Patient-centredness

Citation

Downey-Ennis, K. (2006), "Patient-centredness", International Journal of Health Care Quality Assurance, Vol. 19 No. 5. https://doi.org/10.1108/ijhcqa.2006.06219eaa.001

Patient-centredness

With mounting international pressure to improve patient/customer satisfaction in the healthcare industry a new emphasis has been placed on the patient/customer as the central focus of the process of successful service delivery. Patients entering healthcare do so out of a need more so than from any desire, because of their lack of choice in the matter. The adage that the customer is “king”, long adopted by the other service industries to describe their relationship with their customers, has, over the years been somewhat neglected by healthcare. Increasingly there is a recognition of the patient as the primary “customer” of healthcare providers and should be treated as such, with the satisfaction of patients with their healthcare episode now becoming a critical factor to be taken into consideration.

The traditional structure of the hospital is tailored to meet the needs of the care provider. Although this structure has logical benefits for the running of such a large and complicated enterprise patients and their families often feel left out. This fact, when coupled with long waiting times, inconvenient processes and bureaucracy can often leave healthcare consumers frustrated. As well as the feelings of frustration felt by patients as they move through the system are feelings of anguish, more specifically threat, fear and anxiety. In this issue healthcare providers are offered a unique insight for caregivers into the emotional state of a real patient as they receive treatment in a hectic healthcare system.

Literature on the subject of patient focus is replete with measures and systems to streamline the customer’s journey to health and to elevate patient satisfaction levels. When discussing these issues (Garside, 1993) advocated the adoption of a patient focused care which is described as:

… a philosophy and a set of principles guiding the delivery of care in an organisation. It represents a radical re-examination of the way care is delivered in a hospital, scrutiny of structural processes behind the delivery of care, and realigining care delivery with the patient at the centre of the process. The patient experience is the single most important driving principles. Hospitals in particular have organisational processes, which have built up over the years resulting in excessive specialisation, centralisation and compartmentalisation. Taking these processes apart and redesigning care systems around the patient is the essence of Patient-Focused Care

Delivering customer focused care redefines the relationship between providers and consumers by involving patients in all aspects of their care emphasising the uniqueness of each patient’s circumstances.

The concept encouraging a patient dialogue about healthcare delivery is certainly not a new one, and indeed many within the service would firmly believe that patient involvement occurs on every occasion, however this involvement is often merely assumed, or if any occurs is just misunderstood.

So how far along is patient focused healthcare in the twenty-first century? Reading the experiences of one patient further on in the issue one is not imbued with confidence that the sector has aligned itself in a significant way with the above definition of patient focused care. Coulter and Cleary (2002) argue that despite efforts to improve healthcare from the patient perspective most have yielded only disappointing results due to various factors such as the harsh realities of budgetary constraints, staff shortages and other managerial imperatives which all displace any originally held good intentions about involving and responding to patients in and about their own treatment process, thus eliminating any opportunity of gaining a valuable insight into the perspectives of both the patient and those of their carers, so vital to the provision of care.

One way of resolving this dilemma is to move away from the provider mentality of:

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  Viewing the need to focus on customer requirements as merely “one more added pressure”. This is especially pertinent in the hospital environment where the needs of physicians, employees, administrators and patients can so often conflict.

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  Believing that you cannot please everyone so why try to please anyone?

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  Believing that because the system has worked so far, it should not be altered.

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  Feeling it is easier to get patients to adjust rather than adjust the practices of many departments.

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  Creating systems, schedules and policies without consulting customers.

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  Seeing the education of customers to “our way of doing things” as a means of gaining confidence and satisfaction.

To one which places the patient/consumer in the centre, to:

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  Focus on satisfying customers to the best of their abilities.

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  Identify and define their customers and to extensively research the needs and expectations of these customers.

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  Find out how customers perceive the service delivered.

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  Measure success by customer satisfaction.

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  Make important management decisions based on implications for customer satisfaction.

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  Repeatedly communicate the importance of a customer orientation to staff with conviction.

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  Screen job applicants for both technical competence and customer orientation skills.

It can be hoped with the adoption of such measures future patients of the healthcare industry can expect to be treated not only in a medicinally advanced manner but also to be treated with the respect and dignity that they deserve thus creating an altogether more fluid and stress free healthcare system for all.

Kay Downey-Ennis