Patient-Centered Health Care

In this article, Working Together to improve the Patient Experience, author Richard Billingsley(2014) explains how working together amongst providers, the patients, and the patient's family improves the patient experience, thus markedly heightening the quality of care. In this article, he also shares how other organizations have successfully adopted a model to facilitate cultural change within their facilities. This cultural model is referred to as patient family centered care (PFCC), and while it is not a new concept, it's emphasis has gained popularity as insurance companies adjust the criteria that encompasses what constitutes as high quality care.

In 2001, the US Institute of Medicine’s seminal report, ‘Crossing the Quality Chasm: A New Health System for the 21st Century’, recommended six goals for improvement in healthcare, with one focusing on patient-centred care (Institute of Medicine [IOM], 2011). Furthermore, various international organisations, such as the Institute for Patient- and Family-

Quality patient centered care is vital to a hospital or clinic’s ability to treat whole patients. Dabney and Tzeng (2013) address the necessity to implement patient-centered care into clinic and hospital settings. The article clarifies what patient-centered care and service quality is by consolidating many works and sighting benefits medical professionals can observe in their practice.

This essay aims to describe briefly what is meant by patient-centred care. It will also focus and expand on two key aspects of patient dignity - making choices and confidentiality. Patient-centred care (PCC) is an extensively used model in the current healthcare system (Pelzang 2010:12). PCC is interpreted as looking at the whole person and considering their individual values and needs in relation to their healthcare. By implementing a PCC approach it ensures that the person is at the very centre of any plans that are made and has a dynamic role in the decision making process (Pelzang 2010:12).

Providing patient centered care each and every time I am in the hospital is something that I hold to a very high esteem for myself and everyone I work with. My preceptor and I both think it is very important to treat patients like they are our own family member or friend, so there are many examples I could give for how I exhibited patient centered care while I completed my senior practicum on 5200/5300. Perhaps the most memorable from my time on this floor was when I had a patient who had been in the hospital for more than 30 days. This patient was getting restless, had been in restraints, was unable to really communicate due to a tracheostomy, and had also been NPO for multiple days while waiting for surgery to insert a PEG tube and fix an elbow fracture. Although this patient was in isolation and many team members were worn down with him constantly trying to get out of bed, I was a fresh face and spent hours upon hours by his side trying to understand why he was acting the way he was.

In a day and age where everything is becoming mobile and consumer-driven, healthcare is no exception. Patients are now able to drive healthcare industry spending and have access to more health services. “A growing body of evidence suggests that the patient-centered medical home is an effective model to transform primary care and serve as a foundation for accountable care organizations, working together in integrated communities of care” (Harbrechet & Latts, 2015). Patient centered care could change the outdated medical models by focusing on patient-doctor relationships and what the patient deems important in their healthcare (Kahn, 2014). “Patient centered care has a triple aim: to improve individuals’ health; achieve improved population health; and reduce cost trends. A complementary goal was to improve satisfaction for patients and health care teams“ (Harbrechet & Latts, 2015). Early studies suggest that this type of care will also improve efficiency and lend us closer to the frontier of health production. The Patient Centered Health model is the fastest growing healthcare delivery system innovation (O’Kane, Barr, &Scholle, 2014). This is largely due to the Affordable Care Act and its impact on health coverage (Fifield, Forrest, Burleson, Martin-Peele, & Gillespie, 2013; Harbrechet & Latts, 2015). This paper will focus on how patient centered medicine impacts efficiency in healthcare.

In the physical realm of patient-centered care pain, comfort, sleep, and rest are important aspects of the fourth dimension of patient-centered care. Patient-centered care is the complete focus of the medical team on providing respectful care to meet patient needs, preferences and values guide decisions on each individual patient care. To understand the subjective view of the patient, these four aspects are at the forefront of their needs within the hospital setting to provide the best patient outcome. Nurses provide good patient-centered care by actively partnering with patients to determine care priorities and plans to tailor their level of involvement, according to their preferences, and being flexible by changing the care plan as the situation changes including providing smooth transitions between care goals. By doing this, nurses can assist patients with all pain by providing comfort and assuring the patient that there will be no deficiency of their quality of sleep.

I experienced the patient-centered competency in my public health clinical when the public health nurse would specifically address the patient’s main concerns or illnesses. This was seen at the individual level with the home and community care nurse when she made sure she knew her patient’s specific needs before getting into their house. She knew their personalities and could be prepared to help the veteran in the most efficient way that she could. She did this by getting the medications and other medical items she could potentially need on her trip, and by reviewing the patient’s information with her nursing team before she left for the day, so they could suggest if she was missing anything. The public health nurse stated, “You always want to take everything they might need, because the day you don’t is the day you will need it.”

What would happen if patients were able to create their own healthcare experience? What would it look like? How would they benefit? I plan to discuss these hypotheticals through research regarding Patient-Centered Care. After all, studies and surveys performed by the Institute of Medicine and the Institute for Healthcare Improvement, read that engaged patients in any health care setting, have better perceived health outcomes, thus higher actual quality patient outcomes.

When I decided a few years ago that I was going to become a pharmacist, the reason why I made that decision was because I wanted to make a difference in the life of every patient I come across. Dr Jacobsen reiterated this idea in his speech when he talked about his reason for having a specialized residency in primary care which is equivalent to today’s post graduate year two (PGY2) program. Patient centered care approach is an immense way of advancing patients health outcome by a healthcare provider.

The two ideas that caused me to think and reflect on my past experiences are as follows:

Patient centered practice is an important aspect in health care settings for chartering progress as well as future aims , as a student this will help promote a more patient centered approach to address barriers and set realistic goals together with patients. With patient centered practice in place, care is coordinated, personalized to the need of an individual promoting adherence to intervention and thus adopting a healthy behavior and allowing patients opinions to be heard for improving their care quality and

Patient-centered intervention and strategies facilitate excellent, safe, and quality care. Ensuring the proper use of devices through effective evidence-based education and skills competency contribute to the provision of safe, outstanding, and superior care. The strategy of educating the nursing staffs and other healthcare team focuses on the patient and staff in any healthcare setting. The project of decreasing the rate of inappropriate use of physical restraint is aligned with the patient-centeredness as well as the staff focus. Empowering the staffs of the proper use of physical restraint assists in the provision of appropriate delivery of health care services, thus, preventing any sentinel events which spotlights on patient safety.

Nursing has a crucial responsibility when it comes to managing, treating, diagnosing, and pinpointing evidence-based strategies to tackle quality of life in persons who suffer from chronic illness (Gies 2016). To have effectual nursing practice, patient-centred care, and improved patient outcomes, understanding the correlations and distinctions of self-perceived health, health-related quality of life, and quality of life is essential (Gies 2016).

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.