Planetree: A Radical Model for New Healthcare/Healing/ Wellness Excellence Tom Peters/10.04.2004

1
Planetree A Radical Model for New
Healthcare/Healing/Wellness ExcellenceTom
Peters/10.04.2004
2
Learn more about Planetree/The Planetree
Alliance www.planetree.org
3
If one didnt know better, one might think that
hospitals set out to design systems that provide
the most sophisticated technical care but deliver
the worst possible experience to sick people.
Putting Patients First, Susan Frampton, Laura
Gilpin, Patrick Charmel
4
It was the goal of the Planetree Unit to help
patients not only get well faster but also to
stay well longer. Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
5
Those of us working in healthcare have an
obligation to be of service in this world, to be
bringers of light and hope. Our work is spiritual
by its nature, as the Planetree model has
acknowledged for decades.Our definition of
spirituality is coming into a right relationship
with all that is, establishing a loving,
nurturing, caring relationship. Planetrees has
been to refocus our attention on the power of
relationships, and, in particular, the
mind-body-spirit relationship essential to
healing. It has opened a door that will never be
closed. Leland Kaiser, Holistic
HospitalsSource Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
6
Much of our current healthcare is about curing.
Curing is good. But healing is spiritual, and
healing is better, because we can heal many
people we cannot cure. Leland Kaiser, Holistic
HospitalsSource Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
7
The curative model narrowly focuses on the
goal of cure. From many quarters comes evidence
that the view of health should be expanded to
encompass mental, social and spiritual
well-being. Institute for the Future
8
Determinants of HealthAccess to care
10Genetics 20Environment 20Health
Behaviors 50Source Institute for the Future
9
The 9 Planetree
Practices1. The Importance of Human
Interaction2. Informing and Empowering Diverse
Populations Consumer Health Libraries and
Patient Information3. Healing Partnerships The
importance of Including Friends and Family4.
Nutrition The Nurturing Aspect of Food5.
Spirituality Inner Resources for Healing6.
Human Touch The Essentials of Communicating
Caring Through Massage7. Healing Arts Nutrition
for the Soul8. Integrating Complementary and
Alternative Practices into Conventional
Care9. Healing Environments Architecture and
Design Conducive to HealthSource Putting
Patients First, Susan Frampton, Laura Gilpin,
Patrick Charmel
10
1. The Importance of Human Interaction
11
There is a misconception that supportive
interactions require more staff or more time and
are therefore more costly. Although labor costs
are a substantial part of any hospital budget,
the interactions themselves add nothing to the
budget. Kindness is free. Listening to patients
or answering their questions costs nothing. It
can be argued that negative interactionsalienatin
g patients, being non-responsive to their needs
or limiting their sense of controlcan be very
costly. Angry, frustrated or frightened
patients may be combative, withdrawn and less
cooperativerequiring far more time than it would
have taken to interact with them initially in a
positive way. Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
12
Press Ganey Assoc/1999 139,380 former patients
from 225 hospitals0 of top 15 factors
determining Patient Satisfaction referred to
patients health outcomePS directly related to
Staff InteractionPS directly correlated with ES
(Employee Satisfaction)Source Putting
Patients First, Susan Frampton, Laura Gilpin,
Patrick Charmel
13
Mgrs re staff wages, security, promotion
opportunitiesStaff re staff interesting work
(M5 of 10), appreciation (5 of 10), sense of
being in about whats going on (10 of 10)
Source Putting Patients First, Susan Frampton,
Laura Gilpin, Patrick Charmel
14
The Customer Comes Second Put your People First
and Watch Em Kick Butt, Hal Rosenbluth (and
Diane McFerrin Peters)
15
100 Best Places to Work/RLevering/2001Get
straight answersAppreciationCollaborationInt
erest in me as a personCamaraderie (Fun place
to work)
16
Perhaps the simplest and most profound of all
human interactions is kindness. But if it is so
simple, it is surprising how frequently it is
absent from our healthcare environments. Many
staff members report verbal abuse by
physicians, managers and coworkers. Putting
Patients First, Susan Frampton, Laura Gilpin,
Patrick Charmel
17
An estimated 60 to 90 percent of doctor visits
involve stress-related complaints.
