Our recent report Vital Signs: how to deliver better healthcare across Europe highlighted, as one of our vital signs, patient engagement and empowerment. This week's blog, by one of our colleagues in our Irish member firm, Gary Comiskey, caused me to reflect on the report and to wonder if we had omitted a key element of patient engagement, specifically the need to recognise that patients are first and foremost people with individual needs and goals, and that staff need to engage more with the person being treated. Don't take my word for this, but read Gary's blog below and decide for yourselves.
Getting the basics right
Last week I attended a conference on personalised health. The conference was excellent with some really innovative ideas and discussions about the role technology and e-health can play in delivering person centred healthcare. However, about half way through the conference I started thinking that we might be trying to run before learning to walk.
I have just returned to work having been treated for non-Hodgkin lymphoma. Over the past six months or so I have learned as much about our healthcare sector from my personal experience as I have from delivering services to the sector for the previous six years What strikes me most from my own experience is that we need to start by getting the basics right. As all of the new ideas flowing out of the personalised health conference will achieve nothing if we don't build the right foundations for our healthcare system.
Treating the patient as a person
The hospital where I was treated is in the middle of a project to roll out the '#hellomynameis' campaign.i The idea came from Dr Kate Granger, a doctor and a terminally ill cancer patient.ii During a hospital stay in August 2013 she observed that many of the staff did not introduce themselves before delivering her care and that it felt incredibly wrong that such a basic step in communication was missing. When it was launched it had seemed strange to me that such an initiative was necessary, yet, as a patient, and despite the campaign being adopted across many healthcare organisations, I shared her experience. As a management consultant, I can't imagine meeting a client and not introducing myself or offering a handshake – yet in the healthcare sector this is not the natural first step.
Don't get me wrong, the level of care I received was excellent, and the staff were always friendly and kind – but maybe the first step in personalised care is not some new tech device but rather treating the patient as a person.
Keeping the patient informed
Another experience from my care is recognising the importance of sharing information and keeping the patient informed. I am lucky enough to have private health insurance (about 46% of the population do in Ireland)iii and this meant that many of my diagnostic procedures were done in a private hospital. On arrival it was a little like checking into a hotel – the reception staff greeted me, showed me to my room and gave me a brief overview of what would happen over the course of the day. Amidst the anxiety and uncertainty of being diagnosed with lymphoma, it was a great relief to know what was going to happen and understand what the next steps would be.
In contrast, when I arrived for my treatment in the public system, I handed in my appointment card and was told to take a seat – and nothing else. Sitting there I had no idea what was next, how long I would be waiting or who I was going to see first. In the end I was only waiting for a few minutes, but when I did meet the nurse to have my vitals checked, my blood pressure was unusually high. Looking back, I can't help thinking if I can been given a brief overview of what was to happen, I would have been more relaxed and maybe there would have been no need to recheck my blood pressure.
My personal experience also left me wondering if doctors have enough time and opportunity to prepare for their patient consultations – in many of my encounters with my consultants, it seemed they were reading my file as I was in the consultation room. In fact, in one case, when my regular consultant was away, the consultant who reviewed my case had very little information about me. He firstly apologised as my latest blood results had not returned from the lab and further apologised for not having a copy of my recent CT scans. We had a very pleasant and general chat about the course of my treatment which was helpful, but the consultation lacked the specifics that we really should have covered. I could not help thinking what would happen if I arrived at one of my clients without reading the background material or specific reports which they had provided. I suspect we would have a short meeting and a robust discussion if I attempted to charge for my time! Yet for the clinicians this type of experience does not seem to be out of the ordinary.
As I reflect on the ideas for personalised care I think the solutions are not merely some new gadget or technology but rather some basic steps: to see the patient as a person, keep patients informed of what will happen during their treatments and take the time to prepare for the consultation.
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