Quality is all the buzz in healthcare. But long before the Leapfrog Group or the IOM reports, there was Planetree.
Founded in 1978 by Angelica Theriot, a patient who decried the lack of personalized care she received while hospitalized, Planetree's foundation is "human interactions in the hospital environment," executive director Susan Frampton says.
Started in San Francisco, Planetree became a not-for-profit subsidiary of Derby, Conn.-based Griffin Health Services in 1998. It will celebrate its 25th anniversary in 2003 and, after a slow start in attracting adherents to its patient-centered model while the country went down the road of managed care, finds interest now is on the rise. The organization had 15 affiliates in 1998 but has 55 now, Frampton says.
"We've finally been around long enough to collect the data to make a business case," she says, explaining the increase.
Planetree also changed focus. Until the 1990s, it wasn't trying so much to add members--its first affiliate signed on in 1992--as to solidify the model itself, Frampton says.
This model includes not just the architecture and design of the rooms, but changes incorporated from literally looking at the hospital from the perspectives of the patients--often lying on their backs staring up at harsh fluorescent lights. Double rooms are set up to allow window views for both patients, soothing artwork hangs on the walls, shelves hold cherished photographs, and room controls are installed by the beds.
The model also includes the caretaking process. Planetree advocates including family members in patients' hospital care, "learning things they'll need to do once the patient goes home," Frampton says.
Frampton says Planetree is conscious of financial realities and has tried to make affiliation cost-neutral for its members. She says affiliation doesn't impact the nurse-patient ratio because, along with enlisting help from families, the model relies heavily on volunteers. Decorating, too, is relatively inexpensive: "It costs no more for pretty paint than ugly paint," Frampton says.
Planetree steering teams oversee the value-based principles in care delivery at each affiliate. Annual assessments, reviewed by Planetree, measure progress in staff education and training and patient education. They also look at the renovation of patient and staff-use areas according to Planetree architecture and design standards and the promotion of a healing environment through music, stress reduction programs and therapeutic massage.
Patient-centered care, Frampton says, is "a quality issue; it's a culture issue. Patient satisfaction has become a very acceptable measure."