“Yes, doctor.” It’s easy to agree with your doctor. After all, she knows what’s good for your health. Right? You do, too. Right? Discussing one’s personal health, in a collaborative way, can be a very difficult conversation.
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Call to action
Last month I participated in the Patients as Partners Provincial Dialogue conference in Vancouver. I was there offering input from a Family Caregivers of BC perspective. Patients as Partners, as a concept, is not new. It does though reflect a trend; decision-making around personal healthcare decisions should be a participatory happening, not an acquiescence to power. “Patients affected by health care decisions should be involved in the process of reaching that decision.”
Why support the patient/citizen? In my province, British Columbia, health expenditures account for 40% of the provincial budget; $18Billion is spent on health care, annually. Not sustainable. Health care is almost totally publicly funded. Slowly, societal consensus is building that when people fully participate in the system, they are better informed, will make better decisions (i.e., healthy choices), resulting in less downstream costs (eg., hospital time)…
Nothing like escalating health costs and an elder boom to grab our collective attention. Urgency is what catalyzes us.
Shifting the balance of power…
…towards the patient. Here’s the definition used at the Vancouver conference for Patient-Centred Care: “Relationship-based care that meets individual patient and family needs, preferences and priorities via the principles of: dignity and respect, information sharing, participation, and collaboration.”
What follows are three key conference takeaways for me, that speak to a changing client service relationship dynamic.
1. Self-management support for the patient
Patient and family centred care, offered from the provider side, needs to happen in parallel with self-management support. Self-management is largely done outside the health system. BRAINS, a shared decision-making tool, developed by the Centre for Collaboration Motivation & Innovation, is a simple tool that serves as a patient/family member guide to a conversation with a health care team member. The goal is to make informed decisions. I really like this tool. It can be used in many contexts; e.g., mediation. It’s also a smart mix of right and left brain, decision-making.
2. Adding the patient voice to your (provider) decision-making process
Providers often focus on their own part of the health care system; whereas the patient may be the only one who actually experiences the entire system of care. The Patient Voices Network matches patients/caregivers/family and others with health care providers who want the patient voice as part of their decision-making process.
ImpactBC, a BC nonprofit, administers the Network. Patient reps/voices are trained. The degree to which a health care provider is seeking patient participation is based on the International Association of Public Participation’s (IAP2) continuum of engagement; inform, consult, involve, collaborate, empower.
Patient voices may be matched/added to advisory committees, focus groups, improvement teams, conferences, monthly teleconferences, health care projects, etc.
3. Consistency in provider/patient interactions
You’re staying in a hospital. The day shift staff are going home. The night shift are starting work. Did they communicate everything they need to know about you? Did they handoff successfully? Hopefully, yes. If not, well, that’s how groups such as Consumers Advocating for Patient Safety (CAPS) come into being. I first became aware of CAPS through some unfortunate hospital handoffs that my extended family experienced.
Handoffs are hugely important. Doing them better is primarly an issue of better communications; getting everyone on the same page. BC-based health service providers; e.g., Providence Health Care, are placing a focus on handoffs, and consistency in patients/family member interactions with hospital staff. Clarity of message, every time. Nobody intentionally seeks a medical error. Not surprisingly, better handoffs are becoming big business.
Corollary in other businesses?
Pick your sector; civic, justice, education… You name it.
- How are you helping the person you serve self-manage?
- How are you truly representing their voice in your “system”?
- How are you giving consistency to your interactions with them; your relationship?
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