Module 1
Title
The Impact of Patient and Family-Centered Care (PFCC) on Service Excellence and Care Outcomes
Overview
Patient and family-centered care (PFCC) is a multidimensional concept that involves the practice of caring for patients and their families in ways that are meaningful and valuable to the individual. Providing care that is respectful of, and responsive to the individual patient’s preferences, and ensuring the patient and family are involved in clinical decisions can significantly improve quality of care, patient satisfaction and reduce cost of care. Developing a PFCC culture requires a sustained and substantial commitment from healthcare organizations. An effective workplace culture stems from a common vision and values that are actualized through behavioral practices necessary to provide PFCC. The ability to provide quality care with high patient satisfaction is important to hospitals as it can impact their reimbursement. It is important to understand the research and rationale behind the move towards patient and family-centered care.
Objectives
By the end of this module the learner will be able to:
- Outline the differences between the medical and patient and family-centered care models.
- Describe the benefits of the patient and family-centered care approach to care delivery.
- Understand the theory and concepts related to implementing PFCC practice.
Content Outline
- Evidence to support a patient and family-centered healthcare care model
- Dissatisfaction with current healthcare delivery systems
- Medical model
- Disease oriented
- Fragmentation
- Costly
- Poor outcomes
- Low morale among healthcare workers
- Benefits of PFCC
- It is the right thing to do
- Increased patient engagement
- Improved quality outcomes
- Lowered costs
- Increased satisfaction with care
- Increased employee satisfaction
- Dissatisfaction with current healthcare delivery systems
Theoretical and conceptual basis of PFCC practice
- Watson’s theory of Human Caring
- Patient and Family Centered Care Framework
- Donabedian’s Structure Process Outcome Model
Links to Differentiated Essential Competencies
- Member of the profession
- Assume responsibility and accountability for the quality of nursing care provided to patients families and communities
- Provider of Patient Centered Care
- Synthesize comprehensive assessment data to identify problems, formulate goals/outcomes, and develop plans of care for patients, families, populations, and communities using information from evidence-based practice and published research in collaboration with the above groups and the interdisciplinary health care team.
- Provide safe, compassionate, comprehensive nursing care to patients, families, populations, and communities through a broad array of health care services.
- Member of the Healthcare Team
- Coordinate, collaborate, and communicate with patients, families, populations, communities, and the interdisciplinary health care team to plan, deliver, and evaluate care.
Links to Texas Concept Based Curriculum
Concepts Psychosocial
- Interpersonal Relationships
Concepts of Health Care Systems
- Patient-centered care
- Quality Improvement
- Evidence-Based Practice
Resources
The Health Foundation (2015). Person-centered care made simple. Retrieved from https://www.youtube.com/watch?v=6Dk3CV-Wt38
Watson’s theory of Human Caring/Caring Science. Retrieved from https://www.watsoncaringscience.org/files/Cohort 6/watsons-theory-of-human-caring-core-concepts-and-evolution-to-caritas-processes-handout.pdf
The SHARE Approach: Five Essential Steps of Shared Decision Making. Retrieved from http://www.ahrq.gov/professionals/education/curriculum-tools/shareddecisionmaking/index.html
References
- American Nurses Association (2010). New care delivery models in health system reform: Opportunities for nurses & their patients. ANA Issue Brief retrieved from http://nursingworld.org/MainMenuCategories/Policy-Advocacy/Positions-and-Resolutions/Issue-Briefs/Care-Delivery-Models.pdf
- Berwick, D.M. (2009). What ‘patient-centered’ should mean: confessions of an extremist. Health Affairs, 28(4), 555-565.
- Burton, R. (2012). Improving care Transitions. Better coordination of patient transfers among care sites and the community could save money and improve the quality of care (Health Policy Brief September 12, 2012). Retrieved from Robert Wood Johnson Foundation, Health Affairs website http://healthaffairs.org/healthpolicybriefs/brief_pdfs/healthpolicybrief_76.pdf.
- Donabedian A. (2005). Evaluating the quality of medical care. 1966. Milbank Quarterly. 83(4), 691–729.
- Elhauge, E. (Ed.) (2010). The fragmentation of U.S. health care: Causes and solutions. New York, NY: Oxford University Press USA.
- Frandsen, B.R., Joynt, K.E., Rebitzer, J.B. & Jha, A.K. (2015). Care fragmentation, quality and cost among chronically ill patients. The American Journal of Managed Care, 21(5), 355-362.
- Hippocrates. (n.d.). AZQuotes.com. Retrieved September 21, 2016, from AZQuotes.com Retrieved from http://www.azquotes.com/author/22138-Hippocrates
- Hughes, R. (2011) Overview and summary: Patient-centered care: Challenges and rewards. The Online Journal of Issues in Nursing. 16 (2). Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-16-2011/No2-May-2011/Overview-and-Summary-Patient-Centered-Care.html?css=print
- McCormack, B. & McCance, T.V. (2006). Development of a framework for person-centered nursing. Journal of Advanced Nursing. 56(5), 472-479.
- Rathert, C. & May, D.R. (2007). Health care work environments, employee satisfaction, and patient safety: Care provider perspectives. Health Care Management Review. 32(1), 2-11.
- Stewart, M., Brown, J., Donner, A., McWhinney, I., Oates, J., Weston, W., et al. (2000). The impact of patient-centered care on outcomes. Journal of Family Practice. 49(9), 796-804.
- The Rand Corporation (2013). Factors affecting physician professional satisfaction and their implications for patient care, health systems and health policy. Washington, DC: Author.
- Watson, J. (1985). Nursing: Human science and human care – A theory of nursing. New York, NY: National League of Nursing Press
- Watson’s Caring Science Institute (2010). Watson’s theory of human caring core concepts and evolution to caritas processes. Retrieved from https://www.watsoncaringscience.org/files/Cohort 6/watsons-theory-of-human-caring-core-concepts-and-evolution-to-caritas-processes-handout.pdf
Discussion Questions
Do you see yourself as having all the competencies needed to provide patient and family-centered care?
What challenges do you see in implementing patient and family-centered care?
What kinds of training will healthcare providers need to be able to provide high quality patient and family-centered care?