When you hear someone say they love their doctor, what is the reason? I posed this question to a hybrid audience at the 27th Annual NRC Health Symposium in August. Here are the responses we heard:
“They communicate.” “I trust them.”
“They’re spending time with me.” “They care about me.”
“They listen.” “They are available when I need them.
“They know me.” “They know why I’m here.
What these answers clearly show – and what comes out every time I’ve asked this question over the years – is that people see relationships as the key to great care experiences. The answers also break the false dichotomy in the question, “Would you rather have a physician who is a great clinician or a great communicator?” People want the whole package. This is the essence of human understanding in healthcare: turning transactions into relationships improves the experience and delivery of care for patients and members of the healthcare team.
So how do you build healing relationships in your daily clinical practice? It begins by recognizing that the vast majority of a patient’s life takes place outside of care. Even a patient who has a 15-minute checkup every week of the year is spending 99.8 percent of their waking hours doing other things. It is therefore essential to understand how the life of this patient affects and is affected by his health. “Expert Meetings” are a good way to think about productive relationships in health care, where clinicians are experts in clinical care and patients are experts in their lives. Care works best when each participant respects the expertise of the other.
Incorporating contextual information to inform care requires focusing our attention on patients as unique people, learning what matters to them, and hearing their stories. Through no fault of their own, most clinicians don’t have the time – whether in the office, in the hospital, via telehealth, or on home visits – to get a clear picture of what matters to each patient. at this moment. The challenge is to balance the wants and needs of patients with the time that providers can realistically devote to each patient. How can health organizations make human understanding tangible?
Adapt care to the patient’s life context
We know that patients want to feel seen, heard and respected as the unique people they are. For clinicians to meet these expectations, they must first understand what matters most to their patients. In this regard, innovative digital tools like NRC Health Stories can be of tremendous benefit in helping patients share, helping healthcare teams listen, and helping organizations learn. Inspired by the science of communication, Stories enables patients to safely and easily provide essential insights before their clinical encounters. An inSIGHT summary is then shared with clinicians via the EHR, which helps improve every patient interaction. In just 15 seconds, clinicians can better understand what matters to their patients as individuals, enabling them to personalize care to the n = 1 level and do an even better job without taking more time. At the population level, leaders can see relationships that are organized to promote learning and improvement.
I take this as radical common sense: we can better meet the needs of a patient if we know what those needs are. Overall, this approach increases patient engagement, optimizes care, and improves the overall care experience, leading to better relationships and increased patient and provider retention. Specifically, focusing on what matters most to patients – things like their agenda, goals, obstacles, pressures, worries, and how their health affects their lives – helps healthcare teams:
- Combat implicit biases by tailoring care to the person, rather than guessing what “people like them” think or need
- Build trust by making personal connections, recognizing preferences and solving problems
- Meet expectations in advance, instead of catching up after the meeting
- Provide support to help the patient cope with the challenges they face
- Rediscover purpose and joy in practice by connecting with their patients
When we first implemented five years ago, 95% of patients using Stories said their visit was “extremely well” compared to 81% of pre-implementation visits. And that’s just the tip of the iceberg. A recently published randomized controlled trial showed double-digit gains in patients’ perception that their provider “treated me with respect” (+13 percentage points; p = 0.04), “showed interest for my ideas “(+14 percentage points; p = 0.03),” showed concern and concern “(+16 percentage points; p = 0.02) and” spent roughly good times with me ”(+11 percentage points; p = 0.05).
Even providers who have many years of experience with their patients report that stories transform care: 82% confirmed that the inSIGHT summary helps them know what is most important to their patients, and 72% noted that the tool does not add any time to the patient. visit. As a chief medical officer of a major health care system put it, “This is the most revolutionary thing we have done since implementing the EHR.
The successful implementation of Stories strengthens the power to capture contextual data generated by patients prior to clinical encounters and makes it easier for healthcare teams to use, at the time of and at the point of care. Armed with this data, patients and providers are building stronger connections and better care based on human understanding, and transforming healthcare in the real world.