Patient-Centered Medical Home Model Analysis

Both Nurse Practitioners (NP) and Physician Assistants (PA) are two very important professionals in the field of medicine. They both work under the supervision of a licensed physician, and their functions are also quite similar with very minor differences between the two. Due to such similarities it has become very difficult for the general population to differentiate between these two professionals (Nurse Practitioner School, 2015). The nurse practitioners are registered nurses who have gone on to earn a master's or doctorate degree in a specialty area of nursing, such as family practice, adult practice, pediatrics or women's health. Their duties include diagnosing and treating acute and chronic conditions, prescribing medication,

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

Overview of the Patient Centered Medical Home project piloted by Geisinger Health System in Danville, Pennsylvania

The patient centered medical homes (“PCMH”) approach “focuses on keeping people well, managing chronic conditions like diabetes or asthma, and proactively meeting the needs of patients.” According to the Arkansas Department of Health, chronic diseases like cancer heart disease or diabetes affect approximately over fifty percent of adult Arkansans. Yet chronic diseases are often preventable. The high rate of chronic diseases can partly be attributed health insurance coverage—“when people don’t have health insurance they tend to avoid seeing doctors. People

Patient-Centered Medical Homes (PCMH) are growing in popularity as the right thing to do improve patient care. PCMH are growing in popularity, as there is early evidence of their effectiveness (Egge, M. 2012). The PCMH concept has been widely promoted as a way to enhance primary care and deliver better care to patients with chronic conditions. This model of care has stimulated the attention of payers, Medicaid policy makers, physicians, and patient advocates, as it has the potential to address several of the limitations of the current healthcare system (Wang, J. et al 2014). Currently, primary care in the United States is focused on acute and episodic illness, it inadvertently limits comprehensive, coordinated, preventive and chronic care (Bleser, W. et al 2014). The PCMH address these limitations through organizing patient care, emphasizing team work, and coordinating data tracking (Bleser, W. et al 2014). A PCMH and HMO have some similarities but are markedly different.

The role of nurse practitioner is valuable when discussing collaborative care. There are so many levels of care, so many health entities, and so many insurer criteria involved that it is instrumental to have a role that can work towards help bring all aspects together. In addition to diagnosing, treating, and managing care, the role of the nurse practitioner is to manage simple and episodic acute health issues along with chronic disease (Sangster-Gormley, Martin-Misener, & Burge, 2013). It is important to note that although this is a function of this role, nurse practitioners also practice from a holistic point of view which allows them to help manage patient conditions or wellness in a more complete fashion. This includes helping patients have access to care beyond primary and secondary care settings. This encourages nurse practitioners to work alongside other health care and allied health professions, and families to create an individualized plan for every patient (van

Patient-centered care refers to the view that patients and their family members are partners in developing a care plan. This stems from the belief that the patient is in control and that the care provided is rooted in respect that addresses the patient’s personal needs and values (Barnsteiner & Sherwood, 2012). Creating a partnership with a patient that allows them to grasp the goals and methods of their plan of care and includes them in the decision-making process can prevent errors from occurring. This gives the patient the opportunity to correct any

The success of NPs depends on practicing evidence-based care with competency in assessment, diagnosing, managing patients, and maintaining a caring practice. The nursing component of the NP role continues to be challenged from within nursing, as well as by large national physician organizations. NPs are extensions of nursing practice who are guided by nursing theory. The transformation from nurse to the advanced practice role of NP involves development of advanced knowledge and skills for listening, knowing, being with patients, connecting patients to their communities, promoting health,

Hederson, S., Princell, C. O., and Martin, S. (2012, December). The patient-centered medical home. American Journal of Nursing, 112(12), 54 59. doi: 10.1097/

Mobile Integrated Healthcare, Community Paramedic (MIH/CP) is a nationally recognized program where local Emergency Medical Services (EMS) have become involved in providing patient-centered care in partnership with local resources such as social services and primary care (Mobile Integrated Healthcare and Community Paramedicine (MIH-CP): A National Survey, 2015). These programs range in services from in-home consultation for chronic disease management to deploying telemedicine to connect homebound patients with offsite care givers. The author states: “From medical homes to care teams to accountable care organizations, the concept of collaborative, integrated, patient-centered care is a major theme of healthcare reform - and MIH-CP (p. 9)”.

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.

Patient-centered care encompasses ideas, skills, and attitudes that promote greater patient empowerment, responsibility, and prioritizing patients’ needs and experience of healthcare in influencing how care is delivered (Lorig, 2012). Patient-centered care focuses on individualizing care to meet the health care needs of individual patients but also encourages patient’s to be active participants in their own care. Important aspects of patient-centered care that focuses on the patient’s experience include cultural competency, involvement, and continuity of care.

Primary care practice will be greatly impacted by health care reform. To provide better health care, the country will see a trend away from specialty to primary care and the avoidance of acute issues by delivering this care in the community setting. As a result, primary care physicians will be overwhelmed with the patient load as the number of the insured increases exponentially. The committee recognizes the scope of nursing practice that remains untapped and therefore the profession

In comparison and contrast between Chronic Care Model and Patient-Centered Medical Home Model, it is pertinent to know that Chronic is a condition which “requires ongoing adjustments by the affected person and interactions with the health care system” (Improving Chronic Illness Care, 2006-2011) and is related to the Chronic Care Model which initiates an improved an system between the organization, the community and the level of care. Patient-Centered