Patient Centered Care : An Essential Aspiration Of High Quality Health Care Systems

Many healthcare leaders are advocates for, and believe that patient engagement and experience has gained true importance and value in improving healthcare quality, it has easily become the ‘heart’ of the core definition of ‘quality care’. It is clear that patients are able to provide expertise beyond generic feedback on ways of improving the patient experience.

Robinson, J., Callister, L., Berry, J., & Dearing, K. (2008). Patient-centered care and adherence: Definitions and applications to improve outcomes. Journal of the American Academy of Nurse Practitioners, Volume 20(Issue 12), 600-607. doi:10.1111/j.1745-7599.2008.00360.x

Nevertheless, many organizations continue to struggle with what “it” is. This ambiguity ultimately leaves many with vague or muddled expectations for what constitutes patient-centered care. Is it a surprise, then, that many leaders report feeling bewildered at how to go about becoming more patient-centered? Or that others, convinced that their approach is indeed a patient-centered one, are surprised to find data reflecting patient and/or staff discontent? In the broadest terms, patient-centered care is care organized around the patient. It is a model in which providers partner with patients and families to identify and satisfy the full range of patient needs and preferences. Not to be overlooked in defining patient-centered care is its concurrent focus on staff. To succeed, a patient-centered approach must also address the staff experience, as staff’s ability and inclination to effectively care for patients is unquestionably compromised if they do not feel cared for themselves. Although patients may not always be able to accurately assess the clinical quality of their care, or whether safety processes are in place, patient safety and high clinical quality are fundamental to a patient-centered approach. Patient-centered care does not replace excellent medicine―it both complements clinical excellence and contributes to it through effective partnerships and communication. A wealth of resources exists to guide organizations in addressing clinical

Respect, compassion, concern, shared decision making and communication are seen as basic elements for PCC. PCC is said to improve the quality of patient care, reduce the cost of care, and increase satisfaction among nurses, physicians and patients by strengthening professional practice and maintaining the values of the patient and healthcare providers. It is evident that effective PCC requires health professionals to have good knowledge of clinical practice, as well as skills in data gathering, clinical reporting/documentation, procedures, communication, and relationship development with patients their families, and other professionals. However, inadequate emphasis on PCC in education, a lack of coordination and collaboration among health professionals, a shortage of staff, and the dominance of a biomedical model of health care act as barriers to the delivery of PCC. This implies that the implementation of PCC requires a planned and coordinated approach, with sufficient staff, efficient teamwork, and adequate education of healthcare providers. Hence, this report analyses the advantages and disadvantages of Patient Centered Approach to Health care System trying to focus on the consumer satisfaction and importance in terms of providing effective health care service. In today’s technological advanced century, people do not have time to ponder

Quality and Safety Education in Nursing (QSEN) was started around 2005 by the Robert Wood Johnson Foundation. QSEN's main goal is to “prepare future nurses with knowledge, skills and attitudes (or KSAs) necessary to continuously improve the quality and safety of the healthcare system,” (QSEN, 2017). “Integration of clinical skills with the intellectual capacity to safely manage the complexity of nursing work in key to quality care in a time of diminishing resources,” ( Dolansky, 2013). “It is vital for schools of nursing to meet the needs of today's complex health care systems by including principles of quality and safety throughout the curriculum,” (Lewis, 2016). Within the KSAs are six main categories; patient-centered care, teamwork

The overall goal through all phases of The Quality and Safety Education for Nurses (QSEN) is to address the challenge of preparing future nurses with the knowledge, skills and attitudes necessary to continuously improve the quality and safety of the healthcare systems in which they work. In order to accomplish this goal, six competencies were defined. These competencies from the Institute of Medicine (IOM) are patient centered care, teamwork and collaboration, evidence-based practice, quality improvement, informatics and safety. Over a decade has passed since the Institute of Medicine’s reports on the need to improve the American healthcare system. The Quality and Safety Education for Nurses

Over time the health care industry has become more complex. Health care is rapidly evolving and continuing to complicate our delivery of care, which in turn has the same effect on quality of care. This steady evolution and change results in nursing shortages and an increase in the prevalence of errors being made. In hopes of preventing these errors and creating safe and high quality patient care, with the focus on new and improved ways of thinking, The Quality and Safety Education for Nurses (QSEN) initiative was developed. The QSEN focuses on the following competencies: patient-centered care, quality improvement, safety, and teamwork and collaboration. Their initiatives work to prepare and develop the knowledge, skills, and attitudes that are necessary to make improvements in the quality and safety of health care systems (Qsen.org, 2014).

