Lisbeth Kallestrup's presentation from Hospital + Innovation 2015
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Reflections on the rewards and challenges of patient involvement Centre Director MD Lisbeth Kallestrup Abdominal and Paediatric Centre Aarhus University Hospital How do we meet the patients’ expectations for the hospitals of the future?
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Transcript of Lisbeth Kallestrup's presentation from Hospital + Innovation 2015
Reflections on the rewards and challenges of patient involvement
Centre Director MD Lisbeth KallestrupAbdominal and Paediatric Centre
Aarhus University Hospital
How do we meet the patients’ expectations for the hospitals of the future?
New expectations
Health as a "a state of complete physical, mental, and social well being not merely the absence of disease or infirmity”
Babyboomers –”68 generation”• Autonomy in own life• Information seeking• Expects dialogue • Expects shared decision
making
Population Health
Per capita Cost
Triple Aim Change to Population Responsibility
Experience of Care
IHI 2007: Triple Aim Framework
Requirements for new hospitals• Involvement of patients and their families• Quality of health outcomes• Patient safety • Bed reduction 20%, change to out patient services• Increase in total number of patients treated
Investment and Hospital Plans, Denmark 2008
Patient involvement Patients are our change agents
• Policy• Organisational• Pathway• Individual
Unwarranted variation in healthcare delivery
60%25%
15%
Supply-sensitive
Preference-sensitive
Necessary
N
Wennberg J. 2010
AUH inventory of out patients 2014Patients assessment
Necessary – no alternatives
Unnecessary – alternatives available
64% (n=480)Can continue as usual
11% (n=82)Clarified communication with the patient about objective of visit
17% (n=129)Expectations should be negotiated before rescheduling
8% (n=56)Can be changed immediately
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Aaby, Kallestrup: Patient voices contribute to organisational change. 2015
Patient pathway
Projects in 23 departments 1. Reality check – patient perpective
3. New pathway
2. Prototype
• ”Shadowing”• ”Tracing the pathway”• ”Patient Dialogue”• ”Local Patient Advisory Boards”
Follow Patient Pathways
Patients’ stories and needs
Continuity
Coordination
Co-creating
Integrated Personalised
Services
According to my agenda,
please
Patient Pathway
Decision
Self-management
Decision
Decision
Self-management
Self-management
Self-managementSelf Assessment
Patient initiated care
Direct Access to Operation and Perioperation unit
Win-Win-Win
Shared Decision MakingRenal Failure – Choice of Dialysis Mode
Decision AidChoice of dialysis mode
Home haemodialysis
P-dialysis Dialysisat the hospital
What may I eat and drink?
There are only a few things that you may not eat and drink. More frequent dialysis means more freedom.
There may be a few things that you may not eat and drink. Maybe you need to reduce your water intake.
There will be a lot of things you may not eat and drink. There will also be a reduction in relation to how much you may drink.
Developed according to The International Patient Decision Aid Standards
Radical Changes
Decision
Decision
Decision
Self-management
Self- management
Self-management
Waiting area Patients do not wait – they do something else
What makes a professional?What makes a patient?
Whose agenda?
Reality check
• Be curious to learn from patients • Focus on Patient perspective • Practical, experimental learning approach • Mutual developmental process including both the
expertise of the patients and that of other involved professionals
Albert Einstein
