Chapter 21: Patient-Centered Care: Formalizing the Practice at MD Anderson
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Description
Dr. Rodriguez talks about the shift in healthcare to a focus on patient-centered care and addresses the specific ways that MD Anderson is putting this approach into practice. She first explains that patient-centered care is a shift in focus and explains the value is shifting from treating disease to treating people (and seeing them as customers). She notes that MD Anderson patients experience the kindness and devotion of providers. She lists some patient centered practices instituted and notes others that need improvement.
Identifier
RodriguezA_04_20150605_C21
Publication Date
6-5-2015
Publisher
The Making Cancer History® Voices Oral History Collection, The University of Texas MD Anderson Cancer Center
City
Houston, Texas
Interview Session
Topics Covered
Building the Institution; The Administrator; Institutional Mission and Values; MD Anderson Culture; The MD Anderson Brand, Reputation; Building/Transforming the Institution; The History of Health Care, Patient Care; Patients; This is MD Anderson; The Life and Dedication of Clinicians and Researchers; Volunteers and Volunteering
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.
Disciplines
History of Science, Technology, and Medicine | Oncology | Oral History
Transcript
Tacey A. Rosolowski, PhD:
All right, today is June 5th, 2015, and the time is about eight minutes after two. And I’m on the eighteenth floor of Pickens Tower in the office of the Physician in Chief, talking my fourth session with Dr. Alma Rodriguez. So thank you very much for making the time. I know this has been a lot of sessions.
Alma Rodriguez, MD:
Not a problem.
Tacey A. Rosolowski, PhD:
And I really appreciate the gift of time that you have given to the project.
Alma Rodriguez, MD:
You’re welcome. Thank you.
Tacey A. Rosolowski, PhD:
So, we were strategizing a little bit before we turned on the recorder. And I first wanted to ask you about an area within the scope of Medical Affairs that we’ve touched on, but not really addressed, you know, forthrightly, which is the institution’s very explicit move to patient-centered care. So I was wondering if you could address that, and also talk a bit about the Psychosocial Council which is under the scope of your role, as I understand it.
Alma Rodriguez, MD:
Right. Well, I think that certainly the concept of patient-center care is not unique to our organization, it is part of a national movement that acknowledges that, obviously, that’s the reason that healthcare happens, is that we are taking care of individuals. And furthermore, that we are not—again, there’s a shifting in consciousness, if you will, that we’re not really treating a disease, or a series of disease processes, but we were actually treating a person. And so, which then, if you will again, shifts the elements of the experience that are being paid attention to. So for example, it would never have—when I did my training in medical school, it would never have occurred to us to ask a patient how satisfied were they with their experience of being in the hospital, because our assumption was, they were not happy, and it was a terrible experience.
Tacey A. Rosolowski, PhD:
Oh, wow.
Alma Rodriguez, MD:
Why would we ask people that, right?
Tacey A. Rosolowski, PhD:
Yeah, that’s the first time anybody’s ever said that. (laughs)
Alma Rodriguez, MD:
Why would you ask people that? The assumption would be that it is terrible, that is not—is something outside of your experience. So the novel thing today is that we are, if you will, customer-centered. And we wanted to know if the patient had a good experience in terms of how the lobby looked, how the meal was, how courteous people were. And frankly, I think that’s a valid question, because although on the surface, it might appear to be, how shall I say, a set of trivial events, the truth is that when you are ill, when one is ill, all of these other things can, of course, soften the blow, if you will. And so to a good degree, having just a pleasant environment and a pleasant interpersonal exchange with the individuals taking care of one can, in fact, make the experience of the illness bearable, if you will. So the realization that it isn’t just the therapeutic intervention that matters, that, in fact, all the other interventions are part of the success of that story of that narrative for the patient during illness is relatively new in the consciousness of healthcare. And so, we—imagine how much more dramatic all of that is when the patients have a diagnosis of really serious and potentially life-threatening illnesses, which many cancers can be, right? So we are sort of, if you will, we’re attempting to move in that direction. I don’t think that we’re there yet, I don’t think, that we have, if you will, for lack of a better word, mastered all the elements of improving the patient experience. But in general, I think that patients have consistently, across time, experienced that MD Anderson is the kindness and the devotion of the people who work here, particularly in the clinical care setting; the nurses, the Physicians, the technicians, the Therapists. The people who are sitting face-to-face with patients have to be special to work here. And that’s my subjective observation, if you will. I don’t have the scientific evidence to say across the board we all have this particular psychological profile, and we all behave in this way. I mean, we don’t have that kind of profile, but I can tell you just from observing and interacting with the individuals who work there that in general, across the board, they’re kind, thoughtful, dedicated persons. And patients sense that. They know that. So many of the comments that we get in feedback pertain to that. And in particular, one of the biggest treasures of our Institution, actually, are the volunteers that come to our Institution. Many of them are cancer survivors. They either have had cancer themselves, or they have been caregivers for someone who had cancer, so they understand what the experience is like, and they can relate to the patients. And if you will convey that empathic message of, you know, we understand, we care how you feel. So that’s one of our great advantages. We also moved sometime back to the concept of room service, that is that people could request their meals at their own time, when they were ready to eat. I mean, certainly people who are undergoing cancer treatments can have challenges in feeling hungry or being able to enjoy food, but it turns out that if you allow people to have control over the times at which they eat, and choose the kinds of foods they want to eat, that, you know, they can be better-nourished. So we’ve done that. And the food service usually is one of the things that gets better ratings in our—as opposed to many hospitals, where the food service gets terrible ratings! (laughs)
Tacey A. Rosolowski, PhD:
I was just going to say that. It’s like a joke about hospitals—
Alma Rodriguez, MD:
Yes.
Tacey A. Rosolowski, PhD:
—the food is so terrible. Wow.
Alma Rodriguez, MD:
So we do some things very well. You know, we still have to improve on other things; you know, the efficiencies of our workflows, decreasing wait times, improving our information and communication systems with patients so that they get information in a more timely fashion, all of those process changes we’re still working on.
Recommended Citation
Rodriguez, Alma MD and Rosolowski, Tacey A. PhD, "Chapter 21: Patient-Centered Care: Formalizing the Practice at MD Anderson" (2015). Interview Chapters. 352.
https://openworks.mdanderson.org/mchv_interviewchapters/352
Conditions Governing Access
Open
