The Canadian Cardiovascular Congress

It is clear that there has been a major shift in focus from acute to chronic care – chronic disease is now on everyone’s mind. I am currently writing this blog entry from the Canadian Cardiovascular Congress, where the first welcoming session began with a long talk by Perry Kendall, Provincial Health Officer of British Columbia. His audience of heart professionals was given a short primer on public health issues. He began by pointing out how much the Lalonde report had changed our understanding of the health field and specifically noted that only a quarter of good health was due to interventions by our current healthcare system. He then covered a range of topics – everything from inequalities in health to obesity. Not a mention was made of infectious diseases, not even Ebola.

The longest part of his talk was about the difficulty in changing the amount of unhealthy food that is being distributed in Canada by a very well-organized food industry. The industry has tried to minimize and even block change in every area from labelling to sodium and sugar content of foods. They declare publicly that they are in favour of these changes, but they work very hard to defer them or stop them entirely. Kendall said that reducing the sugar and fat content of processed food is hard work and would continue to be. For example, the first attempt to introduce voluntary reductions of salt in processed foods at the federal level was rejected out of hand by the Prime Minister’s Office. Efforts to do this at the provincial level will be long and drawn out because of the large number of constituencies. And because compliance is voluntary, there is no certainty when and how the food industry will respond.

He talked quite a bit about the contributors to chronic disease in Canada and could not cover everything. I noticed that on one of his slides there was some material that he did not speak to at all. It is an area where doctors themselves contribute to the ill health of people with chronic diseases, and it seemed like the part they really needed to hear. According to the slide, a significant portion of people with chronic conditions are made worse by overmedication. It was somewhat surprising to me that Kendall did not allude to this problem at all. Here is an area where the heart community could make a difference to public health by developing better practices. Perhaps they were aware of these efforts and there was nothing for Kendall to add.

This became a bit more problematic when I looked through the program. The Platinum sponsors of the congress are AstraZeneca, Bayer, Bristol-Myers Squibb, and Pfizer. I went into the exhibition hall and one of the handouts was a “passport” that you could have stapled at all the important stations to win an iPad. The Passport participants were almost all drug companies. In fact, the exhibition hall was filled with exhibits by drug companies and equipment companies. Becel was the only healthy food company with a stand, and there were almost no exhibits devoted to chronic care prevention.

Right now in Canada, we are the second highest users of prescription drugs in the world after the United States. We spend over $900 per person per year on prescription drugs (Lexchin and Gagnon). I think that this is because our healthcare system offers few options to doctors. If you get high blood pressure, an early stage of heart disease, it is easiest to offer medication to control it. If you have high cholesterol, it is similarly easiest to provide statins. And if you have multiple conditions you will have a good chance of being prescribed many different drugs. Often as you get older these many drugs can cause their own problems.

Our healthcare system is not set up to offer the range of supports needed to avert the four main chronic conditions: heart disease, lung disease, cancer and diabetes. But this deficit is becoming more obvious. I hope that the next Cardiac Congress will be more devoted to averting early stages of heart disease in a drug-free manner, by imposing lifestyle changes. It is time for the change to be more thoroughgoing.

 

Lexchin, Joel and Gagnon, Marc-André. “CETA and Intellectual Property: The debate over pharmaceutical patents.” http://labs.carleton.ca/canadaeurope/wp-content/uploads/sites/9/CETD-Policy-Brief_CETA-and-pharmaceutical-patents_MG_JL.pdf. Oct 2013. 7 pages. Web. 27 Oct 2014.

Thanks to you

As President of Patients Canada, I’m excited to share with you some important progress for the organization and for patient partnerships generally. I invite your feedback and comments. Find more information about Patients Canada here.


I would like to thank a few of the many people who have helped Patients Canada over the past few years. In the last few weeks, Patients Canada has been represented at several conferences by speakers and patient panels. At a conference sponsored by the McGill University Health Centre in Montreal, there were more than 40 patients present from across the country. They joined over 100 providers from the hospital to consider the future of patient partnerships in healthcare.

