Tuesday, April 26, 2011

Sincerely yours, Patient-Centered Care Department

A friend had some complaints and suggestions about a relative's stay in a New York City hospital. She asked me for advice as to how she might best get a response from the hospital, and so I of course suggested that she write to the CEO.

She did get a timely response, which she shared with me. The stunning aspect of the reply was that it was from the "Patient-Centered Care Department."

Should we feel good about this? I think not. The idea that there should be a department of this name is like suggesting that there should be a similar department named "Avoiding Nosocomial Infection Department" or "Let's Operate on the Right Site Department."

Patient-centered care -- or as I prefer, patient-driven care -- is not the purview of a separate department. It is the job of the entire hospital and all who work there. By creating a department with that name, you suggest that most staff members are free to let that part of the mission be in the hands of others.


Medical Quack said...

I very much agree, you ask for help and information and all you seem to get today is "another crappy Iphone app". Yes I'm exaggerating a bit but sometimes that is true. I like technology and help people with it, but we are losing valuable ethics and people are thinking very strangely as to "how" some technologies can help them and it ends up being a "brush off" instead, sad but I think we see too much of that every day as we have lost our balance.

Unknown said...

"No matter if it is a white cat or a black cat; as long as it can catch mice, it is a good cat." - Sichuan proverb

Chuck said...

A quick google search identifies the hospital and department you're referencing. From reading their press release, it seems the department is a conglomerate of those services previously scattered throughout the hospital (patient services, pastoral care, volunteers, etc). I think it's great that patients can find this info in one place. I agree that the name is slightly problematic, but is it any worse than Patient Services or Patient Representative? Shouldn't we all be servicing and representing our patients?

Paul Levy said...

The press release unfortunately reinforces the point of my post: "Bringing all our patient-centered programs under one umbrella will enable everyone to focus on improving the experience of patients and their families,"  says Bernard Birnbaum, M.D., chief of hospital operations.  "The goal is to make the entire system work better."

Those programs are: Patient Representatives, Patient Satisfaction, Patient and Family Education, Community Outreach, Pastoral Care, Integrative Medicine, and Volunteers.

Maybe it is just semantics, but I find it problematic to use a term like "patient-centered" to describe a department and these units within it -- as distinct from an attribute of overall care throughout the hospital. In other words, the "all" in the quote above is what is problematic.

(I don't dispute the intention of consolidation of these particular functions, by the way. And the programmatic initiatives look very sensible, too.)

George said...

Thank you, Paul. That IS certainly part of their problem, or the problem. If you or your friend have not done so, that reply should be brought back to the attention of that CEO, and the message that it conveyed.

Anonymous said...

If it is the word all that is problematic, how would you suggest modifying the sentence? Would replacing "all" with "some" be better?

dateless nerd said...

I can appreciate that it makes sense to have one location, or department, take the primary responsibility. In many organizations, when there's no designated locus of responsibility, what often happens is that no one feels responsible.

On the other hand, the problem I see with a "patient-centered care department" is that it allows issues - and complaints in particular - to be fobbed off, sometimes inappropriately.

I experienced a medical injury during a hospital stay several years ago, with some very unfortunate and permanent results. I had to file two written complaints before I got a response. The injury was serious enough that a medical director or medical department head should have at least reviewed the case and discussed it with me. Instead I was delegated to a "patient services representative" - someone who didn't know me, didn't know anything about my case and wasn't even a clinician. On top of this she was incredibly rude.

By all means, hospitals should do better at listening to patients and responding constructively. But patient-centered care departments shouldn't become a mechanism for allowing clinicians to avoid difficult conversations and taking responsibility when something doesn't go well for the patient. There is no substitute for the actual relationship between caregiver and patient.

Keith said...

How would patients ever know what this dept. does or does not do from its name? How would anyone realize pastoral services were included in this department?

I agee; a silly name that does not truly tell us what they do and can seemingly absolve everyone else of dealing with a complaint or problem.

76 Degrees in San Diego said...

How do you know that that everyone in the hospital is not a member of Patient Centered Care Department?

Anonymous said...

Ah, 76; pithy again. :)


MT-PM said...

Having a Patient-Centered Care (PCC) Department is actually a step in the right direction. PCC is becoming a must for all of the reasons stated in the comments. Hospitals are now starting to focus on the needs of the patient,as told BY the patient. Having a PCC department shows that this hospital is dedicating resources to this effort. They may not be "there" yet, but at least they are making strides.