Advancing patient-centered care through transformative educational leadership: a critical review of health care professional preparation for patient-centered care

Patient-centered care is at the nexus of several overlapping institutional reforms to improve health care system performance. However, we know little regarding Medicaid patients’ experience with their doctors along several key dimensions of patient-centered care, and how their experience compares with Medicare and privately insured patients. We studied 4 outcomes using the 2017 National Health Interview Survey: patient–provider concordance on racial/sexual/cultural identity, respectful provider attitude, solicitation of patient opinion/beliefs during the care encounter, and patient-centered communication (PCC). The primary independent variable was Medicaid enrollee status. We dichotomized responses and ran multivariate logistic regressions for each type of care experience outcome, controlling for sociodemographic factors, health care access, and health care utilization of respondents. Compared to Medicare and privately insured enrollees, Medicaid enrollees reported much lower odds of seeing providers who treated them with respect (OR = 1.91, P < .001; OR = 1.62, P < .01) and who offered PCC (OR = 1.35, P < .05; OR = 1.35, P < .01), but similar odds of seeing concordant providers (OR = 0.78, P = .96; OR = 0.96, P = .72). Importantly, Medicaid enrollees reported higher odds of seeing providers who solicited their opinion/beliefs/preferences than their Medicare or privately insured counterparts (OR = 0.82, P < .05; OR = 0.87 P < .10). Medicaid enrollees report less patient-centered experiences in some important facets of their provider interaction than their Medicare or privately insured counterparts. Federal, state, and local policies and practices directed at improving these facets of patient–provider interaction are needed and should be aimed squarely at Medicaid providers, especially those working in geographic areas and settings with a disproportionate number of racial, gender, cultural, and linguistic minorities.

Download Full-text

Unique Challenges for Otolaryngology Patients During the COVID-19 Pandemic

Otolaryngology ◽

10.1177/0194599820954838 ◽

2020 ◽

pp. 019459982095483

Author(s):

Melissa Ghulam-Smith ◽

Yeyoon Choi ◽

Heather Edwards ◽

Jessica R. Levi

Keyword(s):

Health Care ◽

Health Care Delivery ◽

Care Delivery ◽

Patient Centered Care ◽

Patient Centered ◽

Intimate Contact ◽

Respiratory Mucosa ◽

Increased Risk ◽

Centered Care ◽

Upper Respiratory

The coronavirus disease 2019 (COVID-19) pandemic has drastically altered health care delivery and utilization. The field of otolaryngology in particular has faced distinct challenges and an increased risk of transmission as day-to-day procedures involve intimate contact with a highly infectious upper respiratory mucosa. While the difficulties for physicians have been thoroughly discussed, the unique challenges of patients have yet to be considered. In this article, we present challenges for patients of otolaryngology that warrant thoughtful consideration and propose solutions to address these challenges to maintain patient-centered care both during and in the aftermath of the COVID-19 pandemic.

Download Full-text

Innovation in patient-centered care: lessons from a qualitative study of innovative health care organizations in Washington State

BMC Family Practice ◽

10.1186/1471-2296-13-120 ◽

2012 ◽

Vol 13 (1) ◽

Cited By ~ 16

Author(s):

Peter Reed ◽

Douglas A Conrad ◽

Susan E Hernandez ◽

Carolyn Watts ◽

Miriam Marcus-Smith

Keyword(s):

Health Care ◽

Qualitative Study ◽

Health Care Organizations ◽

Patient Centered Care ◽

Washington State ◽

Patient Centered ◽

Centered Care

Download Full-text

Health literacy and palliative care

Public Health Forum ◽

10.1515/pubhef-2016-2129 ◽

2017 ◽

Vol 25 (1) ◽

pp. 94-95

Author(s):

Melissa G. French

Keyword(s):

Health Care ◽

Palliative Care ◽

Health Literacy ◽

Patient Preferences ◽

Health Care Organizations ◽

Patient Centered Care ◽

Patient Centered ◽

Centered Care ◽

Pathway To Care

Abstract Health literacy and palliative care have been receiving more attention within health care organizations and systems in recent years. Both can offer a pathway to care that is better for patients and has the potential to be of high value. A health literate approach to palliative care provides patient-centered care that is better aligned with patient preferences and needs.

Download Full-text

Adoption of a Personal Health Record in the Digital Age: Cross-Sectional Study

Journal of Medical Internet Research ◽

10.2196/22913 ◽

2020 ◽

Vol 22 (10) ◽

pp. e22913

Author(s):

Consuela Cheriece Yousef ◽

Abin Thomas ◽

Ahmed O Alenazi ◽

Sumaya Elgadi ◽

Laila Carolina Abu Esba ◽

...