In Toronto, a panel of patients presented their perspective to more than 800 members of Family Health Teams from across Ontario. Sandra Dalziel, Cathy Fooks, Alies Maybee, Emily Nicholas, and Sara Shearkhani presented their thoughts about how Family Health Teams can better partner with patients and family caregivers. Next week we will have a patient panel at a Conference Board Health Summit; Brian Clark will be introducing patients as part of a Health Workforce conference in Ottawa; and I will be going to Vancouver to speak about patient decision support in cardiac care. We have been representing the patient perspective across Canada for more than four years and these five conferences mark a significant change that has been developing over that time.

Our first conference was the Patient Centred Primary Care Summit in 2010. We’d been sent a notice about it and upon looking through the agenda, we found that there were no patients listed as participants however there were many meetings about patients. There were researchers on patient centred care, researchers on shared decision making, and even researchers on patient participation. This was a conference on patient centred care and we felt that it was time to bring patients to it. We called on Maureen O’Neil from the Canadian Foundation for Health Improvement (CFHI) to give us a hand, and her organization graciously gave up their slot. We drafted in André Picard from The Globe and Mail; Martin Dawes, the Professor of Family Medicine at McGill; and Abe Fuchs, a former Dean at the McGill medical faculty. They joined two patients, Elke Grenzer and I. We all spoke to the need for the patient voice to be present in healthcare – including conferences like that one.

We learned that many organizations had been working towards patient centred care with little or no patient representation and so this was a wonderful opportunity to begin to change that. Patients Canada, among others, has been bringing the patient voice to meetings across the country for the last four years. Now patients are routinely consulted, and participate actively in conferences and working meetings in healthcare organizations across the country. The last few weeks are not so unusual these days!

In 2007, we worried that patient centred care would come and go – that it would just be another flavour of the month, and we were determined not to let that happen. Our organizing group included Kevin Leonard, Alex Jadad, Elke Grenzer, Murray and Larry Enkin, John Feld, Rosalee Berlin, Ariane Hanemaayer, Anita Stern, and Jan Plecash. They kept us clear to our purposes. We got early help from people from other organizations such as Sandra Dalziel of Patient Destiny, lots of people at CFHI, Vaughan Glover of the Canadian Association for People-Centred Health, Zal Press who started Patient Commando, Ted Ball of Quantum Transformation, and we have received constant support from the Centre of Global eHealth Innovation. Joyce Resin from Impact BC, Willow Brocke from Alberta Health, and many others across the country lent an early hand to keep the movement alive. Individuals like Vytas Mickevicius and Neil Stuart gave lots of time and effort to help organize what has become Patients Canada.

We are growing apace and in November we will have a reunion of early joiners to bring everyone up to date. Here are some of the successes we’ve noted over the past few years:

  • From these few people and with the help of our Communications Coordinator, Christina Spencer, we now reach many thousands of people through our website, open meetings, and social media channels such as Facebook and Twitter.
  • We have had Patients Canada Volunteers as speakers at dozens of conferences across Canada.
  • We have partnered with the Ontario Medical Association (OMA) to sponsor the very successful Patients’ Choice Awards.
  • We have had several books published with the enormous help of Ryan Devitt, and now we have contracts for more to come.
  • We have held four successful conferences that brought together patients, providers, researchers, policymakers, and almost everyone interested in healthcare.
  • We have sat on more than fifty healthcare committees concerned with research, policy development, quality improvement, and patient and family advisory committees. This has been achieved with the help of volunteers and a dedicated staff including Karthiha Krishna and Jennifer Carroll.
  • We have visited organizations across the country to see how they partner with patients and have helped many individuals and organizations to begin and develop the process of patient partnerships.

We are particularly excited for our current initiative. We have received an array of patient health experiences and worked with an ongoing panel of patients and others to identify Key Performance Targets (KPTs) that will make the experience of healthcare better for everyone. We have developed a number of targets and last week I included six of them in my blog. We are currently working on many others as part of a five-year research and application exercise that will, we expect, result in significant change. This work has already had an impact on the primary care performance indicators used by Health Quality Ontario and has informed some of the new standards for healthcare organizations being developed by Accreditation Canada.

