What does patient-centeredness really mean?

This is the 3637th article of Da Yi Xiao Hu

“Patient-centered” is a familiar slogan in the medical community;

“Patient-centered” is a slogan that is often displayed on banners in major hospitals;

"Patient-centered" is the service tenet of many hospitals in carrying out their work.

But what is “patient-centered”? How can we achieve “patient-centered”?

In daily life, we often hear people around us say, "The service attitude of XX hospital is really good! The care is very thoughtful." Or "The service attitude of XX hospital is not so good. Some doctors and nurses speak too harshly."

A nurse from Peking Union Medical College Hospital said: "All patients who come to Peking Union Medical College Hospital are 30% better before they see a doctor. They feel at home when they see Peking Union Medical College Hospital. Some patients even said, 'Even on the bustling Wangfujing Street, you can recognize who is a nurse from Peking Union Medical College Hospital. Their manners are very different.'"

The reason why there is such a big gap between hospitals is mainly because of the different management concepts of hospitals. In this special period when the doctor-patient relationship is tense, we should implement this important service concept to the end.

What is “patient-centered”?

The JCI, the world's top medical and health care certification committee, gives the following assessment criteria for hospitals: "The hospital and all medical staff combine factors such as the patient's condition, the patient's psychological feelings, the financial pressure the patient can bear, and the requirements of the patient's family to provide the patient with the 'best medical solution'."

Mr. Qiu Fazu, a famous Chinese surgeon, once described the doctor-patient relationship in this way: "Treatment is like crossing a river. Both the doctor and the patient aim to reach the other side, and the doctor carries the patient across the river. In the turbulent river of disease, doctors and patients are an alliance and need to work together."

Therefore, "patient-centered" does not mean that doctors should completely obey the requirements of patients and their families, but under the premise that both parties have different professional levels, different perspectives, and considerable deviations in medical experience, they should try their best to make diagnosis and treatment decisions based on the principles of "respect, understanding, and harmony."

The world-renowned Mayo Clinic has a very good example in this regard. In a lecture by a Mayo doctor, he explained that Mayo Clinic's understanding of "patient-centered medical services" is: "Providing care that is respectful of and responsive to individual patient preference, needs, and value and ensuring that patient values ​​guide all clinical decisions." (We should provide such care: respecting patients while targeting their personal preferences, needs, values ​​and guarantees, so that the patient's values ​​guide the overall medical decisions.)

How can we be “patient-centered”?

Medical staff

It is often said that medical staff are just passers-by in the lives of patients. How to be a good passer-by should be a question that every medical worker thinks about. Don Berwick wrote in the book "Future Medical Services": The purpose of patient-centered medical services is to treat patients as independent people first. Respecting patients can start with the following basic behaviors:

1. Maintain a pleasant mood during the conversation and take the initiative to introduce your name and position to the patient. Avoid using medical terms that the patient and his or her family members cannot understand during the introduction.

2. Ask the patient or their family how they would like to be addressed. Make eye contact when communicating with the patient and their family, and smile if necessary to show your concern.

3. Knock on the door before entering the inpatient room, inform the patient what you are going to do when examining the patient, and let the patient know what needs to be done next before you leave.

4. Listen carefully when patients and their families express their opinions, so that patients feel that you value their suggestions, questions, and concerns. Stay open and receptive when they share their views.

Hospital Operators

Chen Chunhua, Dean of BiMBA Business School at the National School of Development at Peking University, once said: The essence of business is "customer-centric". If hospital operators want to establish their own era, they must concentrate the hospital's energy on matching target customers - patients. It is not just about treating diseases, but more about curing patients.

To give you an example, in May 2021, Dazhou City Hospital of Integrated Traditional Chinese and Western Medicine set up a "one-stop" outpatient clinic, with the goal of ["one-stop" service, so that patients "only need to go once at most"], to guide medical staff to firmly establish "patient-centered" and "everything for patients" and other high-quality service concepts. The outpatient clinic of Dazhou City Hospital of Integrated Traditional Chinese and Western Medicine started by solving common medical problems for patients, gradually integrating multi-party resources and business processes, and standardizing the establishment of an outpatient "one-stop" convenience service center. It has truly achieved the social effect of patients only having to go once at most and getting "the whole thing done" at one time, further improving the medical experience, improving service satisfaction, and achieving the goal of convenient and fast medical treatment for the masses.

Hospital managers must have clear goals and directions, have keen thinking senses, be able to mobilize hospital resources around patients, ensure that both technology and quality meet patients' expectations, and thus create medical value.

All sectors of society

Some experts said that "patient-centered" service is not simply an activity participated in and practiced by medical institutions, it also requires support from all sectors of society.

The release and reform of government systems affect the interests of medical institutions and patients. For example, the adjustment of my country's medical insurance system and the reform of special medical insurance negotiations have had a profound impact, allowing hospitals to purchase good drugs, doctors to prescribe good drugs, and patients to afford good drugs.

The active cooperation of the community can play a significant role in medical treatment. Now all major hospitals will arrange follow-up visits, community assistance and other projects to bring medical treatment into daily life and allow more people to find and solve problems in a timely manner. In this process, the community can play a certain role as a health advocate and actively encourage the public to participate.

I once heard a sentence that really helped me: "People will forget what you said or what you did, but they will never forget how you made them feel." Patients are sensitive to illness, and every detail, every smile, and every comfort we give may affect the patient's treatment outcome.

"Patient-centered" is the greatness of doctors, and finding the "best treatment plan" for patients and their families is the great achievement of doctors.

Author: Jitang College of North China University of Technology

Yuan Jie

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