Newsweek/Health for Life/09.27.2004
18
Planetree is about human beings caring for other
human beings. Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel (Ladies
and gentlemen serving ladies and gentlemen4S
credo)
19
2. Informing and Empowering Diverse Populations
Consumer Health Libraries and Patient
Information
20
Planetree Health Resources Center/1981Planetree
Classification SystemConsumer Health
LibrariansVolunteersClasses, lectures
(CR)Health FairsGriffins Mobile Health
Resource CenterOpen Chart PolicyPatient
Progress NotesCare Coordination Conferences (Est
goals, timetable, etc)Source Putting Patients
First, Susan Frampton, Laura Gilpin, Patrick
Charmel
21
3. Healing Partnerships The importance of
Including Friends and Family
22
When hospital staff members are asked to list
the attributes of the perfect patient and
family, their response is usually a passive
patient with no family. Putting Patients First,
Susan Frampton, Laura Gilpin, Patrick Charmel
23
Family members, close friends and significant
others can have a far greater impact on
patients experience of illness, and on their
long-term health and happiness, than any
healthcare professional. Through the Patients
EyesSource Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
24
A 7-year follow-up of women diagnosed with
breast cancer showed that those who confided in
at least one person in the 3 months after surgery
had a 7-year survival rate of 72.4, as compared
to 56.3 for those who didnt have a
confidant.Institute for the Future
25
The Patient-Family ExperiencePatients are
stripped of control, their clothes are taken
away, they have little say over their schedule,
and they are deliberately separated from their
family and friends. Healthcare professionals
control all of the information about their
patients bodies and access to the people who can
answer questions and connect them with helpful
resources. Families are treated more as intruders
than loved ones. Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
26
Institute of Medicine/ Crossing the Quality
ChasmRespect for preferencesInvolvement in
Decision MakingAccess to careCoordination of
careInformation and educationPhysical
comfortEmotional supportInvolvement of Friends
and FamilyContinuity of careSource Putting
Patients First, Susan Frampton, Laura Gilpin,
Patrick Charmel
27
Care Partner Programs (IDs, discount meals,
etc)Unrestricted visits (Most Planetree
hospitals have eliminated visiting restrictions
altogether.) (ER at one hospital has a policy
of never separating the patient from the family
and there is no limitation on how many family
members may be present.)Collaborative Care
ConferencesClinical Guidelines
DiscussionsFamily SpacesPet Visits (POP
Patients Own Pets)Source Putting Patients
First, Susan Frampton, Laura Gilpin, Patrick
Charmel
28
4. Nutrition The Nurturing Aspect of Food
29
Meals are central eventsvsThere, youre
fed.Irony Focus on nutrition has
reduced focus on food and serviceSource
Putting Patients First, Susan Frampton, Laura
Gilpin, Patrick Charmel
30
KitchenBeautiful cutlery, plates, etc.Chef
repSource Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
31
Aroma therapy (e.g., smell of baking
cookies)Source Putting Patients First,
Susan Frampton, Laura Gilpin, Patrick Charmel
32
5. Spirituality Inner Resources for Healing
33
Spirituality Meaning and Connectedness in
Life1. Connected to supportive and caring
group2. Sense of mastery and control3. Make
meaning out of disease/find meaning in
sufferingSource Putting Patients First,
Susan Frampton, Laura Gilpin, Patrick Charmel
34
Spiritualitybody-mind-spiritprayer-meditation-
visualizationSource Putting Patients First,
Susan Frampton, Laura Gilpin, Patrick Charmel
35
Griffin redesign chapel (waterfall, quiet music,
open prayer book)Other music, flowers,
portable labyrinthSource Putting Patients
First, Susan Frampton, Laura Gilpin, Patrick
Charmel
36
6. Human Touch The Essentials of Communicating
Caring Through Massage
37
Massage is a powerful way to communicate
caring. Putting Patients First, Susan Frampton,
Laura Gilpin, Patrick Charmel
38
Mid-Columbia Medical Center/Center for Mind and
BodyMassage for every patient scheduled for
ambulatory surgery (Go into surgery with a good
attitude) Infant massageStaff massage (caring
for the caregivers)Healing environments
chemo!Source Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
