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Opinion: Shift focus to people-centered care

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When we think of our favorite doctors, nurses and overall hospital experiences, we oftentimes think of the nurse who held our hand during a difficult time or the physician who took extra time to answer questions. We think of the people who walked with us through our process and helped us meet our mental, physical or emotional goals. These are great examples of what can happen when patient-centered care is effectively implemented.

Unfortunately, with the complexities of health care today, it’s not uncommon to hear patients also express confusion or a feeling of being processed through a complex bureaucracy with little evidence of humanity.

When environments like these exist, it generally stems from a place where passionate providers conflict with a bureaucracy of unskilled supervisors who weren’t trained to motivate or lead people. These organizations lose accountability and cause everyone on the team to become frustrated and disengaged. That causes physicians and nurses to miscommunicate and provide poor care for patients, leaving everyone, including patients, more frustrated than ever before.

Therefore, a sole focus on patient-centered care is the wrong approach.

Think about a hospital department that has low patient scores and incredibly low morale. Employees are divided into factions, each working to protect themselves and hold on to the little power they have inside the department. The department has a reputation for being the place where good managers go to get burned out. Hospital administrators get weekly complaints from employees inside the department and from the patients who interact with the department. Patient-centered care is stressed time and again but just isn’t taking hold.

The administration decides to make a change. They start to focus on the team itself, implementing people-centered care. They listen to the employees and empower them to make changes in the department. They support the manager and supervisor by training them to be more effective and engaging with the staff. They break down factions by engaging members of both “sides” to solve problems together. They hold toxic employees accountable and send a clear message that toxicity will no longer be tolerated.

This approach drastically improves team morale. Members of the team work together and begin to see management as a partner instead of as an obstacle. Then something else incredible happens. Patient scores start improving dramatically. The department who was at the bottom 1 percent of patient satisfaction rises to one of the top departments in the system scoring up to 99 percent in some areas.

What is the lesson learned?

The concept of patient-centered care is a powerful way to look at health care. However, the first focus for any department should be on creating an environment where health providers can do what they do best.

In other words, it’s about becoming people-centered, about creating systems and training that engage employees. These systems include developing managers to learn how to lead and develop staff, as well as creating places where team members can collaborate to solve some of their own challenges. It includes processes that deve
lop poor performers quickly or move them on to other jobs outside the organization.
The best way to provide patient-entered care might just be to take care of your team first.

Don Harkey is the owner and CEO at People Centric Consulting Group. He can be reached at


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