Sunday, September 27, 2009

Patient-Centered Care Awareness

October is Patient-Centered Care Awareness Month, but many do not even know what patient-centered care is or how important this philosophy is to health reform. I have written previously on some aspects of patient-centered care (such as letting a patient see and even make their own chart notes). I suggest you see this post first if you have not read it yet, and especially watch the fun video clip so that you are in the right frame of mind for this discussion. Healthcare has been evolving away from a "disease-centered model" and toward a "patient-centered model." I look forward to the focus on patient-centered care this month.

Although the phrase "patient-centered care" is defined and used in a variety of ways, the essential theme is the importance of delivering healthcare in a manner that works best for patients. In a patient-centered approach to healthcare, providers partner with patients and their family members to identify and satisfy the full range of patient needs and preferences. Organizing the delivery of healthcare around the needs of the patient seems like an obvious approach, but healthcare is a complex system and very little about it is simple. Over 30 years ago when the idea of patient-centered care was born it was swiftly dismissed by all but the most philosophically progressive providers as unrealistic, too expensive and unattainable. To learn more about our own efforts in this area see Courage to be First. Times have certainly changed...

With the introduction of the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) patient experience of care survey, there now exists a standardized tool to evaluate the way care is provided from the patient perspective. HCAHPS examines those aspects of the health care experience that mean the most to patients, including communication with nurses and physicians, cleanliness and noise levels, pain control, and quality of discharge instructions and medication information. Of course, reimbursement methods can drive organizational changes in philosophy and we are now seeing many healthcare systems embrace a patient-centered focus.

The development of a patient-centered medical home provides an enhanced model of primary care in which care teams attend to the multi-faceted needs of patients and provide whole-person comprehensive and coordinated patient-centered care. Since 2006 more than 30 states have initiated projects to advance medical homes in Medicaid and Children's Health Insurance Programs (CHIP), and several states also are driving state-wide transformation. This National Academy of State Health Policy/Commonwealth Fund report provides state policymakers with examples of promising practices and lessons learned.

There is evidence that patient-centered care improves outcomes. The study in the Journal of Family Practice The Impact of Patient-Centered Care on Outcomes found that patient-centered practice improved health status and increased the efficiency of care by reducing diagnostic tests and referrals. There is little doubt that putting the patient at the center of their care makes

If you want to know more about patient-centered care then first go to the Planetree website at These websites also provide valuable information on patient-centered practices: