Through the years of healthcare innovation and reform, even going as far back as the 1990's, one of the favorite rallying cries of administrators is delivering and offering "patient centered care."  When I first heard the phrase, as a manager in an acute care hospital, I thought, "Um, isn't that what we WERE delivering?"  I couldn't imagine what OTHER type of care there would be.  But I do admit to being a bit naive back then.

Recently, we were working with a patient who had been hospitalized for several weeks.  Several transfers through different units in the hospital contributed to the family's confusion about their mom's plan of care.  They had a multitude of questions….Was she going home?  Which doctor was covering her?  Why was she having more trouble breathing?  Guardian Nurses got involved and began to initiate requests for a family meeting so that the clinical team could sit down with the family and explain what was going on. 

Our requests went to physical therapy, and social work, and various other integral departments.  Then we asked nursing.  More specifically, the nurse manager on the current unit.  (Understand that throughout the hospital there were signs touting the facility's patient centered care and high patient satisfaction scores.)  It took a little while before we got a response because the nurse manager was out of her office. 

When she did become aware of our request, she told our nurse advocate that she would not be able to attend the family meeting because she had a budget meeting.   Incredulous, the nurse advocate tried to gently point out the irony but the nurse manager was not amused and maintained that she could not attend.  

Patient centered care?  Sure, as long as it doesn't interfere with any meetings!   

Patient centered care is just that—PATIENT CENTERED.  Not bureaucracy centered.