Although the humanization of healthcare is a topic that has been making headlines and news for years, in the last year and a half the pandemic has revealed deficiencies in the system as well as the latent need to review many social and healthcare processes.
Some deficiencies that negatively affect the degree of humanization that exists with the patient – who must be in a real way at the center of the system and which must be counted on at all times – but also with health professionals , who need to feel valued and care to give the best of themselves and that all this has a positive impact on the quality of care.
Concerned about all this, four years ago the Humans Foundation was born , which recently launched the first International Humans Congress on the Humanization of Healthcare . From it, a multidisciplinary collaboration is advocated that not only involves doctors, nurses and patients, but also other professionals such as architects, computer scientists, volunteers or mediators in the common goal of offering a more humanized, empathic, ethical and committed care . We talked about all this in this interview with Dr. Blanca Fernández-Lasquetty , president of the Scientific Committee of the Congress.
When and why did the Humans Foundation arise?
Humans was born in October 2017, it is a non-profit foundation and its main objective is to promote humanization throughout the healthcare environment. Understanding humanization not only as being and being with patients but in everything that is the health care process. It is also humanization with professionals, humanization from environments, humanization from processes …
It is everything that refers to health care: how we can improve it so that people really feel that they are being welcomed and treated in a dignified manner, with the highest ethical capacity and in an environment that is as favorable and friendly as possible for all. Normally we tend to understand humanization as from professionals to patients but it also goes in all other senses.
“Only with an interdisciplinary vision is how we are going to be able to make a humanization of health care”
How does Humans work towards the humanization of the social and healthcare environment?
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The Foundation is made up of a president and six trustees, among whom we find different professionals – a doctor, a physiotherapist, two nurses and a pharmacist – and a patient. We understand that only with an interdisciplinary vision is how we are going to be able to make a humanization in the entire health care environment.
And to promote this humanization we develop different projects around the care of patients with certain health problems -for example psoriasis or mental health-, or in certain settings such as in a pharmacy service. We address different areas of humanization, be it a disease process, a health environment or a process based on the interest in a given topic.
“Although we are human beings working with other human beings, situations very far from the most humanistic aspects occur”
They point out that one of the reasons for organizing this congress is that the pandemic has made us more aware of the deficits that exist in health organizations.
Despite the fact that patients and professionals are all human beings working with other human beings, we see that in the entire health care process situations occur or we are in environments very far from the most humanistic aspects. The pandemic has made it much more evident and, in addition, as it has caught us completely off guard and disarmed even material equipment, what has been done is to completely shield all the institutions and that has passed a huge bill for patients and professionals.
Because, what greater example of dehumanization that patients have had to die alone in their rooms without the families being able to be there? It has been the most terrible example of what dehumanization is. And for professionals it has been the same because they have been unprotected and because they have had to be and are still under enormous pressure that is taking a significant toll on them.
However, I think we have had the cross but also the face because, on the other hand, we have had all those examples of dedication and commitment, of trying to be with patients as much as possible, trying to bring them closer to families, that their environment was the kindest.
This congress has been a space where we can put all that on the table and share what this terrible experience has been. We have been nurses, pharmacists, doctors, social workers, physiotherapists, psychologists … but also architects, mediators, people who work in NGOs,
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The theme of the congress was “Humanization, science with a heart”. What are the main features that characterize humanized healthcare?
We have totally put the motto into practice because there have been very serious works and research studies that have shown good results but also a lot of heart because we have had patients who have given us real lessons. That they have told us that it is what they really need from us, because many times it is not the treatment or that they are cured but that we teach them to live together and integrate their disease process in their life. What do we have to humanize?
As for the patients, the one that they feel, perceive and are totally respected not only what is the treatment and diagnosis but also their psychological sphere, their culture, their beliefs, their environment … try in a comprehensive way. For professionals who are respected within their institutions, that they are taken into account to grow, that they are recognized, that they have friendly spaces to work like patients …
And then, in all the processes from the moment a patient enters a hospital and is having an encounter with the health system there are a lot of moments when we have to improve. It is about making that patient journey to identify them.
“Professionals ask for education and training to improve their relationship skills”
What are the main demands of professionals in order to make the humanization of healthcare a reality?
Repeatedly in all the projects we have done, both patients and professionals always talk about the need for education and training to improve these relational skills. In fact, in the congress we have put it into practice with four workshops for the training of communication skills, personal growth …
Those skills for humanization have to start as soon as the professionals are studying. They claim that since they begin their careers it is understood that communication, empathy, personalized treatment and all that are the skills for humanization are not something that you have or do not have but trainable skills.
Therefore, they ask for training but also less rigidity in the institutions since it is difficult for people to let people innovate or do things in a different way because the structures are very rigid. They also ask for their work and achievements to be recognized because patients are a room number but professionals are also ‘the nurse on the floor’ or ‘the doctor in office x’.
And this is important to humanize because when a person is well in their work environment, when they are open to recognition and with clear objectives to which the whole unit goes, everyone feels better. If the environments are better, the professionals also work in a more humanized way with the patients.
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Universities are already becoming more aware that all the training and improvement in what are relational skills later impacts on people’s health care, so their thing is to integrate it into the academic curricula. At the European University of Madrid, for example, from the first year of nursing and medicine communication with patients, interprofessional and clinical simulation trainings work.
Studies have shown how these skills improve when you train them in a practical and well-structured way, because only in this way can we put ourselves in the real situation. And this must be done from the first year. We cannot let it be clinical and disease-centered first, and then the rest of the person.
In health care, the biological part and the clinical part are as important as the rest of the person: their psychological part, their personal part, their spiritual part … What is life for them? What does this disease process mean in her?
“Only by listening and talking with the patient will you find the keys to improve”
They give a lot of weight to the opinion of the patients. How can they be empowered and what can be learned from their claims?
Both in our board of trustees and in all the projects we do, there are always patients on the committee because we believe and are convinced that only by their side will we be able to know what matters to them, what interests them and what we have to improve on.
For example, we have recently presented a project on more humanized care in people with chronic pain and in the focus groups with patients they have given us clues that we did not consider so important. People with chronic pain have told us that they need to talk about death and professionals try to avoid those topics.
Because the person who lives with pain every day many times goes through his head, death for them is the only way out of pain and they need us to talk about that maybe there are other ways to face that and we can help them with strategies. Until you talk to them there are things that we cannot understand. What do we have to do? Being with them, listening to them, talking to them because only by doing this will they give us the keys to improve.
We can also empower them not just trying to give them the speech of ‘you have to quit smoking, exercise, you have to walk …’ but how to integrate all of that into your life. The health care model needs to be changed because we focus a lot on disease and convey a lot of advice when health care is something much broader.
“Behind every professional there must be a fantastic scientific-technical training but above all a good person”
One of the fields where they demand greater humanization and empathy is in that of mental health. How is it possible that their protocols are so out of date?
Mental health care continues to be fraught with stigmas and conditioning factors for everyone. In hospitals, mental health units are still placed on the top floor, in the last place and yet very open, it is true that because there has to be a lot of security, but in these units very little attention is paid to spaces. Why are all pediatric units so pretty and there are no geriatric or mental health units that are as friendly when they need it as much or more than children?
These are things that are not taken into account when it is something that needs to be changed. We continue to do a very biological care, very focused on the disease, and not on all the complete needs of the person. When we understand that everything will change.
No one can be a good professional if they are not a good person and behind every professional there must be a fantastic scientific-technical training but above all a good person. And of course, good people carry it in their DNA but there are many aspects that can be trained.