We can now declare that we are not a flavour of the month – there will be many more patient partnerships in healthcare, and patients and family caregivers will play an increasingly important role in future healthcare developments. Thanks to everyone who helped so far. We will need you and many more for the future.

Six Key Performance Targets (KPTs) for hospitals

As President of Patients Canada, I’m excited to share the work we’ve been doing on Key Performance Targets (KPTs) with those of you following my blog. It’s a very important project and I invite your feedback and comments. Find more information about Patients Canada on our website.


It’s time to bring together a few small changes that would have a big impact on the patient’s hospital experience with the idea that these changes would be clear indications that hospitals are indeed becoming more patient and family-centred. I have spoken of them individually, but now it’s time to bring a few of them together and explain how they are derived from our experiences with healthcare.

I was talking with someone who wanted to know more about bringing back dignity to the hospital gown and I mentioned that there were other examples of Key Performance Targets (KPTs) derived from experience.

“For example,” I said, “parking costs can be really burdensome for some people.” I was about to go on when she interrupted me.

“Oh, when my husband had a stroke, I was paying more than $75 a day in parking as I visited him in the morning, afternoon and evening for more than two hours. There were no in and out privileges for visitors. It was awful, but I felt I had no choice.”

I elicited similar responses whenever I went on to explain the various targets together. It seems that they are high on the list of changes that many patients want to see improved. Listing them together often elicits clear recognition of things that niggle but are rarely expressed.

The list of obvious but relatively unnoticed performance targets that will improve patient and family experience includes

  1. A change in the policies surrounding hospital gowns
  2. The reduction or elimination of parking fees for visitors and families of patients
  3. That there is a chair in the triage position in Emergency Departments for a family member or friend who accompanies the patient
  4. That hospitals adopt an open visiting policy so that friends and family members can visit patients any time
  5. That all hospital notes are readily available to patients (and whenever possible, their families) so that they can review them at will
  6. That food policies in hospital are open to allow and even enable family and friends to bring food from home to patients, by, for example, having a patient and family accessible refrigerator and microwave oven on every hospital unit

These six changes in policy and practice would go a long way to making hospitals more patient and family friendly. We encourage hospitals to adopt them.

Process for developing Key Performance Targets (KPTs), developed by Patients Canada.

A solution to hospital gowns

In many discussions about patient experiences in healthcare there are allusions to the loss of dignity that many patients experience when they enter the hospital. Often patients who value their privacy are subjected to extraordinary intrusions which would be intolerable in any other circumstance. Often, because it is such an ordinary part of the hospital experience, we do not see the indignities that occur as a matter of course. The most glaring of these is the hospital gown. Patients’ bodies are only partly covered by a gown that seems to be a mandatory requirement in hospitals almost everywhere. We have forgotten the reasons for it, but assume that gowns are designed to allow doctors and nurses easy access to the patient’s body.

hospital gowns 1It first occurred to me that this was a privacy issue which is not covered by the current privacy regulations, as it’s currently fixed on keeping medical records away from prying eyes. Many patients believe that at least the same amount of attention that’s paid to safeguarding medical records should be paid to keeping their bodies private. I believe that this is yet another hangover from the early days of scientific medicine when patients gave their bodies over to science once they entered the hospital. This is clearly privacy issue of significance to patients.

Last week journalist Tom Blackwell of the National Post wrote a long and varied feature on the issue and interviewed not only physicians, but also patients and representatives from Patients Canada. The article pointed out that the vast majority of patients had no medical need to be so accessible to doctors or nurses, and it was even suggested that the gowns contributed to health deterioration that led to increased returns to hospital.