The healthcare industry has intensely advanced throughout the world, in turn changing the principles that incorporate the practice and culture of nursing practice. Altering the model of care to a patient-centered mode signifies an organizational culture shift and requires the participation of executives at the senior level (Cliff, 2012). To practice this care to provide the best care possible, it goes beyond the nurse to all healthcare professionals and senior leadership. The days of patients and nurses following a physician’s order without favor to care has now loaned themselves to more of an interdisciplinary approach to practice. Though, it is encouraged that the patient makes decisions for themselves, after receiving the proper education and information on their condition. Part of the patient-centered care is to be the patients’ advocate, by letting them know you are there for them when they are unable to speak and advocate for themselves and what is in their best interest. That goes in hand with educating them on “self-management of care, health literacy, patient, and family education through nurse-patient communication and interaction (Finkelman & Kenner, 2016, p. 271).”

Patient centered care is defined as “the practice of caring for patients (and their families) in ways that are meaningful and valuable to the individual patient, which includes listening to, informing and involving patients in their care” (Grenier and Knebel, 2003). Five challenges presented in patient centered care are patient obstacles, physician and practice obstacles, facility obstacles, community obstacles, and health literacy.

The five core competencies identified by IOM and the sixth added by QSEN, safety, are believed to be necessary to improve both quality and safety of the healthcare system within which nurses work (Multimethod teaching). The six core competencies outlined are patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, informatics, and safety (Diffusing Qsen). While all competencies are significant to the healthcare system, patient centered care is vital to positive patient outcomes and focuses on the patient’s perspective within the healthcare system.

Literature reviews revealed a commonality in holistic care supporting patient’s rights and improved patient outcomes, compliance, and/or satisfaction. Three studies included were recognized as being significant and will be elaborated upon further. Collectively these contributors, although using different sample sizes and methods of data collection, came to the same conclusion. Their findings establish patient-centered, holistic care as being imperative in improving patient outcomes and in supporting positive relationships within the healthcare community, which is a right all healthcare recipients

Patient provider relationships play a pivotal role in the healthcare process. This relationship helps to bridge the gap between ailments of the patient and the diagnosis and care of the provider. The need for this relationship and its propensity to create the catalyst for patients need to be fulfilled is second only to the medical knowledge of the provider and the patient 's willingness to get better. As we have moved from a biomedical perspective to a biopsychosocial perspective the relationship between provider and patient has changed from physician centered modes of communication to more of a patient centered style of communication. And with the change of view we find that a strong and cohesive bond between patient and provider is the key to the advancement and overall quality of care for the patient. According to The Impact of Patient-Centered Care on Outcomes a patient centered approach to care has a correlation to a better healthcare outcome. Focusing on the patient increases compliance of the patient.

Nursing involves greater purpose beside the objective of treating patients’ ailments in an efficient and effective manner. Nurses, physicians, and health care providers across the board uphold the duty to treat patients with the utmost value of care. As a universal definition of care does not exist, Anita Finkelman and Carole Kenner explain care is drawn from four perspectives: a sense of care involving compassion, knowledge and expertise that allows nurses to advocate for the patient in addition to treating the medial complication, and “…competence in carrying out all the required procedures, personal and technical, with true concern for providing the proper care at the proper time in the proper way (Finkelman & Kenner, 2013) . Combining the foundation of every perspective leads to the Institute of Medicine’s (IOM) first core competency of patient-centered care. Sans the image of patient-centered care the practice of nursing and medicine alike will lack the passion the American Nursing Association envisions for “the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and care of individuals, families, communities, and populations” (Finkelman & Kenner, 2013). Therefore, the author of this paper explores the IOM’s definition of patient-centered care, implementation of the concept, and its pivotal relationship to the nursing profession.

Patient-centered health care should be the focus of the 21st-century health care system. Such a system will ensure that patients have access to the safest and highest-quality care, regardless of how much they earn, where they live, how sick they are, or the color of their skin. Patients must be the first priority and the focus of the transformed system. Consumer-driven health

There was also concern if current education can develop a nurse’s preparedness in delivering quality care (Griffiths et al, 2012). One of the participants stated “you might be the best clinician in the world but if you can't communicate and you can't listen properly to people and you don't take on board and understand what they're saying you may as well go dig the street” (Griffiths et al, 2012). Furthermore another participant stated “…each individual should be [evaluated] and their needs be assessed and implemented on that particular individual…I just feel it's a conveyor belt system. Get them in and get them out sort of thing” (Griffiths et al, 2012). In another qualitative review which explored nurse’s perspectives on patient-centred care, suggested time management was the largest barrier preventing them from communicating effectively with their patients (Chan et al, 2012). One nurse stated “sometimes, I have to deal with 20 patients in one single shift… if one needs 10 minutes and there are 20 patients in total, how much time would we have to spend on this? Don’t we need to do other tasks?” (Chan et al, 2012). According to the Australian Commission on safety and quality in health care, (2011) effective patient-centred care is employed through training health professionals to