The Science of Compassionate Care Donald J Parker

The Science of Compassionate Care Donald J. Parker President and CEO

COMPASSION LIES AT THE INTERSECTION OF: Empathy (understanding patient’s concerns) and Sympathy (feeling patient’s emotions) The combination is a response to the distress of others and a desire to alleviate that distress.

COMPASSIONATE CARE Compassionate Care addresses the patient’s innate need for connection and relationships and is based on attentive listening and a desire to understand the patient’s context and perspective.

REQUIREMENTS OF THE PROVIDER • The ability to adjust his/her responses to the patient’s needs. • The clinical expertise and professionalism to respond effectively and appropriately. • An awareness by the provider of how his/her reactions affect interactions with the patient and decisions about care. • The ability to use self awareness to manage his/her emotions, in order to act in the patient’s best interest.

What is Organizational Compassion?

FUNDAMENTAL QUESTIONS ABOUT COMPASSION • Can we measure the expression of compassion between individuals? • Can we measure the impact of compassion on givers and receivers? • Can we train/influence people to be compassionate?

THE PATIENT EXPERIENCES COMPASSION AS: • Respect. • Appropriate expressions of caring concern. • Information and decision-making processes that are tailored to patient’s needs.

COMPASSIONATE CARE IS DEFINED BY THE FOLLOWING FOUR ESSENTIAL CHARACTERISTICS: 1. Empathy, emotional support and efforts to understand relieve the patient’s distress and suffering. 2. Effective communication within interactions over time and across settings.

COMPASSIONATE CARE IS DEFINED BY THE FOLLOWING FOUR ESSENTIAL CHARACTERISTICS: 3. Respect for and facilitation of patient’s and family’s participation in decisions and care. 4. Contextual knowledge of the patient as an individual within a network of relationships at home and in the community.

THE IMPACT OF COMPASSIONATE CARE ON HEALTH OUTCOMES Effective communication is shown to improve: � � � Diabetes Pain control Physical and mental quality of life in cancer patients Primary care Geriatric care � � � Decreases anxiety, depression and P. T. S. D. Reduces readmission rates for heart failure and pneumonia patients Blood pressure

DESPITE THE IMPACT AND IMPORTANCE OF COMPASSIONATE CARE: Only 53% of Patients • Only 58% of Physicians • Felt the United States Health Care System was providing compassionate care.

DESPITE THE IMPACT AND IMPORTANCE OF COMPASSIONATE CARE: 55% of Physicians • 67% of Patients • Felt that changes in the Health Care System, including the emphasis on controlling costs, would reduce the practice of compassionate care.

Carrier Clinic’s Patient Experience and Quality teams proposed the creation of a COMPASSIONATE CARE INDEX

THE COMPASSIONATE CARE INDEX WOULD INCLUDE MEASURES OF: • Informed shared decision-making. • Continuity of care. • Trust. • Coordination of care across settings. • Attention to patient preferences.

RECOMMENDATIONS: • CMS include a Compassionate Care Index in National Quality Standards • The Patient-centered Outcomes Research Institute (created by the Affordable Care Act) fund research to determine which aspects of Compassionate Care have the greatest impact on health outcomes, quality of life and patient satisfaction. • New health care payment systems, including CMS’ proposal value-based purchasing system, reward providers for Compassionate Care they provide to patients and families.

RECOMMENDATIONS: • Comprehensive training programs be developed to help health care professionals and trainees develop the necessary skills required to deliver Compassionate Care.

ORGANIZATIONS THAT DELIVER HIGHER DEGREES OF COMPASSIONATE CARE SHARE THE FOLLOWING CHARACTERISTICS • A commitment to involving patients and families in care improvement activities. • Hiring practices and training programs that focus on compassion • A culture of experimentation, Compassionate Care champions and units that model compassion and share their strategies with others

THE CENTER FOR COMPASSION AND ALTRUISM RESEARCH AND EDUCATION Compassion A process that unfolds in response to suffering. It begins with the recognition of suffering, which gives rise to thoughts and feelings of empathy and concern. This, in turn, motivates action to relieve suffering.

SCHWARTZ CENTER STUDY: Building compassion into the bottom line Key findings: • Organizations that place a high priority on delivering Compassionate Care benefit from: ü ü Lower staff turnover Higher retention Recruitment of more highly qualified staff Greater patient loyalty ü ü ü Reduced cost from shorter lengths of stay Lower rates of rehospitalization Better health outcomes

CAREGIVERS WHO ARE ABLE TO EXPRESS COMPASSION FOR PATIENTS, FAMILIES AND EACH OTHER EXPERIENCE: • Higher job satisfaction. • Better health. • Fewer medical errors. • Deeper connection with their caregivers.

CULTIVATION: • Humans have a natural capacity for compassion. • Everyday stress, social pressure and life experience make it difficult to fully express our capacity. • Each of us can choose to nurture and grow the compassionate instinct- like a plant cultivated from a seed. • This process requires patience, steady care, proper tools and a supportive environment.

TRAINING • Training of our own minds. • Developing specific skills in how we relate to other. • Intentionally choosing thoughts and actions.

COMPASSION CULTIVATION TRAINING • Daily meditation practice to develop lovingkindness, empathy and compassion. • Weekly classes that includes lectures and inclass discussions about compassion. • In-class partner and small group listening and communication exercises. • Real-world homework assignments to practice compassionate thoughts and actions.

OUTCOME OF COMPASSION CULTIVATION TRAINING • The strength to be present with suffering. • The courage to take compassionate action. • The resilience to prevent compassion fatigue. • Improvement of personal and work relationship. • • Improvement in one’s own health, happiness and well-being. • • Increased self-compassion and self-care.

COMPASSIONATE CARE AT CARRIER CLINIC • Carrier’s Compassion Quotient –Individual, Business Unit, Organizational, Industry-wide • Consumer Feedback System • Optimized Hiring • Skill Training • Reward/Recognition Systems • Compassion Invigoration • Compassionate Fatigue Prevention/Treatment

THANK YOU!