Discussion: Patient-Centered Care

Discussion: Patient-Centered Care

Discussion: Patient-Centered Care

1. Describe the relationship between the AACN Essentials and your new-found knowledge about Patient Centered Care. Are there opportunities for you to improve?
2. Essential VIII: Professionalism and Professional Values discusses professional standards of moral, ethical, and legal conduct. Review the Professional Integrity Module-Academics and Practice at the beginning of the course (the first module). Then reflect on your own beliefs and values as they relate to professional nursing practice.
3. Discuss implications of professional nursing integrity and academic integrity.

4. Patient-Centered Care Examples

   Patient-focused care is realized in a number of ways, across a variety health care settings, from family care and specialty providers, to acute, emergency, and long-term care providers. Here are a few examples.

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   Discussion: Patient-Centered Care

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   1. Patient-centered care in the doctor’s office.

      Under patient-centered care, care focuses more on the patient’s problem than on his or her diagnosis. Patients have with their doctors in patient-focused care models. Empathy, , and are crucial, as is the ability of the doctor to see beyond a patient’s . This broader look at the needs of the whole patient requires providers to offer services or referral to services such as , social workers, financial counselors, mental and emotional health providers, transportation and daily living assistance, and in some communities, language and literacy education. While human interaction takes a primary role in patient-centered care, physician practices may also employ a variety of to help of their health care outside of the doctor’s office. Tools range from 24/7 online portals that let patients schedule appointments, get information about their condition and , review lab results and , and pay bills at their convenience, to wearable technology and apps that let patients track their “important numbers” such as weight, blood pressure, glucose levels, and cholesterol.

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   3. Patient-centered care in the hospital.

      Strict visiting hours and visitor restrictions are a thing of the past in a patient-centered care model. Patients are given the authority to identify who can visit and when. Family members (as defined by the patient and not limited to blood relations) are invited to visit during rounding and shift changes so they can be part of the care team, participating in discussions and care decisions. When not in the room with the patient, they are kept informed of their loved one’s progress through direct and . A patient-centered care hospital’s infrastructure encourages family collaboration through a home-like environment that not only meets the needs of the patient, but also meets the needs of family members. For example, maternity wards are being redesigned with family-friendly postpartum rooms that can accommodate the mom, new baby, and family members, who are encouraged to spend up to 24 hours a day together in the room to foster family bonding.

   4. Personalized medicine.

      The concept of patient-centered care extends to the clinicians provide. Not only are care plans customized, but medications are often customized as well. A patient’s individual genetics, metabolism, biomarkers, immune system, and other “signatures” in many disease states — especially cancer — to create personalized medications and therapies, as well as companion diagnostics that help clinicians better predict the best drug for each patient.

   Cultural Shift to Patient-Centered Care

   As with other forms of , patient-centered care requires a in the way provider practices and health systems are designed, managed, and reimbursed. In keeping with the tenets of patient-centeredness, this shift neither happens in a vacuum, it driven by traditional hierarchies in which providers or clinicians are the lone authority. Everyone, from the parking valet and environmental services staff to c-suite members, are engaged in the process, which impacts hiring, training, leadership style, and organizational culture.

   Patient-centered care also represents a shift in the traditional roles of patients and their families from one of passive “order taker” to one of active “team member.” One of the country’s leading proponents of patient-centered care, Dr. James Rickert, that one of the basic tenets of patient-centered care is that “patients know best how well their health providers are meeting their needs.” To that end, many providers are implementing patient satisfaction surveys, , and focus groups, and using the resulting information to continuously improve the way health care facilities and provider practices are designed, managed, and maintained from both a physical and operational perspective so they become centered more on the individual person than on a checklist of services provided.

   As the popularity of patient- and family-centered health care increases, it is expected that patients will become more engaged and satisfied with the delivery of their care, and evidence of its clinical efficacy should continue to mount.