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Think tank brands hospitals 'medical factories'

Clinicians don't always provide the care they would want for themselves

OnMedica Staff

Wednesday, 03 December 2008

Hospitals are vast ‘medical factories’ that do not have enough focus on compassion and the experience of the patient, a think tank says.

Today the King’s Fund published a report on the scale and nature of the problems patients experience while in hospital which questions why staff don’t always provide the sort of care they would want for themselves and their own families.

This first report from the Point of Care programme concludes that while patient surveys show high levels of satisfaction, more detailed studies, and stories from patients themselves, indicate a much patchier picture. The report identifies a number of problems, including variations in the quality of care and the need for staff to see the person in the patient.

It also found there was little evidence to support many of the methods now being used to improve services, which often focused on just one group of staff or one aspect of patient experience.

According to the report, current efforts do not do enough to transform hospital culture or to support staff to provide compassionate care. It recommends that action be taken at four levels: the individual staff member; the team, unit or department; the institution as a whole, and the wider health care system.

Director of The King’s Fund Point of Care programme Dr Jocelyn Cornwell said: “Staff come to work intending to provide the quality of care they would want for themselves and their families. But today’s hospitals are vast, time is at a premium and in these busy ‘medical factories’ care of the person can unfortunately get squeezed out. The Point of Care programme aims to help staff and hospital boards improve patients’ experience of care and support staff to see the person in the patient.”

The research identified two practical initiatives to promote compassion in care and improve patients’ experience which will be piloted.

  • Schwartz Center Rounds®, developed by the Kenneth B. Schwartz Center in the USA, provide a monthly one-hour session for staff from all disciplines in a hospital to come together and discuss difficult emotional and social issues arising from patient care. The Rounds will be piloted at the Royal Free Hampstead NHS Trust from early 2009 and other trusts in England from mid 2009.
  • Experience Based Design involves patients and staff working together to improve the experience – or feel – of using services, drawing on ideas from design in which users are a central part of the process. Patients and staff are partners in the process, strengthening the link between them. The Point of Care programme will be piloting Experience Based Design with the Integrated Cancer Centre at Guy’s & St Thomas’ NHS Foundation Trust and King’s College Hospital NHS Foundation Trust over the next three years.

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