scholarly journals Patient centeredness: The perspectives of uninsured primary care patients in the United States

2019 ◽  
Vol 22 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Akiko Kamimura ◽  
Shannon Weaver ◽  
Bianca Armenta ◽  
Bethany Gull ◽  
Jeanie Ashby
Keyword(s):  
United States ◽  
Primary Care ◽  
Health Outcomes ◽  
Patient Involvement ◽  
The United States ◽  
Patient Centered Care ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Centered Care ◽  
Primary Care Patients

Introduction Patient-centered care has become increasingly important within the United States (US) healthcare system. Given that patient-centered care predicts patient satisfaction, health outcomes, and cost-effectiveness, it is of the utmost importance to study patient-centered care from the perspectives of marginalized populations including minorities, immigrants, and other underserved populations. The purpose of this study is to examine factors that affect underserved primary care patients’ perceptions of patient centeredness. Methods The data were cross-sectional and collected in Fall 2016. Free clinic patients (N = 723) completed a self-administered survey, which measures patient centeredness, patient involvement in care, and clinical empathy. Validated measures were part of the survey, and the internal consistency of scales was tested. The general linear model was performed to predict factors associated with patients’ perceptions of patient centeredness. Results Higher levels of perceived patient involvement in care and higher levels of perceived empathy in consultation are related to higher levels of patient centeredness. While better physical health is associated with higher levels of perceived empathy in consultation, high levels of emotional health and depression are not. Conclusions Patients’ perceptions of involvement and empathy are important factors for patient-centered care, although this study did not show causal directions among variables. Based on the findings of this study, it is recommended that future studies should focus on the following three points: (1) to develop and evaluate trainings for providers, (2) develop education classes for patients who utilize free clinics, (3) analyze how these programs affect patient-centered care and health outcomes.

scholarly journals Shared Decision Making and Patient-Centered Care in Israel, Jordan, and the United States: Exploratory and Comparative Survey Study of Physician Perceptions (Preprint)

2020 ◽  
Author(s):  
Yaara Zisman-Ilani ◽  
Rana Obeidat ◽  
Lauren Fang ◽  
Sarah Hsieh ◽  
Zackary Berger
Keyword(s):  
United States ◽  
Decision Making ◽  
Shared Decision Making ◽  
The United States ◽  
Patient Centered Care ◽  
Survey Study ◽  
Shared Decision ◽  
Patient Centered ◽  
Centered Care ◽  
Comparative Survey

BACKGROUND Shared decision making (SDM) is a health communication model that evolved in Europe and North America and largely reflects the values and medical practices dominant in these areas. OBJECTIVE This study aims to understand the beliefs, perceptions, and practices related to SDM and patient-centered care (PCC) of physicians in Israel, Jordan, and the United States. METHODS A hypothesis-generating comparative survey study was administered to physicians from Israel, Jordan, and the United States. RESULTS A total of 36 surveys were collected via snowball sampling (Jordan: n=15; United States: n=12; Israel: n=9). SDM was perceived as a way to inform patients and allow them to participate in their care. Barriers to implementing SDM varied based on place of origin; physicians in the United States mentioned limited time, physicians in Jordan reported that a lack of patient education limits SDM practices, and physicians in Israel reported lack of communication training. Most US physicians defined PCC as a practice for prioritizing patient preferences, whereas both Jordanian and Israeli physicians defined PCC as a holistic approach to care and to prioritizing patient needs. Barriers to implementing PCC, as seen by US physicians, were mostly centered on limited appointment time and insurance coverage. In Jordan and Israel, staff shortage and a lack of resources in the system were seen as major barriers to PCC implementation. CONCLUSIONS The study adds to the limited, yet important, literature on SDM and PCC in areas of the world outside the United States, Canada, Australia, and Western Europe. The study suggests that perceptions of PCC might widely differ among these regions, whereas concepts of SDM might be shared. Future work should clarify these differences.