A few days later I received an email from a friend in England who found the article and presented a solution that is being tried in some parts of the NHS: the Dignity Giving Suit. She has allowed me to use images from the site to show a few of the alternatives. She also included her response to the article:

We have designed the innovative patented Dignity Giving Suit which affords patient’s dignity, whilst allowing surgical and medical teams full dignified access to the patient for procedures, lines, leads, drips, drains and catheters. Patients have access to the Dignity Giving Suit to enable them to purchase a version of the hospital Dignity Giving Suit, in a choice of patterns which allow them to feel comfortable and in control in their own choice of ‘pajama’. Their own version of the Dignity Giving Suit can be worn in all departments of the Hospital, including MRI and Xray until they require the Hospital’s sterile version, and for recuperation at home. The Hospital version has been in some Hospitals in the UK for over a year with more hospitals currently trialling or ordering.

According to the site, these hospital suits allow patients to retain their dignity while “giving healthcare practitioners unrestricted access to their patients”. What we need now is a philanthropist who can restore the dignity of patients and help create the next major change in healthcare.

Alternatives to the traditional hospital gown

An update on patient partnerships

Last week we gave out the Patients’ Choice Awards in Sarnia for the fourth time. This is a pretty good time to take stock. How has the Canadian healthcare environment changed since Patients Canada was founded in 2011? Perhaps the most critical thing to say is that the fear that patient partnerships are the flavor of the month seems to be diminishing; it looks like the movement to bring patients as partners in healthcare is growing stronger every month. Canadian patients are involved in many different ways. Critical healthcare organizations have taken patient partnerships on in a systematic way. Here are a few of the changes that we have experienced since we began.

Our very first activity as a patient group was to join a standing committee of a hospital that had spent some years implementing Patient -Centred Care. We were the first patient members. We were soon asked to join a research group to develop a program for housebound diabetics. At the meeting, it emerged that our role was to approve of their draft program so that it could be submitted with patient approval. At that time no one knew what patient-centred care really was and some groups had spent years defining its terms.

We decided very early on that we would not worry about the definition. Instead we would immerse ourselves in patients’ experiences and work in collaboration with the system. Our goal was to create and sustain patient partnerships in healthcare. Our first project was developed in cooperation with the Ontario Medical Association. The idea was that patients would write letters of nomination for doctors who were especially patient-friendly. The winners of these Patients’ Choice Awards would be selected by an all-patient jury and a certificate would be given to the winning doctor signed by the Presidents of our two organizations. Since then, we have given out over 30 plaques to doctors across Ontario with the support of the OMA.

This project was critical to our understanding of our role. It was a collaborative effort and it was based on the experiences that people had with the healthcare system. All our work since then has had these same two elements.

Our most recent project is the development and application of Key Performance Targets (KPTs). I have described some of them in the last few weeks and will present more in the coming weeks. The KPTs are all based on actual experiences that patients have had. They are developed by a panel of patients and health professionals, researchers and managers. They have been instrumental in the contributions we make with our healthcare partners. Last year we joined with the Canadian Institutes for Health Research’s effort to develop patient partnerships in research. We are partners in a five-year project in which researchers will work ever more closely with patients to devise and carry on health research. More recently we became part of an American-funded grant from the Patient-Centred Outcomes Research Institute – an organization with $3 Billion to engage in research with patient partners.

Just last week we worked with other patients and patient groups to revise and strengthen Accreditation Canada’s next iteration of a far more patient-centred accreditation process for Canadian hospitals and healthcare organizations. We also provided a training session for patients and providers to help everyone see the value of the patient perspective. All our contributions are based on our growing collection of patient experiences. The changes that are derived from them will not go away so easily. It looks like patient partnerships are here to stay.

Next week: more KPTs.

André Picard: Elderly people in emergency rooms

André Picard’s recent column that details the horrors of Canada’s emergency rooms is a powerful account of how much our system needs to take into account the experiences of patients and families as it begins to reform itself.

