--- author: TED date: '2026-03-20' guest: '' layout: post.njk source: https://www.youtube.com/watch?v=C81xJ3OioB8 speaker: TED tags: - healthcare-values - compassionate-care - patient-experience - ai-in-healthcare - scaling-challenges title: 健康关怀的真正衡量标准：从效率转向深度连接 summary: 演讲者Andrew Bastawrous探讨了医疗保健领域从追求效率转向深度关怀的重要性。他通过亲身经历和Peek Vision的发展历程，阐述了倾听和建立信任如何能带来更好的患者结果、减少医护人员的职业倦怠。最终，他提出衡量生命价值的关键在于人与人之间的连接，而非物质成就。 insight: '' draft: true series: '' category: ai-application area: tech-engineering project: [] people: - Andrew Bastawrous companies_orgs: - Peek Vision products_models: [] media_books: [] status: evergreen --- ### 医疗保健的核心驱动：关怀而非生产力 我们踏入医疗保健专业，初衷并非追求**生产力**（Productivity）或**效率**（Efficiency）。它之所以被称为“健康关怀”，正是因为我们驱动于**关怀**（Care）。然而，当前医疗系统的巨大**压力**（Pressure）正迫使我们倾向于多次**浅层化**（Superficially）的接触，而非一两次**深度关怀**（Deep Care）。我们应努力展示证据，证明后者能为**患者**（Patients）和**医护人员**（Health Workforce）带来更优的**成果**（Outcomes）。
Original English When we enter the health care profession, none of us actually ever go in with an aspiration of productivity or efficiency. It’s called health care for a reason. We go in because we care. Currently the pressure on the health care system means we'll choose to see someone three or four times superficially, rather than once or twice deeply. I'd like us to show the evidence that once or twice deeply actually leads to better outcomes for both the patients and the health workforce.
### 被真正看见的力量：一位患者的故事 我的名字是**Andrew Bastawrous**，我是一名眼科医生、全球健康学教授，也是**Peek Vision**的创始人兼CEO。多年前，我在英国担任眼科医生时，管理着一个异常繁忙的诊所。那天，我已知晓自己还有至少四名患者等待就诊，而门诊时间已近尾声。墙上的时钟发出清晰的滴答声，仿佛在不断催促。与此同时，我能感受到外面排队等待的患者因迟迟未被接见而产生的不满。 这时，一位女士走进来。她看起来饱经风霜，生活似乎十分艰辛。她就诊的时间也比患有**白内障**（Cataracts）的患者在英国的标准晚了很多。大多数人不会等到近乎失明才就医。她分享道，自己迟迟未来就诊的原因是过去四年一直在照顾患有癌症的女儿，而女儿不久前刚刚去世。那一刻，她分享的仿佛是某种神圣的体验，而我的敷衍回应则显得是对她的不公。我没有太多言语，只是静静地倾听。或许只有十分钟，但对我而言，这十分钟的倾听，其意义远超我为她进行眼部手术的十分钟。 她的白内障手术进展顺利，几天后我在门诊再次见到她。我原以为她会因为重获视力而十分高兴。她确实带着一个包来了，里面却不是巧克力，而是一本相册。她一一给我展示了她和女儿的照片。我仔细看着她，意识到她从未提及自己能看见了。我耐心地等待她主动开口，甚至主动询问：“Jackie，你的眼睛怎么样了？”她回答：“哦，挺好的，不疼。”然后，她收起了照片，合上相册，说道：“谢谢你。你是唯一一个听我说话的人。”我给予她的最大礼物，并非她的视力，而是让她感到自己被**真正看见**（Truly Seen）。我认为，人生中没有什么比能帮助一位同胞更能带来喜悦了。
Original English My name is Andrew Bastawrous. I’m an eye surgeon, a professor of global health and founder and CEO of Peek Vision. Years ago, when I worked as an eye surgeon in the UK, I was running a really busy clinic. I knew that I had at least another four patients to see that day, and I was already at time for the end of the clinic. We had a clock on the wall. I could just hear ticking. And that tick seemed to be louder and louder. I'd also be more tuned in to everyone outside complaining that they hadn't been seen yet. And a lady came in to see me. She looked weary, like life had been hard. And she'd also come in very late for someone with cataracts in the UK. Most people don’t come in near-blind. And she shared that the reason she hadn't come was she'd been nursing her daughter for four years, and her daughter had had cancer, and she'd only just died. In that moment, it felt like she'd shared something sacred with me. And just to pass it by felt like I was doing her an injustice. I didn't really have to say anything, I just listened. I think it was maybe around 10 minutes, but that 10 minutes I know meant more to her than the 10 minutes I spent operating on her eye. Her cataract operation went well, and a couple of days after that I saw her in my clinic. So I expected her to come in pretty happy. She did come in with a bag, but it wasn't a box of chocolates. It was a photo album. And one by one she showed me these pictures of her with her daughter. And the whole time I looked at her and I realized she hadn't mentioned that she could see. So I waited for her to mention something. I even prompted her and I said, "Jackie, how's your eyes?" She said, "Oh, it's fine, it doesn't hurt." And then she finished showing me the photos. She closed the album and she said, "Thank you. You were the only person that listened to me." The greatest gift I could give her was not her sight but to have her be truly seen. I think there's very few things in life that are as joyful as being able to help a fellow human being.
### Peek Vision 的诞生与规模化的悖论 人们并非天生不关心或缺乏**同情心**（Compassion）；问题在于，如果**环境**（Environment）不允许人们停下来去关怀，那么人们就无法活出自己的价值观。**Peek Vision**的概念始于2012年，当时我住在肯尼亚，我们正在设立100个临时的眼科诊所，将设备和受过训练的工作人员带到这些偏远的地区。我逐渐意识到，这种模式永远无法**规模化**（Scale）地解决问题，必须找到一种触及更多人的方法。于是，我们开发出利用智能手机进行**筛查**（Screen）、**诊断**（Diagnose）和**转诊**（Refer）的技术。 2014年，我们在两年内服务了7000人；而如今，我们每两个月就能触达百万人。我的团队和我一直在思考一个问题：**规模化**（Scaling）会带来哪些**非预期后果**（Unintended Consequences）？我回想起了与Jackie的经历，当时存在着尽可能多看患者的巨大压力。我们意识到，我们也可能正在制造同样的压力。我们设定了各种**指标**（Metrics），让人们了解识别视力障碍者所需的时间，以及转诊一人所需的时间。一切都围绕着**效率绩效**（Efficiency Performance）进行追踪。
Original English People aren't inherently not caring or not compassionate. It's if the environment is one that doesn't allow people to stop and care, then people don't live to their values. Peek Vision started as a concept in 2012 whilst I was living in Kenya, and we were setting up 100 temporary eye clinics, taking equipment and trained staff to all of these remote locations. And it dawned on me that this would never solve the problem at scale, that there had to be a way to reach more people. And so we built ways of being able to screen and diagnose and refer people, all on a smartphone. In 2014, we’d seen 7,000 people over two years, but today we reach a million people every two months. One of the questions my team and I have been asking is what are the unintended consequences of scaling? And I went back to that experience I had with Jackie, where there was pressure to see as many people as possible. And we realized we were potentially creating that same pressure. There was all of these metrics that allowed people to know how many seconds it took them to identify a person with vision loss. How many seconds it took to refer someone. And it was tracking everything around that efficiency performance.
### 重拾同情心：证据与信任的构建 我们决定（或者说，我们发起这项事业）并非为了**效率**，而是为了**同情心**。核心理念是：**同情心**是与生俱来的，只要**环境**（Environment）允许人们去关怀，它就能得以展现。因此，我们现在鼓励筛查人员在发现有视力问题的人时，能够停下来，放慢脚步，真正地倾听。我们希望从“软性证据”（即同情心是件好事）转向“硬性证据”，证明**深度关怀**（Compassionate Care）实际上能带来更佳的**数字**（Numbers）表现。 为此，我们与印度的合作伙伴进行了一项**试验**（Trial）。其中一半的筛查人员获得了额外的时间，以及不同的**结局衡量指标**（Measures of outcomes）。他们的**关键绩效指标**（Key Performance Indicators, KPIs）不再是“筛查和转诊了多少人”，而是“记住了多少位他们所见的患者的故事”。可以预见，如果与人们相处的时间大大增加，那么每天能服务的人数会显著减少，我们对此早有预期。然而，我们期望的是，**整体**（Overall）能有更多人真正前来接受**治疗**（Treatment）。 对许多人来说，仅仅是去看医生就是一个巨大的**勇气**（Courage）之举。而决定接受一项自己不完全理解或缺乏有效性证据的治疗，完全取决于你与建议者的**关系**（Relationship）。因此，如果这位建议者承受着仅仅是诊断和开具转诊单的压力，我们认为这是导致许多真正需要治疗的人未能前来就医的原因之一。反之，如果建立了**信任**（Trust），我们相信他们更有可能接受**护理**（Care）。 由此产生的**次级效应**（Secondary effect）是，提供护理的医生和护士的**职业倦怠**（Burnout）会降低，因为他们与工作本身建立了更深的**连接**（Connected），他们感到的压力将从“需要看多少数字”转变为“需要关怀多少人”。当患者有更多时间被倾听，医生有更多时间去倾听时，每个人都会更快乐，**结果**（Results）也会随之改善。
Original English And we've decided, well, we started this not as a means of efficiency, but as a means of compassion, and this idea that compassion is actually inherent, provided the environment is conducive to people being allowed to care. And so now we're trying to encourage that when a screener finds someone with a vision problem, that they stop and they slow down, and they listen. We want to move from having soft evidence that being compassionate is a good idea to hard evidence that actually it yields better numbers. So we have run this trial with our partners in India, where half the group of screeners are given extra time and different measures of outcomes. Their key performance indicators are going from how many people they've screened and referred to how many stories they remember of the people they've seen. You'd expect if you're spending that much more time with people, you'll get through much fewer people per day, and we expect that to be true. However, we expect many more people overall to turn up for treatment. For many people, even going to see a doctor is a huge step of courage, and a decision to take treatment that you don't necessarily understand or have evidence that it works is all down to the relationship that you have with the person who suggested it. And so if that person's under pressure just to diagnose and send the referral, we think that's one of the reasons why not that many people turn up who need it. And so if trust is built, then we think they're much more likely to take up the care. The secondary effect is the doctors and the nurses providing the care will burn out less because they're more connected to the work that they're doing, and they'll feel less pressure to see numbers and more pressure to see people. If patients are given more time to be heard and doctors have more time to listen, everyone will be happier and the results will improve.
### 重新定义成功：超越指标的深度连接 我们倾向于以“拥有最多”来衡量进步或成功，这可以体现为**市场份额**（Market Share）、**财富**（Dollars）或**权力**（Power）。然而，我们内心深处都渴望着某种超越这些的意义。我们必定是在玩一场不同的游戏。衡量一个**生活是否充实**（Life Well Lived）的标准，不在于我们做了多少事，而在于我们与彼此——与我们所爱的人，以及我们所服务的人——建立了多少**连接**（Connect）。
Original English We tend to measure progress or success in terms of who's got the most, and that could be measured in market share or the most dollars or the most power. But we all deeply resonate with there being something more than that. There's got to be a different game that we're playing. The measure of a life well lived isn't how much we do, but how much we connect with one another, with the people that we love and the people that we serve.