IPCHS. Integrated People-Centred Health Services

Contents

Contents tagged: patient-centered care

Sept. 4, 2020 Americas Publication

Case management service quality and patient-centered care

Providing care that is patient-centered is an important objective in the modern healthcare industry. Despite this objective, hospital inpatient case managers and the services they provide are evaluated routinely without including patients' perspectives. Therefore, the purpose of this study is to fill this research gap by using patient expectations and perceptions to assess the overall quality of and patient satisfaction with hospital case management services.

April 17, 2020 Africa Publication

'They are inconveniencing us' - exploring how gaps in patient education and patient centred approaches interfere with TB treatment adherence: perspectives from patients and clinicians in the Free State Province, South Africa.

Tuberculosis (TB) treatment loss to follow up (LTFU) plays an important contributory role to the staggering TB epidemic in South Africa. Reasons for treatment interruption are poorly understood.Treatment interruption appears to be the culmination of poor health literacy of patients and inadequate health education provided by clinicians. Limited occupational opportunities, fear of disclosure and stigmatization all contributed to treatment LTFU. Clinicians concurred that poor patient understanding of TB and that biomedical management lacking a psycho-social dimension further exacerbated the poor treatment outcome. TB remains a social disease, the successful management of which hinges on patient-centred care.

April 13, 2020 Europe Publication

Implementation of patient-centred care: which organisational determinants matter from decision maker’s perspective? Results from a qualitative interview study across various health and social care organisations

Health and social care systems, organisations and providers are under pressure to organise care around patients’ needs with constrained resources. To implement patient-centred care (PCC) successfully, barriers must be addressed. Up to now, there has been a lack of comprehensive investigations on possible determinants of PCC across various health and social care organisations (HSCOs). Our qualitative study examines determinants of PCC implementation from decision makers’ perspectives across diverse HSCOs.

Dec. 6, 2019 Global Publication

Mapping Evidence of Patients’ Experiences in Integrated Care Settings: A Protocol for a Scoping Review

Integrated care (IC) models have emerged to address gaps in care for individuals with complex healthcare needs. Although the clinical and cost-effectiveness of IC models are well-established, the understanding of whether IC models facilitate a patient-centred care experience from the patients’ perspective is not well understood. This scoping review aims to comprehensively map the literature to provide a broad overview of patients’ experiences in IC settings with a focus on the experiences of complex patients with comorbid mental and physical illnesses. It also aims to describe current gaps identified in the literature in our understanding of aspects of care that are often unrecognised.

Nov. 26, 2019 Americas Publication

Association of the Implementation of the Patient-Centered Medical Home with Quality of Life in Patients with Multimorbidity

The patient-centered medical home (PCMH) has clinical benefits for chronic disease care, but the association with patient-reported outcomes such as health-related quality of life (HRQoL) is unexplored in patients with multimorbidity (two or more chronic diseases). The aim o this study was to examine if greater clinic-level PCMH implementation was associated with higher HRQoL in multimorbid adults.

Nov. 21, 2019 Global Publication

Patient-Centered Care: An Examination of Provider–Patient Communication Over Time

The aim was to examine the quality of provider communication over time considering the increasing emphasis on patient-centered care (PCC). Patient-centered care has been shown to have a positive impact on health outcomes, care experiences, quality-of-life, as well as decreased costs. Given this emphasis, it expect that provider–patient communication has improved over time.

Oct. 30, 2019 Europe Publication

Evaluation of integrated care services in Catalonia: population-based and service-based real-life deployment protocols.

Comprehensive assessment of integrated care deployment constitutes a major challenge to ensure quality, sustainability and transferability of both healthcare policies and services in the transition toward a coordinated service delivery scenario. To this end, the manuscript articulates four different protocols aiming at assessing large-scale implementation of integrated care, which are being developed within the umbrella of the regional project Nextcare (2016-2019), undertaken to foster innovation in technologically-supported services for chronic multimorbid patients in Catalonia (ES) (7.5 M inhabitants). Whereas one of the assessment protocols is designed to evaluate population-based deployment of care coordination at regional level during the period 2011-2017, the other three are service-based protocols addressing: i) Home hospitalization; ii) Prehabilitation for major surgery; and, iii) Community-based interventions for frail elderly chronic patients. All three services have demonstrated efficacy and potential for health value generation.

Oct. 23, 2019 Europe Publication

The “Patient-centered coordination by a care team” questionnaire achieves satisfactory validity and reliability

Increasing prevalence of chronic conditions and multimorbidity challenges health care systems and calls for patient-centered coordination of care. Implementation and evaluation of health policies focusing on the development of patient-centered coordination of care needs valid instruments measuring this dimension of care. The aim of this validation study was to assess the psychometric properties of the French version of the 14-item Patient-Centered Coordination by a Care Team (PCCCT) questionnaire in a primary care setting. 