In Canada, there are 14 million visits to the emergency room with about one third of patients arriving in ambulances. He provides statistics for wait times in Quebec but they are probably not that different in other provinces. Patients who arrive by ambulances are a different story. If they are trauma cases they are seen almost immediately – within 10 minutes, but they are about 1% of this group of patients. The others are triaged relatively quickly like everyone else, but then they wait even longer than those who walk in on their own. They are the frail older people, usually with multiple chronic conditions like COPD and heart disease. According to André Picard they wait, on average, 18.4 hours in the ERs in Quebec. He goes on to say

Remember, that’s an average; waits of 24 to 48 hours are not uncommon. We stick them in hallways, behind curtains or in transformed broom closets. These patients, in their 70s, 80s and 90s, are essentially living on a gurney for days with little or no access to meals, toilets or privacy, and they are often alone.

The ones who are alone are usually brought in from nursing homes or other long stay facilities, because there is not adequate nursing care in their home institutions. The nursing staff in such facilities may not be able to set up an appropriate IV or do a particular test, or provide some other technical service that might be required. As the direct care requirements for patients in long-term care increases because of their increasing age, and as technical medical and nursing care become more complex, the capacity of long stay facilities to keep people in house decreases and the medical and nursing protocols require that they be sent to hospital. The entry for such patients has traditionally been the emergency room. According to the Quebec commissioner who reviewed the situation, 60 per cent of patients who go to the emergency room should not be there at all. André Picard says

They should be treated in primary care, by physicians or nurse practitioners. But lots of people don’t have a regular doctor and very few of those who do can get same-day appointments for urgent (but not emergency) problems….

Some of the gurney-bound are waiting for a hospital bed, but only about one-third are admitted to hospital. Beds are in short supply because there are many frail seniors already stuck living in hospital with nowhere to go for lack of home care or long-term care beds….

The majority of elderly ER patients have the same dilemma: They’re not sick enough to be hospitalized, but too sick to go home alone, or back to a nursing home where there is no medical care.

He concludes that

We don’t need bigger ERs. We need to shift resources from hospitals into primary care for the ambulatory and home care and community care for the non-ambulatory. Until we do, our parents and grandparents will continue to fill emergency departments and fester in hospital hallways, gasping for care.

But the system is incredibly slow to change. The inability of the system to respond to these terrible situations really shows that there is a need for the injection of new players: Patients are beginning to participate in healthcare as partners, and their experiences will count more and more in the co-design of new services and the articulation of patient friendly policies. They can help the system respond to the true needs of patients and families.

Four Key Performance Targets (KPTs) for eHealth

As President of Patients Canada, I’m excited to share the work we’ve been doing on Key Performance Targets (KPTs) with those of you following my blog. It’s a very important project and I invite your feedback and comments. Find more information about Patients Canada on our website.


eHealth has changed considerably over the last year. Patients now have apps that allow us to monitor our heart rates, photograph the inside of our ears, even perform an electrocardiogram using our mobile phones. These technological breakthroughs are enthralling and no doubt will begin to transform healthcare in the future.

But in a far more prosaic way, we see the beginnings of what and how we want out of eHealth. Canada Health Infoway is helping family practices adopt ways to book appointments online. Yesterday Infoway announced the second wave of registration for this initiative: they will provide financial support to practices that introduce e-booking. After the first wave more than 700,000 Canadians can book appointments online. To see examples of e-booking initiatives presently underway across Canada, click here, or read the latest benefits evaluation report on e-booking.

Having the ability to schedule an appointment online is a good example of a Key Performance Target (KPT) for primary care. It marks the launch of widespread electronic communications between patients and our doctors’ offices. When it becomes widespread it will bring Canada closer to the international level of electronic interaction between patients and their doctors.

Through patient surveys we have identified some simple things that patients want as targets in primary care.

Key Performance Target 1: We want to be able to make appointments online

Key Performance Target 2: We want to be able to access test results online

Key Performance Target 3. We want to be able to renew prescriptions online

Key Performance Target 4: We want to be able to communicate with our doctors online

Canada remains among the worst of the developed countries to have these four capacities for patients. Whenever I speak to information technology groups I ask if anyone has their doctor’s email address. So far very few people speak up, if any. Some people can get test results online through MyChart. And the fax machine remains a necessity almost everywhere for renewing prescriptions. But now we have the hopeful sign that in a growing number of practices appointments can be made online.

