Relationship-Based Care: A Model for Transforming Practice, edited by Mary Koloroutis. Minneapolis, Creative Healthcare Management, 2004. 258 pages, softcover, $34.95 plus S & H, order [email protected]
Early in the introduction, Mary Koloroutis, editor, identifies the "heart of the matter" when she quotes Marie Manthey: "I am convinced that the chaos we are experiencing in health care will settle down when we truly focus on the patient." Mary then goes on to define relationship-based care (RBC) as being composed of 3 crucial relationships: care provider's relationship with patients and families, care provider's relationship with self, and care provider's relationship with colleagues.
RBC is a model of care in which the center is the patient and the family. They, in turn, are surrounded by the key elements of RBC, Leadership, Teamwork, Professional Nursing, Care Delivery, Resources, and Outcomes, all of which occur in a caring and healing environment. The authors of different chapters provide an overview of each dimension, a discussion of the theory behind the dimension, followed by approaches for practical applications. All chapters end with a summary of key concepts along with questions to help readers assess how this dimension is currently represented in their organization.
The book draws the reader in with some thoughts on nursing known to all of us for a long time, such as the role of the professional nurse and how that role impacts patient care. Using a highly creative equation, I2E2, the authors organize exemplars of the dimensions using Inspiration (I1), Infrastructure (I2), Education (E1), and Evidence (E2). We read of moments of excellence from such places as University of Minnesota Hospital, Centra Health in Lynchburg, Va, Kaleida Health in Buffalo, NY, Children's National Medical Center in Washington, DC, Tufts New England Medical Care, and others.
Interwoven in the chapters are some very practical tables that anyone can use no matter where he or she is on the RBC continuum. For example, the chapter on Outcomes Measurement provides a generic outcomes grid that almost any frontline manager can use on his or her unit. It includes indicator, definition, method of collection, source, report format, numerator/denominator, validity/ reliability, target, and celebration. Thus, the book is both thought-provoking and practical at the same time.
If your customer satisfaction surveys are identifying a low score on caring and/or your quality program has broken through the culture barriers of silos to a customer-focused organization, then this book will be a practical tool to integrate evidence-based practice with a caring healing environment.