Va. Hospital Treats the Whole Person

Emergency pediatric cases are handled in this room at Fauquier Hospital.
Emergency pediatric cases are handled in this room at Fauquier Hospital. (By M.j. Mcateer For The Washington Post)
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By M.J. McAteer
Special to The Washington Post
Tuesday, March 24, 2009

At Fauquier Hospital in Warrenton, a patient doesn't have to worry about getting stuck with a chatty roommate: All 86 of the hospital's rooms are private. Restricted visiting hours are a thing of the past, too: Family and friends can drop by any time, day or middle of the night.

Fauquier patients can order decidedly non-institutional dishes such as breakfast burritos, brick-oven pizza, Mongolian stir fry and desserts that are to die for, although the hospital probably wouldn't care to put it that way. And if a patient is accustomed to dinner at 8 or likes to sleep until 10, the concierge will take note and try to oblige.

Because of those and other features, Fauquier has been given "designated" status by Planetree, a nonprofit that promotes a more humanistic approach to health care. Planetree, which takes its name from the type of tree under which Hippocrates sat to teach his medical students, was founded in 1978 and now has 140 hospital affiliates, mostly in the United States; of those, eight have the "designated" label.

Other organizations serve as similar resources for health-care institutions, but Planetree was "the pioneer," says Rick Wade, a spokesman for the American Hospital Association. "The public doesn't know about Planetree," he says, "but health-care people know it means a commitment to a certain kind of internal culture. Before Planetree, hospitals were all about getting patients well, but not about what the patient was experiencing. Now 80 percent of the nation's hospitals are making some effort at patient-centered care."

Planetree addresses topics as diverse as patient education, social support, nutrition, spirituality and building design. Changing the culture of a very large hospital can be extremely difficult, Wade says, so most Planetree affiliates tend to be small- to medium-size facilities looking for a way to stand out. "Planetree doesn't market itself to hospitals," Wade says. "Hospitals come to Planetree."

Fauquier Hospital chief executive Rodger Baker was first impressed with Planetree when he attended a talk about the organization's philosophy and its vision of hospitals as "sacred healing places."

In the late '90s, when Fauquier was planning a $60-million-plus expansion and renovation, Baker sought advice from the organization, made site visits with staff to facilities using the patient-centered approach and, in 2000, paid the $15,000 fee for his hospital to become an affiliate. That gave him access to the organization's educational and professional resources as the hospital worked on implementing Planetree's 10 core components of patient-centered care. Planetree tracked Fauquier's progress; in October 2007, it judged the hospital to have met 45 specific standards for patient care and support staff, and gave it the "designated" label.

Baker estimates that such architectural features as private rooms with built-in sleeping accommodations for family members, carpeted corridors and additional windows added 10 to 20 percent to the cost of the construction project. Those extra expenses were worth it, he says, because the Planetree approach as a whole has resulted in improved market share and higher patient and employee satisfaction; as a result, no additional fees have been levied on patients or insurers.

The design differences at Fauquier are obvious. In waiting areas, lamps have replaced overhead lighting; halls have been carpeted to keep down noise or are finished in faux wood for a warmer feel. Community artwork hangs on the walls. "We try to look more like a hotel," Baker says.

Barriers between patients and staff, such as those sliding-glass windows that close nurses off from patients and the public, have been removed. Elevators for patients and the public are separate: No one really wants to be seen in a hospital johnny. No constant paging over the intercom system, either; instead, unobtrusive music plays all the time.

"Planetree," Wade says, "has had a tremendous impact on how hospitals are being designed and built, even if they aren't Planetree."

Family-Friendly Features

Changes extend beyond the physical structure to the human factor.

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