Johns Hopkins Medicine International (JHI) experts work with affiliates around the world on concrete, quantifiable efforts like creating comprehensive clinical programs, designing medical education programs, implementing quality and safety programs, and improving operational efficiencies. However, our consulting work with our international collaborators also emphasizes the “soft” skills necessary for providing patient- and family-centered care.
Patients’ needs may vary based on culture, religion and other factors. But some values hold true universally in providing quality care: communication, comfort, compassion and humility. We help our collaborators work with their clinical staff to instill and enhance these core tenets of care delivery.
Patients and their families want to understand and be understood. They want to be treated as people, not as the diseases they have. So we advocate for clear and respectful communication in the health care setting.
For example, JHI nurse consultant Wilma Berends presented the lecture “The Relationship Between Difficult Conversations and Patient Safety” at an international nursing symposium hosted by our Brazilian affiliate Hospital Moinhos de Vento. She described the relationship between tough discussions and patient safety, gave examples of how to support effective exchanges and shared actionable tools for improving communication in health care.
As clinicians, our primary responsibility is to alleviate patients’ suffering. Physical pain often accompanies many forms of treatment, like surgery, and we minimize that pain as quickly and effectively as we can. Emotional pain is often avoidable ― and more important than we think.
We can minimize emotional stress by creating a warm and comfortable physical space, including the landscape, ambiance, seating, etc. in the medical setting. And we can ensure clinical workspaces that flow well to improve logistics and ensure high standards of care.
As a common-sense example, while Johns Hopkins oncologists were on the ground at Johns Hopkins Aramco Healthcare (JHAH) in Saudi Arabia, they observed patients waiting in the hallways for various types of testing. On our recommendation, JHAH opened up the waiting area, which made the space more appealing and improved patient flow, increasing access to this much-needed service in the Kingdom.
Health systems also should ensure warm interactions throughout patients’ medical journeys, with every hospital staff member they encounter. If you’ve stayed at a ritzy hotel or visited Disney World, you’ve interacted with staff who’ve mastered the art of hospitality. We think hospitals should also make patients and families feel warm and welcomed.
We must also remember that patients and patients’ families are smart and observant. A bad bedside manner makes a bad ― and lasting ― impression, and this can impact communication and a patient’s compliance with treatment protocol.
At the Johns Hopkins University School of Medicine, we cultivate compassion through our Genes to Society curriculum, which emphasizes the wide range of factors that influence specific patients’ health and disease risks. Our students begin interacting with patients from the first month of medical school, and they focus on the impact that social, community and environmental issues have on individuals’ health. We’ve worked with international colleagues to develop student, trainee and faculty development programs that emphasize effective communication and ethical behaviors.
We’ve also made great strides in our residency training to emphasize patient-centered care and have welcomed medical trainees from our partners, including Monterrey Tec in Mexico, Tawam Hospital in the United Arab Emirates and Hospital Moinhos de Vento. Additionally, Hopkins internal medicine, anesthesia, pathology and emergency medicine residents have traveled to Bermuda, Brazil, Lebanon, Singapore and the U.A.E. to better understand the cultural similarities and differences of patients abroad.
Even when we embrace these values and put patients at the center of care, we’re still going to uncover areas for improvement. We need channels where patients can give us constructive criticism, and we have to be humble enough to act on it.
Press Ganey Associates is the most widely used outpatient satisfaction survey agency in the United States. It surveys patients after discharge, including their perceptions about the cleanliness of the ward and whether they saw their doctors wash their hands. The company then puts that data online so other patients can factor in these reviews as they research and choose a hospital. It’s like looking at other travelers’ comments on Expedia when booking a vacation.
Having these data available — and in such a public format — is a great resource and impetus for medical institutions to do better and provide patients with both the quantitative and qualitative services they need.
Each year, nearly 3 million people from around the world seek out care at the hospitals associated with Johns Hopkins Medicine. Yet, we never rest on our laurels. We constantly strive to provide each patient and family with care that is compassionate, respectful and personalized — and we choose to align ourselves with global collaborators who share this commitment.