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Improving health care delivery Patient and family engagement By Lisa Juliar; Nora Vernon, MS, RN; and Rahul Koranne, MD
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Positive psychiatry A new approach to mental health By Dilip V. Jeste, MD
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edical practice has traditionally focused on determining the causes of illnesses, developing and using safe and effective treatments, and reducing the associated suffering and disability. These components are, however, not sufficient to fulfill the enormous potential of medicine to promote human welfare. The World Health Organization has defined health, not as an absence of disease or infirmity, but as a state of complete physical, mental, and social well-being. Research shows that higher levels of positive psychosocial characteristics such as resilience, optimism,
and social engagement are associated with objectively measured better health outcomes including greater longevity. While physicians are experts in health, most of the field’s attention has been devoted to managing disorders. Positive psychosocial characteristics are rarely addressed in our textbooks or journals. The health care system is changing rapidly for several reasons. These include the rapidly growing older population with greater health care needs, the decreasing number of available Positive psychiatry to page 16
ffective delivery of health care is inherently dependent on health care providers whose mindset is that of a highly-trained expert. Can we improve health care delivery by supplementing the provider perspective with greater and more structured input from patients and families? For the past two years, the Minnesota Hospital Association (MHA) has made it a strategic goal to answer that question. By inviting several patients and families, including co-author Lisa Juliar, to partner with them as patient advisors, MHA has learned much about how to authentically include patients and families as experts in their care. The results are early, but unambiguous: patient and family involvement improves health care delivery. Hence, MHA has developed an evolving model of authentic inclusion of patients called Include Always. Background Recent years have brought a major shift in the way health care operates. Patients and families are becoming integrated as meaningful, respected partners in the systems that provide care to them and their communities. MHA’s efforts recognize that true patient and family Improving health care delivery to page 18