Finding innovation in patient-centred care
Judith John is someone who knows her way around a hospital. She spent many years working in hospitals as a senior communications executive, first at Toronto’s Mount Sinai and later, the Hospital for Sick Children. Then in 2009, John had a brain tumour that hemorrhaged. And she began to see another side of the hospital – as a patient.
This experience is what informs John’s work today as a patient advocate – work she’ll be sharing as one of the keynote speakers at the CMA Health Summit in August.
John is quick to point out that as a patient, she received excellent care from physicians with knowledge, experience and skill. She describes this care as the “solid brick” on which Canadian health systems are based.
“But between the bricks, the mortar is uneven,” says John. “It can be smooth or it can be cracked or it can be crumbling. And I think if we smooth the mortar, through the process of the caregiving, the whole patient experience would be elevated.”
Back when she was working in health care administration, John says she spent a lot of time analyzing evidence, processes and technology as ways of making the health system better. Innovation was often understood as increasing efficiency.
As a patient advocate, she now sees innovation very differently.
“To me, the best innovation in care, is care. It was innovative to me when a nurse – who I had met just once – left a card with fireworks on the cover next to my hospital bed, because I had joked with her earlier that my double vision was great for seeing fireworks.”
“In the quest for the new and amazing – in artificial intelligence and technology – we risk forgetting the basic thing people are looking for is care from another human being.”
John says one of the challenges in patient care is that the medical profession doesn’t have a way of sharing best practices. Physicians have access to research studies on patient outcomes from a new hip surgery procedure, for instance, but they don’t always have access to the best practices for acknowledging and interacting with patients as people.
Sharing this kind of information is now part of John’s work as a patient advocate, and she’s always looking for examples. She references a recent interview she did with a doctor at Holland Bloorview Kids Rehabilitation Hospital, who applies the “two sentence rule” with her trainees.
“She tells physicians-in-training they’re allowed to say two sentences to the patient and then they have to stop and give the patient time for two questions. And they can’t just say, ‘Do you have any questions?’ because most people are too stunned and frightened to respond to that. They have to say ‘What questions do you have?’” says John. “So that’s a simple tip. But it has a big impact.”
John adds that patients also have a role to play in better patient care, by understanding the limitations and pressures physicians face.
She says some patients have unreasonable expectations of physicians. “We want them to come in and say, ‘We found out what’s wrong, here’s what we’re going to do about it and by the time you get out of the hospital tomorrow, it’ll all be done.’ Well, it doesn’t work like that.”
In the years since John first became a patient advocate, a lot has changed. Patient-centred care has become a mantra for many health care organizations, with committees and staff devoted entirely to the patient experience. But progress can be slow, particularly in a world where technology often creates more distance between practitioners and patients.
John says her solution for better patient care goes back to the basics: that many problems in health care could be solved by creating more solid connections between people.
“Innovative ways to approach the patient experience come from the basics of knowledge and compassion and trying to learn more about ways to deal with people and the issues that being a patient raise.”