Views of institutional leaders on maintaining humanism in today's practice

PATIENT EDUCATION AND COUNSELING

卷:102

Article

Gilligan, MaryAnn C.¹  Osterberg, Lars G.²  Rider, Elizabeth A.^3,4  Derse, Arthur R.^5,6  Weil, Amy B.⁷  Litzelman, Debra K.⁸  Dunne, Dana W.⁹  Hafler, Janet P.¹⁰  Plews-Ogan, Margaret¹¹  Frankel, Richard M.^12,13  Branch, William T., Jr.¹⁴ 

[1] Med Coll Wisconsin, Dept Med, Div Gen Internal Med, Milwaukee, WI 53226 USA

[2] Stanford Univ, Sch Med, Dept Med, Palo Alto, CA 94304 USA

[3] Harvard Med Sch, Dept Pediat, Boston, MA 02115 USA

[4] Boston Childrens Hosp, Dept Pediat, Div Gen Pediat, Boston, MA USA

[5] Med Coll Wisconsin, Inst Hlth & Equ, Ctr Bioeth & Med Humanities, Milwaukee, WI 53226 USA

[6] Med Coll Wisconsin, Dept Emergency Med, Milwaukee, WI 53226 USA

[7] Univ N Carolina, Sch Med, Dept Med, Chapel Hill, NC 27515 USA

[8] Indiana Univ Sch Med, Indianapolis, IN 46202 USA

[9] Yale Univ, Sch Med, Dept Internal Med, New Haven, CT 06510 USA

[10] Yale Univ, Sch Med, Dept Pediat, New Haven, CT 06510 USA

[11] Univ Virginia, Sch Med, Dept Med, Div Gen Geriatr Palliat & Hosp Med, Charlottesville, VA 22908 USA

[12] Indiana Univ Sch Med, Dept Med, Indianapolis, IN 46202 USA

[13] Cleveland Clin, Inst Educ, Cleveland, OH 44106 USA

[14] Emory Univ, Sch Med, Dept Med, Div Gen Med & Geriatr, Atlanta, GA USA

关键词: Humanism;    Organizational culture;    Faculty development;    Burnout;    Leadership;    Values;    Compassionate healthcare;   

DOI  :  10.1016/j.pec.2019.04.025

来源: Elsevier

【 摘 要 】

Objective: To explore leadership perspectives on how to maintain high quality efficient care that is also person-centered and humanistic. Methods: The authors interviewed and collected narrative transcripts from a convenience sample of 32 institutional healthcare leaders at seven U.S. medical schools. The institutional leaders were asked to identify factors that either promoted or inhibited humanistic practice. A subset of authors used the constant comparative method to perform qualitative analysis of the interview transcripts. They reached thematic saturation by consensus on the major themes and illustrative examples after six conference calls. Results: Institutional healthcare leaders supported vision statements, policies, organized educational and faculty development programs, role modeling including their own, and recognition of informal acts of kindness to promote and maintain humanistic patient-care. These measures were described individually rather than as components of a coordinated plan. Few healthcare leaders mentioned plans for organizational or systems changes to promote humanistic clinician-patient relationships. Conclusions: Institutional leaders assisted clinicians in dealing with stressful practices in beneficial ways but fell short of envisaging systems approaches that improve practice organization to encourage humanistic care. PRACTICE IMPLICATIONS: To preserve humanistic care requires system changes as well as programs to enhance skills and foster humanistic values and attitudes. (C) 2019 Elsevier B.V. All rights reserved.

【 授权许可】

Free