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What Role Does Selection Play in Patient Centered Care?

December 1, 2011

We hear it all the time – “Patient-Centered Care”.  Is it just the latest buzzword?  Is it some vague, un-obtainable goal?  Once we know what it is, how do we achieve it?

A definition of patient centered care advanced by the Institute for Health Care Improvement (IHI) includes:

Consideration of “patients’ cultural traditions, their personal

preferences and values, their family situations, and their lifestyles. It makes the patient and their loved ones an integral part of the care team who collaborate with health care professionals in making clinical decisions… [and] ensures that transitions between providers, departments, and health care settings are respectful, coordinated, and efficient. When care is patient centered, unneeded and unwanted services can be reduced.”

Don Berwick’s (departing CMS Administrator), in a speech entitled “What ‘Patient-Centered’ Should Mean: Confessions of an Extremist” (later published in Health Affairs), said this:

For better or worse, I have come to believe that we—patients, families, clinicians, and the health care system as a whole—would all be far better off if we professionals recalibrated our work such that we behaved with patients and families not as hosts in the care system, but as guests in their lives. I suggest that we should without equivocation make patient-centeredness a primary quality dimension all its own, even when it does not contribute to the technical safety and effectiveness of care.

Don’t even think about a “legal” definition.  While the term is used repeatedly in the Patient Protection and Affordable Care Act, lawyers may struggle with definition of “patient” and what is meant by “centered”!  Either way, the concept will be woven into regulations on care and reimbursement.

How do we teach and measure patient-centered care?  Recently, at least there is a realization that the patient “experience” is more important than their “satisfaction” as that is recorded in surveys.  Teaching it?  We can design new delivery models. We can adopt processes that increase the likelihood that the patient will play a greater role in his or her care, but how do we teach people to be “patient-centered?”

At its core, we are talking about providers that are able, in the face of heavy workloads and hectic workdays, to keep the patient at the forefront, to always demonstrate compassion, professionalism and empathy, and even the ability to adapt to these new approaches and adhere to them at all times.  This is where selection comes in.  The science of selection has demonstrated that we can identify those individuals with the inherent functional behaviors we just listed.

We can train on process, we can develop and reinforce certain behaviors but the likelihood of success is greatly enhanced when each hiring decision, each member we add to the team, comes with some of these key behavioral traits.  How are you examining them during the hiring process?

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Bryan Warren Bryan Warren is the President of J3 Personica, a consulting, assessment, training, and coaching firm, and a guest blogger for PSI. Bryan is an expert in progressive talent strategies, with a particular focus on leader and physician selection and development.