What We Know, Cures; Who We Are, Heals

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IntroductionHealth care is about curing and healing, art and science, mind and heart, skills and knowledge, technology and compassion, living and dying. Funding in health care is based on a business model of efficiency, while experiences of illness, the delivery and outcomes of care are all about relationship—relationships of individuals with themselves and others. The relational quality of the healthcare workplace affects virtually every dimension of organizational performance: decreased mortality, patient/provider satisfaction, staff retention and budget.[1][2] Relationship centered care (RCC) has been shown to promote cohesion, empathic support and collegiality by balancing science-based practice with the centrality of relationships and the importance of the personhood of practitioners, patients and their families.[3] RCC provides a theoretical model for re-conceptualizing what is vital and significant in health care by developing a paradigm focused on caring, healing and community.[4] From the perspective of RCC, patients are both central and embedded in a web of relationships.[5] This presentation will describe how the theoretical framework of RCC can be translated into a core competency training module in a national curriculum for critical care residents.MethodThe model we have developed in partnership with Canadian Blood Services’ Deceased Donation team includes strategies to assist clinicians in developing knowledge and skills and clarifying values to form caring, healing relationships with patients and their families, with colleagues and with themselves.[4] It will initially be implemented, as a pilot project, with health care providers who are part of the donation community. This work is particularly important to the donation community as it aligns with continued focus on optimizing end of life conversations to collaboratively and compassionately support patients and patients’ loved ones. The model will include strategies relevant to clinicians' relationships with themselves, patients and patients’ families, and other clinicians.ConclusionThis presentation will describe how the theoretical framework of RCC can initially be translated into a core competency training module in a national curriculum for critical care residents and subsequently expanded for other health care providers. It will include a description of measures to determine effectiveness of the various components of the model including ongoing learner and program evaluation. This work is essential to integrating relationship centered care into daily practice thereby transforming the culture within the donation community and the broader health care system. How we work together affects the integrity, functional capacity and resilience of patients, their families, our colleagues and ourselves.[5]References:1. Suchman AL, Sluyter DJ, Williamson PR. Leading change in healthcare, transforming organizations using complexity, positive psychology, and relationship-centered care. Radcliffe Publishing, 2011.2. Kuhl D, Cave D, Pearson H, Whitehead P. Treatment and Prevention Work: Centre for Practitioner Renewal in Do Good; Do No Self Harm. C Figley, P Huggard, CE Rees (eds). Oxford University Press, 2013.3. Suchman A. A new theoretical foundation for relationship-centered care. Journal of General Internal Medicine. 2006; 21: 40-44.4. Pew-Fetzer Task Force on Advancing Psychosocial Health Education. Health Professions Education andRelationship-Centered Care. San Francisco: Pew Health Professions Commission: 1994.5. Beach MC, Inui T, Relationship-Centered Care Research Network. Relationship-centered Care, A Constructive Reframing. Journal of General Internal Medicine. 2006; 21:S3-8.6. Soklaridis S, Ravitz P, Adler Nevo G, Lieff, S. Relationship-centred care in health: A 20-year scoping review. Patient Experience Journal. 2016; 3:1.

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