scholarly journals From protocolized to person-centered chronic care in general practice: study protocol of an action-based research project (COPILOT)

2019 ◽  
Vol 20 ◽  
Author(s):  
Mieke J.L. Bogerd ◽  
Pauline Slottje ◽  
Francois G. Schellevis ◽  
Anneliet Giebels ◽  
Mieke Rijken ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
General Practice ◽  
Chronic Diseases ◽  
Person Centered Care ◽  
Care Approach ◽  
Centered Care ◽  
Person Centered Approach ◽  
The Impact ◽  
Multiple Chronic Diseases

AbstractAim:To develop a proactive person-centered care approach for persons with (multiple) chronic diseases in general practice, and to explore the impact on ‘Quadruple aims’: experiences of patients and professionals, patient outcomes and costs of resources use.Background:The management of people with multiple chronic diseases challenges health care systems designed around single disease. Patients with multimorbidity often receive highly fragmented care that may lead to inefficient, ineffective and potentially harmful treatments and neglect of essential health needs. A more comprehensive, person-centered approach is advocated for persons with multiple morbidities. However, examples on how to provide more person-centered care and evidence of its impact are scarce. A group of Dutch general practitioners (GPs) took the initiative to develop such a care approach.Methods/Design:Mixed methods with a development and pilot-testing phase. The proactive person-centered approach will be developed using an action-based research design consisting of multiple plan-act-observe-reflect-adjust cycles. In each cycle, experiences of patients and primary care professionals from 13 practices will be collected via interviews, observations and focus groups. Starting point for the first cycle is a ‘person-centered consultation’ of up to 1 h in which the GP discusses the health status and health care needs of the patient. Furthermore, shared decisions between GP and patient are made on treatment goals and follow-up. In the pilot-test phase, a nested case cohort study allows to explore the impact of the new approach on ‘Quadruple aim’ outcomes comparing persons with and without exposure to the new care approach.Discussion:This study will provide a proactive person-centered approach for persons with multimorbidity in primary care and estimate its potential impact on quadruple outcomes.

The Distinct Value of OT: Examination of Person-Centered Care in Practice

2021 ◽  
Vol 75 (Supplement_2) ◽  
pp. 7512510251p1-7512510251p1
Author(s):  
Elizabeth Jayne Braun ◽  
Erin Casey Phillips ◽  
Hannah Corner ◽  
Shayla Murphy ◽  
Alayna Pullara ◽  
...  
Keyword(s):  
Health Care ◽  
Clinical Practice ◽  
Capacity Building ◽  
Evidence Based ◽  
Person Centered Care ◽  
Centered Care ◽  
Person Centered Approach ◽  
Primary Author

Abstract Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Health care is shifting from volume to value, and there is a need to define the distinct value of services. OT is founded on the principles of person-centered care, and the intentional use of these strategies must be part of evidence-based outcomes in order to solidify the value of OT services. This study examined the use of person-centered care in clinical practice, and results were used to develop capacity-building strategies for implementation of a person-centered approach. Primary Author and Speaker: Elizabeth Jayne Braun Additional Authors and Speakers: Erin Casey Phillips, Hannah Corner Contributing Authors: Shayla Murphy, Alayna Pullara, and Nathan Kies

Person-Centered, Skilled Services Using a Montessori Approach for Persons with Dementia

2018 ◽  
Vol 39 (03) ◽  
pp. 223-230 ◽  
Author(s):  
Jennifer Brush ◽  
Michelle Bourgeois ◽  
Natalie Douglas
Keyword(s):  
Health Care ◽  
Nursing Home ◽  
Health Outcomes ◽  
Health Care System ◽  
Advisory Board ◽  
Person Centered Care ◽  
Centered Care ◽  
Person Centered Approach ◽  
International Advisory ◽  
Skilled Person

