Medical Education Show Jan 2016 Aaron M. Clay, RN and Bridget Parsh, RN, MSN, EdD Patient- and family-centered care (PFCC) is changing the way hospitals provide patient care, increasing staff satisfaction, decreasing costs, and improving patient outcomes [1, 2]. Although hospitals make unique, organization-specific PFCC principles, all of them tend to endorse similar core values by recognizing the importance of family members’ roles in individual patients’ health care experience, establishing relationships with and supporting patients and families, and helping patients discover how their own strengths and weaknesses influence their health and health care. When patients’ needs are prioritized, they engage in treatment and the treatments are more effective [1-4]. Hospitals where PFCC is part of the organizational culture find not only that patient, family, and staff satisfaction ratings significantly increase, but also that patients’ health outcomes improve [2, 5]. Implementation of PFCC is also correlated with a decrease in patients’ emergency department visits, faster recovery, and decreased utilization of health care resources [2, 6-7]. PFCC has become widespread throughout health care [6, 8-12]. The PFCC concepts of patient-physician collaboration and treating the patient as a whole person are not new. Fifteen years ago, the Institute of Medicine (IOM) semi-annual report, Crossing the Quality Chasm [8], included PFCC as an initiative to improve quality in the list of ten rules for redesigning health care [13]. The IOM report emphasized the need to involve patients in their own health care decisions, to better inform patients of treatment options, and to improve access to information [8]. PFCC provides a holistic approach to patient care, including psychological, spiritual, cultural, and emotional considerations that contextualize experiences of illness or injury and go beyond a focus on disease processes only [1]. The term “family-centered” does not remove control from competent patients to make decisions concerning their own health care [11]. Instead, this concept emphasizes that a patient’s health care decisions should be contextualized in terms of a patient’s broader life experiences. This term also recognizes the role a patient’s family members play in extended and at-home care planning and care giving. As medical care continues to become more collaborative, with a focus on holistic care for patients and their sources of support, principles of PFCC are now commonly taught to medical residents [14, 15]. For example, to be recognized by the Magnet Recognition Program, developed by the American Nurses Credentialing Center, hospitals must implement family-centered care [16]. No longer just for pediatrics, patient- and family-centered care applies to patients of all ages and can be practiced in any health care setting and at any point in care delivery; the Joint Commission suggestions include providing discharge instructions that meet the patient’s needs, informing patients of their rights, and identifying patients’ dietary restrictions that affect treatment [1]. Giving patients control, customizing care according to patients’ needs and values, and providing information to patients and their loved ones are other IOM recommendations that promote PFCC [8]. Recognizing the importance of patients’ loved ones in patients’ health care experiences, clinicians try to work with patients and families to ensure their health and well-being in a mutually beneficial relationship [8, 11, 12]. Principles of PFCC include listening to families, facilitating choice, sharing information, and building confidence to participate in health care decision making [2, 11]. By implementing PFCC, clinicians benefit by gathering more information, improving follow-through, making efficient use of professional time, and decreased health care utilization [6, 9, 11]. Based on the latest research and guidelines [1, 4, 10, 14], these strategies for successful patient- and family-centered care are suggested:
Prominent organizations including the Institute of Medicine (IOM), the Institute for Patient- and Family-Centered Care (IPFCC), the Institute for Healthcare Improvement (IHI), the American Academy of Pediatrics (AAP), and the American College of Emergency Physicians have endorsed PFCC practices, helped to define PFCC, and illustrated the importance of incorporating patients and their loved ones into health care discussions and decisions [8-12]. PFCC improves quality and safety of care, chronic disease management, and patient satisfaction; reduces hospitalizations and medical errors; and lowers costs [1, 2, 6, 11, 17, 21]. References
What is person centred care in nursing?Being person-centred is about focusing care on the needs of individual. Ensuring that people's preferences, needs and values guide clinical decisions, and providing care that is respectful of and responsive to them.
What is patientPatient-centered communication, also known as person-centered communication or client-centered communication, is defined as a process that invites and encourages patients and their families to actively participate and negotiate in decision-making about their care needs, as cited in [7].
How effective communication supports nurses in providing person centred care to patients?Therapeutic communication is essential in patient centred care, as listening to patients will help identify patient needs, help nurses develop awareness as a health professional, and increase empathy towards patients.
What are the barriers to person centred care?Results. Barriers to patient and family-centred care broadly fall under four categories; lack of understanding of what is needed to achieve patient and family-centred care, organizational barriers, individual barriers and interdisciplinary barriers.
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