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Creating a Sustainable “Healing Culture” Throughout a Healthcare System: Using Community Psychology Principles as a Guide

Creating a Sustainable “Healing Culture” Throughout a Healthcare System: Using Community Psychology Principles as a Guide by  William D. Neigher, Ph.D. and Sharon Marie Hakim, M.A.

Author: William D. Neigher, Ph.D. and Sharon Marie Hakim, M.A.

Abstract:

Creating a Sustainable “Healing Culture” Throughout a Healthcare System: Using Community Psychology Principles as a Guide

William D. Neigher, Ph.D. 1 and Sharon Marie Hakim, M.A. 1,2
1Atlantic Health System [NJ], 2Wichita State University

This presentation describes foundational initiatives to create a sustainable “healing culture” within a large, multi-hospital healthcare system, the Atlantic Health System [AHS] in northern New Jersey. We will describe our guiding principles, implementation process, barriers and facilitators, progress to date, and next steps.


Article:

Creating a Sustainable “Healing Culture” Throughout a Healthcare System:
Using Community Psychology Principles as a Guide

William D. Neigher, Ph.D. (1) and Sharon Marie Hakim, M.A. (1,2)
1Atlantic Health System [NJ], 2Wichita State University

Abstract
This presentation describes foundational initiatives to create a sustainable “healing culture” within a large, multi-hospital healthcare system, the Atlantic Health System [AHS] in northern New Jersey. We will describe our guiding principles, implementation process, barriers and facilitators, progress to date, and next steps.

Introduction
Perhaps you are puzzled already: “isn’t a hospital system by definition a healing culture?”
Of course it is.  However these two words, “healing culture,” have meaning together beyond their distinct definitions, and each brings challenges and opportunity in our current operating environment.

U.S. hospitals are facing extraordinary pressures to balance “mission with margin.”  Decreasing reimbursement from commercial and federal payers [Medicaid and Medicare], competition from physician-owned facilities, the shift from inpatient to outpatient care, tighter staffing ratios, focused efforts to reduce mortality and infection rates, the skyrocketing cost of new technologies, the shortage of primary care doctors in many areas, information system mandates, and upkeep on aging physical plants are among the challenges.  All of which contribute to the uncertainties of expected changes under new healthcare reform legislation [Patient Protection and Affordable Care Act, PL 111-148, 2010].

However a healthcare system today is more than just an acute inpatient setting. AHS includes in its continuum of care: emergency and trauma, post-acute and rehabilitation; same day surgery, ambulatory care [outpatient], and home health and hospice services. Yet the hospital setting may present the greatest challenge for creating a healing culture.  When we ask who in an audience has ever been a patient in a hospital for an illness or injury, most raise their hands.  When asked “for how many of you was it among the best experiences of your life?” there is usually not a single hand [having a baby is usually a great exception].

The corollary, in contrast, evokes nervous laughter and many hands raised: “for how many of your was your hospital experience among the worst experiences of your life?”

Our AHS workplace has a legacy of over a century of community service; like other hospitals it has never closed-- even for a minute, even in the worst disaster.  And it is emotional place for patients, families, visitors, medical staff and employees: every day here life begins, life ends, lives are saved, and everything else in-between.
“Above all, do no harm, cure whenever possible, treat appropriately, and heal always.”

These guiding principles of medicine and healthcare are familiar and profound; if we try our best to follow them why do we need a special effort to create a healing culture?  For the most part we only begin the healing process.  We say that about 15% of healing takes place within our walls; the rest is up to the patient and a host of other factors within and outside of their control.

Our patients can face sudden and life-changing events for themselves and their families. Their recovery can take months or even years, and their return to pre-illness or injury levels of functioning is not always certain.  How can a healthcare system prepare our patients better for the challenges of recovery—whether they are physical, psychological, social or economic?  In other words, how can we make them more “adaptable?” That is one major challenge in creating a “healing culture,” and the topic of our presentation.

This paper will take a look at how we define and express our healing culture in the context of our healthcare system’s mission, vision and values, and how the principles of community psychology inform the process.

Download the PDF to read the entire presentation, including slides and narrative.


Author

William D. Neigher, Ph.D. and Sharon Marie Hakim, M.A.

William D. Neigher is at Atlantic Health, and Sharon Marie Hakim is a doctoral student at Wichita State University.


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