Planetree: A Radical Model for New Healthcare/Healing/ Wellness Excellence Tom Peters/10.04.2004

Planetree: A Radical Model for New

Healthcare/Healing/Wellness Excellence

Tom Peters/10.04.2004

Learn more about Planetree/The

Planetree Alliance:

www.planetree.org

“If one didn’t know better, one might think that hospitals set out to design

systems that provide the most sophisticated technical care but

deliver the worst possible experience to sick people.” —Putting Patients First, Susan

Frampton, Laura Gilpin, Patrick Charmel

“It was the goal of the Planetree Unit to help

patients not only get well faster but also to stay well longer.” —Putting Patients First, Susan Frampton,

Laura Gilpin, Patrick Charmel

“Those of us working in healthcare have an obligation to be of service in this world, to be bringers of light and

hope. Our work is spiritual by its nature, as the Planetree model has acknowledged for decades.”

“Our definition of spirituality is coming into a right relationship with all that is, establishing a loving,

nurturing, caring relationship. Planetree’s has been to refocus our attention on the power of relationships, and, in particular, the mind-body-spirit relationship essential to healing. It has opened a door that will

never be closed.” —Leland Kaiser, “Holistic Hospitals”

Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

“Much of our current healthcare is about curing.

Curing is good. But healing is spiritual, and healing is

better, because we can heal many people we cannot

cure.” —Leland Kaiser, “Holistic Hospitals”


“The ‘curative model’ narrowly focuses on the goal of cure. …

From many quarters comes evidence that the view of health

should be expanded to encompass mental, social and

spiritual well-being.” Institute for the Future

Determinants of Health

Access to care: 10%Genetics: 20%

Environment: 20%

Health Behaviors: 50%Source: Institute for the Future

The 9 Planetree Practices

1. The Importance of Human Interaction2. Informing and Empowering Diverse Populations: Consumer Health Libraries and Patient Information3. Healing Partnerships: The importance of Including Friends and Family4. Nutrition: The Nurturing Aspect of Food5. Spirituality: Inner Resources for Healing6. Human Touch: The Essentials of Communicating Caring Through Massage7. Healing Arts: Nutrition for the Soul8. Integrating Complementary and Alternative Practices into Conventional Care9. Healing Environments: Architecture and Design Conducive to Health


1. The Importance of Human Interaction

“There is a misconception that supportive interactions require more staff or more time and are therefore more costly. Although labor costs are a substantial part of any hospital budget, the interactions themselves add nothing to the budget. Kindness is free. Listening to

patients or answering their questions costs nothing. It can be argued that negative interactions—alienating

patients, being non-responsive to their needs or limiting their sense of control—can be very costly. …

Angry, frustrated or frightened patients may be combative, withdrawn and less cooperative—requiring far more time than it would have taken to interact with them initially in a positive way.” —Putting Patients First,

Susan Frampton, Laura Gilpin, Patrick Charmel

Press Ganey Assoc/1999: 139,380 former patients from 225 hospitals

0 of top 15 factors determining Patient Satisfaction referred to patient’s health outcome

PS directly related to Staff Interaction

PS directly correlated with ES (Employee Satisfaction)


Mgrs re staff: wages, security, promotion opportunities

Staff re staff: interesting work (M:5 of 10), appreciation (5 of 10), sense of being “in” about

what’s going on (10 of 10)


The Customer Comes Second: Put your People First and Watch ’Em Kick Butt, Hal Rosenbluth (and

Diane McFerrin Peters)

“100 Best Places to Work”/RLevering/2001

Get straight answers

Appreciation

Collaboration

Interest in me as a person

Camaraderie (“Fun place to work”)

“Perhaps the simplest and most profound of all human interactions is kindness. … But if it is so simple, it is surprising how

frequently it is absent from our healthcare environments. … Many staff members report verbal ‘abuse’ by physicians,

managers and coworkers.” —Putting Patients First, Susan

Frampton, Laura Gilpin, Patrick Charmel

“An estimated 60 to 90 percent of doctor

visits involve stress-related

complaints.” —Newsweek/

“Health for Life”/09.27.2004

“Planetree is about human beings caring

for other human beings.” —Putting Patients First, Susan

Frampton, Laura Gilpin, Patrick Charmel (“Ladies and gentlemen serving ladies and gentlemen”—4S credo)

2. Informing and Empowering Diverse

Populations: Consumer Health Libraries and

Patient Information

Planetree Health Resources Center/1981Planetree Classification System

Consumer Health LibrariansVolunteers

Classes, lectures (CR)Health Fairs

Griffin’s Mobile Health Resource CenterOpen Chart Policy

Patient Progress NotesCare Coordination Conferences (Est goals, timetable,

etc)


3. Healing Partnerships: The

importance of Including Friends

and Family

“When hospital staff members are asked to list the attributes of the ‘perfect patient and family,’ their

response is usually a passive patient with no family.” —Putting Patients First,

Susan Frampton, Laura Gilpin, Patrick Charmel

“Family members, close friends and ‘significant others’ can have a far

greater impact on patients’ experience of illness, and on their

long-term health and happiness, than any healthcare professional.” —Through

the Patient’s Eyes


“A 7-year follow-up of women diagnosed with breast cancer

showed that those who confided in at least one person in the 3

months after surgery had a 7-year

survival rate of 72.4%, as compared to 56.3% for those who

didn’t have a confidant.”Institute for the Future

The Patient-Family Experience

“Patients are stripped of control, their clothes are taken away, they have little say over their schedule, and they are deliberately separated

from their family and friends. Healthcare professionals control all of the information

about their patients’ bodies and access to the people who can answer questions and connect

them with helpful resources. Families are treated more as intruders than loved ones.”

—Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

Institute of Medicine/ “Crossing the Quality Chasm”

Respect for preferencesInvolvement in Decision Making

Access to careCoordination of care

Information and educationPhysical comfort

Emotional supportInvolvement of Friends and Family

Continuity of care


Care Partner Programs (IDs, discount meals, etc)

Unrestricted visits (“Most Planetree hospitals have eliminated visiting restrictions altogether.”) (ER at one hospital “has a policy of never

separating the patient from the family; and there is no limitation on how many family members may be present.”)

Collaborative Care ConferencesClinical Guidelines Discussions

Family SpacesPet Visits (POP: Patients’ Own Pets)


4. Nutrition: The Nurturing Aspect

of Food

Meals are central events

vs

“There, you’re fed.”*

*Irony: Focus on “nutrition” has reduced focus on “food” and “service”


KitchenBeautiful cutlery, plates, etc.

Chef rep


Aroma therapy (e.g., “smell of baking cookies”)


5. Spirituality: Inner Resources for Healing

Spirituality: Meaning and Connectedness in Life

1. Connected to supportive and caring group2. Sense of mastery and control3. Make meaning out of disease/find meaning in suffering


Spirituality

body-mind-spirit

prayer-meditation-visualization


Griffin: redesign chapel (waterfall, quiet music, open prayer book)

Other: music, flowers, portable labyrinth


6. Human Touch: The Essentials of Communicating

Caring Through Massage

“Massage is a powerful way to communicate caring.” —Putting Patients

First, Susan Frampton, Laura Gilpin, Patrick Charmel

Mid-Columbia Medical Center/Center for Mind and Body

Massage for every patient scheduled for ambulatory surgery (“Go into surgery with a good attitude”)

Infant massageStaff massage (“caring for the caregivers”)

Healing environments: chemo!


7. Healing Arts: Nutrition for the Soul

Planetree: “Environment conducive to healing”

Color!Light!

Brilliance!Form!Art!

Music!


Florence Nightingale/Notes on Nursing/patient’s need for beauty, windows, flowers: “People say the

effect is only on the mind. It is no such thing. The effect is on the body, too”


Griffin: Music in the parking lot; professional musicians in the lobby

(7/week, 3-4hrs/day) ; 5 pianos; volunteers (120-140 hrs arts & entertainment

per month).


8. Integrating Complementary and

Alternative Practices into Conventional Care

CAM (Complementary & Alternative Medicine):

83M in US (42%)CAM visits 243M greater than to PCP (Primary Care

Physician) (With min insurance coverage)W-F-Educated-Hi incDon’t tell PCP (40%)

OTA: <30% procedures used in conv med have undergone RCTs (randomized clinical trials)


Griffin IMC/Integrative Medicine Center

MassageAcupuncture

MeditationChiropractic

Nutritional supplementsAroma therapy


9. Healing Environments: Architecture and

Design Conducive to Health

“Planetree Look”

Woods and natural materialsIndirect lighting

Homelike settings

Goals: Welcome patients, friends and family … Value humans over technology .. Enable patients to participate in their care … Provide flexibility to

personalize the care of each patient … Encourage caregivers to be responsive to patients … Foster a

connection to nature and beauty


SoundTextureLighting

ColorSmellTaste

Sacred space


Access to nurses station:

“Happen to”vs

“Happen with”Source: Putting Patients First, Susan Frampton, Laura Gilpin, Patrick Charmel

The Eden Alternative

The Ten Principals of the Eden Alternative

1. The three plagues of loneliness, helplessness, and boredom account for the bulk of suffering among Elders.2. Life in an Elder-centered community revolves around close and continuing contact with children, plants, and animals. These ancient relationships provide young and old alike with a pathway to a life worth living.3. Companionship is the antidote to loneliness. In an Elder-centered community we must provide easy access to human and animal companionship.4. A healthy Elder-centered community seeks to balance the care that is being given with the care that is being received. Elders need opportunity to give care and caregivers need opportunities to receive care.


“The Eden paradigm allows elders to care for animals,

birds, and children as well as each other.” —Susan Eaton, Harvard/JFK school



5. Variety and Spontaneity are the antidotes to boredom. The Elder-centered community is rich in opportunities to sample these ancient pleasures.6. An Elder-centered community understands that passive entertainment cannot fill a human life.7. The Elder-centered community takes medical treatment down from its pedestal and and places it into the service of genuine human caring.



8. In an Elder-centered community, decisions should be made by the Elders or those as close to the Elders as possible.9. An Elder-centered community understands human growth cannot be separated from human life.10. Wise leadership is the lifeblood of any struggle against the Three Plagues. For it, there can be no substitute.


“The most basic question we need to

pose in caring for others is this: Is this a loving act?” —Leland Kaiser, “Holistic

Hospitals”


Conclusion: Caring/Growth “Experience”

Care!Control!Connect! Engage!Grow!

De-stress!

“The single best way to predict the future is to

create it.” —anon

Documents

Planetree: A Radical Model for New Healthcare/Healing/ Wellness Excellence Tom Peters/10.04.2004