As part of its multi-pronged strategy to become a developed nation by 2047, India has made rapid strides in both health and healthcare. We are witnessing a digital boom, which has been a game changer — especially where universal health coverage is concerned. The Ayushman Bharat Digital Mission (launched by the government nearly two years ago) is moving quickly to ensure that every person at the last mile has access to quality healthcare. ABHA (Ayushman Bharat Health Account) is slated to revolutionise the healthcare sector and significantly improve the overall healthcare experience. The push for healthcare digitisation, infrastructure, coverage and other inputs is showing a clear improvement in multiple healthcare metrics.
Universal health coverage requires that health services are not only available, affordable and accessible but also that they are rendered to every person in an acceptable, compassionate and respectful manner — which is a determinant of the quality of care. Abundant research has established that "healthcare" is not just about treatment of the disease or availability of infrastructure to enable treatment, but also about the overall wellness of the person. There are several instances that reveal how respectful healthcare played a vital role in fast-tracking the recovery of a patient, adding grist to the belief that patient experience has to be at the centre of all solutions in an industry as personal and service-oriented as healthcare.
Healthcare is a perpetually evolving, stressful and high-risk industry, which lays a vast burden on healthcare providers. This is where the ability of these providers to navigate and manage the situation compassionately and deliver respectful care comes into play. The need of the hour, if respectful healthcare is to become integral to our healthcare system, is to ensure that compassionate leadership is built within the public healthcare system on priority. His Holiness the Dalai Lama has consistently stressed that we need compassion today more than ever. Compassion is the quiet, beating heart of the entire healthcare system. During Covid, we witnessed multiple acts of compassion from doctors, nurses, and frontline workers. However, such acts should be the norm and not a result of extreme circumstances. Hence, this requires multi-pronged and out-of-the-box approaches.
To successfully integrate compassion into the system at every stage, it is necessary to build a curriculum and deliver it to those responsible for administering health care respectfully. The government of Bihar has already taken the lead on this, supported by the Piramal Foundation. An eight-stage curriculum, developed by Emory University, (where HH Dalai Lama is a Presidential Distinguished Professor), that furthers the Dalai Lama's vision of educating both heart and mind for the greater good of humanity, is being rolled out.
To date, 1,200 healthcare providers across 20 districts in Bihar have been impacted through the vital components of the cognitive-based compassion training provided towards building compassionate leadership. This has seen the creation of compassionate leaders at every level — from the security guards at the entry to the nurse or doctor treating the patient to the hospital manager. Every healthcare provider feels empowered by their ability to manage and resolve complex situations and offer respectful care.
While the curriculum itself is a quantum leap towards building compassionate leadership, institutionalising it will also bring in real change. Every academic institution and every department mandated with the responsibility to deliver health-related learning (be it medical/nursing colleges or government departments for building learning and capacities of other healthcare workers) should develop and adopt compassion-based curricula.
To make compassionate leadership the core of the healthcare system, state and regional health institutions must also be built with the capacity to deliver the same. Partnerships with established academia and development sector organisations can enable the organising of master coaches and master facilitators, thereby creating public goods that can be delivered by all.
Additionally, all healthcare providers are expected to carry out a wide range of tasks within the system, which often leads to burnout and impacts patient experience adversely. Hence, it is vital to strengthen systems internally to make respect and compassion intrinsic to the ethos. Building a network of compassionate practitioners in every state, district and block hospital is crucial to fan the winds of change by starting with self-compassion first and then moving to compassion for others.
Valuing and measuring organisational culture is just as critical as patient outcomes. Developing sound metrics to measure culture and employee satisfaction, self-compassion and compassion for the team assume greater significance to building an institution whose foundation is compassion.
Respectful healthcare is already mentioned in the National Health Mission (NHM) guidelines, with the LaQshya guidelines issued by NHM stressing respectful maternal care. Such guidelines need to be the warp and weft of every policy and every guideline developed by public health authorities to improve patient experience.
India is historically known for its values of compassion. It is compassionate leadership that can truly realise this and bring alive the words of Hippocrates, the father of medicine, "Wherever the art of medicine is loved, there is also a love of humanity".
(Dr. Swati Piramal is Vice Chairperson, Piramal Group, and Kartik Varma is Head, Aspirational Districts Collaborative, Piramal Foundation-NITI Aayog)
This article was first published on 07 April 2023, on The Indian Express
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