  1. Making appointments online will begin to spread now as doctors recognize the freedom it gives their administrative staff to do other things.
  2. As patients we can take the lead in expecting that electronic communications should increase. As electronic medical records become more pervasive our family doctors should be able to share test results with us online. In fact, there is a growing movement of creating ‘shared notes': some doctors are partnering with patients to prepare the notes for each visit and then preparing a copy for them to take home.
  3. There are already no serious technical obstacles to renewing prescriptions online. It has just not been agreed to overcome them. In fact, most of the major pharmacies already allow access to patients prescription history across their entire network. The step to easy prescription renewal is modest.
  4. A small but growing number of Canadian doctors are beginning to circulate their email addresses to patients and are setting up ways for their patients to reach them more easily. Those who have done so have found that patients really appreciate this increased access and the doctors do not find the effort burdensome. In fact, for most it makes their lives significantly easier: It can avert unnecessary visits and more time can be allocated to patients who need more face-to-face time.

We are hopeful that these four performance targets are widely achieved. We look forward to next year’s measurement.

Small Changes with Impact: The Third Chair in Triage™

As President of Patients Canada, I’m excited to share the work we’ve been doing on Key Performance Targets (KPTs) with those of you following my blog. It’s a very important project and I invite your feedback and comments. Find more information about Patients Canada on our website.


Small changes can improve the experiences that patients and families have with healthcare. We have been talking about things like hospital parking and food as areas that are relatively non-controversial but have room for clear and concrete changes that would significantly impact our experiences as patients or family members. We’ve developed these ideas to act as key performance targets (KPTs) that can be used by healthcare organizations and bodies to help improve their care.

These KPTs were identified by listening to patient experiences for many years and discussing them with a panel of patients, family members, providers and researchers to determine how these experiences could be improved. We’re now excited to announce Patients Canada’s Small Changes with Impact initiative – a set of key performance targets for healthcare, informed by patient and family member experiences with the system.

The first of these ideas sets the tone for what we are doing; it is a small change that has not so far occurred to service providers, has only been implemented in hospitals with a well-developed patient voice, and can be seen as a challenge for change in hospitals that have not yet implemented it.

Over the last few years, we have heard hundreds of stories from patients and families who have visited emergency rooms. From them, we learned that most emergency rooms have two seats in the triage office – one for the patient and one for the triage nurse. Over time, it became obvious that a third chair for a family member would be a tremendous help not only for the patient and the accompanying person (often a family member), but also for the triage nurse who could gain that extra insight when making the decision about what to do next.

The Third Chair in Triage™ is our first key performance target. We have been told by the CEO of the Kingston General Hospital, Leslee Thompson, that the third chair has already been installed in their hospital emergency room. Obviously, their Patient and Family Experience Advisors came to the same conclusion that we did.

Our challenge is not only to hospitals, but also to researchers in emergency medicine, regulatory bodies, accreditation groups and others to respond to this minimal intervention. The hospitals can add the chair and researchers can evaluate the impact. After that, regulatory agencies might adopt it as a requirement for accrediting emergency facilities. We believe that this would be an important step forward in making healthcare services more patient-friendly. What do you think?

Next week I will present more key performance targets.

 

™:  The Third Chair in Triage is a trademark owned by Patients Canada.

Hospital parking: Patients meet the Ministry

Hospital parking has become an issue for the Ministry of Health and Long-term Care (MOHLTC) in Ontario. I attended a meeting last week to hear what patient groups had to say about reducing the cost of parking for patients and families who make frequent or extended use of hospital parking lots. Five groups with special interest in the patient perspective were called to meet with the Ministry to discuss the development of new guidelines for parking.

