Have you integrated patient-centered care into your practice? Patient-centered care is a practice model that emphasizes the needs and preferences of the patient to provide the best possible care. Associated with higher patient satisfaction, improved outcomes, and enhanced communication, the patient-centered care model is a popular evidence-based approach to healthcare, no matter your modality or specialty. Continue reading to learn more about the benefits of patient-centered care and the strategies you can implement to improve patient care in your practice.
What is patient-centered care?
According to the Institute of Medicine (IOM), patient-centered care involves “providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.” (2)
Patient-centered care is one of six domains of healthcare quality as outlined by the IOM, which also include safe, effective, timely, efficient, and equitable healthcare. (2) Since the IOM has emphasized the importance of patient-centered care, interest among healthcare professionals and organizations to implement this approach has increased. (2)
The shift from a traditional, biomedical perspective and practitioner-centered approach to a biopsychosocial, patient-centered approach that honors a patient’s preferences, needs, desires, and experiences helps improve various markers of patient satisfaction and clinical outcomes. (12) This type of care model requires open communication between the patient and practitioner, encouraging patients to play an active role in clinical decision-making and care management. (4) Integration of patient-centered care is essential during all phases of health care–from consultation to treatment and follow-up. (7)
Patient-centered care benefits
Applying a patient-centered care model offers many benefits for patients and your practice.
Improved health outcomes
Extensive research has demonstrated the benefits of patient-centered care, particularly for improving clinical outcomes. Patient-centered care can improve knowledge regarding health conditions and treatment plans, as well as perceptions of care. Patient-centered care can also encourage patients to take an active role in condition management, which can help improve their mental and physical well-being. (15)(17)
Additionally, low health literacy is associated with poorer health outcomes. (11) By integrating a patient-centered approach that incorporates tailored education, patients can leave your office with the knowledge and confidence they need to reach their health goals successfully. (18)
Reduced cost burden for patients
Patient-centered care is associated with reduced healthcare utilization and, consequently, lower annual medical costs for patients. According to a 2011 study of over 500 patients, those who received patient-centered care over the course of a year had significantly fewer annual visits to specialty care practitioners and required fewer hospitalizations and laboratory or diagnostic testing. (6)
Increased treatment adherence
A 2016 meta-analysis demonstrated that patient-centered care is associated with improvements in treatment adherence, a measurement of how closely a patient’s behaviors follow an agreed-upon prescription or therapeutic regimen. It’s suggested that emphasizing the clinical benefits of adhering to a treatment plan versus simply instructing patients to take their medications or supplements as directed is a successful approach for improving treatment adherence. (10)
Enhanced communication and patient satisfaction
Communication plays a vital role in a patient’s perception and satisfaction of care. Patient-centered care, which prioritizes patient-practitioner communication, is associated with a 23% improvement in overall patient satisfaction. (14)
The 2015 National Healthcare Quality and Disparities Report Chartbook on Patient-Centered Care concluded that the perceived level of communication between practitioner and patient is a significant indicator of patient satisfaction. (3) According to the report, minority groups, particularly black and Hispanic populations were more likely to report having poor communication with their healthcare provider compared to white individuals. Individuals with lower levels of education also reported poorer communication with their practitioner versus higher-educated individuals. Furthermore, individuals covered by Medicare or other public insurance were more likely to have poor communication with their providers than privately insured patients. Although these disparities are still widely present in healthcare, the report did note that communication has significantly improved between 2002 and 2013 for all ethnic, education, income, and age groups. (3)
Reduced health disparities
Despite improvements to healthcare access, many individuals continue to face barriers to high-quality care. Some evidence suggests that the patient-centered care model is an effective tool for reducing racial, ethnic, sexual, and gender health disparities. (20) By establishing trust and providing a welcoming and inclusive environment that honors your patient as a whole person, you can improve quality of care and patient outcomes for your patient. (9)(16)
Increased job satisfaction
Practitioners and their level of job satisfaction may benefit from the patient-centered care model given that this type of care allows practitioners to effectively address their patients’ needs, contributing to feelings of fulfillment and accomplishment. In fact, according to one study, employees of healthcare facilities that utilized patient-centered care strategies reported improved job satisfaction and experienced higher employee retention. (5)
Elements of patient-centered care
What does patient-centered care look like? A 2017 review published in the European Journal for Person Centered Healthcare identified six elements of patient-centered care. (8) Outlined below are the six elements of patient-centered care and the simple strategies you can incorporate into your practice.
Engage your patient as a whole person
Respecting the individual patient and their needs and preferences is of utmost importance. Treating your patient as a whole person involves assessing multiple aspects of your patient’s health, including their dietary preferences, mental health, family, culture, socioeconomic status, and more. Make a conscious effort to recognize your patients as individuals with unique needs rather than solely focusing on a diagnosis. (8)
Recognize and respond to emotions
As a practitioner, it’s necessary to identify and understand emotional cues as well as validate and respond to these cues. If your patient expresses fear, uncertainty, or other emotions in response to their condition or treatment plan, convey empathy and reassure them that you’re committed to helping them achieve improved health outcomes. For additional support that may be out of your scope of expertise, suggest resources such as support groups or counseling. (8)
Foster a therapeutic alliance
Establishing a trusting relationship with your patient is an essential component of the patient-centered care model. Sharing power is an important consideration when building a therapeutic alliance. Allow your patient to voice their concerns and thoughts regarding their treatment plan to determine a mutually agreeable plan. (8)
Promote an exchange of information
Prioritize communication with your patients throughout all phases of care. In one study, patients reported that clear, timely, and courteous communication from their practitioners is important. (19) Provide educational resources, such as printed handouts or other informational resources, to further enhance communication.
