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Finding the Balance Between Providing Customized and Standardized Health Care throughout the Continuum of Care

Health care organizations today balance the need for customization in patient care and standardization of processes. Customization is the foundation for patient centered care and standardization is the foundation for communication in a complex multidisciplinary system. Each department within a hospital facility needs to provide customized care to effectively meet the unique and specific needs of the individual patients, such as determining the appropriate medication to order. Standardization of processes and procedures provide a strong communication between interventions for patients, such as a centralized process for recording patient medications. Implementing a combination of these two will maximize patient safety and quality while an unbalanced dispersion will result in poor patient outcomes, ineffectiveness and inefficiencies. Healthcare reform encourages all providers to balance customization and standardization in meeting the national goals of decreasing cost, while increasing safety, quality, and efficiency.

A great example of balance between customization and standardization is the introduction of an “organization-wide medicinal prescription using electronic medical records (EMR).” Due to the nature of each department’s specialty, the preference of the individual staff members, and the resources available, each staff member may prescribe and document medication for their patients differently. Methods such as how the prescription is recorded (handwritten vs database), the timing of the updates (immediately vs weekly), and correction methods (notes vs changing records in the system) all play a vital role in the provider communication process. Customizing medication to address the patient’s medical condition is appropriate but standardizing documentation within the EMR is just as important. If the recording of medication in the EMR is not standardized, there could be potential for providers to unknowingly cause harm by prescribing an under- or over-dose of medication. In order to assure the appropriate balance of customized and standardized care, evaluation methods must be in place to properly measure the quality and accuracy of the care given and processes used.

Although this is just one example, many exist and sometimes it is easy to fall into the trap of thinking all care must be customized in order to provide a true patient centered experience OR all care must be standardized in order to minimize risks. Changing clinical care practices and processes can be stressful for some clinical staff who may be hesitant to cooperate due to limited time, different priorities, and certain comfort levels with the original process. It is leadership’s responsibility to listen and understand the staff’s perspective and provide a balanced framework, reasoning and clarification the staff needs to embrace and understand the differences of when to customize care and when to standardize it.

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