Why It Matters
Asking people “What matters to you?” is crucial if your goal is to eliminate suffering — not just reduce harm.
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The Power of Simple Things: “What Matters to You?” Stories from Brazil

By IHI Multimedia Team | Wednesday, October 26, 2016
“What Matters to You?” Stories from Brazil

Salus Vitae is more than a large-scale patient safety program in Brazil. Launched in partnership with the Institute for Healthcare Improvement to reduce hospital-acquired infections in the ICU, its vision is to alleviate suffering and not just reduce harm.

People suffer not only physically, but also psychologically, so medical interventions are not the only ones that matter; empathy and compassion are just as important. With that in mind, the team from Associação Congregação de Santa Catarina (ACSC) accepted an invitation from Health Improvement Scotland to participate on June 6th in What Matters to You Day. The goal was to have meaningful conversations. Instead of just asking “What´s the matter?” the organization challenged health care providers to ask patients and families “What matters to you?”

One woman's response was heartbreaking. She simply wanted to hold her child. Her daughter has encephalopathy and was admitted to Hospital Santa Catarina in São Paulo for seizure and SARS. For a variety of reasons — including the necessity of invasive devices, and her daughter’s hemodynamic instability — non-clinical physical contact had been limited. When this mother told us it had been a year since she had held her daughter in her arms, the whole team worked to make this moment happen.

Santa Catarina mother

Unpredictable Answers

While it is, of course, important to provide safe, reliable care, technical aspects of care never surfaced during the “What matters to you?” conversations. Despite their fears, most of the time staff were able to help patients with what mattered most to them. We found that simple things were what patients often cared about most and had a huge impact on their wellbeing.

A surprising number of patients told us their pets were what mattered most to them. Mrs. Alzira was one of them. A 90-year-old retired translator who lives alone in Blumenau, it was her dog, Nina, who alerted Mrs. Alzira’s neighbor after she suffered a stroke. Nina barked desperately and the neighbor found her lying on the floor.

Despite recovering well at Hospital Santa Isabel, Mrs. Alzira always seemed very sad and quiet. Staff tried to cheer her up by bringing magazines in German for her to translate, but this didn´t help. After a “What matters to you?” conversation uncovered how much she missed her beloved pet, staff arranged a visit from Nina. The dog’s presence brought smiles to both the patient and her care team.

Patient and her dog

Perhaps less surprisingly, many patients said their families mattered most to them. For some, their illness was causing difficult disruptions in their lives. During one “What matters to you?” conversation, for example, a woman named Maria Angélica disclosed that she was sad she wouldn’t see her daughter get married the following Saturday. Since her hospitalization meant she couldn’t go to the wedding, the resourceful and determined staff members at Hospital São José decided — with the help of Maria Angélica’s family and local vendors — to bring the wedding to her.

Hospital wedding

Conversations with patients about what matters most to them reinforced our own values as care providers. They reminded us why we work in health care and demonstrated the power of empathy. We look forward to using what we learned during one joyful day to make all of our improvement efforts more powerful.

Camila Sardenberg, Camila Lorenz, Eliana Argolo, Camila Lajolo, and Fernando Ferragino organized What Matters to You Day at Associação Congregação de Santa Catarina.

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