Sosena Kebede. Ask patients “What matters to you?” rather than “What’s the matter?” BMJ 2016;354:i4045.
…. Maureen Bisognano, one of the keynote speakers at this year’s International Forum on Quality and Safety in Healthcare in Gothenburg, Sweden, told delegates that we should ask our patients, “What matters to you?” rather than, “What is the matter?”….
….. The question “What matters to you?” tries to get to the essence of patient centered care, which the Institute of Medicine has listed as one of the priorities for quality improvement…..
…. The emphasis on diagnostic skill sets alone, however, has led to approaches in which care is designed around disease and the doctor dictating treatment to the patient…..
….. The question “What matters to you?” allows patients to disclose their interests, values, and preferences—as full humans, not just recipients of care….
….. The “sick role,” even for a brief time, is a disempowering and depersonalizing state in which patients have to abide by healthcare professionals’ rules—think for a moment about hospital gowns, intravenous line poles, bed pans, call buttons, bed alarms, blood draws, medical team rounds . . . yet each patient is a son or daughter, sibling, parent, grandparent, spouse, employee, employer, and so on, and each has his or her own identity and unique place in life…..
…… The question “What matters to you?” allows patients to disclose their interests, values, and preferences, and it gives the clinical team a chance to appreciate patients as full humans and not just as recipients of care. This is essential to encourage caregivers’ empathy toward patients……
…… Research has shown that patients value the quality of interaction with their caregivers, and their perception of this correlates with their overall satisfaction. Asking patients what’s important to them is an invitation to a collaborative communication space that recognizes the importance of good rapport for successful care delivery. In turn, good communication has been shown to increase patient adherence to treatment recommendations……
…… Asking questions to find out what really matters to our patients is a great opportunity to improve quality in service delivery…..
….. The optimal way to engage patients and their loved ones in their own care is still not fully clear. Moreover, barriers to engagement include some patients’ inability to fully engage (for social or cultural reasons) and providers’ reluctance to engage with patients (owing to time constraints or a lack of clarity on effective methods)…..
…… I recently asked one of my patients what mattered to her, after attempted pain control did not alleviate her distress. In between tears, she told me about her hobbies and family. A lot of what matters to our patients is outside of our clinical armamentarium, and our success in meeting their needs demands our ability to integrate our care with their lives outside of our four walls……