PROSPECT: Delivering the Promise of Patient-Centered Care
Patients’ concerns while in the hospital can range from medical—wanting to talk about lung scan results or needing help with nausea medication—to more personal, such as hoping to watch the Patriots game.
Patients generally have better experiences when they understand and are actively engaged in developing their plan of care, feel their care team members are attentive to their needs and concerns, send them a consistent message and treat them as people rather than patients.
A multidisciplinary team is promoting a culture of patient-centeredness by bringing new tools to patients and their team of providers that enhance communication and teamwork, and ensure the best patient experience possible. “We believe that the work we are doing now will transform how we deliver care in the 21st century,” said Anuj Dalal, MD, FHM, a hospitalist at BWH.
Through the PROSPECT (“Promoting Respect and Ongoing Safety through Patient-centeredness, Engagement, Communication and Technology”) initiative, patients and their caregivers in the medical intensive care and oncology units have access to a patient portal using a bedside tablet computer. From the patient portal, they are able to view their plan of care, schedule, medications, test results and care team members. They can establish goals, communicate concerns and preferences, and provide feedback to providers in real-time. They are also able to send a question directly to their entire care team through a novel messaging platform—a patient-centered “microblog”—that is integrated into the patient portal and providers’ workflow.
“Patients really want to be able to ask questions when they are ready, and sometimes that means when they are alone and have had an opportunity to process the information they received from their care team,” said Patti Dykes, PhD, RN, senior nurse scientist and program director of Nursing Research. “Through this tool, the patient can submit a question or concern, and the care team will review it, have a discussion and come back and address it with the patient—usually in person.”
In this way, providers are intimately connected to their patients so that they can deliver the type of care that patients truly want.
Martie Carnie, of the BWH Patient and Family Steering Committee, says that the tool is proving useful for patients. “It’s very helpful in giving patients some control over their care, and it makes them feel better connected,” she said. “It’s important for them to know that somebody really cares and is listening.”
Behind the scenes, the care team members have access to the microblog messaging tools that enable them to receive the patient’s questions and have a secure and confidential discussion among themselves. This feature brings all members of the team together virtually and replaces the clinical conversations that currently happen in silos via email and traditional paging among several care team members. The messaging tools are also available on a mobile app, which providers find handy when they are on the go.
“Why not use a single forum, where everyone can view the same conversation and be on the same page?” said Dalal. “The patient-centered microblog ensures that everyone is part of every discussion, and that leads to better communication and better care.”
By giving patients more access to their care team and more awareness of their medications and plan of care, the study is also striving to minimize preventable harm and reduce unnecessary resource utilization.
“We believe that one of the main ways to eliminate preventable harm is to partner with patients and provide them with tools that have the information they need to engage in their care and communicate with us,” said Dykes. “PROSPECT is helping patients and their care team stay on the same page and help the patient progress through the hospitalization.”
Since the study launched last July, more than 250 patients and caregivers have participated. Of all the features on the patient portal, most patients particularly like the ability to view their test results and medications, pose a question and see who all the members of their care team are.
“PROSPECT has helped us establish a culture of patient-centeredness,” said Dykes.
PROSPECT has been ongoing thanks to a $2 million grant from the Gordon and Betty Moore Foundation and support from BWH. To learn more, visit http://www.partners.org/cird/PROSPECT/Index.htm, or email firstname.lastname@example.org.
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