Patient-Centered Care in a Medical Home

2011 ◽  
Vol 16 (2) ◽  
Author(s):  
Colette Carver ◽  
Anne Jessie
Keyword(s):  
Primary Care ◽  
Medical Home ◽  
The United States ◽  
Patient Centered Care ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Patient Centered Medical Homes ◽  
Medical Homes ◽  
Centered Care ◽  
Medical Home Model

There is general consensus that our current healthcare delivery system will not be able to supply an adequate workforce, contain costs, and meet the ever-increasing chronic-care needs of the growing and aging population in the United States (US). Some of the major challenges to the U.S. healthcare system are faced by those on the front lines, namely the healthcare workers in primary care. Part of the emerging solution for primary care is the adoption of the Patient-Centered Medical Home Model. The intent of this model is to provide coordinated and comprehensive care rooted in a strong collaborative relationship. Carilion Clinic in Southwestern Virginia is implementing this patient-centered model in which a proactive, multidisciplinary care team collectively takes responsibility for each patient. In this article we will elaborate on the concepts of patient-centered care and patient-centered medical homes, after which we will offer an exemplar describing the process that Carilion Clinic is using to establish patient-centered medical homes throughout their primary care departments. Limitations of the Patient-Centered Medical Home Model will also be discussed.

scholarly journals A Comparison of Patient-Centered Care in Pharmacy Curricula in the United States and Europe

2016 ◽  
Vol 80 (5) ◽  
pp. 83 ◽  
Author(s):  
Ines Nunes-da-Cunha ◽  
Blanca Arguello ◽  
Fernando Martinez Martinez ◽  
Fernando Fernandez-Llimos
Keyword(s):  
United States ◽  
The United States ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Centered Care

scholarly journals A Randomized Trial to Improve Patient-Centered Care and Hypertension Control in Underserved Primary Care Patients

2011 ◽  
Vol 26 (11) ◽  
pp. 1297-1304 ◽  
Author(s):  
Lisa A. Cooper ◽  
Debra L. Roter ◽  
Kathryn A. Carson ◽  
Lee R. Bone ◽  
Susan M. Larson ◽  
...  
Keyword(s):  
Primary Care ◽  
Randomized Trial ◽  
Patient Centered Care ◽  
Hypertension Control ◽  
Patient Centered ◽  
Centered Care ◽  
Primary Care Patients ◽  
Improve Patient

scholarly journals Strategizing EHR use to achieve patient-centered care in exam rooms: a qualitative study on primary care providers

2015 ◽  
Vol 23 (1) ◽  
pp. 137-143 ◽  
Author(s):  
Jing Zhang ◽  
Yunan Chen ◽  
Shazia Ashfaq ◽  
Kristin Bell ◽  
Alan Calvitti ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Providers ◽  
Patient Centered Care ◽  
Theory Approach ◽  
Care Providers ◽  
Structured Interviews ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Qualitative Interview Study ◽  
Centered Care

Abstract Objective Electronic health records (EHRs) have great potential to improve quality of care. However, their use may diminish “patient-centeredness” in exam rooms by distracting the healthcare provider from focusing on direct patient interaction. The authors conducted a qualitative interview study to understand the magnitude of this issue, and the strategies that primary care providers devised to mitigate the unintended adverse effect associated with EHR use. Methods and Materials Semi-structured interviews were conducted with 21 healthcare providers at 4 Veterans Affairs (VAs) outpatient primary care clinics in San Diego County. Data analysis was performed using the grounded theory approach. Results The results show that providers face demands from both patients and the EHR system. To cope with these demands, and to provide patient-centered care, providers attempt to perform EHR work outside of patient encounters and create templates to streamline documentation work. Providers also attempt to use the EHR to engage patients, establish patient buy-in for EHR use, and multitask between communicating with patients and using the EHR. Discussion and Conclusion This study has uncovered the challenges that primary care providers face in integrating the EHR into their work practice, and the strategies they use to overcome these challenges in order to maintain patient-centered care. These findings illuminate the importance of developing “best” practices to improve patient-centered care in today’s highly “wired” health environment. These findings also show that more user-centered EHR design is needed to improve system usability.

scholarly journals Shared Decision Making and Patient-Centered Care in Israel, Jordan, and the United States: Exploratory and Comparative Survey Study of Physician Perceptions

10.2196/18223 ◽  
2020 ◽  
Vol 4 (8) ◽  
pp. e18223
Author(s):  
Yaara Zisman-Ilani ◽  
Rana Obeidat ◽  
Lauren Fang ◽  
Sarah Hsieh ◽  
Zackary Berger
Keyword(s):  
United States ◽  
Decision Making ◽  
Shared Decision Making ◽  
The United States ◽  
Patient Centered Care ◽  
Survey Study ◽  
Shared Decision ◽  
Patient Centered ◽  
Centered Care ◽  
Comparative Survey

