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Patient Centered Care Glenda M. Payne, MS, RN, CNN
Director of Clinical ServicesNephrology Clinical Solutions
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Disclosures: None
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Objectives
1. State two main concepts of patient centered care
2. Implement a patient centered care program
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You Might NOT Be Patient Centered IF….
The thermostat in the treatment room is set at 62
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You Might NOT Be Patient Centered IF….
Patients enter an unattended space and wait there for more than half an hour without even a greeting...
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You Might NOT Be Patient Centered IF….
Patients are addressed as “Mama,” and they aren’t related to you…
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You Might NOT Be Patient Centered If…One chair is damaged, so you put “matching” duct tape on all the chairs so patients can’t tell which chair to refuse…
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You Might NOT Be Patient Centered IF….
The reason you give for not meeting quality indicator goals is that all your patients are “non-compliant…”
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Disease Centered Vs. Patient Centered Care
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Focus of Care
Disease Centered
Patient is passive
Patient is a recipient of care
Provider dominates decisions
Patient Centered
Patient is active
Patient is a partner in his/her treatment plan
Decision making is collaborative
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Focus of Care
Disease Centered
Disease centered care (focus is dialysis)
Provider talks
Patient compliant (or not…)
Patient Centered
Quality of life centered (Family life is focus)
Provider listens more/talks less
Patient follows treatment plan: self manages
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Words Vs. Deeds
We say we are patient-centered
Yet patients experience:
Fear
Guilt
Anger
IntimidationBear, Robert, Sorrow’s Reward, 2010
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Core Concepts of Patient Centered Care
Dignity and respect
Information sharing
Participation
Collaboration
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Our Panel of Experts:
Adam Goldstein
Roy Graham
Dawn Lawlor
Jamie Roy
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Patient CenterednessCore Concept: Dignity and respect
Institute for Patient- and Family- Centered Care
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What experiences have you had that illustrate this concept?
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Patient Centeredness:Core Concept: Information sharing
Institute for Patient- and Family- Centered Care
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What experiences have you had that illustrate this concept?
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Patient Centeredness: Core Concept: Participation
Institute for Patient- and Family- Centered Care
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What experiences have you had that illustrate this concept?
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Patient Centeredness: Core Concept: Collaboration
Institute for Patient- and Family- Centered Care
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What experiences have you had that illustrate this concept?
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Your Own “Patient” Experience
Have you ever been a patient?
Do you remember how it felt to be on the “other side?”
What would be hard for you?
What would be critical for you to feel safe?
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Moving Toward Patient Centeredness:
Recognizing Challenges
Discomfort with Patient Empowerment:
Not trained for it
Threatened by it
Inconvenienced
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Your Ideas:
..
..
..
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What Are Some Immediate Steps You Can Take Toward Patient Centered Care?
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Immediate Steps…
…
…
…
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Immediate Steps
Listen more
Provide clear information at each step of care
Encourage patients to speak up and ask questions
Ensure all staff react positively to patient questions
Include the patient’s priorities in the plan of care
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I would like to introduce Mr. John Smith, a _______________________________**(gentleman, young man, engineer, grandfather, artist, bowler, grouch}
Who is 54 years old and in addition to kidney failure is managing diabetes and a sinus infection.
Patient Care Plan Participation
Thanks to Bonnie Greenspan
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__Mr. Smith reports that the concerns or goals with which he would welcome help from the team today are:
Would like to be able to play touch football with his kids for a half hour at their family reunion next month. He is currently too tired.He can’t resist cheese and ice cream lately and knows his phosphorous will show it
__ Mr. Smith has no requests of the team at this time
Thanks to Bonnie Greenspan
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Questions?
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Thanks for the Work You Do!