scholarly journals How service modularity can provide the flexibility to support person-centered care and shared decision-making

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
E. A. Bartels ◽  
B. R. Meijboom ◽  
L. M. W. Nahar-van Venrooij ◽  
E. de Vries
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Healthcare Services ◽  
Service Improvement ◽  
Shared Decision ◽  
Healthcare Provision ◽  
Person Centered Care ◽  
Healthcare Practice ◽  
Centered Care ◽  
Insight Into

Abstract Background Today’s healthcare provision is facing several challenges, that cause the level of complexity to increase at a greater rate than the managerial capacity to effectively deal with it. One of these challenges is the demand for person-centered care in an approach that is tuned towards shared decision-making. Flexibility is needed to adequately respond to individual needs. Methods We elaborate on the potential of service modularity as a foundation for person-centered care delivered in a shared decision-making context, and examine to what extent this can improve healthcare. We primarily focused on theory building. To support our effort and gain insight into how service modularity is currently discussed and applied in healthcare, we conducted a scoping review. Results Descriptions of actual implementations of modularity in healthcare are rare. Nevertheless, applying a modular perspective can be beneficial to healthcare service improvement since those service modularity principles that are still missing can often be fulfilled relatively easily to improve healthcare practice. Service modularity offers a way towards flexible configuration of services, facilitating the composition of tailored service packages. Moreover, it can help to provide insight into the possibilities of care for both healthcare professionals and patients. Conclusions We argue that applying a modular frame to healthcare services can contribute to individualized, holistic care provision and can benefit person-centered care. Furthermore, insight into the possibilities of care can help patients express their preferences, increasing their ability to actively participate in a shared decision-making process. Nevertheless, it remains essential that the healthcare professional actively collaborates with the patient in composing the care package, for which we propose a model. Altogether, we posit this can improve healthcare practice, especially for the people receiving care.

scholarly journals Person-centered dementia care in home care services – highly recommended but still challenging to obtain: a qualitative interview study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kari-Anne Hoel ◽  
Anne Marie Mork Rokstad ◽  
Ingvild Hjorth Feiring ◽  
Bjørn Lichtwarck ◽  
Geir Selbæk ◽  
...  
Keyword(s):  
Decision Making ◽  
Home Care ◽  
Shared Decision Making ◽  
Care Service ◽  
Home Care Services ◽  
Shared Decision ◽  
Care Services ◽  
Person Centered Care ◽  
People With Dementia ◽  
Centered Care

Abstract Background Dementia is one of the main causes of disability and dependence in older people, and people with dementia need comprehensive healthcare services, preferably in their own homes. A well-organized home care service designed for people with dementia is necessary to meet their needs for health- and social care. Therefore, it is important to gain knowledge about how people with dementia experience the home care service and if the service responds to their wishes and needs. The aim of this study was to explore the experience of home care services among people with dementia, to understand the continuity in services, how the service was adapted to people with dementia, and how the patient experienced person-centered care and shared decision-making. Methods We used a qualitative, exploratory design based on a phenomenological-hermeneutic approach and performed individual in-depth interviews with persons with dementia. A convenience sample of 12 persons with moderate to severe degrees of dementia from four Norwegian municipalities participated in the study. The interviews were conducted in February 2019. Results The findings identified that the participants appreciated the possibility to stay safely in their own homes and mostly experienced good support from staff. They expressed various views and understanding of the service and experienced limited opportunities for user involvement and individualized, tailored service. The overall theme summarizing the findings was: “It is difficult for people with dementia to understand and influence home care services, but the services facilitate the possibility to stay at home and feel safe with support from staff.” Conclusion The participants did not fully understand the organization of the care and support they received from the home care services, but they adapted to the service without asking for changes based on their needs or desires. Although person-centered care is recommended both nationally and internationally, the participants experienced little inclusion in defining the service they received, and it was perceived as unclear how they could participate in shared decision-making.

Person-centered peritoneal dialysis prescription and the role of shared decision-making

2020 ◽  
Vol 40 (3) ◽  
pp. 302-309 ◽  
Author(s):  
Peter G Blake ◽  
Edwina A Brown
Keyword(s):  
Decision Making ◽  
Peritoneal Dialysis ◽  
Shared Decision Making ◽  
Care Delivery ◽  
Shared Decision ◽  
Person Centered Care ◽  
Modern Health Care ◽  
Patient Reported ◽  
Centered Care ◽  
End Stage

Person-centered care has become a dominant paradigm in modern health care. It needs to be applied to people with end-stage kidney disease considering the initiation of dialysis and to peritoneal dialysis (PD) prescription and care delivery. It is relevant to their decisions about goals of care, transplantation, palliative care, and discontinuation of dialysis. It is also relevant to decisions about how PD is delivered, including options such as incremental PD. Shared decision-making is the essence of this process and needs to become a standard principle of care. It requires engagement, education, and empowerment of patients. Patient-reported outcomes and patient-reported experience are also central to person-centered care in PD.

