Person centred care in the ICU – What skills matter?
It is our 20th birthday this year and before the arrival of COVID-19 I’d started looking back at some of the research we’ve carried out over the years, asking myself if the things that mattered to people 10 or 20 years ago still matter now. And do they still matter during a pandemic?
One piece of research I stumbled across was published in 2006 and explored what patients and their family see as the key competencies for intensive care doctors. A particularly relevant study given the demands that our intensive care units are currently under.
The study, carried out across eight European countries including the United Kingdom, explored views from patients and relatives on the knowledge, skills and attitudes that intensive care doctors need in order to provide high quality person centred care.
Not surprisingly, factors of most importance to people included calmness in a crisis, knowledge about treatment, respect for patients as individuals, and the ability to explain in ways patients can understand. Small differences between men and women were seen with women more likely than men to describe discussing fears and anxieties and involving patients and relatives in decisions as essential competencies. But ultimately medical skill, communication, and interpersonal skills were seen as essential or very important by the majority.
Through the research we carry out and the stories I’ve seen emerging on social media every day, there are so many examples of health and social care staff demonstrating these skills in action and working tirelessly to provide the best possible care experiences despite the challenges faced. Seeing innovative solutions to problems such as how relatives can communicate with their loved ones and how patients can be supported to feel more at ease with staff in protective gear demonstrates that person centred care is a priority.
Some things have changed since 2006, of course they have – we had a labour government, primary care trusts existed and we had the Healthcare Commission (now Care Quality Commission). And this year has required us to make rapid changes to the way we work and to the way care is provided. However, what we all want from our care and what is recognised as good care remains fundamentally the same: it’s just the way we are experiencing it that is different. This is why providers and staff must continue to focus on what matters most, even as they manage current challenges.