IPCHS. Integrated People-Centred Health Services

Contents

Contents tagged: shared decision making

June 1, 2015 Global Publication

What is person-centered health care?

What is person-centred health care? There are many definitions of person-centred (patient-or client-centred) health care in the literature. The Victorian Department of Human Services (2003) defines person-centred care as ‘treatment and care provided by health services [that] places the person at the centre of their own care and considers the needs of the older person’s carers’. The main features of person-centred health care derived from the literature can be encompassed within the concept of partnership. The overriding message is that person-centred care is about a collaborative and respectful partnership between the service provider and user. The service provider respects the contribution the service user can make to their own health, such as their values, goals, past experience, and knowledge of their own health needs, and the service user respects the contribution the service provider can make, including their professional expertise and knowledge, information about the options available to the ...

March 3, 2016 Americas Publication

The patient-as-partner approach in health care: a conceptual framework for a necessary transition.

A new model to enforce the partnership between patients and healthcare professionals has been developed at the University of Montreal’s Faculty of Medicine. Their patient-as-partner approach is rooted in patient-centered perspectives that have inspired previous initiatives like shared decision making, therapeutic education, expert patient and self-management. The main contribution of “Montreal model” is to consider the patient as a caregiver of himself and, as such, a genuine member of the treatment team, endowed with competencies and limitations just like any other member of the team.
This article describes the theoretical basis and summarize the main achievements of this innovative approach, established since 2010. Authors examine the issues of patient partnerships on medical practice and medical education cultures. Two key challenges are identified: 1) Integrate patients in existing professional education structures, instead of separate spaces as patient’s universities and 2) Develop a formal recruitment process for those patients, including ...

May 17, 2016 Europe Publication

Person-centered care - ready for prime time

Long-term diseases are today the leading cause of mortality worldwide and are estimated to be the leading cause of disability by 2020. Person-centered care (PCC) has been shown to advance concordance between care provider and patient on treatment plans, improve health outcomes and increase patient satisfaction. Yet, despite these and other documented benefits, there are a variety of significant challenges to putting PCC into clinical practice. Although care providers today broadly acknowledge PCC to be an important part of care, in our experience we must establish routines that initiate, integrate, and safeguard PCC in daily clinical practice to ensure that PCC is systematically and consistently practiced, i.e. not just when we feel we have time for it. In this paper, we propose a few simple routines to facilitate and safeguard the transition to PCC. We believe that if conscientiously and systematically applied, they will help to make PCC the ...

May 7, 2019 Europe Publication

Shared Decision Making to Improve Care and Reduce Costs

Asleeper provision of the Affordable Care Act (ACA) encourages greater use of shared decision making in health care. For many health situations in which there's not one clearly superior course of treatment, shared decision making can ensure that medical care better aligns with patients' preferences and values. Shared decision making has the potential to provide numerous benefits for patients, clinicians, and the health care system, including increased patient knowledge, less anxiety over the care process, improved health outcomes, reductions in unwarranted variation in care and costs, and greater alignment of care with patients' values.

June 27, 2019 Global Publication

Challenges to patient centredness – a comparison of patient and doctor experiences from primary care

Many countries and international organisations, such as OECD and WHO, have chosen patient centredness as the approach to ensure that the patients’ needs, values, and preferences are appropriately considered in the health care meetings. Whereas most OECD countries show progress in implementing patient-centred care, no country performs in the top group on all indicators in cross-country comparison. Patient-centred consultation methodologies vary, but reoccurring components can be identified in the literature, such as the patient’s narrative and collaboration.
This article designed an observational study to investigate the level of patients’ and doctors’ ratings of patient-centred aspects of the primary care consultation.

Sept. 17, 2019 Europe Publication

Self-management support for chronic disease in primary care: frequency of patient self-management problems and patient reported priorities, and alignment with ultimate behavior goal selection

To enable delivery of high quality patient-centered care, as well as to allow primary care health systems to allocate appropriate resources that align with patients’ identified self-management problems (SM-Problems) and priorities (SM-Priorities), a practical, systematic method for assessing self-management needs and priorities is needed. In this current report, are present the patient reported data generated from Connection to Health (CTH), to identify the frequency of patients’ reported SM-Problems and SM-Priorities; and examine the degree of alignment between patient SM-Priorities and the ultimate Patient-Healthcare team member selected Behavioral Goal.

April 8, 2020 Global Publication

Innovative Integrated Health And Social Care Programs In Eleven High-Income Countries

High-income countries face the challenge of providing effective and efficient care to the relatively small proportion of their populations with high health and social care needs. Recent reports suggest that integrated health and social care programs target specific high-needs population segments, coordinate health and social care services to meet their clients’ needs, and engage clients and their caregivers. We identified thirty health and social care programs in eleven high-income countries that delivered care in new ways. We used a structured survey to characterize the strategies and activities used by these programs to identify and recruit clients, coordinate care, and engage clients and caregivers. We found that there were some common features in the implementation of these innovations across the eleven countries and some variation related to local context or the clients served by these programs. Researchers could use this structured approach to better characterize the core components of innovative integrated ...

Sept. 23, 2020 Europe Publication

What Do Parents Expect in the 21st Century? A Qualitative Analysis of Integrated Youth Care

To provide integrated Youth Care responsive to the needs of families with multiple problems across life domains, it is essential to incorporate parental perspectives into clinical practice. The parental perspectives on integrated Youth Care in this study emphasize that parents have a strong desire for a family-centred approach and active participation in decision making over their own care process. However, since parental expectations regarding these key components of integrated Youth Care are somewhat opposing, professionals should be aware of potential confusion and explicitly discuss mutual expectations during a care process. 

March 28, 2022 Africa Publication

An insight into patients' perspectives on barriers affecting participation in shared decision making among patients with diabetes mellitus in Malawi

Patient participation in decision making is a basic tenet for a patient centred care experience and, has potential to improve care experiences and responsiveness in chronic diseases such as Diabetes Mellitus (DM). However, documented experiences show that patient participation in decisions making is wanting. As Malawi strives to institutionalise patient centred care delivery, it is important to examine patients' experiences and perceptions to identify barriers affecting their participation in shared decision making because this may provide evidence supporting strategies in implementation of the institutionalisation.

Oct. 20, 2022 Americas Publication

The road to patient-centred care in Peru: The difficulties and opportunities to achieve participatory health care

Patient-centred care (PCC) is a pillar of quality health services, where decision-making power is shared between the clinician and the patient. Although, this approach could be adopted with easiness in high income settings or in countries with unified health systems, in settings such as Peru, where universal access and other structural problems remain a challenge, the practice of PCC is not a priority. In Peru, research on PCC has been conducted for almost two decades, but this has not generated a need for development in academia, decision makers, health personal or patients. 

Nov. 16, 2022 Europe Publication

Patient-centred care in Hungary: Contributions to foster a policy agenda

In Hungary, the National Health Insurance Fund provides health care coverage for nearly all residents, but healthcare spending is below the EU’s average (6.4% versus 9.9% of the GDP in 2019, respectively). In 1997, patients’ rights were established by laws of the healthcare system. The patients’ voice, however, has remained weakly embedded in decision-making processes both on the system and individual patient levels. Policy progress achieved in the past years may foster patient-centeredness in health policy decision-making. However, people-reported data are not yet embedded in the Hungarian health information system and national population or household surveys, thus undermining the monitoring of the performance of the health system regarding patient-centred aspects. From the academic research side, several advances have occurred regarding the availability of validated instruments for the measurement of patient-centred aspects. These recent studies have placed Hungary in a uniquely advanced position compared with other countries in ...