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Good to Know: Improve hospitals by asking patients, family members how

As the chief patient experience officer, Kevin Gwin,

As the chief patient experience officer, Kevin Gwin, center, makes rounds with units throughout MU Health Care to discuss patient feedback and opportunities to improve patient experience. Credit: MU Health Care/Justin Kelley

Here's a novel idea to help make hospitals more person-centered: Include patients and their families in the key decisions for the medical centers. This is an idea that's slowly starting to catch hold.

That's the conclusion of a fascinating recent research report from the Experience Innovation Network, or EIN — a community of U.S. and Canadian thought leaders focused on elevating patient-centered care, reducing health costs and restoring care-team resilience.

Time for more person-centered care

For the study "Co-Architecting Healthcare Transformation: How Leading Health Systems Put Patients and Families at the Forefront of Design," EIN surveyed 103 health system leaders and 54 patient/family partners.

The gloomy reality, according to the survey, is that hospital systems still generally view patient/family input in decisions as "optional," particularly for hiring decisions and day-to-day hospital operations. Only about 1 in 5 of the health system respondents said their hospitals required patient/family input into such strategic decisions as opening new facilities.

What's more, the study said, is that patients and families still lack representation at the highest board level, "where votes and decision authority often rest." Only 33 percent of health system respondents said there are patients and families on their board of directors.

But — and here's the glimmer of hope — growing numbers of hospitals are now insisting that patients and families be part of the decision-making process to keep the medical centers running well. The study said 81 percent of system respondents noted that their organization has at least one hospital-level patient/family advisory council. A few states, like Massachusetts, have passed laws mandating such councils.

Hospitals that get it

A few hospitals include patients and families in much bigger ways, though.

For instance, Bronson Healthcare in southwest Michigan involves patient/family "partners" in a variety of ways. Marilyn Potgiesser, its system manager for patient- and family-centered care, works with a team of patient/family advisers to join nursing huddles, participate in hospital employee events and have seats on most of the health system's key committees.

University of Missouri Health Care's Chief Patient Experience Officer Kevin Gwin actively looks for patients and family members who have shown interest in a particular issue. His health system scours patient complaint (and compliment) reports, and surveys patients and families. Then, Gwin and his team identify those who've struggled with receiving care and who want to help the hospital improve. These people are asked to offer ideas.

Unfortunately, examples like these are still far from the norm. The EIN study said patient/family partners generally have "limited involvement in day-to-day operations."

Hospitals appear to think they're doing a better job including patients and families than they really are. While 61 percent of health system respondents said patient/family improvement partners are involved in deciding what problems need to be addressed, just 42 percent of patient/family respondents agreed.

What hospitals can do

How should hospitals behave to become more person-centered?

The EIN report offered this suggestion: Make a rule that if a change involves more than three people or three process steps, patient input is required. Something else that would help: Provide training to patient/family improvement partners. The EIN study said most of these partners get limited or no training to help them succeed.

Many patients and family members truly want to be helpful. The ones who are assisting hospitals said in the survey that they do it to: contribute to their community, make care better for themselves and/or their loved ones, give back to the system that provided them and/or their loved ones with care, create some good out of their illness or experience and "fix a broken system."

Next Avenue's Richard Eisenberg and Shayla Stern write rotating columns on money, health and lifestyle. Readers can contact them at reisenberg@nextavenue.org and sstern@nextavenue.org.

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