Palestra Planetree:
A arte do cuidar
M ICHAEL L EPORE
A NA A UGUSTA B LUMER S ALOTTI
SIMPÓSIO INTERNACIONAL
ALBERT EINSTEIN DE HOTELARIA
August 30, 2011
Overview
PatientCentered
Care Update
Planetree
Planetree
Designation
update
Update and
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Data
Research on
Planetree in
Brazil
Discussion
Angelica Thieriot
Planetree Founder
“...the ideal hospital would combine
the best medicine with the best
care delivery experience in the
most comforting facility to
become a truly healing
environment, where just being
there is healing”
Planetree was founded in1978
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Patient-Centered Care
 Definition: Health care that establishes a partnership
among practitioners, patients, and their families (when
appropriate) to ensure that decisions respect patients
wants, needs, and preferences and that patients have the
education and support they require to make decisions and
participate in their own care (Institute of Medicine, 2001).
 Outcomes





Decreased annual number of visits for specialty care
Less frequent hospitalizations
Fewer laboratory and diagnostic tests
Lower total medical charges
Decreased charges for specialty care clinic visits
(Journal of the American Board of Family Medicine, 2011)
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Facilitators of Patient-Centered Care
1.
2.
3.
4.
5.
6.
7.
8.
9.
Strong, committed senior leadership
Clear communication of strategic vision
Active engagement of patient & families
Sustained focus on staff satisfaction
Active measurement & feedback reporting of patient
experiences
Adequate resourcing of care delivery redesign
Staff capacity building
Accountability and incentives
A culture strongly supportive of change and learning
(International Journal for Quality in Health Care, 2011)
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Planetree Membership Update
GROWING
GLOBAL
CARE CONTINUUM
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A Growing Global
Influence
• Affiliates in Brazil,
Quebec, Japan & The
Netherlands, USA
• International expansion
of Designation
• International Advisory
Council
• Partners in Quebec and
The Netherlands
• Opportunities for
international interorganizational learning
Planetree Affiliates Worldwide
Planetree Affiliates Across the
Continuum of Care...
Acute Care
Continuing Care
Short-Term Rehab
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Behavioral Health
Integrated Healthcare Systems
Planetree
and the
U.S.
Veterans
Health
Admin.
 Office of Patient-Centered Care
and Cultural Transformation
 More than 1,000 points of care
across the nation
 Serving more than 5.5 million
Veterans
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Planetree Designation: A Framework
for Patient-Centered Quality
23
PLANETREE
DESIGNATED
SITES
WORLDWIDE
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10 IN THE
NETHERLANDS
12 IN THE U.S.
1 IN QUEBEC
International Designation Advisory Council
Joseph Cappiello
Designation Committee
Patrick Charmel
Griffin Health Services
Lucie Dumas
Planetree Quebec Network
Susan Frampton
Planetree
Jose Noronha
Consórcio Brasileiro de
Acreditação
Marcel Snijders,
Planetree Netherlands
Lucie Tremblay
Maimonides Geriatric Centre
Philip Hassen
ISQua
Paul vanOstenberg
Joint Commission
International
Robert Mayer
The Rothschild Foundation
Jim van den Beuken
Planetree Netherlands
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Designation Today
Growing
Integrated to apply across continuum
Evidence-based
Evolving to address emerging issues
Increasingly global
Correlated with quality outcomes
CMS Core Measures
Comparison of U.S. Planetree Designated Hospital Average and CMS National Average
January 2009-December 2009
100%
96.7%
96.6%
95.7%
94.1%
93.2%
93.5%
95%
90.7%
90%
86.8%
85%
80%
Overall Surgical Overall Pneumonia
Care
Care
Overall Heart
Failure Care
Designated Hospital Average
Overall Heart
Attack Care
National Average
Source: The Commonwealth Fund’s WhyNottheBest.org
Data accessed 11.01.10
HCAHPS Comparison of U.S. Planetree Designated
Hospital Average and CMS National Average, 2009
90
**86
85
**79
80
65
60
**74
75
75
70
**79
81
69
66
**64
60
55
50
45
Medication
Nurse
Communication Communication
CMS National Average
Discharge
Information
Overall Rating (9
or 10)
Likelihood to
Recommend
Designated Hospital Average
** Planetree performance is significantly better than the national average at the 95% confidence level
HCAHPS Comparison of U.S. Planetree Designated
Hospital Average and CMS National Average, 2009
85
80
80
75
70
* 74
70
82
* 68
* 72
69
63
65
60
57
59
55
50
45
Cleanliness
Quiet at Night
Doctor
Responsiveness
Communication
CMS National Average
Pain
Management
Designated Hospital Average
* Planetree performance is significantly better than the national average at the 90% confidence level
Planetree e Hotelaria Hospitalar
Pesquisa sobre Planetree no Brasil
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Análise das Contribuições do Modelo de Gestão
Planetree para a Prática de Hotelaria Hospitalar
Referências e Palestra
 Susan Frampton, Phd e Patrick Charmel, Phd;
 Ms. Marcelo Assad Boeger;
 Ms. Fabrízio Rosso;
 Sra Ana Maria Florio de Andrade, Sra. Ana
Paula de Araújo Santos e Sra. Líbia Sammour
 “Política Nacional de Humanização da
Atenção e Gestão do SUS” 18/03/2011
ministrada por Sra. Cleusa Pavan
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Análise das Contribuições do Modelo de Gestão
Planetree para a Prática de Hotelaria Hospitalar
Entrevistas:
Ms. Ana Lúcia Zanovello:
administradora, professora e gestora
em qualidade
Sra. Martha Denstedt: diretora de
programas e serviços do Planetree no
Griffin Hospital
Uma psicóloga, responsável pela
humanização de um hospital da zona
oeste do município de São Paulo
Michael Lepore, Phd: diretor de
qualidade, pesquisa e avaliação do
Planetree
Sra. Magda de Jesus: gerente de
voluntariado do Hospital AACD de São
Paulo (Hospital Abreu Sodré)
Sra. Kit Alff: especialista do modelo
Planetree em consultoria e serviços
Gerente Geral de um hotel de rede
multinacional do município de São
Paulo
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Sra. Rita Grotto: Gerente de
Atendimento ao cliente e coordenadora
da implantação do modelo Planetree no
Hospital Israelita Albert Einstein
Em que Posso Servir?
