Optimal healing environments call on ancient traditions to help bring patients to well-being.
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| Sita Ananth |
The belief that “healing” or bringing the body back into balance, by providing it with the appropriate stimuli and opportunities to become restored to wholeness, is as ancient as traditional Chinese medicine and Ayurveda. While much of this philosophy was lost as individual practices and modalities made their way to the West—and biomedicine became the predominant form of health care—there has been a growing movement to bring back a patient-centered, biosocial model of care that looks at individuals in the context of both their internal and external environments.
Inspired by many of these global health systems, in 2002, Wayne Jonas, M.D., president and CEO of the Samueli Institute, a nonprofit, medical research organization supporting the scientific investigation of healing processes and their role in medicine and health care, developed the concept of an optimal healing environment (OHE) to help transform the way health care is delivered. An OHE, as defined by the institute, is one where the social, psychological, physical, spiritual and behavioral components of health care support and stimulate the body’s innate capacity to heal itself. These major components include:
A graphic of these components, in the form of a framework, can be viewed here.
A Better Approach for Chronic Conditions
As we live longer, due in part to the advances in modern science and technology, chronic conditions have now become the leading cause of disability, illness and death. But our system of care is designed and devoted primarily to deal with acute conditions, causing a dearth of infrastructure to deal with chronic conditions. Because of these rapid changes, notes the Institute of Medicine’s Crossing the Quality Chasm report, the health care delivery system has fallen far short in its ability to translate knowledge into practice and apply new technology safely and appropriately.
“We need to think differently about how health care is delivered and focus on health, healing and health promotion, not just treatment,” says Jonas. “The time has come to create a new model of health care that makes room for both healing and cure.”
To that end, the institute engages in healing research from several different perspectives that range “from bench to bed to boardroom” or basic science to health services research, using the OHE framework to connect the research to the mission. The institute also recognizes the importance of developing knowledge translation strategies in an organization committed to building evidence-based knowledge on the science of healing. What type of evidence is most critical, and how quickly and efficiently can that new knowledge be moved into the hands and minds of the end users?
“One of our goals is to support hospitals and other health care institutions in transforming their organizations into optimal healing environments by making practical, actionable, evidence-based information more accessible to health care decision-makers,” says Barb Findlay of the institute’s OHE program. A second goal of the program is to research the application of healing theory in real-world settings and to measure the return on investment for organizations that are moving in this direction.
Building a business case is the mantra on everyone’s lips these days. Unfortunately, the sustainability of programs and services that enhance a hospital’s healing environment is not based on evidence of clinical effectiveness or improved health outcomes alone. Economic metrics such as nurse retention, patient loyalty, employee and patient safety, and lower litigation rates must also be key factors in establishing that sustainability.
Besides, studies have shown that the majority of hospitals that embark on these healing initiatives do so because they believe it is the “right thing to do.” It reflects their organizational mission and desire to meet the demands of their patients. By doing so, these hospitals are also hoping to enhance clinical effectiveness.
A Place of Peace
When I recently toured the newly constructed Peace Health Sacred Heart Medical Center at Riverbend, Ore.—designed and dedicated to researching the impact of healing design on the well-being of patients, staff and families—it became abundantly clear that creating a healing physical space is intricately woven into the organizational culture, embedding a real passion for taking care of its people, its community and its environment.
Walking through their ICU—with everything from its gorgeous river views to luxurious foldout beds on which family members can rest, and listening to the commitment of the architects, designers and staff who had thoughtfully considered every aspect of the patient and family’s experience—made me reflect on the painful days preceding my mother’s passing, when we, her anxious family, stood for hours outside the door of the ICU waiting for a glimpse of the doctor or nurse to hear about her condition. From the noisy and impersonal physical space to the stressed and angry caregivers, it could not have been a more damaging environment for all. Let us ensure that places like those soon become nonexistent in the world.
Sita Ananth, M.H.A., is director of knowledge services, optimal healing environments, for the Samueli Institute in Alexandria, Va. She is also a regular contributor to H&HN OnLine.
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