The Patient’s Voice: Institution-Wide Training for Housestaff in Patient-Centered Care
Institution: New York Presbyterian Hospital
Principal Investigator: Nicholas H. Fiebach, MD
This project integrates 3 components that will 1) identify the “voice of the patient” at our institution using actual comments from patient surveys and focus groups; 2) develop and pilot with residents strategies for delivering patient-centered care that incorporates simulated patients; and, 3) design an expanded, intensive workshop on patient-centered care practices integrating the lessons learned from the first two components.
The three components are:
1. The Voice of the Patient - Patient Feedback and Patient Focus Groups. Approximately 3,000 lines of individual verbatim comments were retrieved from patient satisfaction surveys and a patient focus group . Abstracted comments were used to construct themes, and specific comments were selected for inclusion in patient scripts for hospital admission and discharge scenarios (see Attachment A for the actual scripts). The project team developed the concepts that hospital admission and discharge (or initiation and conclusion of patient care episodes) may present a series of “potholes” that derail patient-centered care, and that there are concrete behaviors (tools, or Always Events™) that house staff may learn and incorporate in their work to prevent (or “fill”) these potholes.
2. Pilot Workshops with Residents. These 90-minute workshops were informed by the comments of our patients and POTHOLEs themes elucidated in the first component of our project, and were designed to engage residents to identify key patient-centered care behaviors at admission and discharge (Always Events™). They included vivid presentations of the voice of the patient using simulated patients, small-group interactive discussions among residents responding to the patient’s stories and relating them to their own clinical experiences, large group discussion eliciting themes from the small groups, guidance from faculty about facilitating patient-centered care using the POTHOLEs framework, and personal goal-setting.
3. Intensive Workshop. Using information from the patient surveys and focus groups together with feedback from the pilot resident workshops, a more intensive workshop for residents on patient-centered care is being developed. The intensive workshop will build on the content of the pilot workshop, including presentations of the voice of the patient, and will enlarge the guidance to housestaff on incorporating targeted Always Events into their patient encounters.