Oct. 12, 2019 Global Publication

Patient- and Family-Centered Care Coordination: A Framework for Integrating Care for Children and Youth Across Multiple Systems

Understanding a care coordination framework, its functions, and its effects on children and families is critical for patients and families themselves, as well as for pediatricians, pediatric medical subspecialists/surgical specialists, and anyone providing services to children and families. Care coordination is an essential element of a transformed American health care delivery system that emphasizes optimal quality and cost outcomes, addresses family-centered care, and calls for partnership across various settings and communities. High-quality, cost-effective health care requires that the delivery system include elements for the provision of services supporting the coordination of care across settings and professionals

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.

March 7, 2019 Global Publication

Patient Engagement In Research: Early Findings From The Patient-Centered Outcomes Research Institute

Charged with ensuring that research produces useful evidence to inform health decisions, the Patient-Centered Outcomes Research Institute (PCORI) requires investigators to engage patients and other health care stakeholders, such as clinicians and payers, in the research process. Many PCORI studies result in articles published in peer-reviewed journals that detail research findings and engagement’s role in research. To inform practices for engaging patients and others as research partners, this study analyzed 126 articles that described engagement approaches and contributions to research. PCORI projects engaged patients and others as consultants and collaborators in determining the study design, selecting study outcomes, tailoring interventions to meet patients’ needs and preferences, and enrolling participants. Many articles reported that engagement provided valuable contributions to research feasibility, acceptability, rigor, and relevance, while a few noted trade-offs of engagement. The findings suggest that engagement can support more relevant research through better alignment with patients’ and clinicians’ real-world ...

Oct. 22, 2018 Europe Publication

Does the Patient-centered Medical Home Model Change Staffing and Utilization in the Community Health Centers?

 Few studies have looked under the hood of practice redesign to understand whether and, if so, how staffing changed with the adoption of patient-centered medical home (PCMH), and whether these staffing changes impacted utilization. So the objective of this article was to examine the workforce transformation occurring in community health centers that have achieved PCMH status, and to assess the relationship of those changes to utilization, as measured by the number of visits.

Sept. 15, 2018 Americas Publication

Person-Centered Integrated Care for Chronic Kidney Disease

The effectiveness of person-centered integrated care strategies for CKD is uncertain. This study conducted a systematic review and meta-analysis of randomized, controlled trials to assess the effect of person-centered integrated care for CKD.
It searched MEDLINE, Embase, and Cochrane Central Register of Controlled Trials (from inception to April of 2016), and selected randomized, controlled trials of person-centered integrated care interventions with a minimum follow-up of 3 months. Random-effects meta-analysis was used to assess the effect of person-centered integrated care.

April 30, 2018 Global Publication

Using Patient Reported Outcomes Measures to Promote Integrated Care

Patient reported outcome measures (PROMs) have been introduced as standardised outcomes, but have not been implemented widely for disease targeted pathways of care, nor for geriatric patients who prefer functional performance and quality of life

Sept. 1, 2017 Americas Publication

The Impact of Integrated Case Management on Health Services Use and Spending Among Nonelderly Adult Medicaid Enrollees

Medicaid plans, whose patients often have complex medical, social, and behavioral needs, seektools to effectively manage enrollees and imprive access to quality care while containing costs. 

The aim of this study is to examine the effects of an integrated case management (ICM) program operated by a Medicaid managed care plan on health service use and spending for nonelderly, non-pregnant adults. 

Aug. 30, 2017 Europe Publication

Challenges and achievements in integrated care: different health and social care providers working together. Successful projects that show that this is the way

The Catalan health system is a public healthcare system, funded by taxes, with universal coverage and public healthcare services portfolio. There´s a mixed healthcare providers network. Delivery of integrated health and social care witha a shift to a patient-centered model is one of the main challenges of our public system. this artcile share three experiences of different models developed to improve integration of social and healthcare services, to guarantee the continuum of care and to achieve quality health and social care outcomes. 

Dec. 2, 2016 Africa Publication

Patient-Centered Care and People-Centered Health Systems in Sub-Saharan Africa: Why So Little of Something So Badly Needed?

Patient–centered care (PCC) is increasingly recognized as a key dimension of quality healthcare, but unfortunately remains poorly implemented in practice. This paper explores the current state of PCC in sub-Saharan Africa and potential barriers to its implementation, with a focus on public first line health services. They develop an analytical framework based on expert knowledge, field experience, and a conceptual literature review. Factors contributing to the (lack of) implementation of PCC are structured in three distinct but interacting layers. The first layer encompasses factors that influence and shape the performance of providers.  The training of health workers is key in that respect. Training models remain dominated by a biomedical perspective, with little attention for psychosocial dimensions of the illness experience. The second layer of determinants relates to the structural and organizational features of the health system. The emphasis in many African health care systems on specific programmatic outputs, and ...

Sept. 29, 2016 Americas Publication

Impact of Patient-Centered Care Innovations on Access to Providers, Ambulatory Care Utilization, and Patient Clinical Indicators in the Veterans Health Administration

The Veterans Health Administration piloted patient-centered care (PCC) innovations beginning in 2010 to improve patient and provider experience and environment in ambulatory care. We use secondary data to look at longitudinal trends, evaluate system redesign, and identify areas for further quality improvement.

