Thursday 26 February 2009

Creating patient-centric care

Patient-centric care is a central theme of the Darzi review - and hence a key part of the changes and vision for the NHS. This is absolutely right, and long overdue: patient-centric care is known to be effective in contributing to other health system goals such as efficiency and effectiveness.

However international studies show that it is easy to talk about such care, far harder to achieve it: patients often rate hospitals and medical care providers highly, but report "significant problems in gaining access to critical information, understanding treatment options, getting explanations regarding medications, and receiving responsive, compassionate service from their caregivers".

Given the NHS's recent "conversion" to the mantra it is vital to learn from those who have already been shaping service delivery in such a way.

In 2007 the Commonwealth Fund and the Picker Institute in the US carried out interviews with opinion leaders selected for their experience and expertise in either designing or implementing strategies for achieving excellence in patient-centered care. The detailed report (pdf) gives clear guidelines for what is necessary for those in the UK seeking to deliver high quality, patient-centred care and identifies the following critical factors. How many of them does your organisation deliver on?

* Leadership, at the level of the CEO and board, sufficiently committed and engaged to unify and sustain the organization in a common mission.
* A strategic vision clearly and constantly communicated to every member of the organization.
* Involvement of patients and families at multiple levels, not only in the care process but as full participants in key committees throughout the organization.
* Care for the caregivers through a supportive work environment that engages employees in all aspects of process design and treats them with the same dignity and respect that they are expected to show patients and families.
* Systematic measurement and feedback to continuously monitor the impact of specific interventions and change strategies.
* Quality of the built environment that provides a supportive and nurturing physical space and design for patients, families, and employees alike.
* Supportive technology that engages patients and families directly in the process of care by facilitating information access and communication with their caregivers.

Related articles:
NHS hospitals 'suffering from lack of compassion'

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