Why do you think it can be difficult for patients and providers to be true partners in health care?

Barbara Balik, RN; IHI Senior Faculty, Common Fire Healthcare Consulting

There’s different levels. So if we start at the patient and health care practitioner connection level, that level of care, which is really the core of what we’re all about, several things get in the way.

One, it’s how we teach our new professionals how to connect with patients and truly listen. We’re often told or taught as nurses and physicians and pharmacists and respiratory care practitioners and any of our roles that we are the experts. We’re often not told and instructed that patients are experts in their lives and their values and that we have to tap into that expertise. Even if our newer professionals are taught that in education, we tend to squeeze it out of them in the health care settings. We, and I’ve been a CEO, I’ve been a chief nursing officer, and I know what our cultures can do to our new professionals. We squeeze it out of them.

We also have production pressures that mean you have to go fast, or that’s our impression. We have to go fast so sometimes we forget that if we go slow, we can go fast. We’ve learned in my work with physicians and nurses, if you simply pause and ask — “What’s most important to you today?” or “What are you most worried about?” — you’re going to learn just about everything you need to have a great connection. It’s both what we teach, what we have in our practice environment, and what leaders set the stage for. I hold ourselves as leaders, particularly because I’ve been in those roles, highly accountable for what happens in that interaction.

The second is that at the organizational level, when we want to partner with patients in designing and improving our programs, we simply haven’t taken the time or energy to identify patients who can join with us or community members. We haven’t set the stage to teach our colleagues how to listen and learn from our colleagues. I think it’s at two different levels. There’s a reluctance. Sometimes there’s a fear. The fear is that they’ll see that we don’t know how to do this very well. Patients and community members pretty much know our flaws already, truth be told, and some of it is we don’t want to look foolish in front of those we are committed to serve, and so it’s looking good. We forget that we can learn this together.