Richard Hovey

Patient Safety: A Consumer’s Perspective

In this article we provide a reconceptualization of patient-centered health care practice through a collaborative person-centered model for enhanced patient safety. Twenty-one participants were selected and interviewed from the internationally diverse population of individuals attending the Chicago Patient Safety Workshop (CPSW) sponsored by Consumers Advancing Patient Safety (CAPS). Analysis of the participant transcripts revealed three findings related to patient experience: the impact and meaning of communication and relationship within the health care setting, trust and expectation for the patient and family with the health care provider, and the meaning and application of patient-centeredness. Researchers concluded that successful planning toward enhanced patient-centered care requires multiple perspectives, including the voices of the patient and family members who have experienced the trauma of preventable medical error. Collaborative initiatives such as the CPSW and CAPS offer a positive way forward for enhanced patient safety and quality of care.

Healing, the Patient Narrative-Story and the Medical Practitioner: A Relationship to Enhance Care for the Chronically Ill Patient

Patient–health care practitioner communication is riddled with complexities. In this article the authors initially describe how careful listening to another, the patient, within the context of todays health care system has drifted from being an integral part of the “art” of medicine toward a methodological checklist of standard questions designed to support the “science” of medicine. Then they offer a way and a means for todays biomedically trained health care practitioner to rethink or reimagine the value of authentic listening. They conclude with a critical exploration of a pedagogic speaking-listening relationship located within an understanding of dialogue as a means of gaining health-related, patient-specific evidence. By attending to a patients story through the health care practitioners attentive listening, the health care practitioner together with the patient create a place whereby a dialogue exchange actually becomes an indispensable and health-related element fostering a process of mutual learning, knowing, and being.

Understanding the relational aspects of learning with, from, and about the other.

Frequently heard among healthcare providers, administrators, students, and educators, especially within the context of interprofessional collaboration, is the phrase: learning with, from, and about the other. Our purpose in writing this article was to explore the relational aspects of interprofessional collaboration and provide a conversational perspective on how this phrase may be co-constructed by members of the interprofessional team, to achieve a contextual understanding for enhanced practice. It is through understanding and analysing the meaning of commonly held words and phrases that we can begin to understand the differences between transactional ways of gaining knowledge and begin to understand how a transformational shift in attitude, identity, and practice can promote learning with, from, and about the other.

Advancing patient-centered care through transformative educational leadership: a critical review of health care professional preparation for patient-centered care

Martine C Levesque1,2 Richard Bruce Hovey2,3 Christophe Bedos2,4 1Faculte de medecine, Universite de Montreal, Montreal, QC, Canada; 2Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, QC, Canada; 3Faculty of Medicine, University of Calgary, Calgary, AB, Canada; 4Departement de medecine sociale et preventive, Faculte de medicine, Universite de Montreal, Montreal, QC, Canada

Partners in our care: patient safety from a patient perspective

The voice and role of “patient” in patient safety were explored by the Calgary Health Regions Patient and Family Safety Council perspective and the Calgary Health Region, Calgary, Alberta, Canada—an important collaboration for enhanced patient safety. Insights into patient safety were shared and coauthored in this article by the Patient and Family Safety Council with members of the Calgary Health Region staff. The Patient and Family Safety Council members were asked to respond to articles written about the role of patient in patient safety, without direct communication with patients. The authors of this article intended to demonstrate only a few of the ways in which patient involvement and feedback through partnership turn knowledge into action and help inform patients about safety practices and procedures.

The influence of distress on knowledge transfer for men newly diagnosed with prostate cancer.

The purpose of this inquiry was to evaluate the efficacy of prostate cancer education sessions. Implementation of 3-h patient educational sessions was intended to provide men newly diagnosed with localized prostate cancer, who face difficult and complex decisions, information about potential treatment options. Fifty-seven men completed the distress thermometer assessment before the education session to assess baseline levels of distress. Seven of the men were interviewed post-educational session to determine the degree of knowledge transfer from the session. This study explored the efficacy of the patients’ learning experience using an interpretive phenomenological research approach. Resulting data revealed that these patients, as adult learners, were distressed and that, despite the availability of pertinent medical content, the subject material was not learned as intended or readily understood. The conclusion drawn from this preliminary applied educational research study was that the education model used was less than efficacious at ensuring that sufficient knowledge transfer was achieved for medical treatment decision-making processes. These findings suggest a need for future research to explore the application of adult learning theories and approaches that may offer enhanced knowledge translation and transfer for prostate cancer education programs.

Enhancing Indigenous Health Promotion Research Through Two-Eyed Seeing: A Hermeneutic Relational Process:

The intention of this article is to demonstrate how Indigenous and allied health promotion researchers learned to work together through a process of Two-Eyed Seeing. This process was first introduced as a philosophical hermeneutic research project on diabetes prevention within an Indigenous community in Quebec Canada. We, as a research team, became aware that hermeneutics and the principles of Haudenosaunee decision making were characteristic of Two-Eyed Seeing. This article describes our experiences while working with each other. Our learning from these interactions emphasized the relational aspects needed to ensure that we became a highly functional research team while working together and becoming Two-Eyed Seeing partners.

Occasionally a Patient: Always a Person

Currently within the Canadian research landscape, patients as partners or ambassadors have become part of the fabric for research funding; “nothing about me without me” (1). My recent personal experiences at pain conferences and research team meetings as a patient partner, who is also an academic researcher, suggest we need to evolve a philosophy of engagement that serves both the patient and the researchers and/or clinicians. This Perspectives’ contribution is intended to open up possible conversations about the role of patient experience and the interconnections needed to build strong research communities, through a consideration of a personcentered relational model (2).To help locate and describe the role of the patient within the structure of a scientific research community I turn to the work of Merleau-Ponty:

Listening to and letting pain speak: poetic reflections:

The humanities invite opportunities for people to describe through their metaphors, symbols and language a means in which to interpret their pain and reinterpret their new lived experiences. The patient and family all live with pain and can only use their pain narratives of that experience to confront or even to begin to understand the quantifiable discipline of medicine. The patient and family narratives act to retain meaning within a lived pained experience. These narratives add meaning to the person as a stay against only having a clinical–pathological understanding of what is happening to our body and as a person. We need to understand the pathology pain while also being mindful of suffering. In this article, the theoretical and scientific approach to pain research and clinical practice intersects with the philosophical, ontological and reflective lived experience of the person living with pain. Through unique pain narratives, poetry and stories as a means of offering empathy and understanding as healing, the humanities in medicine bring into meaning another kind of therapy equal to the evidence-based medicine clinicians and researchers use to seek a cure. In this way, the medical humanities are addressing the person’s healing through the reduction of suffering and isolation by letting pain speak while others can focus in on their medical knowledge/practice and research while ‘finding’ a cure. Listening to pain opens-up to the possibility that much can be learned through multiple expressions of the pain narrative. This article provides an invitation to learn how we might articulate and listen to pain carefully and differently.