Reinventing Care: Asking “What matters to you?“

Background:

Planetree, an organization dedicated to creating cultures of patient-centered care in healing environments, has recently announced its changes in its Person Centered Care Designation criteria for 2018. Of the five criteria sections, one is devoted to “know what matters” and identifies specific elements to include in uncovering what matters to the patients.

Typically, clinicians focus on “what’s the matter?” and are driven to solve the patient’s immediate clinical needs.  The answer to “what’s the matter” might include:  heart failure, COPD, depression, all very important for the patient’s health.

However, only asking “what’s the matter” usually does not elicit an all encompassing response from patients. The response will be limited by symptoms and may prohibit the patient from expressing root causes or larger concerns with their care and lifestyle. To approach care from a patient-centered approach, organizations like Planetree encourage clinicians to ask, “What matters to you?”.

By  asking the question: “What matters to you?”, clinicians are able to uncover what is most important to the patient—leading to the development of mutual goals and shared decision making.  The list of “what matters?” might include things like: I am lonely, I can’t afford my medications, I want a good night’s sleep, all equally important for the patient’s well-being.

 

In Practice:

Asking about “what matters” can help in uncovering what is most important to the patient. If you asked “what matters to you”, you can learn about meaningful ways to enhance your partnership with patients, what to incorporate into mutual goal setting, and what can be done to immediately provide a better patient experience.

For instance, Katie Boemecke, Director of Service Excellence at Lutheran Medical Center in Wheat Ridge, CO, has added a question to her patient rounds:  “What is most important to you during this hospital stay?”

She reports that sometimes the patients say “to get better, to go home.”  One time, however, the patient said, “ I need  a good night’s sleep.  I can’t seem to get any rest.”  This gave Katie a chance to dig deeper and she learned the patient slept with a fan on at home, creating “white noise.”  Katie was able to get a fan and replicate her at home sleeping environment.  The patient was extremely thankful for what was a relatively easy fix.

She says, “I have found that sometimes it is the littlest things that make the greatest impact with this work, so it is important to ask what matters to the patient.”

This simple question is relevant for more than the acute care hospital setting.  The IHI demonstrates its impact in a home care and outpatient settings.  Patients have preferences and needs wherever their care is provided, and as care providers, it is important we ask them.  So the next time you are doing rounds, ask your patient “What matters to you?”.  The answer might be a seemingly little thing that has the greatest impact.

Barb Davis

Barbara Davis has been involved in quality in healthcare for over 30 years, and currently serves as CipherHealth's SVP of client success. She has worked in complex health care environments, including a university health system, an HMO health plan, and multi-hospital system. Her areas of expertise include quality improvement and Lean, service excellence focusing on organizational culture and the patient experience, patient safety and reliability, regulatory issues and organizational strategic goal setting. Currently she sits on the Patient and Family Advisory Council at Saint Joseph Hospital in Denver.