What is a trend that encourages patients to be more responsible for their own care?

There’s no way to say exactly what counts as self-care, because everyone’s definition is their own and unique.

The underlining rule is that it's something that brings you more sustained joy in the long run, Courtney says. And though there are plenty of examples of self-care that seem to tread a fine line between a health-enhancing behavior and self-indulgence, self-care doesn’t have to be about padding your calendar with luxurious experiences or activities that cost money (though it certainly can).

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Consider a manicure or a massage or any other pampering activity. It might seem indulgent, but if the activity helps you de-stress and carve out time for yourself, it counts as self-care, Amsellem says. If weekly manicures or monthly spa days are beyond your means, there are plenty of other self-care practices you can adopt.

“Self-care does not have to cost anything — it’s just doing things you enjoy. And a lot of the things we enjoy or feel fulfilled from cost nothing,” Amsellem says. “Stepping outside and taking a deep breath, for example, might be the greatest act of self-care.”

Even if you can’t spend lots of time and money, Gill Lopez says you can still practice self-care several times a week by turning things you do every day into self-care practices.

Maybe you try being more mindful of your thoughts on your commute, or maybe you find ways to make daily tasks, like showering, more enjoyable. Pick a soap with a scent that you love and focus on the physical sensations of the shower. Gill Lopez says: What does your shower smell like? What does it sound like? How does the warm water feel on your skin? “For about 10 minutes in the shower, which I have to do anyway, instead of letting my monkey brain run wild, I’m right there,” she says.

Daily chores like making your bed in the morning are also examples of self-care — or can be. “This is where that individuality comes into play, because for some people there is no way making a bed feels like self-care — it may just feel like a chore,” Amsellem says. But if it helps you claim your day and gives you a sense of accomplishment early on, you’ll have that with you even if the rest of the day gets derailed, Amsellem says.

The simple act of making your bed in the morning likely isn’t sufficient to account for all your self-care, she says. You may need to routinely devote time and energy to other self-care practices, she adds. “But if there are some days when you feel out of control, on those days, starting the day off doing what you wanted to do for yourself might be one of the biggest forms of self-care you engage in that day.”

And sometimes when all of our other self-care plans get thrown out of whack (you worked through your yoga class, your friend canceled your coffee date — we’ve all been there), it’s those small practices of self-care that provide just enough calm to help us get through the day and wake up in a better mood tomorrow.

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Respect is an essential component of a high-performance organization. It helps to create a healthy environment in which patients feel cared for as individuals, and members of health care teams are engaged, collaborative and committed to service. Within a culture of respect, people perform better, are more innovative and display greater resilience. On the contrary, a lack of respect stifles teamwork and undermines individual performance. It can also lead to poor interactions with patients. Cultivating a culture of respect can truly transform an organization and leaders set the stage for how respect is manifested.

Research from Kristie Rogers, associate professor of management at Marquette University, demonstrates that people value two distinct types of respect: ‘Owed’ and ‘Earned.' Owed respect meets the universal need to feel valued and included. It rests on the concept that all individuals have inherent value and the right to be treated with dignity. When owed respect is lacking, it manifests as over-monitoring (i.e., micromanagement), distrust, misconduct and indifference (i.e., making people feel like they are easily replaceable). Disrespect can lead to a toxic atmosphere that diminishes joy and fulfillment, leading to dissatisfaction and burnout. Earned respect recognizes individuals who have gone above and beyond expectations. It meets the need to feel valued for accomplishments and a job well-done. Neglecting to provide earned respect can reduce motivation and accountability.

Respect is also established by supporting other members of the health care team. Speaking poorly of another service or health care professional undermines patients’ confidence in the entire health care team and lowers their impression of the system. Interactions with colleagues can be improved by always assuming best intentions and giving other people the benefit of the doubt. Before reaching a negative conclusion, ask questions to clarify and assume that best intentions were in mind.

