Person-centered care is a concept everyone supports – except when it comes to the details.
Person-centered ward rounds is an approach in which patients are viewed as whole persons; it is not merely about delivering services where the patient is located. Person-centered ward rounds involves advocacy, respecting clients’ autonomy and integrity, voice, self-determination and participation in decision-making.
”A patient lying in a bed in a hospital tends to be reduced to an object you examine.”
In practice this means to offer the patient admitted to the ward a private meeting with the whole ward team at the ward station room, facilitating a feeling of presence, focus and sufficiency of time. This is the person-centered ward round, giving space for the team to listen to the patient’s story. A plan for the investigations, treatments and need of care at discharge is conducted together with the patient. A preliminary date for discharge is set. We believe that the profound and accurate first meeting has an impact on the whole stay at the ward.
The patient is informed that meetings will be held when there is need for it, not necessarily every day. Patients could preferably have the relatives with them at these ward rounds. By using virtual technology relatives to the patient or a GP can take part in the meeting online.
A patient lying in a bed in hospital tends to be reduced to an object you examine. You even tend to call the patient by number or by diagnosis, e.g. ”the Appendicitis at 4:2″. A patient lying in the bed looks more sick and even feels more sick. A patient that rises up from the bed will be able to meet the ward team on the same level, thereby becoming an equal to whom he or she speaks. We have discovered that you get a much better medical evaluation of a patient walking in to the ward station and revealing their health status, e.g. the status of a patient with heart failure according to the NYHA functional classification.
”The new ward rounds secures confidentiality”
But is every person at a hospital ready to ”take their bed and go”? After five years’ experience of these ward rounds we have found that approximately 80% of the patients at our wards have no problems getting to the ward station and they have a positive view of leaving the bed that also tends to make them passive. Except for the very ill patients, research shows that activation outside of the bed promotes health. We are convinced that hospital patients in in general spend too much time lying in bed, waiting for something to happen.
This new ward round secures confidentiality according to the Swedish Patient Law and provides integrity and autonomy to the patient. The person-centered round enhances ethical awareness and improves the ability to make ethically justified medical decisions.