October is Patient-Centered Care Awareness Month, and the Visiting Nurse Association of Greater St. Louis (VNA) takes seriously our commitment to placing patients at the center of everything we do.
Patient-centered care means that patients, their caregivers and their families actively participate in the medical decisions and plans set for them. Care is not a prescriptive process of patients and families being told what they need to do but a collaborative effort in which all parties have a say in how treatment is implemented.
Though this commitment is constant across our different programs, there are ways patient-centered care is different depending on the context. The following describes care considerations based on VNA’s core programs:
VNA’s Hospice Care program recognizes that in the same way every patient lives their life uniquely, their wishes regarding their death are unique as well. In order to honor their wishes, VNA has an open dialogue about their values and goals.
“There is no structured plan for end of life care that fits every patient,” says Carol Emmerich, Director of Hospice Care. “Each family has their own traditions, experiences, hopes and fears. The hospice team takes the time to get to know the person and their family.”
This not only benefits patients but also benefits their families and caregivers. “When the patient’s goals are met, the family can be assured that they have actively participated in making that happen,” says Carol. “In hospice care, families become caregivers. VNA’s goal is to teach, train and support the families throughout the process. Caring for a sick person can be daunting, so the hospice team patiently mentors everyone involved in the care.”
Advanced Illness Management
For Advanced Illness Management (AIM), many of the ways in which patient-centered care is manifested look similar to hospice in that plans and goals are set and followed with the consent and direction of the patient in mind. But part of what reflects VNA’s commitment to patient-centered care is the fact a program like Advanced Illness Management exists at all. This is because it gives patients more options when it comes to the level of care they want to receive and the reason they want to receive that care in the first place.
In hospice, the focus is on symptom management at the end of life. In AIM, the focus is on symptom management regardless of the outcome or the patient’s condition. Under patient-centered care, it is the decision of the patient which treatment route they would like to pursue, and that decision reflects their underlying desires regarding the outcome of their treatment.
“People’s quality of life and their empowerment are affected if they’re just told what’s going to happen rather than having a choice,” says Deb Jeffery, Director of Advanced Illness Management. “One of the things we hope to do is give people dignity through having multiple, reasonable choices, and being able to sit down with their families and talk about the future and what’s important to them.”
Vaccination & Wellness Services
Patient-centered care looks a little different in the context of vaccinations, but a core necessity to build relationships remains the same. Even though the interactions are briefer than the bonds built through a process like hospice or AIM, a mutual trust must still be established that VNA nurses and staff are keeping the patient’s needs and wishes front and center when getting them the vaccinations they need.
“It’s focusing on what the patients’ needs are, making sure they’re taken care of and treating them with dignity and respect,” says Tonya Stacy, Director of Vaccination & Wellness Services. “We care about you. It’s just not you’re number one, you’re number two. The nurses get busy, especially at large clinics where they’re giving hundreds of shots, but they take the time to be pleasant and personable and ask patients how they’re doing.”
COVID-19 has highlighted the importance of patient-centered care in VNA’s everyday work. Patients and families need extra attention and information so that they feel empowered to make the best decisions for their health. The Visiting Nurse Association will continue to find ways to provide exceptional care during these unpredictable times.