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4 ways hospitals and health clinics can make care more compassionate

When her mother had a stroke during a beach vacation, Susan Frampton, PhD, and her siblings rushed her to the nearest hospital. Her mother had difficulty speaking, so Frampton and her sisters told her physicians vital information about her health—that she couldn’t hear without a hearing aid, for instance. The siblings camped out on a pullout sofa in their mother’s hospital room for 3 1/2 days.

Dr. Frampton

“[Compassion] is the most important thing we can focus on,” says Susan Frampton, PhD. (Photo by Rose Raymond)

“[The hospital was] wonderful about welcoming us into the clinical setting with my mom,” said Dr. Frampton, who is the president of Planetree, a health care organization that emphasizes compassionate care. “Nobody questioned my sisters and I being in the emergency room with her, at her side, holding her hand and helping to answer questions.”

The hospital’s policy of allowing relatives to participate in care made a huge difference to Dr. Frampton and her family. Such policies are a cornerstone of compassionate care, she said during a presentation at the AOA’s Advocacy for Healthy Partnerships conference in Atlanta on Nov. 23. She explained that improving the patient experience can yield payoffs in patient satisfaction and outcomes.

“At the end of the day, [compassion] is the most important thing we can focus on,” she said.

A Planetree study found that patients and their caregivers are most concerned about continuity of care, having a say in their treatment and the attitude of their health care professionals, Dr. Frampton said. And evidence is beginning to show that empathy impacts patient outcomes, she added. For instance, a 2013 literature review in a British medical journal found a correlation between physician empathy and patient satisfaction. Also, diabetic patients who had physicians with high empathy scores had better clinical outcomes, a 2011 Academic Medicine study found.

Injecting compassion into care

Many physicians and health care institutions aren’t fully aware of the tangible benefits of compassion, Dr. Frampton said. She outlined several changes hospitals and health care clinics can implement to encourage a culture of compassion among staff.

Planetree employees typically participate in experiential exercises during retreats designed to give them a better idea of what patients experience, Dr. Frampton said. For instance, a group is divided into pairs. Then, one member of each pair will feed his or her partner for 15 minutes.

“I still remember going through this exercise 13 1/2 years ago … I literally could not let myself be fed,” Frampton said. “It was so uncomfortable for me.”

Over the years, Dr. Frampton has done this exercise with many groups, and she said most people, like her, find the exercise very uncomfortable. This underscores a good reason for health care professionals to try it, she said.

“We do these kinds of things to patients, often in clinical settings, in long-term care settings, and we never think, ‘How does this feel?’ ” she said.

Another way health care institutions can understand the experience of their patients is to ask them. Dr. Frampton recommended that hospitals establish patient-centered focus groups and advisory councils, allowing patients and their families regularly to provide feedback and discuss ideas to improve safety, quality and the patient experience.

And to further comfort patients, hospitals should grant them access to their medical records, Dr. Frampton suggested. She cited a 2011 Annals of Internal Medicine study in which about 4 out of 5 patients said reading their medical notes helped them feel more in control of their treatment.

Allowing patients to view and keep their medical records can also improve their continuity of care, Dr. Frampton noted. For instance, if a patient switches hospitals, having medical records on hand will mean his or her new physicians will likely see them sooner. And greater continuity of care is one reason Dr. Frampton also touted policies to promote family involvement in patient care. She recommended that health care facilities allow patients’ caregivers and family members to visit whenever they want.

Dr. Frampton noted that 89% of acute care hospitals restrict visitation in some way, but she attested that unlimited visiting hours gives caregivers a greater opportunity to update staff on a patient’s status after shift changes. In turn, family members will have a better understanding of the patient’s condition and care needs, which will be useful when the patient returns home.

Attendee Kaitlin V. Dewhirst, OMS IV, said the importance of family resonated with her. She frequently interviews patients on her clinical rotations, but often finds that family members provide the best information.

“Many times, the patients I’m interviewing aren’t able to give me a full history because they’re too sick or they’re unable to talk,” said Dewhirst, who attends the Lincoln Memorial University-DeBusk College of Osteopathic Medicine in Harrogate, Tenn. “It’s often the wife, the grandchild or the daughter who contributes the details I need to know in order to make a proper diagnosis and plan.”

While on her clinical rotations, Dewhirst said she’s also seen the negative impact of limited visiting hours.

“Sometimes I see patients who are extremely sick,” she said. “And I can tell that they look lonely and sad. They aren’t healing quickly because their family is only allowed to come see them for a few hours a day.”

rraymond@osteopathic.org

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