No one likes being told what to do. We all want a say in any decision that affects us. Health care isn't any different. The odds of adhering to a plan of care are greatly enhanced when you partner with your health care provider to formulate the plan. The idea is simple and it's called patient-centered care. The notion has been in existence for almost two decades but the concept is still foreign to many individuals. Here's a simple definition of patient-centered care:"Nothing about me without me" (Delbanco et al, 2001). In other words, patient-centered care involves the patient in the planning and implementation of his or her care.
In the United States, according to long-standing practice, a patient entering a health care facility gives up control. Patients are relegated to the role of recipients rather than partners in healing practices. This practice hinders the healing process and creates emotional distress for the patient.
Patient-centered care requires collaboration between patient or caregiver and health care provider. The provider continues to be the expert in health care, but the patient integrates their values and preferences into the proposed care plan. Together, a decision is made regarding the best course of treatment or care for the patient. Each patient will have different input because each is unique. It is the provider's job to integrate the patient's input into the plan to achieve optimal results. Care that assumes the provider knows what the patient wants is still provider-centered. Patient-centered care requires providers to ask the patient or caregiver what the patient prefers.
Patient-centered care thrives on two roles for patients and/or caregivers: partner and source of feedback. The patient or caregiver functions as a partner, working in collaboration with the health care team. Active participation in a partnership role is crucial for a successful outcome.
In addition to acting as health care partners, patients and/or caregivers are a source of essential feedback to the medical team. The patient's perspective provides unique feedback to the provider, helping gauge the effectiveness of care, as well as the performance of the provider or organization. Patient surveys provide helpful feedback after the fact, but no one should wait for a survey to communicate. This is your obligation. They can't fix a problem until they know they have one. Your participation in providing feedback is crucial for a successful outcome.
TIPS FOR PARTNERING
1.INSIST UPON PATIENT-CENTERED CARE
Signing the Consent to Treat form upon admission to the hospital is not synonymous with writing, "I give all control to you to do whatever you please to my body."
You have the right to demand patient-centered care for yourself and/or your loved one. Accept nothing less. If your physician doesn't embrace patient-centered care, change doctors. If your nurse refuses to include you in your own plan of care, ask for a different nurse. If you find this difficult, remind yourself that your goal in health care is not to make friends, but to get the optimal outcome. For optimal outcomes, patients, families, and providers all need to be on the same page.
Remember, "Nothing about me without me." The patient has the right to ultimate control in the hospital, and providers should not take control without permission from the patient.
2.ASK QUESTIONS AND MAKE REQUESTS AS A COLLABORATOR
Transparency and information sharing are crucial ingredients in patient-centered care. You have the right and responsibility to understand your own or your loved one's plan of care. At the same time, take care to present your questions and requests as a collaborator rather than an adversary. Ask for printed material on a diagnosis or procedure. Ask for printed information on medications. Ask your providers to recommend websites that provide helpful or supplemental information. Information should flow freely to patients and families. If you have questions about why one treatment is chosen over another, ask. If you believe some alternative treatment would benefit your loved one, discuss it.
3.ACCEPT RESPONSIBILITY TO PROVIDE FEEDBACK
Patient-centered care is a two-way street. Let your doctor, nurse, or hospital administrator know when you are unhappy or a plan of care is not working. You might have an unpleasant conversation with a few people before you get results, but at the end of the day, it will be worth it. Hospitals, doctors, and nurses need to know they are doing the wrong thing in order to fix it. Remember, they want to provide quality care. It might be easy to walk away and internalize your frustration with a broken system, but this will wear on you and your family quickly. Speak up!
4.PERSIST IN LOOKING FOR PROVIDERS WHO THINK IN TERMS OF PATIENT-CENTERED CARE
Be relentless in looking for those pockets of providers who provide patient-centered care. Find those passionate providers who think outside the box. Many of these individuals can move mountains to get things done. Acknowledge those who go out of their way to help you. Remember that like-minded people tend to attract each other. Sometimes, it is beneficial to mention a barrier you are encountering to a provider who has helped you in the past. Many times, that provider knows someone who can help, or can at least point you in the right direction to accomplish your goal. Communicating your needs is crucial to finding those who will help you.
5.LEARN TO SPEAK IN DOLLARS AND CENTS
Money talks, whether you are dealing with the hospital, Medicare/Medicaid, a medical equipment company, or insurance company. Before you go to bat for yourself or loved one, write down your thoughts. Do a little homework on how much things cost via the internet or other sources.
Delbanco, T., Berwick, D.M., Boufford, J.I., Edgman-LevitanDelbanco, T., Berwick, D.M., Boufford, J.I., Edgman-Levitan, S., Ollenschläger, G., Plamping, D., & Rockefeller, R.G. (2001). Healthcare in a land called PeoplePower: Nothing about me without me. Health Expectations, 4 (3), 44-50