PatientCentered Care Current Reality, Barriers, and Proposed Actions

1
Patient-Centered Care Current Reality,
Barriers, and Proposed Actions

• David Swankin, JD
• President and CEO
• Citizen Advocacy Center
• June 17-18, 2002

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What is Patient-Centered Care?

• Patient-centered care customizes treatment
  recommendations and decision making in response
  to an individual patients preferences, needs,
  and beliefs

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Why Do We Need to Teach Patient-Centeredness?

• Changing patient needs and demands
• It improves health outcomes

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Patient-Centered Care Selected Skills

• Respect patients' values, preferences, and
  expressed needs
• Coordinate and integrate care
• Provide physical comfort and emotional support
• Involve family and friends in care
• Inform, communicate, and educate

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Patient-Centered Care Selected Skills

• Understand the course of illness and a patient's
  experience outside of the hospital
• Understand determinants of health, the link
  between health care and healthy populations, and
  professional responsibilities

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State of Education in Patient-Centered Care

• Nursing tradition of emphases on communication,
  incorporating family, care/comfort, promoting
  self-care, cultural sensitivity
• Medicine growing emphasis, but more work is
  needed, ABIM Foundation is a good example
• Allied health and pharmacy too varied to assess

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Education Barriers

• Competing curricular elements
• Lack of replicable curricula and teaching models
• Hidden Curricula/ Unprepared faculty
• Not stated in the missions of the professions
• Dominant biomedical paradigm

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Practice Barriers

• No continuous coordination across care
• Time pressures short encounters
• Organizational expectations
• Fragmented care delivery
• Communication challenges
• between clinicians
• between clinicians patients

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Regulatory Barriers

• Variable vague standards
• Variable interpretations
• Difficulty assessing patient-centeredness

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Actions Education Systems

• Clarify core values of the professions to focus
  on patients
• Recruit and develop faculty
• Admit and evaluate students on their
  patient-centeredness
• Revise education curricula and methods
• Develop students to be reflective

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Actions Regulatory Systems

• Set curriculum standards emphasis on patient
  centered
• Reform/Refine Accreditation define core
  competencies and require learning experiences
• Require related continuing competency assessment

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Proposed Questions for Today

• What strategies can be used in academic and
  continuing education programs so that health
  professionals are better prepared to be sensitive
  and aware of various cultures and populations?
• What strategies can be used to modify faculty
  behavior so that they are better role models in
  incorporating patient involvement in clinical
  decision-making?

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Proposed Questions for Today

• What strategies can be used so that all health
  professionals in academic and continuing
  education programs are educated to communicate
  more effectively (e.g., clear, comprehensive)
  with patients and their caregivers?
• What strategies can be used to ensure that all
  health professionals in academic and continuing
  education programs are educated to promote the
  values of health lifestyles and preventive
  healthcare measures in their clinical practice?

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Proposed Questions for Today

• What strategies can be used so that academic and
  continuing education experiences are designed to
  include patients perspectives and participation
  in clinical decision-making?