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“Flipping Health Care” from the Patient’s Perspective: Insights from Patient/Family Advisors

By Caitlin Littlefield | Friday, February 14, 2014

A number of patient/family advocates attended the 25th Annual National Forum on Quality Improvement in Health Care in Orlando, Florida, on December 8-11, 2013. The excerpts below were written by those who attended the keynote presentation by IHI President and CEO Maureen Bisognano.

Borrowing from the idea of “flipping the classroom,” Ms. Bisognano’s National Forum keynote was titled “Flipping Health Care” to describe the need to move from a system that does things to patients to one that works with patients to achieve the best results. As one example, Bisognano noted how a medical encounter fundamentally changes when a provider goes from focusing only on illness — asking, “What's the matter?” — to centering the care on an individual's needs — asking, “What matters to you?”

  • According to Eileen Fatell, Patient and Family Care Council Member from Hurley Medical Center, one way to flip health care would be to “have ‘community living room’ conversations, where patients and family care members lead informational groups that take place in libraries or community centers. The community living room would help with access to health care, help in coordinating care, and help people in need of community resources.” Ms. Fatell also suggested that patients’ responses to the “What matters to you?” question could be “put into a living history of the patient that stays with the patient in the hospital chart, and in patients’ rooms on the white board that then can be transferred to other facilities upon patient transfer.”
  • Barbara Lewis, Founder of Joan’s Family Bill of Rights, described Bisognano’s message as “thought provoking” and added, “Just as other industries are flipping, such as education — where lessons are learned at home and ‘homework’ is done in classrooms under the teachers’ watchful eyes — Maureen’s request was for the audience to discover a new model of health care.” Ms. Lewis also noted that in IHI President Emeritus and Senior Fellow Don Berwick’s keynote at the National Forum, he invoked Maureen’s flipping health care concept “by imagining a world where we don’t just focus on health care, but rather health creation.”
  • Randi Redmond Oster, Patient and Family Advocate asserted that, “If we focus on our strengths with the common goal of the patient as the center of the health care experience, we can implement Maureen Bisognano’s vision and ‘flip health care.’ We will create a system based on wellness that treats disease when needed.”
  • “So much of the provider/patient encounter is driven by how things have always been done,” notes Jean Rexford, Executive Director from CT Center for Patient Safety, “The opportunity is now to flip the process and, by doing that, we can improve health and experience. Research has shown that many patients usually wait until they are about to exit the exam room before they address the real reason they scheduled an appointment. Has anyone asked them why? Perhaps it is time to do so.” As Ms. Rexford notes, “Providers often say that patients are non-compliant with medication. A better way to look at that is asking why patients have self-determined that they are stopping a drug. It could be it is too costly or it is making them very sick and they cannot reach anyone by phone to see if there is another drug or a means to mitigate the side effects.”
  • Olivia Williams, Access to Care Coordinator from Kommah Seray Inflammatory Breast Cancer Foundation (KSIBCF), described the need for clinicians and patients to “establish a working partnership” and for patients to be “at the forefront of any decision that involves their well-being.”
  • “The little things do matter and make a big difference on many levels,” Monica King Patient Advisor from Bronson Healthcare Group, asserted. “Kindness and understanding for one another is what binds us. Sometimes this is easy to overlook in a world driven by tangible things, but it always stands out where it’s present. It is time to focus on those little things. It is time to take health care to a whole new level.”
  • Alicia Staley, Founder of the Staley Foundation, summarized the feelings of many by stating, “Patient stories and experiences can help provide a unique perspective on the quality and safety initiatives for an organization. Don’t discount the power of the patient experience.”

For more information on the 26th Annual National Forum click here.

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