Background Shared decision making (SDM) is a health communication model that evolved in Europe and North America and largely reflects the values and medical practices dominant in these areas. Objective This study aims to understand the beliefs, perceptions, and practices related to SDM and patient-centered care (PCC) of physicians in Israel, Jordan, and the United States. Methods A hypothesis-generating comparative survey study was administered to physicians from Israel, Jordan, and the United States. Results A total of 36 surveys were collected via snowball sampling (Jordan: n=15; United States: n=12; Israel: n=9). SDM was perceived as a way to inform patients and allow them to participate in their care. Barriers to implementing SDM varied based on place of origin; physicians in the United States mentioned limited time, physicians in Jordan reported that a lack of patient education limits SDM practices, and physicians in Israel reported lack of communication training. Most US physicians defined PCC as a practice for prioritizing patient preferences, whereas both Jordanian and Israeli physicians defined PCC as a holistic approach to care and to prioritizing patient needs. Barriers to implementing PCC, as seen by US physicians, were mostly centered on limited appointment time and insurance coverage. In Jordan and Israel, staff shortage and a lack of resources in the system were seen as major barriers to PCC implementation. Conclusions The study adds to the limited, yet important, literature on SDM and PCC in areas of the world outside the United States, Canada, Australia, and Western Europe. The study suggests that perceptions of PCC might widely differ among these regions, whereas concepts of SDM might be shared. Future work should clarify these differences.

Why Study Attending Physicians?

2017 ◽  
Author(s):  
Molly Harrod ◽  
Sanjay Saint ◽  
Robert W. Stock
Keyword(s):  
United States ◽  
The United States ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Centered Care ◽  
Attending Physicians ◽  
Individual Style

The hospitalist movement has been a key element in the transformation of American hospitals, aiding in the effort to shorten patients’ stay and reduce costs. The ranks of hospitalists have burgeoned to more than 40,000. They can be found in 70% of hospitals, and hospitalists have played a crucial supporting role in the drive toward higher quality, patient-centered care in the United States. Most of the attending physicians in this study are also hospitalists, specializing in the care of patients within the hospital. Although each attending had his or her own individual style of doctoring and teaching, the authors were able to identify qualities and attributes that they all shared. One of the most important attributes that all of the attendings shared was the conviction that they never stop learning.

Patient-Centered Care and Uterine Fibroids

2017 ◽  
Vol 35 (06) ◽  
pp. 560-564 ◽  
Author(s):  
Erica Marsh ◽  
Shani Chibber ◽  
Wael Saad
Keyword(s):  
United States ◽  
Care Delivery ◽  
Uterine Fibroids ◽  
The United States ◽  
Patient Centered Care ◽  
Health Concern ◽  
Benign Tumors ◽  
Patient Centered ◽  
Centered Care ◽  
Reproductive Aged Women

AbstractUterine leiomyomas are the most prevalent tumors in reproductive-aged women and are a major public health concern in the United States. Commonly known as fibroids, these benign tumors continue to be the leading cause of hysterectomy and are responsible for as much as $34 million in costs annually in the United States. Despite the increasing numbers of gains that are being made in understanding the pathophysiology of these tumors, relatively little work has been done to advance understanding of care delivery with regard to these tumors, specifically the patient perspective. Herein, we provide an overview of patient-centered care, a review of the available literature on the fibroid patient's perspective, and a discussion of opportunities to re-envision patient care with regard to fibroids.

Patient-Centered Care and Autonomy: Shared Decision-Making in Practice and a Suggestion for Practical Application in the Critically Ill

2019 ◽  
Vol 35 (11) ◽  
pp. 1352-1355
Author(s):  
Marianna V. Mapes ◽  
Peter A. DePergola ◽  
William T. McGee
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
Critically Ill ◽  
Care Service ◽  
Clinical Care ◽  
Patient Centered Care ◽  
Practical Application ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Centered Care

Decision-making for the hospitalized dying and critically ill is often characterized by an understanding of autonomy that leads to clinical care and outcomes that are antithetical to patients’ preferences around suffering and quality of life. A better understanding of autonomy will facilitate the ultimate goal of a patient-centered approach and ensure compassionate, high-quality care that respects our patients’ values. We reviewed the medical literature and our experiences through the ethics service, palliative care service, and critical care service of a large community teaching hospital. The cumulative experience of a senior intensivist was filtered through the lens of a medical ethicist and the palliative care team. The practical application of patient-centered care was discerned from these interactions. We determined that a clearer understanding of patient-centeredness would improve the experience and outcomes of care for our patients as well as our adherence to ethical practice. The practical applications of autonomy and patient-centered care were evaluated by the authors through clinical interactions on the wards to ascertain problems in understanding their meaning. Clarification of autonomy and patient-centeredness is provided using specific examples to enhance understanding and application of these principles in patient-centered care.

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