What is patient-centered care?

When you think of the word “healthcare,” what comes to mind? There are many associated terms frequently thrown about in medical organizations, like the “cost of healthcare,” and “healthcare regulations,” and “technological healthcare platforms.” These days, clinicians are kept busy trying to stay up to date on the latest regulatory guidance and electronic health records (EHR) mandates—along with a million other emerging issues. These things are important, of course, but somewhere along the way, the true meaning of “care” in “healthcare” has gotten lost in the shuffle. It’s time to take a step back and see the forest for the trees. When considering the question, “What is patient-centered care?” one must first consider the diverse and complex needs of the patient.

There are many possible definitions of patient-centered care. At its heart, however, patient-centered care is focused on forging genuine partnerships between the patient and the care provider. The provider-patient relationship naturally lends itself to encouraging and empowering the patient to become an active participant in their own care. In short, patient-centered healthcare is collaborative.

This approach to care is also holistic in that it encompasses the patient’s need for physical comfort and relief from pain, as well as the patient’s mental, emotional, social, and psychological needs. When appropriate, patient-centered care involves the patient’s family. For example, consider the following:

• Pediatricians aren’t just treating the child; they are working with the child’s parents and perhaps the siblings.
• Oncologists aren’t just treating the cancer patient, but also educating and empowering the family caregivers.
• Obstetricians aren’t just delivering babies, but also working with the mother’s partner to enable them to be an effective birth coach.

As you can see, patient-centered care truly is family-centered care that can take many forms. Physicians and hospitals that encourage patients to take ownership of their healthcare, both in and out of the hospital, are innovators that are leading the way toward a better model of medicine.

Why is it important?

For a moment, imagine that you are one of your patients. You’ve just been diagnosed with a serious disease that may shorten your life and reduce the quality of your remaining years. You’re hearing all sorts of clinical terms, and you are being told to go on this or that medication, or to have this or that treatment. You’re upset and frustrated, and all you really want to do is jump in a time machine so you can go back to a time when you didn’t have to worry about your health.

The patient experience is often upsetting and frustrating, and this needs to change. Patients need to feel empowered to take charge of their health. They need to feel like active participants in their own care, and they need to know that their concerns are being heard. This approach to healthcare prioritizes the person behind the patient. Because of the critical importance of patient-centered care, hospitals should consider it to be a “must-have,” rather than an optional luxury.

Are there benefits?

The benefits of patient-centered care are many. Let’s start with the benefits to the hospital and the healthcare provider. Since this approach improves the quality and comprehensiveness of care, it is capable of drastically improving the reputation of the healthcare facility. Within the community, the hospital can develop a sterling reputation for genuine compassion and clinical excellence. For the individual care provider, the improvement of healthcare brings increased job satisfaction, which in turn enhances motivation and workplace culture.

And of course, there are advantages for the patients. Consider the following benefits of patient-centered care:

• Greater understanding of care coordination and available resources
• Empowerment to make their own healthcare decisions and implement healthy lifestyle changes through more comprehensive patient education
• Ability to set their own desired health outcomes
• Improved accessibility to healthcare and related services
• Positive patient experience and improved satisfaction with the quality of care

In addition, patient-centered care lends itself to better health outcomes. By empowering patients and making them active participants in the healthcare process, this approach can motivate them to eat well, exercise regularly, manage their medications appropriately, and keep track of their health numbers. While patient-centered care is not exactly in the domain of public health, it can sometimes lead to greater health scores among whole populations if it’s implemented consistently.

Furthermore, because patient-centered care embraces the role of family members in the patient’s treatment and recovery processes, this approach enables family caregivers to be better informed and better able to care for their loved ones at home.

What are the elements of patient-centered care?