In 2012, Virginia Mason launched a ‘Respect for People’ initiative that engaged all of their employees in approaches to respecting one another in the workplace. The program involved training, simulation and defining what respect meant. The outcome was a greater sense of personal ownership for how employees respect, support and appreciate their coworkers. The following is their “Top 10” list of ways to show respect:

1. Listen to understand
2. Keep your promises
3. Be encouraging
4. Connect with others
5. Express gratitude
6. Share information
7. Speak up
8. Walk in their shoes
9. Grow and develop
10. Be a team player

A culture of respect also recognizes that everyone in the organization plays a meaningful role in the ability to care for patients. All members of the team are valued and have important contributions to make. Respect is given to everyone, regardless of their position on the organizational chart. For example, when a physician holds the door for a hospital cleaner, this simple act boosts self-worth and appreciation. The same effect is seen with a thank you letter from a peer or supervisor for a job well done.

Equally, if not more important, is respect for our patients. All patients deserve to be treated with dignity and an acknowledgment of their value as individuals. One of the most widely cited elements of disrespect mentioned by patients is simply failing to pay attention to their needs, by leaving them unattended or ignored. Think of how this translates to the way patients are greeted by your front staff, treated in the emergency department, or when they appear lost in the halls. As Don Berwick stated, “We are guests in our patients’ lives.” As such, we must act accordingly. This is demonstrated by listening to our patients, asking for their opinion and recognizing the importance of incorporating their personal values and priorities into treatment decisions. We convey respect by being considerate of patients’ time (e.g., striving to provide timely service and apologizing when we fail to do so). The physical environment that we create for patients is a direct reflection of our respect for them. Our ability to ensure privacy, cleanliness and quiet surroundings speaks volumes. When we request permission to enter a patient’s room, ask a patient how they would like to be addressed and explain to patients who we are and what we plan to do, this all communicates respect for them as individuals. Respect is also showing gratitude to our patients who entrust us with their care. A simple thank you can mean so much.

At Beth Israel Deaconess Medical Center in Boston, the approach to respecting patients was operationalized. In 2015, the organization extended their existing quality and safety reporting systems to include complaints and grievances from patients and families that seemed to describe a disrespectful experience. A mechanism for staff to report episodes of disrespect was also created. As a result, awareness of the principle of respect for patients and families was increased, and respect and dignity became a metric tracked by senior leaders and institutional governance.

Creating a culture of respect requires action on many fronts. Leaders set the tone by modeling respectful conduct in their words, by their actions and in the way they interact with each member of the team. The manner in which leaders treat people will have an impact on the way they treat each other and patients. This applies to all levels of leadership. Treat your clinical staff with the same respect you want them to treat patients. Here is how leaders can impart respect in every day behavior:

• Active listening
• Valuing diverse backgrounds and ideas
• Entrusting others with important tasks
• Remaining open to input
• Providing autonomy
• Affirming value to the organization
• Taking an interest in non-work lives
• Supporting individuals in critical situations

Clear expectations should also be set for everyone in the organization (e.g., clinicians, administrators, support staff, etc.). Ideal acts of respect should be rewarded openly. Acknowledgment or praise from a leader is a powerful catalyst for feeling valued. However, when disrespectful behavior occurs, it must be addressed consistently and effectively regardless of whom it stems from. Constant offenders must be made accountable for correcting their disruptive behavior or leaving the organization. Finally, as a leader you also show respect through humility; acknowledging that you do not have the monopoly on truth and that others bring value and can make meaningful contributions.

We are all responsible for making our health care settings ones that demonstrate the highest level of respect, collegiality and professionalism at all levels. This requires having zero tolerance for inappropriate behavior and being accountable to one another. Treating people the way we would want to be treated is a strong competitive advantage and the right thing to do.

What trend in modern medicine encourages patients?

What is the most common complaint heard from patients?

Which of the following are factors that indicate nonadherence in patients?

What type of note taking method describes how a patient treatment has changed?