39
7. Healing Arts Nutrition for the Soul
40
Planetree Environment conducive to
healingColor!Light!Brilliance!Form!Art!Mu
sic!Source Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
41
Florence Nightingale/Notes on Nursing/patients
need for beauty, windows, flowers People say
the effect is only on the mind. It is no such
thing. The effect is on the body, tooSource
Putting Patients First, Susan Frampton, Laura
Gilpin, Patrick Charmel
42
Griffin Music in the parking lot professional
musicians in the lobby (7/week, 3-4hrs/day) 5
pianos volunteers (120-140 hrs arts
entertainment per month). Source Putting
Patients First, Susan Frampton, Laura Gilpin,
Patrick Charmel
43
8. Integrating Complementary and Alternative
Practices into Conventional Care
44
CAM (Complementary Alternative Medicine) 83M
in US (42)CAM visits 243M greater than to PCP
(Primary Care Physician) (With min insurance
coverage)W-F-Educated-Hi incDont tell PCP
(40)OTA lt30 procedures used in conv med have
undergone RCTs (randomized clinical trials)
Source Putting Patients First, Susan Frampton,
Laura Gilpin, Patrick Charmel
45
Griffin IMC/Integrative Medicine
CenterMassageAcupunctureMeditationChiropracti
cNutritional supplementsAroma therapySource
Putting Patients First, Susan Frampton, Laura
Gilpin, Patrick Charmel
46
9. Healing Environments Architecture and Design
Conducive to Health
47
Planetree LookWoods and natural
materialsIndirect lightingHomelike
settingsGoals Welcome patients, friends and
family Value humans over technology .. Enable
patients to participate in their care Provide
flexibility to personalize the care of each
patient Encourage caregivers to be responsive
to patients Foster a connection to nature and
beautySource Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
48
SoundTextureLightingColorSmellTasteSacred
spaceSource Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
49
Access to nurses stationHappen
tovsHappen withSource Putting Patients
First, Susan Frampton, Laura Gilpin, Patrick
Charmel
50
The Eden Alternative
51
The Ten Principals of the Eden
Alternative1. The three plagues of loneliness,
helplessness, and boredom account for the bulk of
suffering among Elders.2. Life in an
Elder-centered community revolves around close
and continuing contact with children, plants, and
animals. These ancient relationships provide
young and old alike with a pathway to a life
worth living.3. Companionship is the antidote to
loneliness. In an Elder-centered community we
must provide easy access to human and animal
companionship.4. A healthy Elder-centered
community seeks to balance the care that is being
given with the care that is being received.
Elders need opportunity to give care and
caregivers need opportunities to receive
care.Source Putting Patients First, Susan
Frampton, Laura Gilpin, Patrick Charmel
52
The Eden paradigm allows elders to care for
animals, birds, and children as well as each
other. Susan Eaton, Harvard/JFK schoolSource
Putting Patients First, Susan Frampton, Laura
Gilpin, Patrick Charmel
53
The Ten Principals of the Eden
Alternative5. Variety and Spontaneity are the
antidotes to boredom. The Elder-centered
community is rich in opportunities to sample
these ancient pleasures.6. An Elder-centered
community understands that passive entertainment
cannot fill a human life.7. The Elder-centered
community takes medical treatment down from its
pedestal and and places it into the service of
genuine human caring.Source Putting Patients
First, Susan Frampton, Laura Gilpin, Patrick
Charmel
54
The Ten Principals of the Eden
Alternative8. In an Elder-centered community,
decisions should be made by the Elders or those
as close to the Elders as possible.9. An
Elder-centered community understands human growth
cannot be separated from human life.10. Wise
leadership is the lifeblood of any struggle
against the Three Plagues. For it, there can be
no substitute.Source Putting Patients First,
Susan Frampton, Laura Gilpin, Patrick Charmel
55
The most basic question we need to pose in
caring for others is this Is this a loving act?
Leland Kaiser, Holistic HospitalsSource
Putting Patients First, Susan Frampton, Laura
Gilpin, Patrick Charmel
56
Conclusion Caring/Growth Experience
57
Care!Control!Connect! Engage!Grow!
De-stress!
58
The single best way to predict the future is to
create it. anon