Patient-Centered Care

1. Patient-Centered Care Debi Temple, Bella Pepito, Carolina Puig, & Jeff Norris

2. Evolution of Patient-Centered Care • Founded by a patient named Angelica Thieriot in 1978. • Planetree: a non-profit organization that promotes patient centered care. • Mission- facilitates efforts to provide patient-centered care in healing environments

3. Relationship-Centered Caring • Studies show care & kindness are important in healing • Focus is on personalized care • Cognizance and acknowledgement of own vulnerabilities • Listening to patient’s concerns and fears

4. Informing and Empowering Patients • Development of health resources centers • Customized patient information packets • Bedside collaborative care conferences • Patient guides/navigators • Open medical chart policies

5. Involving Family & Friends • Family has a great impact on healing • Patients want their families included & involved in decisions • Illness affects the whole family • Strategies for family involvement- unrestricted visitation, family spaces, care partner programs, collaborative conferences

6. The Nurturing and Healing Aspects of Food • Healing environment through good (hotel quality) food • Smell of baked good/popcorn on floor daily • On-floor dietary. • 24 hour a la carte meal service • International menus

7. Spiritual and Cultural Diversity • Human well being includes more than good physical health • Interfaith chapel, sanctuary, meditation space • Blessing of the Hands ritual • White Rose Program

8. Complementary and Alternative Practices • CAM (Complementary and Alternative Medicine) • Chiropractic, traditional Chinese medicine, homeopathy, accupuncture • P.A.W.S. program • Coronado Hosp. in California requiring licensed team members to be trained in healing touch, clinical aromatherapy and massage.

9. Effects of Art on Health • To alleviate physical discomfort and emotional distress • Waterscapes, landscapes, flower/gardens, figurative art • Painting, storytelling, humorous movies and clowns • Music Thanatology

10. Design of Healing Environment • Incorporates all 5 senses into healing • Inclusion of natural elements throughout • Reduce noise and light pollution • Empower patients with control of environment • Healing design works for staff as well

15. Expanding to a Healthy Community • Core concept of Planetree added in 2002 • Focus • Health and Community • 5 Determinants of Health • Biological, social, intellectual, environmental and spiritual • Community factors • Interest, values, age, shared event, circumstance

16. Community Adaptation • Behavioral health setting • Continuing care environment • Expansive Integrated Healthcare System

17. Quality and Safety • “We have moved past the question of whether providers should partner with patients and families on quality and safety: the question now is how?” (Johnson, etal, 2008). • Focus areas: • Human interactions and communication • Patient education and access to information • Involvement of family and friends • Nutrition • Community partnerships • Structures and processes that support patient involvement • Patient-centered care when things go wrong

18. Building the Business Case • Reduced length of stay • Reduced cost per case • Improved patient satisfaction scores • Improved outcomes • Reduced Litigation

19. Role of the players • Role of public policy is voice of patient • A journey toward outcomes • Priorities involving the continuum of care • Focus on performance measurement • Shift to bundled reimbursement for total care

20. Barriers to Change • Change-averse industry • Flavor of the month improvement process • Fear of increased time and cost • Paradigm shift in provider attitudes • How to overcome barriers