An excellent “A Piece of My Mind” article in the Journal of the American Medical Association entitled, “A Systems Engineer Meets the System”by David H. Gustafson, PhD is a reminder that while systems are important, people caring for people remains the key to good clinical outcomes.
Dr. Gustafson starts out his article by identifying himself as a systems engineer, whose life work has been, and remains, organizational change and quality improvement in health care. He then describes his own experience as a patient with severe heart disease and his ongoing medical journey that includes a new heart courtesy of a heart transplant. He identifies four elements of great care:
Commitment to Greatness: The health care professionals caring for him all did not just consider health care to be a job but instead brought energy and commitment to his care that went beyond work hours and normal work protocols. They were driven by a mission for excellence that could overcome whatever obstacles arose.
Ownership: The excellent medical teams that helped him all had a sense that whatever happened to him was their responsibility. As he phrased it, “…, I knew the staff “owned” me. I wouldn't be passed along somewhere else.”
Advocacy: Dr. Gustafson’s wife was with him constantly and she was always supported by a friend, only a phone call away, who is a physician. His wife acted as his bodyguard, watching everything that was done, and his voice in issues as small as the cleanliness of his room and as large as the need for invasive tests. The friend supported his wife and acted when needed as a “boundary spanner”. He was there to remove barriers (as we say at Accolade) when they arose as they often do in health care and to coach Dr. Gustafson's wife.
Caring: Dr. Gustafson puts it this way, “Caring means commitment, but it also includes having fun; being friendly; and getting to know other people as human beings and not just as clinicians, patients, housekeepers or administrators.” All of us want to be seen and heard as individual human beings with our own thoughts, relationships, needs and values and must be recognized as such for true caring to occur.
At Accolade we have built an organization and a profession whose main role is to act as the “boundary spanner” and the “advocate” and ultimately, the overall Health Assistant for every issue that has to do with accessing the best health care at times of need. We put principles of “ownership” and “caring” into all of our client relationships. By doing so, we improve care and this decreases risk to the individual patient and waste in the entire health care system.