the right tools to achieve this. Together with my colleagues of the Möbius Healthcare team I really want to contribute to tackling these challenges, to guarantee the best possible care, also when I or my loved ones might need it.
Listening to the patient
The first challenge goes without saying: we have to involve the patient and listen to the patient. But this raises the question why this is not yet common practice today. Measuring patient experiences (via ‘PREMs’ or ‘patient-related experience measures’), e.g. after a consultation / stay in the hospital, provides a valuable source of input for further improvement of the service. If this is done more systematically and becomes an evident part of the way of working, we can hopefully also encourage the patient to more actively think along. For patients with a chronic disease, who visit the hospital more frequently, the experience with the hospital (of both patient and relatives) can even co-determine the quality of life. Apart from PREMs, caregivers could start asking themselves to what extent they treat the patient and those caring for him as if they were their own family, and how they can encourage the patient to become in charge?
Using a segmented approach
Every patient is different, with a different context, different needs, different wishes, etc. The personally desired and best possible quality of life for each individual patient must be the focus in providing care and support. Given the ageing population and the increasing number of chronically ill patients, it is even more important to use a segmented approach. In certain settings, like specialized rehabilitation, mental healthcare, … this could even mean adapting the approach up to the individual level. To this end, pathology-specific bio-psycho social care profiles, i.e. checklists with a set of (evidence-based) indicators, which can be filled in by all care providers in the multidisciplinary team individually, could be used. This creates the opportunity for an efficient exchange of patient data in multidisciplinary meetings and results in individual (short- and long-term) goals, specific interventions per care provider, and a long-term care plan. Involving the patient also leads to better results (a.o. thanks to a higher level of therapy loyalty).
Having an eye for the integral perspective
(More intensive) cooperation throughout the entire healthcare chain is a major challenge. We must move away from a ‘silo’ mentality, towards better integration and collaboration between hospitals and other actors in the healthcare sector. It is really time we think in terms of a patient-/demand-driven model, with care paths that are elaborated and connected both within organizations and across organizational boundaries. In addition to decentralization of (chronic) care, some focus in care provision is needed. Hospitals and other healthcare institutions will have to make a proper analysis of the (regional) demand, together with the other hospitals in their network, and decide on some carefully chosen pillars for their offer, rather than continue to offer the whole range of care services. Moreover, it will be important to measure the quality of the provided care (via ‘PROMs’ or ‘patient-related outcome measures’) to allow continuous improvement of quality. But first things first: let’s start with taking down the walls within each institution and improving collaboration.
Ensuring that care providers are ‘empowered’
In the end the care providers are responsible for the (quality of the) care provided to the patient. We are not talking about JCI or NIAZ at this point, but about ideal behavior of care providers. When care provision becomes more flexible, the importance of satisfied and ‘empowered’ employees / care providers further increases. Therefore, it is also important to think about the organizational model and to investigate the principles of self-governance more closely.
Establishing a good (technological) framework
Nothing comes naturally. It is the role of the healthcare institutions to create a framework that encourages multidisciplinary collaboration, supports a segmented approach, fully allows to take advantage of new technologies, … It is important that healthcare institutions invest in a framework where patients get the opportunity to direct their questions (portal, chatbot, e-mail, face-to-face, etc.) and care professionals can make use of the right tools (EHR, checklist, etc.). This will allow the patient and the care provider to communicate better and more quickly… and in the end, that is what is all about.