Compassion as the foundation of patient-centered care: the importance of compassion in action

Abstract

The Institute of Medicine defines patient-centered care as "providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions." What is missing in this definition is an explicit emphasis on compassion. This perspective article draws on the experience of Planetree (CT, USA), a not-for-profit organization that partners with healthcare establishments to drive adoption of patient-centered care principles and practices by connecting healthcare professionals with the voices and perspectives of the patients and family members who utilize their services. Across hundreds of focus groups facilitated by Planetree, patients and their loved ones emphasize that paramount among their needs, preferences and values are compassionate human interactions. For care to be truly patient-centered, a foundation of compassion is essential. Reports from patients and the media, and research from healthcare systems around the world demonstrate the fallacy of assuming that compassion is a current or prevalent feature of the care experience. Concurrently, a growing evidence base highlights the supreme importance of compassion in driving high-quality, high-value care. However, good intentions are not sufficient for delivering compassionate care. Drawing on the experiences of exemplary patient-centered hospitals (recognized as such following a rigorous culture audit to determine fulfillment of the criteria for formal recognition as a Designated® Patient-Centered Hospital [Planetree]), this paper explores practical approaches for embedding compassion in healthcare delivery and organizational culture to meet patients' expressed desires for empathic and respectful human interactions.

Stakeholder perspectives of compassion in nursing: The development of the compassion strengths model

“…The findings here support the theoretical assumptions that pressure to perform under stressful conditions in unsupportive environments can erode nurses’ compassion (Cole‐King & Gilbert, ), and that more is needed to help them develop self‐care techniques to face these circumstances. Barriers to learning about and displaying compassionate care are well documented in the literature (Frampton, Guastello, & Lepore, ; Guastello & Frampton, ), to the degree where some argue that the move to degree from trained nurses could have been partly responsible for what happened at Mid‐Staffordshire (Francis, ). Nurses there were encouraged to focus on targets more than care (Darbyshire & McKenna, ).…”

Measuring Compassion in Healthcare: A Comprehensive and Critical Review

“…In clinical settings, compassion actuates healthcare providers to provide care that focuses on a patient's humanity and uniqueness [4]. Healthcare encounters that include compassion can offer substantial benefits for patients, such as increasing trust in the patient-physician relationship, improving patient satisfaction, symptoms and quality of life and aiding recovery [1,5,[7][8][9][10][11][12][13][14][15][16][17].…”

“…In several studies, patients and their families have identified compassion as a necessity during healthcare encounters [7]. A recent systematic review of compassion in healthcare [5] identified compassion as a patient right [18], central to codes of ethics across healthcare professions [19][20][21], a practice competency that should be evaluated in selecting medical and nursing student admissions, [22,23], a standard of care that healthcare providers must be trained in and systems must measure and report [11,17,24] and a dimension of quality care that should be assessed on an ongoing basis [17,25].…”

Professionalism, professionalization, expertise and compassion: a qualitative study of medical residents

“…The strength of evidence is such that educational frameworks like CanMEDS [2] (an internationally used set of educational and practice competencies physicians require to effectively meet patient needs) enshrine the value of empathy in multiple roles including communicator, collaborator (where situational awareness is emphasized) and professional, with its focus on altruism, self-care and compassion [2]. Closely aligned with empathy is compassion, “a deep feeling of connectedness with the experience of human suffering that requires personal knowing of the suffering of others, evokes a moral response to the recognized suffering that results in caring that brings comfort to the sufferer” [21], and the ability to relate to the vulnerability of others in a meaningful way [18]. Contemporary medical pedagogy generally includes concepts of professionalization, emotional well-being, and clinical empathy [22].…”