Planetree, 130 Division Street, Derby, CT 06418, USA.
J Comp Eff Res. 2013 Sep;2(5):443-55. doi: 10.2217/cer.13.54.
The Institute of Medicine defines patient-centered care as "providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions." What is missing in this definition is an explicit emphasis on compassion. This perspective article draws on the experience of Planetree (CT, USA), a not-for-profit organization that partners with healthcare establishments to drive adoption of patient-centered care principles and practices by connecting healthcare professionals with the voices and perspectives of the patients and family members who utilize their services. Across hundreds of focus groups facilitated by Planetree, patients and their loved ones emphasize that paramount among their needs, preferences and values are compassionate human interactions. For care to be truly patient-centered, a foundation of compassion is essential. Reports from patients and the media, and research from healthcare systems around the world demonstrate the fallacy of assuming that compassion is a current or prevalent feature of the care experience. Concurrently, a growing evidence base highlights the supreme importance of compassion in driving high-quality, high-value care. However, good intentions are not sufficient for delivering compassionate care. Drawing on the experiences of exemplary patient-centered hospitals (recognized as such following a rigorous culture audit to determine fulfillment of the criteria for formal recognition as a Designated® Patient-Centered Hospital [Planetree]), this paper explores practical approaches for embedding compassion in healthcare delivery and organizational culture to meet patients' expressed desires for empathic and respectful human interactions.
美国医学研究所将以患者为中心的护理定义为“提供尊重和响应个体患者偏好、需求和价值观的护理,并确保患者的价值观指导所有临床决策”。这个定义中缺少一个明确的重点,即同情心。本文通过美国非营利组织 Planetree(康涅狄格州,美国)的经验来探讨这个问题,该组织与医疗机构合作,通过将医疗保健专业人员与使用其服务的患者和家属的声音和观点联系起来,推动以患者为中心的护理原则和实践。在 Planetree 主持的数百个焦点小组中,患者及其家属强调,他们最需要、最看重的是富有同情心的人际互动。要实现真正以患者为中心的护理,同情心是必不可少的基础。来自患者和媒体的报告以及世界各地医疗保健系统的研究表明,认为同情心是护理体验的当前或普遍特征是错误的。与此同时,越来越多的证据基础强调了同情心在推动高质量、高价值护理方面的至关重要性。然而,仅仅有良好的意愿是不足以提供富有同情心的护理的。本文通过有代表性的以患者为中心的医院的经验(在经过严格的文化审计以确定是否符合正式认可为指定的以患者为中心的医院[Planetree]的标准后被认可为这样的医院),探讨了将同情心融入医疗保健服务和组织文化中的实用方法,以满足患者对同理心和尊重的人际互动的表达需求。