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Patient-centered means more than satisfaction surveys

September 30, 2014
by Julie Miller
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It seems like a case of too little too late. Minnesota Security Hospital. which nearly lost its license after one patient assaulted and killed another patient in January, has now created a policy to include input from families in the hospital’s strategic decisions. Yes, involving families is a great idea when it comes to behavioral health treatment and recovery, but it’s heart wrenching to think that a tragedy is what created the impetus for the new advisory board. According to an article in the Minneapolis Star Tribune, the hospital has hired new staff and created an avenue for former patients and families to participate in their training.

Previously, the hospital staff was reportedly unsure of how to handle certain situations, such as violent behavior, and was generally disengaged with the patients. Too many people apparently acted--or failed to act--out of fear and ignorance.


Patient-centered care is a trend that’s been picking up speed in the past few years, and behavioral health facilities can’t lull themselves into thinking the trend doesn't apply to them. Some might be tempted to believe they’re the exception because behavioral health is a unique discipline, or worse, that they’re already patient-centered and don't have to worry about it. Patient-centeredness in practice is more than just compiling those pesky satisfaction surveys.

In true patient-centered care, the person’s individual experiences are what make the difference. Rather than delivering care that makes sense on paper, we as an industry have to start thinking of ways to proactively deliver care that engages patients and makes sense in their hearts and minds throughout every step of treatment.

For example, how can you improve the intake process so it’s less scary for patients? Do you have a simple way to specify preferred pronouns, as in “him” versus “her,” for your LGBT patients? How would you approach the nutritional needs for a patient with Asperger’s syndrome who will only eat pizza and grape jelly? A patient-satisfaction survey will not give you these answers.

But a patient’s family certainly will.

Minnesota Security Hospital got the idea for its new family advisory board from nearby Regions Hospital, which has a 26-member consumer committee that meets monthly. The state hospital’s board will begin meeting in November. While poor management at the facility was a horrific tragedy, so is closing a much-needed treatment center. Minnesota Security Hospital will be on probation for two years, but I’m looking forward to following its progress.



Cultural diversity is important in today’s healthcare marketplace. Especially in behavioral healthcare, the cultural appropriateness of services may be the most important factor in the accessibility of services by people of color. Developing culturally sensitive practices can help reduce barriers to effective treatment utilization. Davis (1997) operationally defines cultural competency as the integration and transformation of knowledge, information, and data about individuals and groups of people into specific clinical standards, skills, service approaches, techniques, and marketing programs that match the individual’s culture and increase the quality and appropriateness of health care and outcomes.

A shift in the ethnic diversity of patients accounts for not only a shift in healthcare census, but also accounts for our cultural differences. Therefore, new approaches are needed in service delivery to address cultural differences among consumers. Ensuring the provision of culturally competent services requires healthcare professionals to take on a great deal of responsibility. In particular, there are a number of generally expected levels of knowledge, skills and attributes that are essential to providing culturally competent mental health services. For example: knowledge about the patient’s culture, techniques for learning the cultures of ethnic minority client groups, and acceptance of ethnic differences between people will allow the healthcare provider to begin a dialogue with the patient. However, more intense work will be required to be culturally responsiveness to the new generation of patients.

Davis, King (1997) “Race, Health Status, and Managed Care,” in Epstein, Len
and Brisbane, Francis, eds., Cultural Competence Series, (Rockville, MD:
Center for Substance Abuse Prevention (in press).

Julie Miller

Editor in Chief

Julie Miller


Julie Miller has more than 14 years of experience observing, analyzing and reporting on various...

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