Treating People, Not the Disease
Today, customers are more empowered than ever before, causing a huge disrupt in business practices throughout every industry in America, including hospitals. As customers increase their buying power and are able to make more informed decisions, Patient Experience has become a new focus in healthcare systems. Patients want to be treated with empathy and choose to go to hospitals that offer convenience and hotel-like amenities.
The CAMA Design Lab works with healthcare systems to redefine the patient and family experience through the design of the built environment. In our Design Lab research, we learned of Cleveland Clinic's Patient Experience practices. Cleveland Clinic is recognized as a leader in the patient experience movement. According to their website, they were “the first major academic medical center to make patient experience a strategic goal, appoint a Chief Experience Officer, and one of the first to establish an Office of Patient Experience.” (1) Many institutions look to Cleveland Clinic for inspiration and their annual Patient Experience: Empathy & Innovation Summit grows larger each year.
Since 1975, Dr. Toby Cosgrove, has served as Cleveland Clinic’s President and CEO and he has greatly influenced the patient experience movement. For his annual State of the Clinic address, Cosgrove shared the video Empathy with the Cleveland Clinic staff. The powerful video reveals the personal thoughts and feelings of people healing and working within the hospital. The video concludes by asking, “If you could stand in someone else’s shoes. Hear what they hear. See what they see. Feel what they feel. Would you treat them differently?” (2). Since published in 2013, the video has received over 2.5 million views on YouTube.
In an interview, Cosgrove admits that Cleveland Clinic was once an organization that although provided exceptional clinical care, too often failed to meet patients’ emotional needs. He discusses candidly how his perspective on patient care has shifted over the course of his career. He describes a pivotal moment, when as a guest lecturer at Harvard Business School, a student asked him, “Dr. Cosgrove do you teach empathy?” The woman’s father had required cardiac surgery for mitral valve disease. Cosgrove was an expert in treating this condition but he had a reputation for poor bedside manner. Ultimately, the woman’s family decided to seek care at a competitor’s hospital. The question left Cosgrove speechless and caused him to reflect,
“…as a resident, we used to lose about 20% of our patients…Death was the enemy, and I spent all of my time concentrating on the technology that would reduce the mortality of cardiac surgery…It used to be that if a patient survived, they were incredibly thankful…Currently, people expect to survive, but they also expect someone who is going to be there with them to help them through a traumatic experience...” (3)
Cosgrove is not the first doctor to be criticized for treating the disease, rather than the person. Western medicine fights illnesses first with state-of-the-art technology, and this technology influences medical training, treatment, and the design of hospitals. In the 1970s, healthcare design was called institutional design. Medical equipment and its required supportive infrastructure greatly influenced the planning and design of healthcare facilities. Technological and scientific advances had begun to overshadow the most basic needs of patients and many people began to voice their concerns.
A series of negative hospital experiences inspired Angelica Thieriot to imagine a more holistic model of care. In 1978, she founded the organization Planetree in an effort to humanize the healthcare experience. According to Planetree’s website, “The organization vowed to reclaim for patients the holistic, patient-centered focus that medicine had lost. Everything in the hospital setting was to be evaluated from the perspective of the patient” (4).
Other leaders in the patient-centered care movement included Harvey and Jean Picker. In 1986, they formed the Picker Institute to advocate for the concerns and comforts of patients. The Picker Institute funded a group of researchers from Harvard Medical School to conduct focus groups with recently discharged patients, family members, and hospital staff to better understand the healthcare experience through the patient’s perspective. The research team published their findings in the book, Through the Patient’s Eyes, which outlined the following seven dimensions of patient-centered care: Coordination and integration of care; Information, communication, and education; Physical comfort; Emotional support and alleviation of fear and anxiety; Involvement of family and friends; Transition and continuity; and Access to care (5). Today, the Institute for Patient and Family-centered Care carries out the Picker’s vision promoting the core concepts of dignity and respect, information sharing, participation, and collaboration (6) .
To read more about how CAMA is redefining Patient Experience, click here.