Patient Centered Care
Patient Centered Care
More Than Just a Guest in the Boardroom!
Think of the many times you've seen articles about how to make the care we provide, more patient-centric. The term patient-centeredness was used as early as the 80's. Healthcare providers have worked diligently since to create ways of enhancing the patient's position in the patient-provider relationship. Later, the term evolved into patient-centered care with the hope that this would somehow create a more patient-focused approach to care.
Some of the many suggestions still used today to enhance what is referred to as patient-centered care are given below:
- Encourage patients' use of the provider's "patient portal".
- Create a patient representative seat on the board. Alternate invitations among patients.
- Conduct patient surveys to gauge concerns.
- Improve the language used in the patient pamphlet.
- Use patient satisfaction to gain insight at discharge.
- Place suggestion boxes handily near patient high traffic areas.
- Improve access to care via telehealth.
- Change the focus from "patient" to "consumer".
While some of this thinking produced positive results, though modest in many cases, many providers will say these did not yield the anticipated results and patient participation they had envisioned.
Today, things are looking up for the patient and family!
Shared decision-making and evidence-based health coaching are two interventions having a major impact on the patient-provider relationship by engaging the patient very differently at the point of care!
Shared Decision Making
Shared Decision Making is a process in which clinicians and patients work together to make decisions and select tests, treatments and care plans based on clinical evidence that balances risks and expected outcomes with patient preferences and values (1). One shared decision-making model involves the practitioner exploring and respecting “what matters most” to patients as individuals (2). Characteristics of this model during the patient/provider conversation include:
a) introducing choice,
b) describing options, often by integrating the use of patient decision support, and
c) helping patients explore preferences and make decisions.
Evidence-based Health Coaching (EBHC), as ascribed to by the National Society of Health Coaches, uses Miller and Rollnick's work(3) in motivational interviewing (MI) to guide the provider's conversation with the patient about health behavior change.
(1) From: https://www.healthit.gov/sites/default/files/nlc_shared_decision_making_fact_sheet.pdf
(2) Elwyn, G. et al. (2012). Shared decision making: A clinical model for pracrtice. Journal of General Internal Medicine, (27) pp. 1361-1367.
(3) Rollnick. S., Miller, W.R., and Butler, C.C. (2008). Motivational interviewing in health care: helping patients change behavior. The Guilford Press: NY, NY.