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Patient Educ Couns. 2019 Oct;102(10):1911-1916. doi: 10.1016/j.pec.2019.04.025. Epub 2019 Apr 24.

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

Author information

1
Division of General Internal Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA. Electronic address: Mgilliga@mcw.edu.
2
Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, USA. Electronic address: Larso@stanford.edu.
3
Department of Pediatrics, Harvard Medical School, and Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA. Electronic address: Elizabeth_Rider@hms.harvard.edu.
4
Center for Bioethics and Medical Humanities, Institute for Health and Equity and Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI, USA. Electronic address: Aderse@mcw.edu.
5
Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA. Electronic address: Amy_Weil@med.unc.edu.
6
Indiana University School of Medicine, Indianapolis, IN, USA. Electronic address: Dklitzel@iu.edu.
7
Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA. Electronic address: Dana.Dunne@Yale.edu.
8
Department of Pediatrics, Yale University School of Medicine, New Haven, CT, USA. Electronic address: Janet.Hafler@Yale.edu.
9
Division of General, Geriatric, Palliative and Hospital Medicine, Department of Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA. Electronic address: Mp5k@hscmail.mcc.virginia.edu.
10
Department of Medicine, Indiana University School of Medicine, Indianapolis, IN and Education Institute, Cleveland Clinic, Cleveland, OH., USA. Electronic address: Rfrankel@iu.edu.
11
Division of General Medicine and Geriatrics, Department of Medicine, Emory University School of Medicine, Atlanta, GA., USA. Electronic address: Wbranch@emory.edu.

Abstract

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.

KEYWORDS:

Burnout; Compassionate healthcare; Faculty development; Humanism; Leadership; Organizational culture; Values

PMID:
31097330
DOI:
10.1016/j.pec.2019.04.025

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