How Humanizing Healthcare Leads to Patient-Centered Care

Since the 1970s, there has been a widespread transition for physicians & nurses to move from paper records to electronic health records. In addition to this move, providers need to contend with other outside influences, such as the ever-changing rules, regulations, and billing requirements, including the addition of new technology aimed to prevent, diagnose, and treat diseases. These factors have changed the ways that physicians and healthcare systems deliver care—ways that are sometimes not focused on the needs of the patients they serve, leading to a lack of patient-centered care. “Although these medical developments have improved some elements of the care of patients, such as safety, effectiveness and efficiency, they come with new problems.” [1]

How Dehumanization Interferes with Patient Care

When the constant need for computerized technology and administrative tasks overshadows a physician or nurse’s clinical day, it can easily distract them from the provider-patient interaction, which is vital to giving the best patient care available. “Suffering” is not limited to just our patients—it extends to all of our healthcare providers. This “suffering” refers to depersonalization, where the distraction of a provider’s burdens begin to overpower their thoughts and emotions.

Depersonalization (also known as dehumanization) is when practitioners view the disease process as the only target of medical care. They begin to see patients as only “things” instead of humans.

We can further expand our hypothesis that dehumanization goes beyond the providers, extending to the directors, COOs, and presidents of hospital systems and large medical practices when they only see resources to prevent burnout as a luxury instead of a necessity. In these cases, money is the deciding factor in the quality of patient care.  

Humans as a whole are emotional beings. A fight or flight response may seem remote in the links to the emotional reactions of healthcare professionals—but it is not. Humanization in healthcare is an alliance with the person and his or her way of living. It entails aspects that refer to quality, and constitutes an ethical commitment to consider an individual in their entirety: both in relation to their autonomy and in their more subjective dimension.

To humanize our patients in healthcare, we must respect the fact that each person is unique, who responds differently to life crises. This respect goes beyond just the patients and includes always being empathic to the providers and nurses who serve the patients. For example, insisting that providers see a certain number of patients per day or that nurses work overtime in an already stressful working environment can push these medical professionals to burnout. [2] 

Pat Croskerry, famous for publishing over 80 journal articles and 30 book chapters on patient safety and clinical decision-making, wrote extensively on the need to acknowledge the role of emotion in healthcare safety. He noted, “how providers feel, their emotional or affective state, may exert a significant unintended influence on their patients, and may compromise safety.” [3] In a 2017 study, researchers concluded that clinicians’ emotions can and do affect their clinical decision-making. Additionally, from the nursing literature, the authors of the study reported that the experience of “being touched” by the vulnerability of their dementia patients affected nurses’ own emotions, which, in turn, affected their care for the patients. [4]

Patient-Centered Care and Humanization in Healthcare Work Together

Humanization in healthcare has been compared equally to patient-centered care (PCC), although there is a variation. In the book, “Through the Patient’s Eyes: Understanding and Promoting Patient-Centered Care,” the authors identified several dimensions of patient-centered care: (1) respect for patients’ values, preferences, and expressed needs; (2) coordination and integration of care; (3) information, communication, and education; (4) physical comfort; (5) emotional support—relieving fear and anxiety; and (6) involvement of family and friends. [5]

Studies, like the one published in 2011, have concluded that physicians are not good judges of patients’ health beliefs. Still, they have a better understanding when patients are more actively participating in the consultation. How can patients participate now with all the added constant need for computerized technology and administrative tasks that overlay their physician’s day?

It is a fact that healthcare leaders need to focus on providing patient-centered care (PCC). This will help their healthcare professionals give more tailored care to their patients, which will be more respectful and understanding to each patient’s needs and values.

Moving beyond that, humanization in healthcare embraces these principles and also considers the other stakeholders involved in the process of care (such as patients, patients’ caregivers, healthcare providers, policymakers, and so on) and their interactions. This approach aims to humanize the overall healthcare system by focusing on the relational, organizational, and structural aspects of healthcare, involving all medical tasks and procedures. 

In 2019, researchers conducted a 14 full-text article review to assess relational, organizational, and structural areas; they reviewed 30 key elements such as relationship bonding and adequate working conditions. [6]  The systematic review and synthesis helped researchers to understand the concept of humanization of care overall. The key elements of humanization of care in the study included:

  • An empathetic and respectful approach to patients
  • Sufficient human and material resources in healthcare institutions
  • A balanced workload for healthcare providers

These elements are essential prerequisites for establishing meaningful, mutually beneficial relationships with patients and delivering humanized care. [7]

To reduce emotional errors, we must incorporate an awareness level of the factors that influence emotions into the education of all healthcare professionals, from direct care to management. Healthcare leadership needs to formulate strategies to help healthcare professionals on all levels to identify and remove themselves from the emotional influences that can impact patient care. 

Humanization of healthcare is truly a necessity for all healthcare providers. Healthcare leaders need to consider valuable resources to help physicians in applying humanization back into healthcare. We must design processes and leverage technologies to hardwire humanity back into every step in the patient care experience. Healthcare systems also need to actively engage patients and families in the overall patient care experience and process improvement efforts. We all need to work as a team to improve the patient care experience and work life balance of everyone involved.

 

Written by: Nicole Bramblett, MHA

 

[1] Institute of Medicine (US) Committee on Quality of Health Care in America. Crossing the quality chasm: a new health system for the 21st century. National Academies Press (US), Washington, DC (2001).

[2] https://www.medintensiva.org/en-humanization-in-healthcare-arises-from-articulo-S2173572718300213

[3] Croskerry, P, Abbass, A, Wu, AW. Emotional Influences in patient safety. J Patient Saf 2010; 6: 199–205.

[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5732402/

[5] https://www.wiley.com/en-us/Through+the+Patient%27s+Eyes%3A+Understanding+and+Promoting+Patient+Centered+Care-p-9780787962203

[6] https://link.springer.com/article/10.1007/s40271-019-00370-1

[7] https://pubmed.ncbi.nlm.nih.gov/20652759/