September 22, 2018 | ° F

ABRAHAM: Patient-centered care is essential to enhancing medical facilities


Opinions Column: Code Wellness


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Patient-centered care is defined as “a dimension of quality in which care is individualized and customized to patients and families, and in which they, not clinicians, have control over (their) healthcare decisions." In a patient-centered model, quality is understood as “providing care that the patient needs in a manner and time that the patient desires, according to a paper called A 2020 Vision of Patient-Centered Primary Care. Picker Institute also notes in the same article the eight dimensions of patient-centered care which includes having “respect for the patient’s values, preferences and expressed needs," which includes information and education, access to care, emotional support to relieve fear and anxiety, involvement of family and friends, continuity and secure transition between health care settings, physical comfort, and coordination of care. Patient centered care strives to place the patient and the family at the heart of the healthcare system, thereby enabling clinicians to personalize the delivery of their care, according to the Journal of Nursing Administration

Patient-centered care has a vast history and is by no means a newly developed approach. The patient-centered home care model was first introduced in 1967 by the American Academy of Pediatrics. At that time, it was referred to as “the medical home model,” which embodies several similar characteristics as the patient-centered approach. For instance, the “medical home” was used to explain care that is “accessible, family-centered, coordinated, comprehensive, continuous, compassionate, and culturally effective.” 

There are numerous benefits of using the patient-centered approach. In contrast to non-patient centered approaches, patient-centered care results in “more open patient-provider communication, earlier identification of potential problems, and development of more effective solutions," according to the Journal of Nursing Administration. Another benefit is access to great care that allows the patient to make appointments with ease, according to A 2020 Vision. The article also cites “superb access to care" includes timely response to emails, electronic prescription refills, and an off-hours service that can make primary care accessible any day at any time. The patient-centered approach results in more patient involvement in his or her care as opposed to the non-patient centered models. Instead of constantly searching for a new physician or specialist, the patient-centered approach is designed to have the patient at the center while the healthcare team circles around the patient. This way there is a “smooth transfer (of information)" across a team of providers which will help to avoid duplications of information and tests, according to A 2020 Vision.

Over the years, there have been studies addressing the quality of care and the patient-centered approach. For example, a case study done by McCormack, Dewing and McCance, reported on how resident satisfaction increased when clinicians were patient-centered, such as through language, teamwork and meaningful relationships. "The Future of Nursing" discussed a study, done by the Diabetes Control and Complications Trial Research Group and revealed how patients who were directly involved in managing their own health conditions showed major improvements in their health outcomes with diabetes mellitus. Thus, patient centered care not only leads to better relationships between patients and clinicians, but also results in improved patient outcomes.

Although the concept of patient-centered care has been around for many years, one is bound to wonder why it is so popular now. The Affordable Care Act, which became law on March 2010, promotes the use of health services and the patient-centered model. The Affordable Care Act aims to lower hospital readmission rates by penalizing hospitals with excessive readmissions. As for the penalty, hospitals will experience financial losses, particularly a reduction in their Medicare payments, if readmission rates do not go down. Therefore the Affordable Care Act provides hospitals with an incentive to ensure that the quality of patient care is at its best.

Another explanation for the popularity with patient-centered care stems from the need to develop better health services that meet the demands of the increasing elderly population. "The Future of Nursing" states, given the aging population, the need for long-term and palliative care will continue to grow in the coming years. Many geriatric patients have several specialists as these patients already have, or at higher risk for, several health conditions. Patient-centered care would truly benefit everyone, especially geriatric patients, because the collaborative approach to providing patient care will ensure that unnecessary tests, medications or procedures are avoided.

Healthcare trends reveal an increased demand for patient centered approaches. The incorporation of patient centered care in hospitals and other medical facilities will transform the quality of patient care.

Cilgy Abraham is a Rutgers School of Nursing senior. Her column, "Code Wellness," runs on alternate Mondays.


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Cilgy Abraham

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