DERBY, Conn. (AP) -Visitors to Griffin Hospital first notice the valet parking. Inside, they hear live piano music and smell fresh-baked muffins.

This is no country club private hospital, but a 160-bed community hospital in a former industrial city of 12,300.

Griffin Hospital is the flagship institution for the Planetree Alliance, a coalition of 70 hospitals nationwide that provide a brand of patient-driven care.

Its believers say the Planetree system is a cure for what ails hospitals: staffing shortages, financial pressures and malpractice claims.

A new book by Planetree Alliance leaders, “Putting Patients First,” was published this month to advise hospitals on adopting some of the Planetree philosophy.

Charles Inlander, president of the People’s Medical Society, a consumer advocacy group, praised Planetree. He said there is no reason the system could not work in any hospital.

‘Primary focus’

“The reason most hospitals don’t do well – why errors are made, why satisfaction levels aren’t that great – is because a hospital’s primary focus is not on the patient. It’s on the hospital, and so patients have to take what the hospital can give,” Inlander said.

Simply put, the Planetree system aims to put patients first.

Patients are informed about their medical conditions, tests and treatments. They can review their medical files and do research in the hospital’s library.

Relatives can stay overnight and use kitchens in the hospital to prepare favorite foods.

When patients enter Planetree hospitals, they get handbills that explain what will happen to them day by day. Each patient designates a “care partner” who will be at his or her side throughout.

Within 48 hours of admittance the patient, the care partner, the doctors and nurses have a conference about how the hospital stay will go.

Patients get cheery rooms, better food, snacks, massages, live music and other amenities. Volunteers bake cookies and muffins for patients to enjoy and bring in certified companion dogs for patients to pet.

Planetree hospitals encourage patients to try alternative therapies such as meditation, and to explore their spirituality as they heal.

Doctors, nurses and staff are trained to be more approachable and open with patients, to treat them with respect and dignity.

Also, Planetree hospitals are designed with softer lighting, patios, uncluttered hallways and other comforting features.

The Planetree Alliance was founded in 1978 by a San Francisco hospital patient, Angelica Thieriot. She had such bad experiences that she formed a group to advocate for more patient-centered care.

The system is named after the tree Hippocrates sat under when he taught medicine.

The first Planetree hospital unit, with 13 beds, opened at Pacific Presbyterian Medical Center in San Francisco in 1985. Other units opened around the country.

In 1991, Griffin Hospital was being squeezed by hospitals in New Haven, Bridgeport and Waterbury and looking for a way to distinguish itself, said hospital vice president William Powanda.

It became Planetree’s first affiliate member in 1992. About 25 other hospitals joined soon after.

For a $25,000 fee, Planetree advised hospitals on how to improve their food, surroundings, train their staff and make other improvements.

In the mid-90s the system struggled and about half the members dropped out, Powanda said. There was no reason to stay in the network once hospitals learned the Planetree system, he said. There also were no support systems for the members.

Five years ago, Griffin took over Planetree and assumed about $90,000 of its debt.

“We felt we had so much invested in Planetree that we wanted Planetree to survive,” he said.

The move coincided with a boom in consumer-driven health care. Patients rebelled against HMOs and used the Internet to do their own health research.

Today, there are 70 member hospitals in the United States.

Hospitals that want to join must sign contracts and agree to the Planetree principles, although the principles can be enacted in slightly different ways depending on size and resources.

All the extras – the fresh-baked muffins, live music, the library, the massages – only cost Griffin about $100,000 a year, Powanda said. Much of the work is done by volunteers and students.

Griffin’s costs run lower than the costs of similar-sized hospitals, Powanda said, and the cost per day for the patient is less than other hospitals in the region.

Admissions have grown 26 percent over the past three years, and outpatient services have grown 30 percent – three or four times the growth of other Connecticut hospitals.

Changing to the Planetree system did not happen overnight. Doctors, nurses and staff had to get with the program – a process that took years.

Fortune magazine has named Griffin Hospital as one of the nation’s best 100 employers for four years in a row. Also, under Planetree, the hospitals’ malpractice claims dropped – in part attributed to higher customer satisfaction, Powanda said

The American Hospital Association credits Planetree with spawning a movement for better care.

Rick Wade, a senior vice president of the American Hospital Association, said Planetree has not yet been tested throughout a large, poor city’s hospital system. Its largest member has less than 700 beds.

Planetree is working out a final agreement with the New York-Presbyterian Healthcare System, one of the largest medical systems in the world, with over 2,300 beds and 125,000 employees.

The Planetree system might be hard to sustain in a big hospital, with thousands of beds, tens of thousands of employees and a large number of poor patients, Wade said.

“A lot of hospitals are challenged by funding and work force pressures, and its a real challenge to sustain that culture when you’re under financial siege,” he said.

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On the Net: http://www.planetree.org

AP-ES-05-11-03 1924EDT