Our collective experience over the past 18 months has revealed this simple truth: Each of us is only as healthy as the most vulnerable among us. As healthcare leaders, we can no longer support a system that lets work schedules, social and economic factors, and institutional bias dictate who receives care. It is long past time to adopt a patient-centric care model that meets each person exactly where they are.
Defining patient-centric care
Patient-centric care is any service delivered where, when and how the patient needs it. In many cases, this means extending services beyond hospital walls and into the community. The pandemic reinforced we can deliver an inpatient level of care for some diagnoses (e.g., COVID-19, congestive heart failure and chronic obstructive pulmonary disease) in patients’ homes via the hospital-at-home model.
Truly patient-centric care also shifts our understanding of quality. Until now, most quality measures have been clinical and process-oriented (e.g., turnaround times, readmission rates, use of evidence-based therapies). When we look at quality through our patients' eyes, this definition must broaden to include health and quality of life. Meaningful outcome measures for patient-centric care must take into account the lifestyles our patients desire.
Why patient-centric care?
Changing consumer needs and expectations are driving the adoption of patient-centric care models. Consumers can now buy a home or car from their mobile devices and are accustomed to offline and online interactions with nearly every facet of modern life. Today's patients expect healthcare to be convenient and easily accessible. To that end, hospitals and medical offices can no longer rely exclusively on location-based models of care.
On a more sobering note, the COVID-19 pandemic spotlighted glaring social inequities that we healthcare leaders have an imperative to address. This means we can no longer sit in our hospitals and offices waiting for patients to come to us. We need to find ways to reach patients closer to home in their communities and workplaces.
Barriers and solutions
When it comes to changing care models, health systems are working against the weight of history. Our entire system — from the size and layout of hospitals, to our staffing ratios, to our reimbursement structures — is predicated on the paradigm that patients should travel to providers for care.
Some healthcare leaders and clinicians also have entrenched ideas about what kinds of services need to happen in hospitals. It is time to reexamine these assumptions. A few decades ago, it would have been unimaginable to repair a hernia or remove a gallbladder as an outpatient procedure. Today such operations are routine.
And we can't make this paradigm shift without the help and leadership of our front-line clinicians. When it comes to new care models, it's easy to dive into the weeds and start looking at physical improvements, process engineering, staffing ratios and IT upgrades. But fundamentally, we need to start with culture. To lead this paradigm shift, we must align our teams under the idea that we're all here to do what’s best for patients wherever they are. This starts with appealing to the noble cause that drives us to serve and called us to healthcare in the first place.
Imagining tomorrow's hospitals
Hospital at home, remote monitoring and other emerging patient-centric care models are radically redefining hospitals. For many of us, it's mind-blowing to think of a hospital as a service rather than a physical place. But this is exactly where we're heading.
As we extend the hospital into the community, it will encompass the patient's bedroom, the skilled nursing facility, the workplace and the mobile care team. It's At last, the patient is front and center in care delivery To lead this paradigm shift, we must align our teams under the idea that we're all here to do what’s best for patients wherever they are. This starts with appealing to the noble cause that drives us to serve and called us to healthcare in the first place. Denise Brown, MD, Chief Growth Officer, Vituity By Denise Brown, MD, Chief Growth Officer, Vituity Executive Briefing 11 going to be a massive cultural and operational shift that brings fantastic value to patients and communities. And personally, I'm excited to be part of it.
What will happen to our existing hospitals? While the hospital concept will still include a physical building to care for our sickest patients, it will expand to encompass all virtual and community-based work performed by our care teams. These "unbound" hospitals will become laboratories of change in which engaged clinicians innovate and refine tomorrow's patient-centric care models.
Leading patient-centric transformation
How can healthcare leaders reconfigure health systems to provide integrated, patient-centric care? Here are some tips from my own experience.
- Consider what your patients want and need from your health system. One differentiator health systems can offer versus third-party telehealth providers — we have all the services patients need in one place. What's more, our providers share an EHR as well as cultural expectations around hand-offs, collaboration and consultation. This helps to keep patients from falling through the cracks.
- Design your new delivery system with an eye toward integration. In all the excitement over community-based care and telehealth, clinical integration sometimes gets lost. However, fragmentation goes against the spirit of patient-centered care. It's so important we design processes to keep care teams connected and close the loop with everyone involved after every patient encounter.
- Incorporate specialists into team-based care. Under our current model, a patient with a psychiatric condition might wait months for an office visit to adjust medications. However, it would be far more flexible for a nurse to provide hands-on, day-to-day care in consultation with a psychiatrist. This model also allows a specialist to support a larger caseload, which might ease provider shortages in psychiatry, neurology and other high-demand specialties.
In summary
Shifting our organizations to a patient-centric focus is not for the faint of heart. It requires dedication to mission, inspired leadership, and a spirit of empathy and optimism in the face of resistance. However, by staying the course, we can bring new hope and opportunity to the most vulnerable in our communities. What's more, we can be shining examples to healthcare organizations across the country of what's possible.
Learn more about how Vituity is transforming the way healthcare is delivered: Vituity.com/HealthinPlace