The origin of the push toward patient-centered care is widely attributed to the Picker Institute. On behalf of the Picker Institute and The Commonwealth Fund, researchers from Harvard Medical School developed the Eight Principles of Patient-Centered Care. They are as follows:

• Respect for the patients’ values, preferences, and expressed needs: Every person deserves to be treated with respect and dignity, and they deserve to have their preferences and expressed needs validated. Healthcare providers must continually remind themselves that each of their patients has different values, and that these values may affect their healthcare preferences. The physician’s role is that of an educator and navigator; the patient is the one in the driver’s seat. Make sure to hire the right staff.
• Coordination and integration of care: This principle recognizes that healthcare is not delivered in a vacuum. Patients benefit from many different types of services, and all of these services should be carefully coordinated to work in harmony with each other. Providers must evaluate how the different aspects of a patient’s care may interact with each other, and they must act in the interest of integrating care services and supporting the overall patient experience.
• Information and education: While patients must be empowered to make their own healthcare decisions, they cannot make informed decisions without the right information. Patient education is a cornerstone of quality healthcare. Providers must freely share evidence-based information and explain it when necessary to enhance the patient’s understanding and ability to make decisions.
• Physical comfort: Patients are often faced with uncomfortable and sometimes painful situations. This principle of patient-centered care underscores the importance of helping patients adequately manage their pain and improve their physical comfort. In practical terms, this might mean anything from helping a patient use the pain scale to offering a hospitalized patient an extra blanket.
• Emotional support: 21^st century medicine recognizes that the body and mind are intricately linked. Depression, for example, can cause physical symptoms. This principle of patient-centered care highlights the importance of caring for each patient’s emotional needs.
• Involvement of family and friends: A patient’s support network is crucial for recovery. Providers should actively strive to learn more about each patient’s life and relationships in order to involve appropriate individuals in the patient’s care.
• Continuity and transition: Transitions can often be pain points for patients. It can be difficult for them to know what to expect after discharge, for instance, and how to adhere to the treatment recommendations. Hospitals and physicians should proactively plan each patient’s next transition to ensure continuity.
• Access to care: Every person deserves access to quality healthcare. It should be easy for patients to make appointments and to follow up with their provider when questions occur between appointments.

In addition to these original eight principles, other healthcare organizations and researchers have developed their own elements of patient-centered care. For example, the Mountain States Healthcare Alliance (MSHA) has developed a 10-point program for patient-centered care. It includes the idea that every team member is a caregiver (including the CEO and the housekeeping staff). MSHA also embraces the need for care providers to share information freely among each other in order to better care for the patient. Patient safety is prioritized, as is the maintenance of a soothing, healing environment (pet therapy, healing gardens, soothing color schemes, and music are all recommended by MSHA).

How can hospitals nurture this type of care?

It’s often thought that the individual physician or nurse is primarily responsible for nurturing patient-centered care. After all, the provider is the one who directly interacts with patients and family members. However, an attempt to embrace patient-centered care will not truly thrive unless the entire organization is committed to it.

One of the key elements of patient-centered care is the access to care. Healthcare organizations can prioritize the improvement of patient access to services by considering, among other things, the locations of their services. For example, let’s say you operate a hospital in a mid-size city. You notice that a major portion of the patients accessing your ER have complaints that only justify urgent care. It may be time to assess the feasibility of setting up a satellite urgent care center away from the main hospital in a location that is easily accessible.

However, it isn’t necessary to make such major changes as these in order to improve the model of care within the hospital. Take a look at the ease of scheduling appointments, for instance. Patients who cannot see a provider in a timely manner might give up trying to get an appointment. Another common pain point is referrals. Patients need clear directives on when referrals are necessary and how to get them.

In addition, don’t neglect the role of the family members. Hospitals have long instituted strict visiting hours and regulations. In some cases, these regulations may still be necessary (such as when a major outbreak occurs). However, in most cases, it’s preferable to enable patients to decide for themselves who they want to visit them and how many visitors they want. Furthermore, hospitals should strive to keep family members informed of their hospitalized loved one’s progress through electronic updates when appropriate (within HIPAA regulations, of course).

When clinicians consider the answer to the question, “What is patient-centered care?” does your healthcare organization come to mind? It should. If not, then it’s time to re-evaluate your healthcare leadership, operational processes, or mission and values. If you are looking for help, I provide thoughtful healthcare consulting services for hospitals, clinics, and physicians who would like to prioritize patient care while also building a profitable organization. Contact me today to begin benefiting from our healthcare consulting services.

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