Thursday, April 06, 2006


The following list of 8 dimensions of Patient-Centered Care constitute an update on the series of blogs posted last summer.

NRC and the Picker Institute have merged, and are working with Hospitals and Medical Clinics with a "Customer Satisfaction" survey. The purpose of the survey is to assist the participating Medical Facilitly transition from the current style of "Illness or Doctor Centered" care into Patient-Centered care, based on the 8 dimensions listed below.

Now, here's where I need your help. There's a possibility that I may get the opportunity to address Doctors and Health Care representatives as a Patient Advocate, explaining to them the problems that current patients have communicating with their doctors - particularly patients with Chronic Conditions.

So, as you read the 8 conditions listed below; as you go to the website links, please comment back to me with information that you might have to help Doctors and Health Care representatives better help you!!

Here's the link to the actual website wherein the following data appears.,22,2,1,Documents

Eight Dimensions of Patient-Centered Care

Respect for patient’s values, preferences, and expressed needs
Patients indicate a need to be recognized and treated as individuals by hospital staff. They are concerned with their illnesses and conditions and want to be kept informed.

An atmosphere respectful of the individual patient should focus on quality of life.
Involve the patient in medical decisions.
Provide the patient with dignity, and respect a patient’s autonomy.

Coordination and integration of care
Patients report feeling vulnerable and powerless in the face of illness. Proper coordination of care can ease those feelings. Patients identified three areas in which care coordination can reduce feelings of vulnerability:
Coordination of clinical care;
Coordination of ancillary and support services; and
Coordination of “front-line” patient care.

Information and education
Patients express a fear information is being withheld from them and staff is not being completely honest about their condition and prognosis. Based on patient interviews, hospitals can focus on three communication items to reduce these fears:
Information on clinical status, progress and prognosis;
Information on processes of care; and
Information to facilitate autonomy, self care and health promotion.

Physical comfort
The level of physical comfort patients report has a tremendous impact on their experience. Three areas were reported as particularly important to patients:
Pain management;
Assistance with activities and daily living needs; and
Hospital surroundings and environment.

Emotional support and alleviation of fear and anxiety
Fear and anxiety associated with illness can be as debilitating as the physical effects. Caregivers should pay particular attention to:
Anxiety over physical status, treatment and prognosis;
Anxiety over the impact of the illness on themselves and family; and
Anxiety over the financial impact of illness.

Involvement of family and friends
Patients continually addressed the role of family and friends in the patient experience, and often expressed concern about the impact illness has on family and friends. Family dimensions of patient-centered care were identified as follows:
Providing accommodations for family and friends;
Involving family and close friends in decision making;
Supporting family members as caregivers; and
Recognizing the needs of family and friends.

Transition and continuity
Patients often express considerable anxiety about their ability to care for themselves after discharge. Meeting patient needs in this area requires staff to:
Provide understandable, detailed information regarding medications, physical limitations, dietary needs, etc.;
Coordinate and plan ongoing treatment and services after discharge; and
Provide information regarding access to clinical, social, physical and financial support on a continuing basis.

Access to Care
Patients need to know they can access care when it is needed. Focusing mainly on ambulatory care, the following areas were of importance to the patient:
Access to the location of hospitals, clinics and physician offices;
Availability of transportation;
Ease of scheduling appointments;
Availability of appointments when needed;
Accessibility to specialists or specialty services when a referral is made; and
Clear instructions provided on when and how to get referrals.


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