The Ministry has recognized the importance of high parking costs to patients and has committed to working on it with The Ontario Hospital Association along with other patient groups. As one of those patient groups, it’s our view at Patients Canada that it would be a better idea for patients and hospitals to work on this together to ensure that the patient perspective is brought to the discussion more directly.

There is no doubt that parking costs are too high for some patients to bear. If someone with a sick relative must park at Toronto General Hospital for a month, the cost for parking can be as much as $868. This is no small amount. At a much smaller scale, the daily rate of between $20 and $28 becomes effective after as little as two hours in the parking lot. A single visit to a hospital specialist generally takes more than two hours if you include typical waiting time and travel to and from the parking lot. These and other travel related out-of-pocket costs contribute to the impoverishment of families with relatives who are ill for any length of time, despite our “free at the point of delivery” healthcare system.

At the meeting these concerns were expressed by many groups. I believe that our collective input will have some effect on the guidelines that the Ministry will issue. But that remains to be seen since patients are not yet privy to the negotiations.

Some of us feel that the ultimate goal should be to make hospital parking free for all patients and families. The principle behind this is that according to the Canada Health Act, healthcare services should be free at the point of delivery. Because it can be argued that parking one’s car at a hospital parking lot is part of the health service provided by the hospital, there should be no charge for it. Parking is free in Scotland and Wales for that reason, but not yet in England. (Parking fees have recently become a live issue in England.) We recognize that there is a way to go if we are to achieve free hospital parking in Ontario, including finding alternative sources of revenue for hospitals.

We believe along with some of the other groups that alternate funding sources for parking can be found through sponsorships or major donors. While some sponsors might not consider it to be prestigious enough to have their names associated with a parking structure, others might – Wouldn’t the Chrysler Corporation like its name associated with parking at the University Health Network? Or a Honda dealership with the Sunnybrook Hospital parking garage? Or, better yet, a major toy company associated with parking at SickKids?

Redesigning hospital rooms from the patient perspective

Last Friday, an article in the New York Times described the patient rooms in the new University Medical Center of Princeton, New Jersey. The architect is Michael Graves who is in a wheelchair after suffering from meningitis some years ago. He brings a strong patient perspective to the design of the hospital’s patient rooms.

For starters, the rooms are singles; there are no double rooms. Research shows that patients sharing rooms provide doctors with less critical information (even less if the other patient has guests). Ample space is given to visitors because the presence of family and friends has been shown to hasten recovery.

Ditto the big window: Natural light and a view outdoors have been regarded as morale boosters since long before Alvar Aalto designed his famous Finnish sanitarium in the 1930s (a “medical instrument,” as he called it), bragging about curative balconies and a restorative sun deck. (Kimmelman, pars. 12 & 13)

And generally, they look more like hotel rooms than hospital rooms.

It’s less antiseptic, cluttered and clinical than your average patient room, more like what you find in a Marriott hotel, anodyne and low-key, with a modern foldout sofa under a big window; soft, soothing colors; and a flat-screen TV. (Kimmelman, par. 23)

The new rooms also include a bedside-to-bathroom handrail to make it easier for patients to go to the bathroom safely on their own.

HospitalroomBringing their perspective to the design of hospitals rooms will make a big difference to the experience that patients and families have in hospitals. The hospital in New Jersey is an excellent and concrete example of the difference it makes to consider the patient experience; patient satisfaction ratings are now in the 99th percentile – not just for the room, but for everything from the food to the care. And staff like working there as well.

In the redesigned room, patients asked for 30 percent less pain medication. According to the article, “Reduced pain has a cascade effect, hastening recovery and rehabilitation, leading to shorter stays and diminishing not just costs but also the chances for accidents and infections” (Kimmelman, par. 6).

This is an excellent example of what Patients Canada has been working towards: including the perspective of patients and their families, and thereby contributing to a better outcome for patients and a better experience for everyone involved.

Kimmelman, Michael. “In Redesigned Room, Hospital Patients May Feel Better Already.” The New York Times. The New York Times Company, 21 Aug. 2014. Web. 25 Aug. 2014.