METHODS:

This was a retrospective, observational study using existing secondary data from multiple US Department of Veteran Affairs sources to evaluate changes in veteran and facility outcomes associated with PCC innovations at 2 innovation and matched comparison sites between FY 2008-2010 (pre-PCC innovations) and FY 2011-2012 (post-PCC innovations). Outcomes included access to primary care providers (PCPs); primary, specialty, and emergency care use; and clinical indicators for chronic disease.

RESULTS:

Longitudinal trends revealed a different story at each site. One site demonstrated better PCP access, decrease in emergency and primary care use, increase in specialty care use, and improvement in diabetic glucose control. The other site demonstrated a decrease ...

May 17, 2016 Europe Publication

Person-centred care after acute coronary syndrome, from hospital to primary care - A randomised controlled trial

Highlights

  • Person-centred care in the recovery after an acute coronary syndrome event,
  • Details of a co-created health plan to produce a partnership between patients and health care professionals,
  • The transition of care continuing the partnership from in-hospital care to primary care,
  • Improved self-efficacy by including a partnership compared to standard care alone.

Aim

To evaluate if person-centred care can improve self-efficacy and facilitate return to work or prior activity level in patients after an event of acute coronary syndrome.

Method

199 patients with acute coronary syndrome < 75 years were randomly assigned to person-centred care intervention or treatment as usual and followed for 6 months. In the intervention group a person-centred care process was added to treatment as usual, emphasising the patient as a partner in care. Care was co-created in collaboration between patients, physicians, registered nurses and other health care professionals and documented in a health plan. A team-based partnership ...

March 31, 2016 Europe Publication

Patient and Family-Centred Care toolkit

The Patient and Family-Centred Care (PFCC) toolkit is a simple, step-by-step method for understanding what a care experience is like, what needs to change, and which small improvements can make a big difference to patients, families and staff alike. It is a guide to improving processes of care and staff–patient interactions, using a technique called Patient and Family-Centred Care (PFCC). It offers a simple way for health care organisations to show their commitment to patients’ experience of the care they receive while also attending to the wellbeing of the staff who deliver that care.

The toolkit evolved from the Patient and Family-Centred Care programme, an initiative that was run jointly by the Health Foundation and The King’s Fund to develop a small number of exemplary hospitals and a team of professional staff and managers who could demonstrate their achievements to others and bring sustainable improvement in patients' experience ...

March 31, 2016 Europe Toolkit

Patient and Family-Centred Care toolkit

The Patient and Family-Centred Care (PFCC) toolkit is a simple, step-by-step method for understanding what a care experience is like, what needs to change, and which small improvements can make a big difference to patients, families and staff alike. It is a guide to improving processes of care and staff–patient interactions, using a technique called Patient and Family-Centred Care (PFCC). It offers a simple way for health care organisations to show their commitment to patients’ experience of the care they receive while also attending to the wellbeing of the staff who deliver that care.

The toolkit evolved from the Patient and Family-Centred Care programme, an initiative that was run jointly by the Health Foundation and The King’s Fund to develop a small number of exemplary hospitals and a team of professional staff and managers who could demonstrate their achievements to others and bring sustainable improvement in patients' experience ...

March 30, 2016 Global Event

How can we help people manage their own health?

It is an initiative of the  looking for introduce¡ing a new way to help people look after their own health. Health coaching aims to give people the knowledge and skills to take control of their long term conditions. The tweet hcat will be hosted by  using the hashtag  on Tuesday 22 of March. 

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 ...

Feb. 15, 2016 Global Publication

The Patient-Centered Health Record

Electronic Health Records (EHR) have become a core utility in health management in last decades. In this post, Peter Elias discusses how EHR can be changed in order to place people in the center of EHR.

According to Elias, patient-centered EHR would have the following main characteristics:

  • The basic unit would be one record per patient, and patient would have direct acces to his EHR.
  • Open source would be a core value in the development of patient-centered EHR.
  • Patient would have the control of his own EHR, being able to control who can see, change or use the information contained in his EHR.
  • Clinicians could enter the patient’s EHR in multiple ways, using their propietary owned  system or using a straightforward system to access multiple individual EHR.


Currently, we have professional-centered EHR; this proposal is a first step in the search for alternatives in order to achieve an EHR ...

Feb. 10, 2016 South-East Asia Publication

Enhancing governance and health system accountability for people centered healthcare: an exploratory study of community scorecards in Afghanistan

BACKGROUND:

The premise of patient-centered care is to empower patients to become active participants in their own care and receive health services focused on their individual needs and preferences. Afghanistan has evidenced enormous gains in coverage and utilization, but the quality of care remains suboptimal, as evidenced in the balanced scorecard (BSC) performance assessments. In the United States and throughout Africa and Asia, community scorecards (CSC) have proved effective in improving accountability and responsiveness of services. This study represents the first attempt to assess CSC feasibility in a fragile context (Afghanistan) through joint engagement of service providers and community members in the design of patient-centered services with the objective of assessing impact on service delivery and perceived quality of care.

METHODS:

Six primary healthcare facilities were randomly selected in three provinces (Bamyan, Takhar and Nangarhar) and communities in their catchment area were selected for the study. Employing a multi-stakeholder strategy ...