Relationship Centered Whole Person Care Dr. Tom Hutchinson Director, Programs in Whole Person Care McGill University

Vision The objective is to promote/create a culture of healthcare practice in which individual practitioners and the system relate to patients as vulnerable human beings who need empathic caring and attention. The purpose of care is patient centered but the process is relationship centered. Therefore we need to pay attention to the training and wellness of the clinicians who deliver the care and to the relationships between individuals throughout the McGill health and social services community.

Patient Meets Doctor Patient Clinician Each of our meetings carries with it the potential of our healing, or wounding the other And healing begets, healing, begets healing; wounding begets wounding, begets wounding Which of these agents was I in meeting him or her?  Hutchinson

The Diagnostic Process Clinician Patient Each of our meetings carries with it the potential of our healing, or wounding the other And healing begets, healing, begets healing; wounding begets wounding, begets wounding Which of these agents was I in meeting him or her?  Disease Hutchinson

The Diagnostic Process Clinician Patient Each of our meetings carries with it the potential of our healing, or wounding the other And healing begets, healing, begets healing; wounding begets wounding, begets wounding Which of these agents was I in meeting him or her?  Disease Hutchinson

The Diagnosis Clinician Patient Disease

The Two Therapeutic Relationships Clinician Patient Disease Healing Curing

Simple, Complicated and Complex Problems Getting to Maybe Simple, Complicated and Complex Problems Getting to Maybe. How the World is Changed. Westley F, Zimmerman B, Patton MQ. SIMPLE COMPLICATED COMPLEX Baking a Cake Sending a Rocket to the Moon Raising a Child The recipe is essential. Rigid protocols or formulas are needed. Rigid protocols have a limited application or are counter-productive. Recipes are tested to assure easy replication. Sending one rocket increases the likelihood that the next will also be a success. Raising one child provides experience but is no guarantee of success with the next. A good recipe notes the quantity and nature of the “parts” needed and specifies the order in which to combine them, but there is room for experimentation. Success depends on a blueprint that directs both the development of separate parts and specifies the exact relationship in which to assemble them. Can’t separate the parts from the whole; essence exists in the relationship between different people, different experiences, different moments in time.

Conventional Management Theory: An Organization is a Machine Leading Change in Healthcare. Transforming Organizations Using Complexity, Positive Psychology and Relationship-Centered Care. Edited by Suchman AL, Sluyter DJ and Williamson PR. A machine is designed with a specific purpose in mind, each part moving precisely and reliably to serve its function in the larger process of turning the “input” into the desired “output”. A machine can be fully specified in a blueprint which is the end product of a design process. If the design is sound and the blueprint and operating instructions are faithfully executed, the machine will fulfill the designer’s exact intentions. If a machine does not perform as expected, the engineers try to improve its performance by either correcting errors in how the blueprint was executed or by “going back to the drawing board” to come up with a better design.

Relationship-Centered Administration: An Organization Is a Conversation Leading Change in Healthcare. Transforming Organizations Using Complexity, Positive Psychology and Relationship-Centered Care. Edited by Suchman AL, Sluyter DJ and Williamson PR. An organization is a conversation before it is anything else: it begins with people talking together about something they would like to do that is beyond their capacity to do as individuals. At some point, their shared idea gains sufficient coherence – there is sufficient similarity in what each of the individuals is understanding – that they can begin to coordinate their actions effectively. That's when the organization begins to function.

Reclaiming Conversation Reclaiming Conversation. The Power of Talk in a Digital Age Sherry Turkle

Reclaiming Conversation Reclaiming Conversation. The Power of Talk in a Digital Age Sherry Turkle

Emergent Design Leading Change in Healthcare Emergent Design Leading Change in Healthcare. Transforming Organizations Using Complexity, Positive Psychology and Relationship-Centered Care. Edited by Suchman AL, Sluyter DJ and Williamson PR. Rather than planning a long series of steps in advance and getting anxious when things start to go off course, we can just plan one step at a time and pause after each one to notice what’s happened and only then plan the next step. The plan emerges as we go.

Trends in medical students’ responses to the item “overall satisfaction with the quality of your medical education” on the AAMC Graduation Questionnaire Leading Change in Healthcare. Transforming Organizations Using Complexity, Positive Psychology and Relationship-Centered Care. Edited by Suchman AL, Sluyter DJ and Williamson PR.

Transforming the Culture of a Medical School: The Indiana University School of Medicine Process Formation Team Discovery Team Internal Change Agents Courage to Lead Program

Actions so far 2 meetings with Dean Eidelman. 18 conversations with individuals within the McGill system. (6 physicians, 3 patients, 3 quality improvement professionals, 2 nurses, 2 residents, 1 allied health professional, 1 medical student) A conversation with the patients as partners group at MUHC. Initial meeting of a working group. (2 nurses, 2 physicians, 2 quality improvement professionals, 2 medical students, 1 patient, 1 allied health professional, 1 resident)

Plan An expanded working group that will meet once per month throughout 2018, starting January 24, 2018. A larger consultation group that will serve as a source of information and reflection. Other groups and initiatives as they emerge. A report to Dean Eidelman, December 31, 2018.

Presence. An Exploration of Profound Change in People, Organizations, and Society Peter Senge, C.Otto Scharmer, Joseph Jaworski, Betty Sue Flowers. New York: Doubleday; 2005.