Patient-focussed is not the same as Patient-centred care. All clinicians pride themselves in being patient focussed  - this is about considering (from healthcare worker’s perspective) what patients and their families need and then doing it to or for them. Although well-intentioned this approach can miss the mark and waste time and resources. Patient-centred care is about working with patient’s and their families in a meaningful rather than token way.

Families need to be seen as ‘care partners’ – never as ‘visitors.’ This seemingly simple distinction starts the conversation on how we manage the involvement of families in care, what we mean by a ‘visitor’ policy, can families be seen as a resource (e.g. for psychological comfort and support to patients,  calming a confused relative, aiding with discharge planning) rather than a group to be tolerated

Patient and Family Advisors – many hospitals have developed these roles and such advisors participate in and direct a wide range of activities – from designing care pathways, producing patient information pamphlets, facilitating patient feedback, to sitting on executive decision making committees. Note: Mental Health Services here at CMDHB have such advisors and we will be looking to emulate this work

Patient-centred care is cost saving – most hospitals that have adopted patient and family centred values have seen cost saving. For example Medical College of Georgia (MCG Health) has adopted PFCC as the business model for their organisation and is now in the top centile for cost-effective hospitals. The University Health Systems of Eastern Carolina has publicly adopted PFCC values (posters announce that “we’re in this together: we want families and patients to be part of the team”; patient and family advisors serve with operational leaders and on key committees), and they have seen a 50% reduction in hospital-acquired infections in the past 2 years, 73% reduction in serious safety events and a marked reduction in nurse turnover.

It is important to hear the patient voice frequently and at all levels – the power of patient stories.

In a growing number of instances where truly stunning levels of improvement have been achieved leaders of these organisations often cite - putting patients and families in a position of real power and influence using their wisdom and experience to redesign and improve care systems - as being the single most powerful transformational change in their history (Seven Leadership Leverage Points for Organizational-Level improvement in Healthcare.  2nd Edition, IHI Innovation Series, 2008.  www.ihi.org

Leading in the development of Patient & Family-Centred Care at CMDHB is likely to be pivotal in achieving the aims of the organisation, particularly around how to manage the avalanche of demand for acute services.

New Zealand has been a lot slower than the United States in adopting meaningful patient and family engagement, but CMDHB can lead the way.