His doctor, a specialist in lung disease at a top academic medical center, gave Alvin percent oxygen and powerful antibiotics and steroids, but his condition quickly deteriorated. Faced with the choice of intubation and a mechanical ventilator or palliative care, Alvin chose to forgo life support and spend his last days at home with his family. His family was given a prescription for morphine with little instruction on how to use it appropriately; when they tried to fill the prescription, several pharmacies refused.
Abstract The concept of patient-centered care has received increased attention in recent years and is now considered an essential aspiration of high-quality health care systems. Because of technologic advances as well as changes in the organization and financing of care delivery, contemporary health care has evolved tremendously since the concept of patient-centeredness was introduced in the late s.
Historically, those advocating patient-centered care have focused on the relationship between the patient and the physician or care team.
Although that relationship is still integral, changes to the health care system suggest that a broader range of factors may affect the patient-centeredness of health care experiences. Interactions between patients and care clinicians have expanded beyond the in-office visit to include virtual medicine, peer support groups, and a range of information and communication technologies to support care.
As a result of changes to the notion of a care visit and the proliferation of care delivery arrangements, much of medical care and coverage in the US is fragmented; patients may visit a number of clinicians in different clinics or systems, especially for complex and chronic conditions, and continuity and coordination across clinicians and settings is often lacking.
Hence, the absence of a true health care system has been detrimental to patient centeredness and continues to present obstacles to making care more patient centered. In this article, we offer a multidimensional characterization of patient-centered care that could be applied to a variety of care delivery systems and settings.
Our goal is to provide a framework and real-world examples to readers interested in improving the patient-centeredness of their health care organizations. We use insights from the literature and illustrative examples collected from Group Health Cooperative Group Healthan integrated health care delivery system in Seattle, WA, to show how the attributes of patient-centered care can be embraced at a systems level.
Several important arguments for making care more patient centered have been offered. Patient-centered care results in improved care processes 9 and health outcomes, including survival.
There is a business case for patient-centered care, on the basis of evidence that patients who report stronger relationships with their clinicians undergo fewer tests and are less inclined to pursue legal action if a medical error is handled in a sensitive, patient-centered fashion.
Our Approach to Studying and Improving Patient-Centered Care Group Health coordinates health care and coverage for more thanindividuals in Washington state and operates as a consumer-governed nonprofit system.
Nearly two-thirds of members receive care in Group Health-owned and operated medical centers, and promoting patient-centered care is an organizational guiding principle.
Nevertheless, the complexity of patient-centered care in a large system—where every patient, clinician, team, and encounter varies across time and place—means that embedding patient-centeredness into all daily work remains challenging.
InGroup Health Research Institute, the research arm of Group Health, initiated the Patient-Centered Care Interest Group to serve as a venue for stakeholders from across the organization to discuss timely topics, articles, projects, and related initiatives.
The diversity of departments that are represented—including research, clinical care primary, specialty, and nursinghealth plan product development, organizational communication, quality improvement, measurement and analysis, and patient safety—shows that this is indeed a topic of interest across our system.
The group provides a forum for formal and informal interactions with internal colleagues as well as outside colleagues who are regularly invited to share their expertise, and it fosters improvements to internal care delivery initiatives as well as research projects.
Topics have included measuring patient experience in real-time, best practices for patient advisory boards, and user-centered design methodology, among many others.
Medical Directors are among the regular interest group participants. The conference is a unique opportunity to describe high-profile organizational initiatives and to disseminate key messages to medical leaders and frontline staff simultaneously.-Nursing theory is a conceptualization of some aspect of nursing that describes, explains, predicts, or prescribes nursing care -A nurse that practices this theory can anticipate such factors when designing an education plan for the patient.
How does the structure create an environment of support for client centered care?
The organizational structure plays an important role in the creation of a positive environment which supports the client centered care. In actuality, the use of parallel organizational structure allows to optimize the organizational performance and provide clients with health care services of the top quality.
How does the structure create an environment of support for client-centered care? Discuss the use of information systems communication methods and a decision making-ability with culture and organizational structure of the hospital where you work (elaborate at free will here use general concepts applied to my hospital).
Clinicians and health care staff work tirelessly to care for their patients in an increasingly complex, inefficient, and stressful environment.
However, the structure, incentives, and culture of the system in which they work are often—perhaps usually—poorly aligned to support their efforts to respond to patients' needs as their core priority. • Identify the type of organizational structure.
• How does the structure create an environment of support for client-centered care? • Discuss the use of information systems, communication methods, and a decision making-ability with culture and organizational structure of the agency.
State and federal lawmakers are focusing increasingly on health care reform, and a growing number are expressing serious interest in "patient-focused" or "consumer-centered" approaches.