Centre for Relationship-Based Care

What is relationship-based care?

Relationship-centered care is a conceptual framework that recognizes the central importance of relationship in all aspects of health care.

The Pew-Fetzer Institute published a report in 1994, entitled Health Professions Education and Relationship Centered Care, which concluded that

healing relationships are at the core of humane and effective medical care: relationships between physicians and patients, among members of care provider teams, between care providers and their communities, and physicians' own self-awareness and self-care.

From doctor-patient partnership, to patient-centered policy, to health systems management, relationship is the foundation of excellence in health care delivery.

Creating a thriving relationship-centered health care system requires a strong commitment to delivering excellent primary care. Ongoing provider-patient relationships are key building blocks of effective, integrated and sustainable health care.

What is primary care?

Primary care refers to the entry point of most patients into the health system. For the majority of patients, this entry point will be with a family doctor, or through services provided by community nursing. The bulk of patient care occurs at this level rather than through specialty or hospital-based services.

The key attributes of primary care are that it provides first-contact health services that are person-focused, coordinated, comprehensive and continuous over time.

There is clear evidence to show that high performing health systems with a strong foundation in primary care have better health outcomes and lower costs.

Benefits of relationship-based care

By being more efficient, effective and sustainable, relationship-based care benefits everyone within the health system - patients, service providers, administrators, policymakers and the public.

Clinical benefits

The foundation of a patient-centered, relationship-based approach to health care delivery is a partnership over time between a patient and a provider. There is compelling evidence that patients whose care is overseen by regular physician tend to:

receive more appropriate preventative care
have problems recognized
require fewer diagnostic tests and prescriptions
require fewer hospitalizations
visit the emergency department less frequently
be more likely to be more accurately diagnosed
have lower [per-patient] costs of care

(Starfield and Mackinko, 2005)

Organizational benefits

The life and function of an organization is defined by the quality of its internal relationships (with clinicians and administrators) and external relationships (with policy makers and the public). The decision to mindfully prioritize relationship-based care within an organization can significantly impact the quality of health care delivery and has been positively linked with improved patient health outcomes.

Relationship-based care acknowledges complexity

Relationship-based health care recognizes that human societies, health systems and human bodies are all complex systems that contain non-linear and reciprocally dependent elements. Complexity theory recognizes that the whole of a system (e.g., a patient) is often greater than the sum of its parts (e.g., organs).

As the World Health Organization notes in its 2008 report “Primary Care Now More Than Ever:”

Dealing with health problems is complicated by people’s need to be understood holistically: their physical, emotional and social concerns, their past and their future, and the realities of the world in which they live.

What is the UBC Centre for Relationship-Based Care?

The UBC Centre for Relationship-Based Care (CRBC) represents a group of faculty and key stakeholders dedicated to teaching and researching issues around relationship-based care. The CRBC seeks to engage and collaborate with providers, policy makers, educators and the public in the creation of tools, policies and frameworks that recognize the central importance of relationships in all aspects of health care delivery.

What work will the UBC Centre for Relationship-Based Care engage in?

The Centre will work to broaden its knowledge and community engagement in four distinct realms:

Education

Strengthen focus on relationship-based care in undergraduate and postgraduate medical curriculae
Develop a learning environment and culture that values continuity of care

Research

Gather evidence locally and globally on the impact of relationship-based care at individual, organizational and system-wide levels (private practice, hospitals, health systems)
Conduct original research

Policy

Help inform policy by focusing on relationship at all levels of health care delivery
Assess potential impacts of information technology on relationship-based care
Develop positive frameworks for the use of technology to support and enhance human partnerships
Advocate for patients as partners in shared informed clinical decision making

Engagement

Develop interdisciplinary collegial connections
Connect and collaborate with key stakeholders in the broader community (patients, providers, policymakers, public)

The CRBC will not be housed in a ‘bricks-and-mortar’ structure; rather, it will be a ‘virtual’ centre that represents the cooperative and collaborative efforts of multiple stakeholders invested in exploring and enhancing patient-centered, relationship-based models of health care delivery.

How do I become involved with the UBC Centre for Relationship-Based Care?

If you would like to contribute to the dialogue of the CRBC, please email Dr. Tracy Monk.

Centre for Relationship-based Care