Putting the patient first
Posted on 11 Feb 2022
An orthopaedic surgeon at Mediclinic Kloof aims to improve medical clinical outcomes by placing his patients at the front and centre of the treatment process.
“The core of medicine is that the patient must be at the centre of the care process. Ultimately, all of it is about them,” says Dr Shaun East, an orthopaedic surgeon with special interests in sports-related injuries and hip and knee arthroplasty. As a forward-thinking clinician, he’s also driven to improve patient outcomes and experiences.
Having recently completed a year-long master’s course in healthcare transformation at The University of Texas at Austin, he’s now equipped with the practical tools to make a real difference in his patients’ lives and push his field of expertise into the future.
The course, presented by the Value Institute for Health & Care at the university’s Dell Medical School, covered topics as diverse as outcome measurements, overcoming inertia, financial challenges, platforms, strategy, as well as leadership and communications. It was chaired by Elizabeth Teisberg, a leading figure in the value-based healthcare strategy movement, who co-wrote Redefining Health Care: Creating Value-Based Competition on Results, and Scott Wallace, who served on the faculty for Harvard Business School’s executive education programme on healthcare strategy.
These are two of the most renowned figures in the field, says Dr East, and their insights are particularly applicable in the South African context.
“Too often, private healthcare is wasteful. When only a minority of the population has access to high-quality, immediate treatment, then the focus is on the wrong aspect of care,” he explains. “What value-based healthcare should mean is decreasing cost and improving patient outcomes. Usually, we measure aspects like theatre time and days in hospital, whereas what we should be measuring – what would truly make a difference – is the kind of outcomes that really matter to the patient’s own experience.”
How many days it takes before a patient is without pain after surgery, or how many days or weeks later they’re able to walk again, or, in time, the range of motion they’re able to achieve again: this is the data Dr East feels would make a tangible difference.
He’s not alone. Dr East and his colleagues explored innovative ways of transforming the traditional patient care model, such as establishing integrated practice units (IPUs) – an integrated in-hospital team-led approach to managing patients’ treatments, and the flipped clinic model, where doctors draw on comprehensive patient records and histories before the initial clinic consultation.
Dr East is even transforming his own space. “Usually, when we see patients, they come into the rooms, wait and then get seen. After that, they see the physiotherapist or physician in other rooms. But by creating patient-centric treatment spaces, the patient remains in one space and the doctors, physios and others rotate around them. This prevents the inconvenience of moving around, saves time and reduces confusion – but most importantly, it allows the focus to be on the patient. They’re empowered to ‘own’ the treatment space for the duration of their time in the room – move furniture around, connect to Wi-Fi and work in between visits while waiting for the next person to consult with them.”
This arrangement has the potential to place the patient quite literally at the centre of their treatment model and dramatically improve their understanding and experience of the process. In the field of arthroplasty, where much of the treatment success relies on active and consistent physical rehabilitation, this is a crucial metric – helping a patient feel positive about the outcomes they can achieve is priceless.
“Value-based care is about making healthcare more efficient and accessible,” Dr East says. “But it can also make our care measurably better. This course gives you the tools to do this, to stand up and make a difference. It connects you to an international community with a similar drive and ambition, and the resources to accomplish this.”
Mediclinic’s continuum of care is expanding rapidly, with several value-based care initiatives.
These include Mediclinic’s innovative partnership with ICON Oncology, which brings a traditionally fragmented treatment journey under one roof at Mediclinic Constantiaberg; our Care Expert programme, which places the patient at the centre of their own arthroplasty treatment journey, creating a more efficient and cost-effective experience; and Mediclinic Renal Services clinics, which bring expert renal care directly to lower-income communities.
These projects and programmes put patients first by prioritising the individual treatment experience and creating efficiencies that empower our hospitals to provide transparent, accessible care of a high clinical standard.