7-strategies-improve-client-centered-care

7 Strategies to Improve Your Client-Centered Care

Picture this…

You’ve been waiting at the doctor’s office for about 45 minutes, despite arriving on time for your appointment.

When you’re finally called back, a nurse takes your vitals and then shows you to an exam room where you wait even longer. When you finally see the doctor, he spends about 5 minutes asking you questions, makes his diagnosis, writes a script, and leaves.

Does this sound familiar?

Unfortunately, this is a situation that’s become all too common in the healthcare world today. Luckily, as occupational therapists, we know how integral client-centered care is to healthcare outcomes.

As holistic healthcare providers, we separate ourselves from prescriptive professions by ensuring that our patients are always involved as the primary stakeholders in their care.

While this may seem obvious in theory, truly having a client-centered practice requires careful thought and intention.

Here are seven aspects to consider when addressing your client-centered care.

1. Take your time.

In the example above, the biggest issue is the amount of time spent in face-to-face care. Your patients have likely seen a variety of healthcare professionals before making their way to you. This is a wonderful opportunity for you to make your patient feel heard. Ask them questions about their injury, their life, their previous occupations, but allow them time to ask you questions as well.

And while this may seem impossible in a healthcare climate that is ever-focused on productivity and insurance requirements, keep pushing back. The quality of your work will shine through.

2. Find out what is important to the client.

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While you may encounter many of the same diagnoses across your career as an OT, it is rare that you will encounter people with the exact same priorities. Ask your client what they want to improve. Do they want to cook safely, or did they mostly eat out before their injury?

And don’t fall into the trap of thinking this only applies to adults – ask your pediatric patients too! While you may not have as much freedom to work on whatever the child wants, setting goals together and having buy-in is necessary to have results that last longer than your one hour session.

3. Involve the family.

This is especially true in pediatric practice where your patients may not be able to express their goals or hopes. Involve the family and find out what could make their days easier. What do they wish they could do with their child?

Outside of pediatrics, involving the family can still have great dividends. I once had a patient in the SNF setting that I dreaded seeing. No matter what activity I chose, no matter what time of day I tried, no matter how much I split up the required minutes, this patient complained and refused to participate in therapy every day. It was early in my practice and I felt like I was failing her. She was several states away from the majority of her surviving family and never had any visitors.

We were eventually able to schedule a care conference over the phone with one of her nieces. I politely explained how we all had the same goal of discharging this patient to home, but it had been challenging as she generally did not want to or was unable to participate in therapy and as such was not improving.

Even though we only spoke over the phone, hearing from her niece was the push my patient needed to start working. Something clicked and she finally understood that if she wanted progress to the next level of care, she had to start participating in therapy. I started looking forward to our sessions and she was discharged soon after.

I don’t know if we could have ever gotten there without the motivation of a family member that she trusted had her best interests at heart.

4. Keep your biases in check.

Different cultures value different things. When going over prior level of function with one of my 12-year-old patients and his mother, I was surprised to find out that he was not responsible for washing his hair even before his injury. Even though this is a skill I consider important for a child at that age, it wasn’t valuable to them, so we didn’t address it.

Similarly, with older adults, many cultures do not consider independence the be-all, end-all. Many older adults look forward to their last years as a time when roles reverse and their family spends time taking care of them.

This relates back to finding out what is important to this specific client and not just putting everyone through the same static treatment plan. Don’t work on something just because it’s what you value – find out what activities and roles they still want to participate in and go from there.

5. Get to know them.

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While this may be a given, really getting to know your patient involves more than just asking about their day or even life. Find out what your patient likes and incorporate it into treatment!

This is a great way to keep your sessions occupation-based as well. Beyond planning your treatment around your client’s preferences, just listening and remembering your conversations will go a long way in developing a rapport.

The thing I liked most about practicing in the SNF setting was hearing my patients’ life stories and their perspective on things. It’s the same with kids – I love hearing how they’ve come to understand the world. If your patients are nonverbal or otherwise communication-impaired, this advice doesn’t disappear. Instead, you may have to learn how to communicate differently.

I like to bring a variety of activities to try and see if they respond positively to any. This also ties in to involving the family – ask the people that are with them more often what activities they love, their favorite show, etc.

Above all else, make sure you’re talking to your nonverbal/lower communication patients. Even if they don’t respond, they are benefiting from the interaction.

6. Share about yourself.

One of the greatest ironies of my life is that I’m a school-based OT with terrible handwriting. But, the nice thing about it is is that I’m able to directly relate to my students. If a kid is struggling, I can share a story about how I had trouble with handwriting too.

This carries over across settings – giving people small details about your life or otherwise empathizing is how you can most effectively develop rapport. Be sure not to make it all about you or otherwise burden your client, but otherwise, you’re not a robot sent here to “therapize” them. People respond to treatment best when they feel like they can connect with their providers.

7. Don’t forget about your own self-care.

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Providing this type of care is much more taxing than phoning it in. Burnout is a very real problem in the healthcare field, and combating it before it begins is the most effective strategy. Don’t be tricked into thinking self-care is just means that you can justify eating that extra piece of cake. True self-care is also work, which is why you should ensure you have enough time in your schedule to keep up with it.

My best advice for self-care is working less than a 40 hour workweek if you are able. This will provide you with more time to make sure you’re taking care of your mind and your body.

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Providing true client-centered care requires daily attention and hard work. However, the more you incorporate it into your practice, the more natural and instinctive it will become. And by implementing these strategies, you’ll be there in no time.

Tell us! How do you provide client-centered care?

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