The Three C's Of Lydia Hall

The patient is at the center of the Nightingale model, which shows a holistic view of the

Although leaders in the health professions have advocated incorporating patient /consumer centeredness in the curriculum of health professionals, there remain several educational, practice and regulatory barriers to implementing a patient-centred vision. The following are some of the most important barriers

The Chapelhow et al. (2005) effectively portrays a framework that provides patients with an approach to person centered care. It provides health professionals with important aspects that allow them to perform in an effective way that has the best interests of the patients at heart. The characteristics it outlines are assessment, communication, risk management, record keeping and documentation, professional decision making and managing uncertainty.

In some areas of population health, technology in enhanced patient information is utilized to perform risk stratification to identify the high risk patients. These patient’s often have uncontrolled BP, diabetes with an HgbA1c over 9, COPD, etc. Once identified as high risk or potential high risk, these patients receive additional care or patient outreach to help manage their condition. Some organizations employee RN Health Coaches and Care Coordination teams to help these patients and identify gaps in care. The primary care physician assumes care of the patient along with striving for the patient to become active in their overall health thereby keeping them out of the hospital (Sanford, 2013). One enhanced area of population management is the PCMH model. PCMH practices increase patient’s engagement in shared decision making while providing compensation for care coordination, care management and medical consultation outside of traditional face-to-face visits (Berryman, Palmer, Kohl &Parham, 2013). A patient centered approach pushes for changes not only in the delivery of medicine but in traditional encounters. In addition, PCMH encourages increased access to the patient’s primary care physicians and improved patient satisfaction scores. PCMH and population health encourages providers to increase after hours care to decrease emergency department visits and/or hospitalizations. Thereby reducing cost and improving the patient’s

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/

These objectives reflect a shift away from the traditional provider centered medical model, in which patients are often treated as passive recipients of care, and toward a more patient centered service model in which health decision making is expected to involve the active participation of the patient or consumer. In keeping with the Healthy People 2020 objectives and incorporating the Institute of Medicine’s goals for evidence-based care which emphasize patient centered care and respecting patients’ individual preferences (Institute of Medicine, 2001), the Health Outcomes Research Program at St. Luke’s Mid-American Heart Institute has developed a database with which patient-specific data can be used to estimate and model individual patient outcomes during clinical care. Decision aids created from these predictive risk estimates can

The new rules allow patients to participate with all aspect of their healthcare decisions. It focuses on patient’s involvement, decisions, continuous healing and patient control. The new rules are design to meet the patient’s needs. Throughout the years, physicians had more of a paternalistic view with competent patient’s healthcare choices. Even though, the physicians optimal goals is to practice non-maleficence and beneficence care, their knowledge regarding patient’s illness and care paternalistically diminish patient’s autonomy and involvement. The new rules reinforce those principles; it changes patient’s involvement, choices and preferences. It increases transparency, predict patient’s needs, continuity of care among physicians, institute evidence-based decisions and health records access.

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.

Patient-centred care also referred to as person-centred care. Relates to treating an individual receiving healthcare with dignity and respect also including the patient in all decisions about their health outcome. The principles for patient centred care for all health professionals involves respect for patient’s preferences and values, emotional and physical support, education, continuity, coordination of care, and involvement of family and friends. Many health professionals including general partitioners, pharmacists and resisted nurses, focus on embedding patient-centred communication principles in health practice, which is important as there is a lot of uncertainty with patients. The type of communication approach conveys the effectiveness of

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).”

On March 20, 2010 President Barack Obama signed into law the Patient Protection and Affordable Care Act (ACA). With that signature, a new healthcare paradigm set into motion. Under Title III: Improving the Quality and Efficiency of Healthcare, Section 3506 requires establishment of programs that develop, test and disseminate “patient decision aids”. Tools that are designed to facilitate collaborative shared decision making between health care providers and patient beneficiaries. This provision outlines requirements to promote engagement of all stakeholders in informed decision making, mandates provision of up-to-date clinical evidence for all treatment options and promotes decision making that accounts for individual beliefs, preferences and circumstances.

When addressing patient obstacles usually, problems arise when the patient “demonstrates noncompliant behaviors, such as missing appointments or failing to make healthy lifestyle changes such as quitting smoking or losing weight” (Hyden, 2011). This is difficult because if people do not want to take an active role in their care, then patient centered care will be compromised. “Evidence demonstrates that patients who are involved in their care decisions and management have better outcomes, lower costs, and higher functional status than those who are not so involved” (Grenier and Knebel,

The current health care sector is too costly and too fragmented with a lot of variation in care even with established evidence based guidelines. Providers lack the tools, support and information they need to offer the coordinated health management that can reduce cost and improve outcomes. Primary Care Physicians are constrained in their abilities to perform any proactive care that involves avoiding Hospital or ER visits, and influencing healthy lifestyles.

Moreover, increasing costs of healthcare delivery and emerging trends toward patient empowerment and patient-centered care in order to achieve higher quality healthcare, needs patients to play a more active role in their