Patient Care Manager Perspective on Chronic Groin Pain After Hernia Repair




© Springer International Publishing Switzerland 2016
Brian P. Jacob, David C. Chen, Bruce Ramshaw and Shirin Towfigh (eds.)The SAGES Manual of Groin Pain10.1007/978-3-319-21587-7_46


46. Patient Care Manager Perspective on Chronic Groin Pain After Hernia Repair



Brandie Forman  and Bruce Ramshaw1, 2, 3, 4


(1)
Advanced Hernia Solutions, Transformative Care Institute, 557 Health Blvd Suite 100, Daytona Beach, FL 32114, USA

(2)
Surgical Momentum, LLC, 125 Basin Street, Suite 200, Daytona Beach, FL 32114, USA

(3)
The Bruce Kennedy General Surgery Residency Program, Halifax Health, Daytona Beach, FL 32114, USA

(4)
Florida State University, Daytona Beach, 32114, FL, USA

 



 

Brandie Forman



Keywords
Care coordinationPatient care managerChronic pain after hernia repairPatient-centered careShared decision processPatient care teams



Introduction


Where should one begin in defining “patient-centered care” for those suffering from chronic groin pain after hernia repair? Identifying and caring for the medical needs of a patient should certainly be at the center of the focus of the caregivers in any medical or surgical facility. State-of-the-art equipment and procedures, with highly trained physicians and nurses, are aimed at meeting the medical needs of every patient. To assume, however, that “patient-centered care” can and will result solely from the use of specialized equipment and the presence of dedicated physicians and nurses creates the potential for overlooking many important patient needs and fails to achieve true patient-centered care. The need for such care is especially important in dealing with more complex patients such as those who have chronic pain.

True “patient-centered care” begins with the broadest possible definition of a patient’s needs. To limit that definition to a medical condition requiring specific medical or surgical procedures may overlook subordinate needs that can rise to overshadow the medical need. Patient-centered care must begin by understanding the total situation from the patient’s perspective. This involves meticulous care in communicating with the patient as early as possible in the cycle of care and maintaining that communication far beyond the end of the clinic visit or the hospital stay. This communication must be aimed at establishing the highest level of understanding possible.

The communicator must be able to listen as intently as she speaks. What does a particular question or absence of a question suggest about the patient’s understanding of the entire situation? Why was there such a long pause after your last explanation before the patient’s next question? Did the patient really understand what was being explained? Instead of simply answering questions, the communicator must also ask appropriate questions to identify the level of the patient’s understanding and to be sure that there are no gaps or holes in that understanding.

Such patient-centered communication must extend beyond the individual seeking and receiving care and must also include the family members who will be involved in the preparation for the care, who will be waiting as the procedure takes place, and who will be providing comfort and assistance for the patient following the clinic visit and/or surgical procedure. Communication with the patient’s support system can also identify factors that could be of benefit or could be detrimental to the treatment of chronic pain. For example, our team has observed in some cases that a controlling female influence (mother and/or spouse) for an adult male suffering from chronic pain after hernia repair can predict a more challenging recovery and potentially a less successful outcome. This factor currently observed by our hernia team is potentially related to outcomes. Factors such as this will need to be evaluated in a factor analysis to determine the weighted correlation to various outcomes for a more objective evaluation.


The Role of the Patient Care Manager


The role of the patient care manager in the clinical team is to provide true patient-centered care by facilitating all levels of communication. The patient care manager must become the communicator who creates the environment that will identify the total needs of the patient—including the patient’s family/support system—and who will coordinate meeting those needs in an appropriate manner with the entire clinical team. At the same time, the patient care manager and the clinical team must be able to transfer critical information from the medical team to the patient in a manner that will ensure that the ongoing needs of the patient will be met. Listening, explaining, and understanding are the key ingredients in facilitating the dynamics of this exchange.

As previously mentioned, this communication process must begin at a very early stage. In order to ensure proper patient-centered care in a program treating patients with chronic groin pain, the appropriate clearances must be obtained from primary care physicians or referring medical specialists in such areas as pulmonology, cardiology, and other specialized fields. The patient must be informed of the various alternatives for travel to and from the medical facility. Possible needs and alternatives must be explored for convenient accommodations for patient and family members before, during, and following the planned treatment, test, or procedure at the medical center. The patient must be aware of the specific paperwork required for employers, insurance providers, and others with whom the patient is connected. The patient care manager and the clinical team must be aware of and actively considering these needs in order to provide all of the information needed by the patient as soon as it is required. The viewpoint required for all of this is that of the patient. The clinical team should be thinking, “What does the patient need?”

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Oct 21, 2016 | Posted by in PAIN MEDICINE | Comments Off on Patient Care Manager Perspective on Chronic Groin Pain After Hernia Repair

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