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 didn’t 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. Planetree’s 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 Hospitals”Source: 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 Hospitals”Source: 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: 10%Genetics: 20%Environment: 20%Health Behaviors: 50%Source: 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 interactions—alienating patients, being non-responsive to their needs or limiting their sense of control—can be very costly. … Angry, frustrated or frightened patients may be combative, withdrawn and less cooperative—requiring 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 patient’s 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 (M:5 of 10), appreciation (5 of 10), sense of being “in” about what’s 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 answersAppreciationCollaborationInterest 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 gentlemen”—4S 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 FairsGriffin’s 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 Patient’s 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 confidedinatleastoneperson in the 3 months after surgery had a 7-year survival rate of 72.4%, as compared to 56.3% for those who didn’t have a confidant.”Institute for the Future

25. The Patient-Family Experience“Patients 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 Chasm”Respect 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 eventsvs“There, you’re fed.”**Irony: Focus on “nutrition” has reduced focus on “food” and “service”Source: 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 healing”Color!Light!Brilliance!Form!Art!Music!Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

41. Florence Nightingale/Notes on Nursing/patient’s 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, too”Source: 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 incDon’t tell PCP (40%)OTA: <30% 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 CenterMassageAcupunctureMeditationChiropracticNutritional supplementsAroma therapySource: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

46. 9. Healing Environments: Architecture and Design Conducive to Health

47. “Planetree Look”Woods 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 station:“Happen to”vs“Happen with”Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

50. The Eden Alternative