Keyword(s):

Health Care ◽

National Guard ◽

Personal Health Record ◽

Patient Centered Care ◽

Personal Health ◽

Health Record ◽

Objective Data ◽

Patient Centered ◽

Cross Sectional ◽

Centered Care

Background As health care organizations strive to improve health care access, quality, and costs, they have implemented patient-facing eHealth technologies such as personal health records to better engage patients in the management of their health. In the Kingdom of Saudi Arabia, eHealth is also growing in accordance with Vision 2030 and its National Transformation Program framework, creating a roadmap for increased quality and efficiency of the health care system and supporting the goal of patient-centered care. Objective The aim of this study was to investigate the adoption of the personal health record of the Ministry of National Guard Health Affairs (MNGHA Care). Methods A cross-sectional survey was conducted in adults visiting outpatient clinics in hospitals at the Ministry of National Guard Health Affairs hospitals in Riyadh, Jeddah, Dammam, Madinah, and Al Ahsa, and primary health care clinics in Riyadh and Qassim. The main outcome measure was self-reported use of MNGHA Care. Results In the sample of 546 adult patients, 383 (70.1%) reported being users of MNGHA Care. MNGHA Care users were more likely to be younger (P<.001), high school or university educated (P<.001), employed (P<.001), have a chronic condition (P=.046), use the internet to search for health-related information (P<.001), and use health apps on their mobile phones (P<.001). Conclusions The results of this study show that there is substantial interest for the use of MNGHA Care personal health record with 70% of participants self-reporting use. To confirm these findings, objective data from the portal usage logs are needed. Maximizing the potential of MNGHA Care supports patient engagement and is aligned with the national eHealth initiative to encourage the use of technology for high-quality, accessible patient-centered care. Future research should include health care provider perspectives, incorporate objective data, employ a mixed-methods approach, and use a theoretical framework.

Download Full-text

Patient-centered care pathways: what does it mean? An integrative conceptual framework to meet the need of an international consensus: a qualitative systematic review protocol

10.31219/osf.io/c6asn ◽

2021 ◽

Author(s):

Jean-Baptiste Gartner ◽

Kassim Said Abasse ◽

Ghita Ben Zagguou ◽

Frédéric Bergeron ◽

Paolo Landa ◽

...

Keyword(s):

Systematic Review ◽

Health Care ◽

Care Delivery ◽

Care Pathway ◽

Patient Centered Care ◽

Patient Centered ◽

International Consensus ◽

Patient Journey ◽

Centered Care ◽

Health Care Delivery Systems

Background: Faced with increased expectations regarding the quality and safety of health care delivery systems, a number of stakeholders are increasingly looking for more qualitative and efficient ways to deliver care. This study is conducted to provide a clear definition of the patient-centered care pathway and its characteristics to meet the need for an international consensus. Methods: This qualitative systematic review aims to perform a systematic synthesis of published evidence concerning (1) the definition of the patient trajectory, patient pathway or patient journey and (2) their characteristics. With a consulting librarian, a comprehensive and systematic search in three databases was conducted (PUBMED, Embase, ABI/Inform), from 1995 to 2020 without language criteria. Eligibility criteria guiding data selection will follow the PICo mnemonic criteria consisting of (1) Population : all types of patients managed by health care delivery systems for an acute or chronic condition regardless of age or condition, (2) Phenomena : studies that contribute to the definition and conceptualization of the concepts of care trajectory, care pathway and patient journey resulting in a theoretical and conceptual contribution, and (3) Context : health care providers include all providers of primary, secondary, tertiary, and quaternary care in any geographic area. Two reviewers will independently screen, select, extract data and make a critical assessment of the methodology used with the JBI Qualitative Assessment and Review Instrument (JBI QARI).Discussion: This systematic review will provide much-needed knowledge regarding patient-centered pathways. The results will benefit clinicians, decision makers, and researchers by giving them a clear and integrated definition and understanding of the patient-centered care pathways and their characteristics to finally meet the need for an international consensus.

Download Full-text

Trends in Patient-Centered Care in South West Nigeria: A Holistic Assessment of the Nurses Perception of Primary Healthcare Practice

Global Journal of Health Science ◽

10.5539/gjhs.v12n6p73 ◽

2020 ◽

Vol 12 (6) ◽

pp. 73

Author(s):

Adepeju M. Lateef ◽

Euphemia M. Mhlongo

Keyword(s):

