Aligning Forces Humboldt, an Aligning Forces for Quality initiative funded by the Robert Wood Johnson Foundation, has been working towards a patient centric approach to health care quality improvement and decreasing the cost of care since 2008. At the heart of these efforts are engaged patients who participate actively in the process. Antoinette Martin participates in two of projects with Aligning Forces Humboldt. She is a peer leader for an evidence-based Chronic Disease Self-Management Program (CDSMP) licensed by Stanford University and run by Aligning Forces Humboldt. CDSMP is aimed towards activating patients and helping them become better managers of their chronic conditions by providing them information, tools, and resources. Ms. Martin also participates as a Patient Partner. Patient Partners are members of office practice improvement teams who are members of Primary Care Renewal, a quality improvement collaborative. The Primary Care Renewal project consists of teams from primary care, internal medicine, and specialty offices working together with each other and hospitals to transform their practices. Within these teams, Patient Partners collaborate with physicians, nurses, and other personnel to identify strategies to improve quality and the patient experience. Ms. Martin describes her experience with both programs:
Under our Robert Wood Johnson Aligning Forces for Quality Grant, I have had the opportunity to serve in many roles. I am a patient with several chronic diseases. I am aging with strong, appropriately paced, medical care. I am a peer leader for our local Chronic Disease Self-Management Program (CDSMP) and for the last three years under the support of this grant have had an opportunity to serve as a Patient Partner in the office of my primary care doctor, Dr. Bruce Kessler, who has been our family doctor for over 30 years. He is a superb doctor and I was honored when he asked me to join them as a patient partner.
Throughout the process of being a Patient Partner, my empathy grew for the providers of my care and I expanded my perceptions about my role as a patient. For example I realized that when I was scared about an eye operation, I wanted Bruce, my doctor, to take away my fear. That wasn’t his problem to solve so it was an unnecessary burden I brought to him. Realizing this helped me to be more focused as a patient and to ask him about things he could respond to.
This opportunity was part of a larger effort known as Primary Care Renewal which provided year-long meetings teaching providers and their staffs how to implement changes to improve the experiences of their patients. I learned a great deal from the process, from the PCR meetings and watching and participating in the implementation of changes taught through the PCR. The whole experience demonstrated that improved effectiveness of service for both patients ad providers is teachable. It also taught me about the complexity and pressures involved in providing good medical care and began my wonderings about how patients could help this process. As a result of that contemplation, I would like to say a few words about presence.
Each time we come together — patient, patient advocates, providers; we often end up talking about time and most often about our conviction that there is too little.
A few years ago, earlier in these efforts, we held a meeting of patients and providers. During the meeting, participants were all asked to respond to one question. “What do you want most from your provider?” In many different ways, they all said, “We want him or her to be present.”
What does that mean to a patient? It means that my provider is there and focused on me. It means that I am not alone facing whatever I have to face. Temporarily, I don’t want to be grown up. I don’t want to feel alone. I don’t want to feel the limitless inevitability of life. I don’t want to think about you as a business, which you surely have to be to survive; I don’t want to think of you as a person with terrible time pressures. I want the illusion of timelessness. I want you to take my hand for a minute, then I can hear you. We really are partners – as human beings and individuals.
With regard to the anxiety about time, the truth is if you are clearly present, it actually takes less time because trust builds more quickly as the patient feels safe. Patients and providers can learn to be honest about this dilemma and say, “We have 15 minutes. How can we use it the most effectively?” Being honest and personal actually saves time.
I am thankful to my providers for my health and well being.
Antoinette Martin, Patient Partner & CDSMP Peer Leader
Ms. Martin’s photo was created by DeSantis Breindel.