AbstractThe current mandate for person-centered care throughout the health care system, and especially in the nursing home industry, requires that speech–language pathologists ensure that the services they provide to elders with dementia are skilled, person centered, and relevant to positive overall health outcomes. Guidelines developed by the Association Montessori International Advisory Board for Montessori for Aging and Dementia are one avenue toward such skilled and person-centered services. The purpose of this article is to provide clinicians with practical strategies for guiding their assessment, goal writing, and intervention plans to meet the expectations of a person-centered approach to services for elders with dementia, using the Montessori approach as a philosophical guide.

scholarly journals Impact of cardiac physiotherapy on the functional capacity of elderly people in primary care

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
L Lopes Do Nascimento ◽  
DQO Viana ◽  
LNTR Rodrigues
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Chronic Diseases ◽  
Elderly People ◽  
Functional Capacity ◽  
Exercise Program ◽  
Care Program ◽  
Supervised Exercise ◽  
Physiotherapy Program ◽  
The Impact

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Primary health care (PHC) is the first level of health care, and it includes health promotion and protection, as well as the prevention of aggravations from chronic diseases and comorbidities. The cardiovascular physiotherapy program in PHC is an important ally in prevention chronic diseases and maintaining functional capacity.  Purpose: to evaluate the impact of a cardiovascular physiotherapy program on a functional capacity of elderly people in primary care. Methods: This is a randomized clinical trial, carried out with 30 elderly people who attended the FISIOCAP (cardiovascular physiotherapy program in primary care) program for at least 6 months. The assessment of functional capacity was performed through the six-minute walk (6MWT) and 1-min sit-to-stand test (1-MSTS). The patients were submitted to a supervised exercise program lasting 90 minutes, twice a week, for a period of 16 weeks. Each session consisted of a warm-up phase (10 minutes), conditioning (60 minutes), calm down (10 minutes) and health education (10 minutes). At the end of 16 weeks, the elderly underwent a reassessment on the 1MSTS and 6MWT. Results: After the cardiovascular physiotherapy program, the participants increased the distance covered by the 6MWT by 19% (p = 0.002) and significantly exceeded the distance covered predicted for gender and age. In 1MSTS, the participants obtained a significant improvement in the number of repetitions in the test (25.25 ± 5.72 to 27.67 ± 5.55, p = 0.04). Conclusion: The cardiovascular physiotherapy program significantly benefited the functional capacity of elderly patients attending PHC.

PRELIMINARY ASSESSMENT OF GPS' KNOWLEDGE AND ATTITUDE ABOUT PERSON CENTRED CARE

2018 ◽  
Vol 28 (2) ◽  
pp. 567-570
Author(s):  
Radost Assenova ◽  
Levena Kireva ◽  
Gergana Foreva
Keyword(s):  
General Practice ◽  
Patient Empowerment ◽  
Patient Relationship ◽  
Preliminary Assessment ◽  
Doctor Patient Relationship ◽  
Patient Centered ◽  
Term Care ◽  
Family Doctors ◽  
Person Centered Care ◽  
Centered Care

Introduction: The European definition of WONCA of general practice introduces the determinant elements of person-centered care regarding four important, interrelated characteristics: continuity of care, patient "empowerment", patient-centred approach, and doctor-patient relationship. The application of person-centred care in general practice refers to the GP's ability to master the patient-centered approach when working with patients and their problems in the respective context; use the general practice consultation to develop an effective doctor–patient relationship, with respect to patient’s autonomy; communicate, set priorities and establish a partnership when solving health problems; provide long-lasting care tailored to the needs of the patient and coordinate overall patient care. This means that GPs are expected to develop their knowledge and skills to use this key competence. Aim: The aim of this study is to make a preliminary assessment of the knowledge and attitudes of general practitioners regarding person-centered care. Material and methods: The opinion of 54 GPs was investigated through an original questionnaire, including closed questions, with more than one answer. The study involved each GP who has agreed to take part in organised training in person-centered care. The results were processed through the SPSS 17.0 version using descriptive statistics. Results: The distribution of respondents according to their sex is predominantly female - 34 (62.9%). It was found that GPs investigated by us highly appreciate the patient's ability to take responsibility, noting that it is important for them to communicate and establish a partnership with the patient - 37 (68.5%). One third of the respondents 34 (62.9%) stated the need to use the GP consultation to establish an effective doctor-patient relationship. The adoption of the patient-centered approach at work is important to 24 (44.4%) GPs. Provision of long-term care has been considered by 19 (35,2%). From the possible benefits of implementing person-centered care, GPs have indicated achieving more effective health outcomes in the first place - 46 (85.2%). Conclusion: Family doctors are aware of the elements of person-centered care, but in order to validate and fully implement this competence model, targeted GP training is required.