Health Care ◽

Primary Health Care ◽

Research Study ◽

Patient Centered Care ◽

Participatory Action ◽

Patient Centered ◽

Quality Healthcare ◽

Primary Health ◽

South West ◽

Centered Care

BACKGROUND: A key dimension of a quality healthcare to patients is patient-centered care approach which is increasingly gaining recognition worldwide. However, this concept is not fully implemented in practice. AIM: The aim of this study is to provide outcomes from assessment of nurses’ perceptions about patient-centered care and the current trends in Primary Health Care system in South West Nigeria. METHODS: This study employed a qualitative participatory action research study approach and conducted a semi-structured individual interview with thirty-five nurses and four focus group discussions in Osun State South West Nigeria Primary Health Care centres. RESULTS: Primary Health Care (PHC) nurses perceived and described patient-centered care (PCC) as a global approach to improve and enhance nursing care to foster patient participation. The narratives were categorised into two: positive and negative perception. Ten main themes emerged: (I) Attitude of the nurses (ii) Lack of enforcement and implementation, (iii) Experience of the nurses, (iv) Quality-Caring, (v) Effective communication with patient, (vi) Motivated and Proactive healthcare, (vii) Sharpen the form of care, (viii) Outcome and after-effect driven healthcare, (ix) Approved support, and (x) Guarantor of service and motivation. CONCLUSION: Our participatory action research study on the assessment of nurses’ perception on the utilization of PCC at the PHC for effective and quality healthcare service revealed the importance of nurses’ role, acceptability of PCC and current nursing care practice at the Primary Health Care (PHC) rural community setting. Nurses as healthcare providers expressed PCC as a common and global approach that would enhance patient experiences and improves the quality of nursing healthcare delivery through integration of PCC and healthcare service at the PHC healthcare system.

Download Full-text

Association of American Medical Colleges (AAMC) joins health care leaders to discuss patient-centered care

Leadership in Health Services ◽

10.1108/lhs.2011.21124bab.004 ◽

2011 ◽

Vol 24 (2) ◽

Keyword(s):

Health Care ◽

American Medical ◽

Patient Centered Care ◽

Patient Centered ◽

Health Care Leaders ◽

Centered Care ◽

Medical Colleges

Download Full-text

A Brief Survey on Six Basic and Reduced eHealth Indicators in Seven Countries in 2017

Applied Clinical Informatics ◽

10.1055/s-0038-1669458 ◽

2018 ◽

Vol 09 (03) ◽

pp. 704-713 ◽

Cited By ~ 3

Author(s):

Reinhold Haux ◽

Elske Ammenwerth ◽

Sabine Koch ◽

Christoph Lehmann ◽

Hyeoun-Ae Park ◽

...

Keyword(s):

Health Care ◽

Information Processing ◽

Health Care Professionals ◽

The United States ◽

Patient Centered Care ◽

Patient Centered ◽

Political Will ◽

Record Data ◽

Centered Care ◽

Future Work

Background Holistic, ubiquitous support of patient-centered health care (eHealth) at all health care institutions and in patients' homes through information processing is increasingly supplementing institution-centered care. While eHealth indicators may measure the transition from institution-centered (e.g., hospital-centered) information processing to patient-centered information processing, collecting relevant and timely data for such indicators has been difficult. Objectives This article aims to design some basic eHealth indicators, which are easily collected and measure how well information processing supports holistic patient-centered health care, and to evaluate penetrance of patient-centered health as measured by the indicators internationally via an expert survey. Methods We identified six basic indicators that measure access of health care professionals, patients, and caregivers to the patient's health record data and the ability of providers, patients, and caregivers to add information in the patient's record. In a survey of international informatics experts, these indicators' penetrance were evaluated for Austria, Finland, Germany, Hong Kong, South Korea, Sweden, and the United States in the summer of 2017. Results The eHealth status measured by the indicators varied significantly between these seven countries. In Finland, most practices measured by the indicators were fully implemented whereas in Germany only one practice was partially realized. Conclusion Progress in the implementation of practices that support patient-centered care could mainly be observed in those countries where the “political will” focused on achieving patient-centered care as opposed to an emphasis on institution-centered care. The six eHealth indicators seem to be useful for measuring national progress in patient-centered care. Future work will extend the number of countries analyzed.

Download Full-text

Reflections on Patient-Centered Care: From the Perspective of a Young Otolaryngologist

Otolaryngology ◽

10.1177/0194599817721455 ◽

2017 ◽

Vol 157 (4) ◽

pp. 543-544

Author(s):

Nausheen Jamal

Keyword(s):

Health Care ◽

Health Outcomes ◽

Health System ◽

Patient Engagement ◽

Patient Centered Care ◽

Patient Centered ◽

Quality Outcomes ◽

System Medicine ◽

Key Factor ◽

Centered Care

It is now well recognized that patient engagement in health care is a key factor in improving satisfaction; however, it is also critical if we are to improve the health outcomes of our patients, as well as the economic and quality outcomes of our health system. Medicine, though, has traditionally resisted a culture of patient-centered or patient-controlled care. What follow are the reflections of one otolaryngologist on the importance and challenges of making the transition to patient-centered care.

Download Full-text