Listening First and Shared Decision-Making: The Patient Centered Value System

Serving patients is the core purpose of healthcare. 

Yet, the system is frequently created without input from those receiving said care, ultimately creating barriers to ideal experiences and outcomes. 

From one’s socioeconomic status and level of community support to the built medical environment and interactions with staff, clinicians, and physicians, many factors absent from the patient chart nevertheless impact treatment efficacy and results. 

In actuality, the care experience goes far beyond the walls of the hospital and starts long before making an appointment, and includes pertinent information that is often missed or not addressed.

We regard this gap in knowledge and understanding as an opportunity to design better care delivery with what matters to patients at its core. 

Where Do I Start? 

Enter, the Patient Centered Value System. 

Inspired by efforts at the Institute for Healthcare Improvement in Boston, and first implemented at the Bone and Joint Center in Pittsburgh, the Patient Centered Value System, or PCVS, examines the patient journey holistically. It also examines the entire patient pathway, from a patient’s home and back again. 

Using qualitative information gathering techniques adapted from human-centered design theory, this approach considers details from a patient’s life journey, history, personal relationships, and priorities as important information for providers to gather and try to understand. 

That is, rather than focusing solely on how to improve internal processes, PCVS starts with asking patients for their thoughts, and by listening to the answer of a simple question. 

What Matters to You? 

Rather than follow the typical symptom-focused dialogue that starts by asking, “What’s the matter?”, PCVS begins by flipping the script. 

By first asking patients, “What Matters to You?”, a new conversation and opportunity to connect opens up; their priorities come to the forefront of the conversation. 

This small yet significant change creates empathy between provider and patient, and allows for a richer, more nuanced interaction, ultimately leading to better care. 

Why Does What Matters… Matter? 

Created by orthopaedic surgeon Dr. Tony DiGioia, the PCVS methodology invites patients to be active participants in shared decision making about their health and care.

This commitment goes beyond a single conversation, catchphrase, or care experience. On the contrary, centering, valuing, and incorporating the patient’s input throughout their pathway and beyond, allows for the care experience to improve, as well as help improve that of other patients. 

In this way, What Matters creates a lasting ripple effect capable of transforming experiences across the healthcare world.

The Patient Centered Value System is our way of finding out the true experience of our patients so that we can continue to serve our patients with responsive, high-quality care shaped around what matters most to them. 

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