The Impact of COVID-19 on Primary Care General Practice Consultations in a Teaching Hospital in Shanghai, China

2020 ◽  
Author(s):  
Zhongqing Xu ◽  
Jingchun Fan ◽  
Jingjing Ding ◽  
Xianzhen Feng ◽  
Shunyu Tao ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Teaching Hospital ◽  
The Impact

scholarly journals From Micro to Macro: Exploring Preference-Based Person Centered Care from Multiple Perspectives

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 836-836
Author(s):  
Katherine Abbott ◽  
Kristine Williams
Keyword(s):  
Nursing Home ◽  
Assisted Living ◽  
Fixed Effects ◽  
Nursing Home Residents ◽  
Direct Care ◽  
Multiple Perspectives ◽  
Person Centered Care ◽  
Fixed Effects Panel Regression ◽  
Centered Care ◽  
The Impact

Abstract Advancing our knowledge related to honoring nursing home resident preferences is a cornerstone of person-centered care (PCC). While there are multiple approaches to providing PCC, we focus on resident preferences as assessed via the Preferences for Everyday Living Inventory (PELI). The PELI is an evidenced-based, validated instrument that can be used to enhance the delivery of PCC. In this symposium, we explore the perspectives of a variety of stakeholders including nursing home residents, staff, and the impact of preference-based care on provider level regulatory outcomes. First, we present a comparative study of preference importance among n=317 African America and White nursing home residents that found more similarities than differences between the two groups. Second, a content analysis of the responses from n=196 interviews with nursing home residents details the barriers and facilitators connected to their levels of satisfaction with their preferences being fulfilled. Third, perspectives from n=27 direct care workers explore the concept of pervasive risk avoidance to the delivery of PCC. Fourth, systems-level practices, such as shift assignments and provider schedules are identified as barriers to successfully fulfilling resident preferences from the perspectives of n=19 staff within assisted living. Our final presentation utilizes a fixed-effects panel regression analysis with n=551 Ohio nursing home providers to explore the impact of PELI use on regulatory outcomes such as substantiated complaints and deficiency scores reported in the CMS Nursing Home Compare data. Discussant Dr. Kristi Williams will integrate findings, highlighting implications for policy, practice, and future directions. Research in Quality of Care Interest Group Sponsored Symposium.

scholarly journals The impact of chronic disease and disability on the elderly

1999 ◽  
Vol 55 (3) ◽  
pp. 9-14
Author(s):  
C. J. Eales
Keyword(s):  
Health Care ◽  
Chronic Disease ◽  
Chronic Diseases ◽  
Health Care Systems ◽  
The Elderly ◽  
Therapeutic Interventions ◽  
Elderly Persons ◽  
Care Systems ◽  
And Function ◽  
The Impact

Health care systems for elderly people should aim to delay the onset of illness, reducing the final period of infirmity and illness to the shortest possible time. The most effective way to achieve this is by health education and preventative medicine to maintain mobility and function. Changes in life style even in late life may result in improved health, effectively decreasing the incidence of chronic diseases associated with advancing age. This paper presents the problems experienced by elderly persons with chronic diseases and disabilities with indications for meaningful therapeutic interventions.

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