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Defining Long-Term Patient-Centered Care

Patient-centered care considers the individual patient’s needs, preferences and values when making healthcare decisions. This patient-focused approach may seem like common sense, but the truth is, that it is relatively new to the long-term care industry.

The term patient-centered care, was first coined in 1991 following a survey that asked recently hospitalized patients what part of their care was most important to them. The survey was part of a Picker/Commonwealth initiative that focused on identifying the different aspects of hospital care.

nurse-providing-patient-centered-careThe Institute of Medicine defined patient-centered care, a decade later, as “providing care that is respectful of and responsive to individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions, in its 2001 article: Crossing The Quality Chasm.

Another decade later, the Affordable Care Act (ACA) attempts to legislate patient-centered care for long-term care patients.

The ACA “encourages person – and family – centered care that ensures patients and families are engaged in decisions about their care so that the care received reflects their priorities and goals. Shared decision making models exemplify person – and family – centered care by including patients, caregivers, and providers in health care decisions and considering patient values and preferences in the development of care plans.

“Patients alone cannot create patient-centered care, nor can providers.  This is a collective effort, grounded in partnerships that nurture trust, transparency and collaboration,” according to Planetree website. Planetree is an organization dedicated to advancing patient-centered care solutions.

The Agency for Healthcare Research and Quality offers tutorials for physicians who wish to employ patient focused care practices but aren’t certain how to go about it.

The Institute of Health listed the following 10 rules for redesigning the 21st Century healthcare system for patient-centered care in 2001. More than 13 years later, they are still applicable.

  1. “Care is based on continuous healing relationships.” This implies that healthcare should be available by whatever means are available; phone, Internet and not just in person.
  2. “Care is customized according to patient needs and values.” Whether its cultural differences or personal preferences, the patient’s wishes should be considered before developing a treatment plan.
  3. “The patient is the source of control.” Patients should be given all necessary information to make an informed decision about their own healthcare.
  4. “Knowledge is shared and information flows freely.” Patients should have access to their complete medical records and clinical knowledge so they can effectively communicate with their physician.
  5. “Decision making is evidence based.” Care should be evidence based and therefore not vary from physician to physician for the same condition.
  6. “Safety is a system priority.” Closer attention to systems and compliance with standards will help to limit accidental patient injury.
  7. “Transparency is necessary.” The Affordable Care Act (ACA) expands Sunshine rules that require certain data about healthcare providers and facilities to be reported to the Centers for Medicare and Medicaid Services, so the public can access the information to make informed decisions.
  8. “Needs are anticipated.” Preventing disease should be the focus of medical care rather than reacting to medical events. The ACA calls for penalties to hospitals with high rates of hospital readmissions, and hospitals in turn are scrutinizing the readmission rates of long-term care facilities they refer patients to.
  9. “Waste is continuously decreased.” Patient time and resources should be considered valuable.
  10. “Cooperation among clinicians is a priority.” Clinicians and facilities each need to ensure they are communicating to ensure continuity of care for patients especially during transitions from hospital to long-term care.

General Medicine, The Post Hospitalist Company has been practicing patient-centered care since we began more than 30 years ago.

Our post-hospitalists specialize in, and care exclusively for, post-acute care patients in long-term care facilities. They keep regular, onsite office hours and provide 24/7 on-call services rather than seeing patients in addition to daily practice work and hospital rounds. That means there is time for meaningful and beneficial doctor/patient relationships to develop. It also means quick assessments, interventions and monitoring of your patients when a patient heath concern arises, which leads to far fewer hospitalizations.

Learn how a General Medicine Post-Hospital can help you implement patient focused medical practices in your post-acute care facility by contacting our team today.

Tom Prose

CEO at General Medicine, P.C.
As founder and CEO of General Medicine PC, the nation’s premier post-hospitalist care company,Tom Prose leads an exceptional team of internal medicine, geriatrics and healthcare administration specialists.