It’s also essential to ensure that your patients clearly understand the information you’re sharing with them. For example, when using technical jargon or other complex medical terminology, consider asking your patients to repeat back their understanding. This provides an opportunity to clear up any misunderstandings before the end of your consultation. (8)
When discussing potential treatment plans and ideal outcomes, it’s beneficial to engage in shared decision-making versus prescribing without considering patient input. During their visit, encourage your patient to open up about any perceived barriers, reservations, or preferences. Ensure mutual understanding and agreement by first defining the problem you and your patient want to address, outlining treatment goals and priorities, and determining the specific roles and tasks for which you and your patient will be responsible. (8) Additionally, for some conditions and treatment options, using a validated decision aid can help you and your patient determine the potential benefits and risks of each option. (13)
Enable continuity of care, self-management, and patient navigation
Providing information to your patient to help them self-manage their condition can also be beneficial. Self-management is defined as assistance offered to patients to help them navigate their chronic condition and manage their symptoms on a daily basis. (1)
Strategies for enabling self-management and continuity of care include:
- Maintaining regular communication through email, phone calls, text messages, or other means
- Offering educational materials
- Planning routine preventative care appointments and follow-up visits
- Providing referrals to additional resources such as other integrative healthcare providers, support groups, and smoking cessation programs (1)
The bottom line
Patient-centered care considers the unique needs and preferences of a patient to improve patient satisfaction and health outcomes. You can implement the patient-centered care model into your practice by acknowledging your patient as a whole person, being responsive and empathetic to emotions, building a trusting alliance, enhancing communication and exchanging information, sharing decision-making, and enabling continuity of care and self-management.
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- Agency for Healthcare Research and Quality. (2013). Self-Management Support. https://www.ahrq.gov/ncepcr/tools/self-mgmt/self.html
- Agency for Healthcare Research and Quality. (2015). Six domains of health care Quality. https://www.ahrq.gov/talkingquality/measures/six-domains.html
- Agency for Healthcare Research and Quality. (2016a). Chartbook on person- and family-centered care. https://www.ahrq.gov/research/findings/nhqrdr/chartbooks/personcentered/index.html
- Agency for Healthcare Research and Quality. (2016b). Priorities in Focus – Person- and Family-Centered Care | Agency for Healthcare Research and Quality. https://www.ahrq.gov/workingforquality/reports/priorities-in-focus/priorities-in-focus-person-family-centeredcare.html
- Balbale, S. N., Turcios, S., & LaVela, S. L. (2014). Health care employee perceptions of Patient-Centered care. Qualitative Health Research, 25(3), 417–425.
- Bertakis, K. D., & Azari, R. (2011). Patient-centered care is associated with decreased health care utilization. The Journal of the American Board of Family Medicine, 24(3), 229–239.
- Bokhour, B. G., Fix, G. M., Mueller, N. M., Barker, A. M., Lavela, S. L., & Hill, J. N. (2018). How can healthcare organizations implement patient-centered care? Examining a large-scale cultural transformation. BMC Health Services Research, 18(1), 168.
- Clarke, S., Ells, C., Thombs, B. D., & Clarke, D. (2017). Defining elements of patient-centered care for therapeutic relationships: A literature review of common themes. European Journal for Person Centered Healthcare, 5(3), 362.
- Collado, M. (2019). Just putting patients at the center of health care is not enough to improve care. Health Affairs.
- Conn, V. S., Ruppar, T. M., Maithe Enriquez, R., & Cooper, P. S. (2016). Patient-Centered outcomes of medication adherence interventions: Systematic review and Meta-Analysis. Value in Health, 19(2), 277–285.
- DeWalt, D. A., Berkman, N. D., Sheridan, S., Lohr, K. N., & Pignone, M. P. (2004). Literacy and health outcomes. Journal of General Internal Medicine, 19(12), 1228–1239.
- Greene, S., Tuzzio, L., & Cherkin, D. (2012). A framework for making Patient-Centered care front and center. The Permanente Journal, 16(3), 49–53.
- An introduction to patient decision aids. (2013). BMJ, 347(jul23 2), f4147.
- Nielsen, M., Olayiwola, N., Grundy, P., & Grumbach, K. (2014). The patient-centered medical home’s impact on cost & quality: An annual update of the evidence, 2012–2013. https://www.pcpcc.org/sites/default/files/resources/Executive%20Summary%20Only%20with%20Evidence.pdf
- Nyhof, B. B., Jameel, B., Dunn, S., Grace, S. L., Khanlou, N., Stewart, D. E., & Gagliardi, A. R. (2020). Identifying strategies to implement patient-centred care for women: Qualitative interviews with women. Patient Education and Counseling, 103(7), 1422–1427.
- Ruud, M. (2018). Cultural humility in the care of individuals who are lesbian, gay, bisexual, transgender, or queer. Nursing for Women’s Health, 22(3), 255–263.
- Stewart, M., Brown, J. B., Donner, A., McWhinney, I. R., Oates, J., Weston, W. W., & Jordan, J. (2000). The impact of patient-centered care on outcomes. The Journal of Family Practice, 49(9), 796–804.
- U.S. Department of Health and Human Services. (2010). National action plan to improve health literacy. https://health.gov/sites/default/files/2019-09/Health_Literacy_Action_Plan.pdf
- Van Berckelaer, A., DiRocco, D., Ferguson, M., Gray, P., Marcus, N., & Day, S. (2012). Building a Patient-Centered medical home: Obtaining the patient’s voice. The Journal of the American Board of Family Medicine, 25(2), 192–198.
- Wilkerson, L., Fung, C. C., May, W., & Elliott, D. (2010). Assessing patient-centered care: One approach to health disparities education. Journal of General Internal Medicine, 25(S2), 86–90.