Enxergando por uma Nova Perspectiva
 Griffin Hospital
 “The Patient’s Voice”
(Platte Valley Medical
Center)
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Pacientes Enxergam Serviços Fracos
como Falta de Segurança
22% de 193 entrevistados relataram uma
“experiência insegura recente”.
Desses,
apenas 1% foram relacionados à incidentes
envolvendo erro médico e 2% foram “quase erro”
Mais da metade dos eventos foram classificados
como “incidentes na qualidade dos serviços”
30% relacionado à espera e atrasos;
21% relacionados à comunicação insuficiente;
12% relacionados à fatores de ambiência
Fonte: “Patient Reported Safety and Quality of Care in Outpatient
Oncology” Joint Commission Journal on Quality and Patient Safety; 2007
Gráfico
Fonte: “Planetree: Improving the Patient Experience” FRAMPTON, Susan 2010
Planetree Designation Components
I. STRUCTURES AND
FUNCTIONS NECESSARY FOR
CULTURE CHANGE
VII. ARTS PROGRAM /
MEANINGFUL ACTIVITIES
& ENTERTAINMENT
II. HUMAN INTERACTIONS /
INDEPENDENCE DIGNITY
AND CHOICE
VIII. SPIRITUALITY AND
DIVERSITY
III. PROMOTING PATIENT
EDUCATION, CHOICE AND
RESPONSIBILITY
IV. FAMILY INVOLVEMENT
V. HEALTHY FOOD CHOICES
VI. HEALING ENVIRONMENT:
ARCHITECTURE AND DESIGN
IX. INTEGRATIVE
THERAPIES / PATHS TO
WELL-BEING
X. HEALTHY
COMMUNITIES /
ENHANCEMENT OF LIFE'S
JOURNEY
XI. MEASUREMENT
Planetree Designation and Assessments Ask:
What’s Important to the Patient?
Family Involvement:
Access to Family &
Friends
 24-hour, patient-directed
visitation (IV.A.)
 Formalized Opportunities
for Family Involvement
(IV.B.)
 Family Spaces (VI.C.)
Patient Education & Information
79% of patients
(N=4,500) are
interested in reading
their medical record
Why?
 To be more involved in their health care (74%)
 To see what the physician said about them (74%)
 To understand their condition better (72%)
Archives of Internal Medicine, 2004
Sleep deprivation
can lead to
decreased cellular
function, ICU
psychosis, poor
outcomes,
increased lengths
of stay and can
lead to decreased
patient
satisfaction.
Joint Commission
Journal on Quality and
Safety
Healing Design Impacts Patient
Engagement and Recovery
Evidence-based design supports quality
 Noise control (e.g., sleep; blood pressure)
 Lighting (e.g., medication mistakes)
 Falls (e.g., bathroom access from bed)
Am. Journal of Medical Quality, C. Clancy, AHRQ
Humanização Exige Respeito
Política Nacional de Humanização
PNH e Planetree:
 Importância da
Humanização
 Alinhamento de
Diretrizes;
 Mudanças dependem
mais de pessoas do que
de recursos.
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Planetree & Hotelaria Hospitalar
Conclusões da Pesquisa
 Planetree
valoriza a importância da hotelaria
nos hospitais não apenas como parte integrante
do cuidado, mas enfatiza sua importância para a
assistência em diversos níveis:
suporte fundamental para atuação da equipe
clínica;
fator chave para a percepção de qualidade e
segurança na perspectiva dos clientes;
estratégia para mudança da experiência dos
mesmos com relação à hospitalização
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Planetree & Hotelaria Hospitalar
Conclusões da Pesquisa
 Os valores essenciais de humanização e
cuidado com foco no paciente são resgatados,
resultando no aumento do índice de
satisfação dos clientes internos e externos.
Planetree at Albert Einstein
Staff Perspectives, 2011: Planetree compliments
the humanistic values of Albert Einstein Hospital.
“Planetree is a program of humanization to attain clinical
improvement of the patient with more sensitive and
humanized care.”
“Planetree is a philosophy where we look and work
through the vision of the patient... It is a philosophy that
is concerned with multiple kinds of needs from the
viewpoint of the patient. The patient has a right to know
what is happening to him and what choices he has.”
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www. patient-centeredcareconference.com
Thank you!
Questions?
[email protected]
[email protected]
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