EDITORIAL INTRODUCTION: ICPCM EDUCATIONAL PROGRAM ON PERSON-CENTERED CARE: CARE PLANNING, SHARED DECISION MAKING, AND INTERPROFESSIONAL COLLABORATION

2020 ◽  
Author(s):  
James Appleyard ◽  
Juan E. Mezzich
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Shared Decision Making ◽  
Latin American ◽  
Educational Program ◽  
Interprofessional Collaboration ◽  
New Delhi ◽  
Shared Decision ◽  
Person Centered Care ◽  
Centered Care

This journal issue includes the third part of the Educational Program on Person-Centered Care of the International College of Person Centered Medicine (ICPCM) that in its initial version was presented at the 6th International Congress of Person Centered Medicine in New Delhi in November 2018. The overall themes of the four papers [1–4] are the planning of care, shared decision making, and interprofessional collaboration. In addition, there is the Lima Declaration 2018 entitled “Towards a Latin American Construction of Persons-Centered Integral Health Care,” which recognizes how important these concepts are to the development of general strategies for integrated health care with persons placed at the center of and as the goal of health actions. Reports from the Symposium on Person-Centered Medicine held during the 2018 World Medical Association’s Conference in Reykjavik and the First Peruvian Conference on Person-Centered Medicine add further evidence of the importance of these perspectives.

Healthcare Decisions

2019 ◽  
pp. 118-136
Author(s):  
Ulrik Kihlbom ◽  
Christian Munthe
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Healthcare Professionals ◽  
Clinical Care ◽  
Decision Making Process ◽  
Shared Decision ◽  
The Core ◽  
Person Centered Care ◽  
Centered Care ◽  
Core Idea

The aim of this chapter is to outline how different relational aspects of families may ground obligations on the part of healthcare professionals toward patients and their families in the decision-making process. The exploration starts from the core idea within person-centered care of having patients’ general life situation, experiences, wants, and values to be a substantial topic of concern in a process of shared decision making. If relational decision-making paradigms are to be minimally functional, healthcare professionals’ stances need to involve complex schemes of including people closely related to patients, who will have to be recognized as legitimate stakeholders and partners in, as well as resources for, clinical care.

The Role of Shared Decision-Making in Audiologic Rehabilitation

2014 ◽  
Vol 21 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Helen Pryce ◽  
Amanda Hall
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Behavior Changes ◽  
Shared Decision ◽  
Patient Centered ◽  
Treatment Information ◽  
Centered Care ◽  
Potential Risks ◽  
Audiologic Rehabilitation

Shared decision-making (SDM), a component of patient-centered care, is the process in which the clinician and patient both participate in decision-making about treatment; information is shared between the parties and both agree with the decision. Shared decision-making is appropriate for health care conditions in which there is more than one evidence-based treatment or management option that have different benefits and risks. The patient's involvement ensures that the decisions regarding treatment are sensitive to the patient's values and preferences. Audiologic rehabilitation requires substantial behavior changes on the part of patients and includes benefits to their communication as well as compromises and potential risks. This article identifies the importance of shared decision-making in audiologic rehabilitation and the changes required to implement it effectively.

Comparisons of Client and Clinician Views of the Importance of Factors in Client-Clinician Interaction in Hearing Aid Purchase Decisions

2015 ◽  
Vol 26 (03) ◽  
pp. 247-259 ◽  
Author(s):  
Laya Poost-Foroosh ◽  
Mary Beth Jennings ◽  
Margaret F. Cheesman
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Hearing Aids ◽  
Hearing Aid ◽  
Purchase Decisions ◽  
Shared Decision ◽  
Centered Care ◽  
Importance Ratings ◽  
The Mean ◽  
Client Needs

Background: Despite clinical recognition of the adverse effects of acquired hearing loss, only a small proportion of adults who could benefit use hearing aids. Hearing aid adoption has been studied in relationship to client-related and hearing aid technology–related factors. The influence of the client-clinician interaction in the decision to purchase hearing aids has not been explored in any depth. Purpose: Importance ratings of a sample of adults having a recent hearing aid recommendation (clients) and hearing healthcare professionals (clinicians) from across Canada were compared on factors in client-clinician interactions that influence hearing aid purchase decisions. Research Design: A cross-sectional approach was used to obtain online and paper-based concept ratings. Data Collection and Analysis: Participants were 43 adults (age range, 45–85 yr) who had received a first hearing aid recommendation in the 3 mo before participation. A total of 54 audiologists and 20 hearing instrument practitioners from a variety of clinical settings who prescribed or dispensed hearing aids completed the concept-rating task. The task consisted of 122 items that had been generated via concept mapping in a previous study and which resulted in the identification of eight concepts that may influence hearing aid purchase decisions. Participants rated “the importance of each of the statements in a person’s decision to purchase a hearing aid” on a 5-point Likert scale, from 1 = minimally important to 5 = extremely important. For the initial data analysis, the ratings for each of the items included in each concept were averaged for each participant to provide an estimate of the overall importance rating of each concept. Multivariate analysis of variance was used to compare the mean importance ratings of the clients to the clinicians. Ratings of individual statements were also compared in order to investigate the directionality of the importance ratings within concepts. Results: There was a significant difference in the mean ratings for clients and clinicians for the concepts understanding and meeting client needs, conveying device information by clinician, supporting choices and shared decision making, and factors in client readiness. Three concepts—understanding and meeting client needs, conveying device information by clinician, and supporting choices and shared decision making—were rated as more important by clients than by clinicians. One concept (ie, factors in client readiness) was rated as more important by clinicians than by clients. Conclusions: The concepts rated as most important by clients and clinicians are consistent with components of several existing models of client-centered and patient-centered care. These concepts reflect the clients’ perception of the importance of their involvement in the decision-making process. A preliminary model of client-centered care within the hearing aid uptake process and implications for clinical audiology are described.

Sign in / Sign up

Export Citation Format

Share Document