Quality with a human face? The Samuels Planetree model hospital unit.

BACKGROUND: Hospitals across the country are seeking to restructure the delivery of care. Planetree, an international consumer health care organization, works with hospitals to cultivate educated health care consumers and to create caring inpatient environments. This article gives an overview of Planetree's philosophy, examines staff and patient satisfaction, and contrasts Planetree with total quality management (TQM)/continuous quality improvement (CQI) as practiced at one hospital. PLANETREE'S PHILOSOPHY: Planetree's model differs from other patient-centered or patient-focused care models because of its emphasis on educating patients and making them active partners in the care process. To help make the hospital environment less forbidding, more homelike, and more conducive to social interaction, Planetree physically redesigns the hospital space. STUDY RESULTS: Planetree hopes to achieve many goals with its restructuring of patient care, two of which are staff and patient satisfaction. Preliminary surveys indicate that nurses and nursing assistants on Planetree are more satisfied than are staff on comparable units. The results of patient surveys, however, are more ambiguous. Planetree patients are no more, or no less, satisfied with their care than patients on comparable units. DISCUSSION: Both Planetree and TQM/CQI have goals of improving the delivery of patient care, and there are times when these approaches work in concert. There are times, however, when the different vantage points of TQM/CQI and Planetree may raise different questions and foster different solutions. Questions are also raised regarding whether Planetree benefits all patients in the same way. Furthermore, since it is not clear if Planetree's vision of humanizing patient care brings the results it hopes for, a long-term multifaceted research program is called for.