Implementation of Patient-Centered Concepts - Essay Example

?APA Implementation of Patient Centered Concepts to Improve Quality Outcomes and Control Cost One of the core components in today’s healthcare is patient-centered care. This is a concept that recognizes that a patient is a person to be cared for and not a condition to be treated. In broad terms, it is a model in which providers of patient healthcare partner with patients and their families in order to ensure that all decisions made respect and satisfy all the wants, needs and preferences of patients while at the same time, supporting personal and professional aspirations of their staff. The model aims at soliciting the input of patients on the support and education they need to make decisions and participate in their individual care. It is therefore an innovative approach used to healthcare planning, delivery and evaluation. The concept can be implemented in any healthcare setting. However, its implementation in the current healthcare system has a lot of potential impacts and many healthcare providers struggle with how to actualize the concept into the daily business of caring for patients and their families. Potential impact of Patient-Centered Concept on the current health system’s finances According to Lorig (2002), the concept of patient-Centered care can impact positively on the business metrics of the current health system like finances, safety, satisfaction, quality and market share. Overall, the model reduces the costs of providing patient care and it is associated with increased efficiency of care. This is mainly seen in terms of reduced number of referrals and reduced diagnostic tests. Increased patient participation during visits by healthcare providers reduces their anxiety and perceived need for investigations/diagnostic tests and referrals. However, there could also be a need to increase the financial resources in some hospitals and increased their levels of staffing to match with the level of staffing required to provide continuity of care. Despite these costs of education, support and other interventions, there is usually a general resource utilization leading to a positive financial result. Generally, the model is associated with improved patient satisfaction and improved health status and this has the potential of increasing the demand for services offered by the heath system (Stewart et al, 2000). This can be equated with high sales because of increased market share and the end result of this is increased profits. The model is not about technological innovations or renovations and the acquisition of new equipment. Instead, it is mainly about kindness, compassion, empathy and attitude all of which are completely free and their provision require the hiring of new staff. It entails a maximization of the interactions with patients at the current staffing levels present in the current health system. The exact areas of the budget that may be impacted There are two main areas of the health system budget that are impacted by patient-centered care are expenses for referrals and diagnostic tests. As noted above, increased patient participation during visits by healthcare providers reduces their anxiety and perceived need for investigations/diagnostic tests and referrals. Reduced referrals and diagnostic tests mean reduced costs per unit for the health system. For example, it is cheaper both for the family and the health system to attend to a patient at home than maintaining the same patient in hospital. Cost/benefit analysis that would be helpful in assessing this trend One of the ways to achieve a cost/benefit analysis for assessing this trend is assessing the overall costs of managing long-term illnesses verses patient outcomes. For example, if the costs of managing such long-term diseases have reduced while at the same time, the survival rates have been increased and mortality rates reduced, then is the model is good. Impact on the structure of health systems and organizational dynamics Effective patient-centered care requires a shift of the current health system from being organised around dictates of payment mechanisms and customs of clinicians into provision of healthcare from the perspective of individual patient. It will also entail a shift from the provision of healthcare in a specific setting into response to patient needs across setting (Bauman et al, 2003). The model requires organizational and system structures that support interdisciplinary partnership. This means the health system has to be restructured in such way that it allows for easy collaboration between professionals of various disciplines and related fields in providing care for the patient. One of the organizational dynamics that will be impacted by the patient-centered approach is the use of staff. It will increase the involvement of lower level nurses in patient care and change the duty of providing patient care from being exclusively the function of nurses into being the function of all staff members of an organization. Each of them is expected to be responsive to the needs of the patient and their families. This model will also require a change on some policies for example extension of visiting hours to ensure that the needs of the patient and their loved ones are accommodated. Potential impact on nursing organizationally and professionally According to Agency for Healthcare Research and Quality National Institute of Mental Health. (2001), the model allows a shift from the utilization of higher-cost registered nurses (RN-staff) into the use of lower-cost ancillary staff. The model is highly-demanding in terms of workforce and thus RNs will not be sufficient to attend to all patients. Professionally, nurses will be forced to increase their level of competency to enable them deal with an increased range of medical conditions. Nurses will be required to graduate with knowledge on how to handle a variety of patients and navigate them through the health system across various settings. Legal, ethical and risk considerations The ethical consideration that are considered in this model are the presentation of least harm to the patient as directed by the ethic of non-maleficence and respect of patient freedom as directed by ethical principle of autonomy. These ethics require that health providers act to the best interests of the patient and consider their wishes and goals. Despite this, health providers should provide care that meets the legal standard. They have to consider what a professional and prudent physician would do in similar circumstances in order to met legal standards and meet patient needs. Some of the risk management considerations in the model include right of the patient to refuse treatment, surrogate decision-making and limited capacity of some patients to make decisions. A fully empowered and informed clinician may decide to take risks or refuse to adhere to management guidelines (Sine and Sharpe, 2011). Overall potential to improve the health of the community and how to quantify The concept of patient-centered care has a great potential of improving the health of the community. This is mainly because all the decisions and recommendations made by health providers will based on quality information that has direct impact on the health of the patient both physical and psychologically. Stewart et al (2000) explain that patients are co-managers of their healthcare and are in a position to take part in important decision-making at a level they feel comfortable to do so. The model involves increased interaction with patients and this means that care providers will adjust their services according to every slight progress made by the patient. Some of the ways of quantifying community health as a result of patient-centered care are survival rates, mortality rates and patient satisfaction/patient feedback. Conclusion Patient –centred care model recognizes that an effective clinician-patient-relationship should be an end result of a relationship in which the recommendation of a physician are informed by their understanding of the needs of the individual patient and the context in which they live in order to enhance the ability of the patient to act on information provided. The model is associated with enhanced health status among patients and increased efficacy of care which is mainly seen in terms of reduction in the number of referrals and diagnostic tests. These results are both statistically and clinically significant and this makes the adoption of this model an attractive alternative for the current health system. References Agency for Healthcare Research and Quality National Institute of Mental Health. (2001). PATIENT-CENTERED CARE: CUSTOMIZING CARE TO MEET PATIENTS’ NEEDS. Online: http://grants.nih.gov/grants/guide/pa-files/PA-01-124.html. Viewed on 14th November, 2011. Bauman, A. et al. (2003). “Getting it right: why bother with patient-centred care?” Medical Journal of Australia. (5) pp 253-256. Lorig, K. (2002). “Partnerships between expert patients and physicians.” Lancet (359) pp 814-815. Sine, D. and Sharpe, V. (2011). “Ethics, risk, and patient-centred care: how collaboration between clinical ethicists and risk management leads to respectful patient care.” Healthc Risk Manag. (1) pp 32-37. “The Impact of Patient-Centered Care on Outcomes.” The journal of family practice. (9) pp 796-804. Read More