Top Strategies for Improving Patient Outcomes: Integrative, Patient-centered Care

Florence Nightingale was not only the founder of modern-day nursing, but she was also one of the first people to use patient outcomes to evaluate healthcare as she kept careful records of her patients, their care, and how their conditions impacted their health. (10) 

Since that time, patient outcomes have encompassed the following:

• Clinical endpoints such as symptoms, lab values, and longevity
• Functional status such as physical, mental, and social
• General well-being including health perceptions, energy/fatigue, pain, and quality of life
• Satisfaction with care including access, convenience, financial feasibility, and quality of care (7) 

Improving patient outcomes can lead to better health and a more empowered patient, which sounds like the perfect clinical goal. (2) 

Patient outcomes in healthcare

Many factors influence patient outcomes. “Patient outcomes have several dimensions including the subjective experience of receiving care, relief of functional limitations imposed by medical conditions, and longevity,” explained Klaus Kjaer, MD, MBA, who is Chief Quality and Patient Safety Officer at Weill Cornell Medicine. “Socioeconomic determinants of health such as economic stability, educational level, physical environment, social context, and reliable access to high-quality healthcare play major roles in patient outcomes.”

Despite all of these variables, Dr. Kjaer and other experts in the field agree that the patient-provider relationship is foundational to improving patient outcomes. “A therapeutic alliance between patients and providers is a game-changer,” said Dr. Kjaer, who is also a Professor of Clinical Anesthesiology, Healthcare Policy and Research with Weill Cornell. But it’s not up to just one provider, he says.

“In modern healthcare delivery, one of the big influencers of outcomes is the performance of teams rather than individuals,” he explained. “Team performance is in turn influenced by culture, which is why building a high-reliability culture based on the psychological safety of team members is so important.”

Integrative health pioneer Ronald Hoffman, MD, agrees and says cultivating a solid clinical team is critical. “Don’t skim on support staff that includes paraprofessionals and administrative people to help patients better engage in the clinical practice,” said Dr. Hoffman, who is the founder of the Hoffman Center in New York City and has been in clinical practice for more than 30 years. “It’s also important to create a healing atmosphere in the office that is conducive to achieving better patient outcomes.”

Focusing on the patient’s experience goes hand-in-hand with improved patient outcomes.

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Top strategies to improve patient outcomes

According to the Agency for Healthcare Research and Quality, there is a growing demand among patients for a better healthcare experience, and there is increasing evidence linking the patient’s positive experience to improved clinical outcomes. (1) A patient’s experience has become a key indicator of not only the quality of care but is also correlated with patient safety and treatment efficacy. (3) 

Oftentimes, at the heart of the patient’s experience is education.

Improving patient outcomes with education

Information and communication have been identified as core values that can profoundly influence the patient-provider dynamic to create a partnership that encourages the most optimal health outcomes. (8)

The research is clear that when we improve patient education, we improve health outcomes, and healthcare providers are in an ideal role to take on low health literacy. (9) According to the Center for Health Care Strategies Inc, an estimated 90 million Americans, about 36%, have low health literacy, which means they may not be able to obtain, process, and understand health information. (4) 

It’s important to consider that there are two forms of health literacy: personal and organizational. The US Department of Health and Human Services defines the two forms of health literacy this way:

• Personal health literacy is an individual’s ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.
• Organizational health literacy is an organization’s ability to equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others. (11) 

In addition to addressing health literacy, research also shows that when a practitioner displays empathy, really listening to and understanding the patient’s needs and fears, health outcomes and patient satisfaction are improved. It’s also associated with overall better well-being of the physician. (5) 

It’s understood that displaying empathy, providing patient education, and improving patient outcomes all take time. “Structure your practice to allow plenty of facetime with patients,” said Dr. Hoffman, who is the creator and host of the Intelligent Medicine Podcast. “Time is the missing ingredient in modern medicine.”

Improving patient outcomes with an integrative approach

Integrative practitioners are uniquely positioned to help improve patient outcomes. Research shows that an integrative, whole-person care model improves clinical outcomes, enhances the patient experience, and reduces healthcare costs. (6) 

Dr. Hoffman offers up these other top strategies that integrative practitioners can use to help improve patient outcomes:

• Be a role model by maintaining a healthy lifestyle that will encourage patients to do the same.
• Encourage consults with specialists beyond the scope of your practice by developing relationships with supportive colleagues.
• Enlist family members when possible for additional support.
• Manage expectations by encouraging patients but not overselling unrealistic recovery goals.
• Screen prospective patients thoroughly before accepting them to ensure they have the means and commitment to follow your integrative approach.
• Stay in your lane, know your strengths, and accept patients accordingly.

The bottom line 

What does the future hold for improving patient outcomes?

“I would like to see all patients have the opportunity to establish a trusting relationship with a healthcare provider who coaches them on staying healthy and is readily available to provide them with care when medical problems do arise,” concluded Dr. Kjaer.

To help improve health outcomes, consider utilizing a team approach, focusing on education and empathy, and incorporating other proactive strategies into your clinical practice. The patient, provider, and entire healthcare system will reap the benefits when improving patient outcomes becomes a key clinical goal.

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