Care with Compassion


Keeping Track – PCC


Care with Compassion

Patient-Centred Care (PCC) represents a fundamental shift in healthcare delivery, where the patient’s preferences, needs, and values take centre stage in every clinical decision. Embracing PCC means hospitals must redesign their structures, processes, and culture to prioritise individualised care that treats patients as active participants in their healthcare journey….

By Dr Anuradha Pichumani

Patient-Centred Care (PCC) entails delivering healthcare in a manner that respects and responds to each patient’s preferences, needs, and values, ensuring these personal yardsticks are the cornerstone of all clinical decision-making.

Implementing PCC in hospitals represents a paradigm shift from traditional healthcare models towards a more holistic and individualised approach to patient care. This transition involves redesigning the care model with reorienting hospital structures, processes, and culture to prioritise the preferences of patients in all aspects of their healthcare journey.

Fundamentally, PCC revolves around treating patients as active participants in their healthcare, with their unique needs and values, steering clinical choices. It advocates for a comprehensive approach to care that encompasses not only the physical aspects of health but also addresses the emotional, mental, social, and spiritual facets of patient well-being.

Effective Strategies for Implementing PCC in Hospitals
To shift healthcare practices towards PCC, strategic planning and execution are essential. This involves redefining care delivery models to prioritise patient needs and aspirations, fostering collaboration among healthcare teams, and integrating patient feedback into continuous improvement efforts. Success in PCC implementation hinges on adopting a holistic, patient-first approach across all levels of healthcare provision.

Cultural and Structural Transformation: Transitioning to a patient-focused model necessitates profound shifts in both the cultural and organisational fabric of healthcare institutions. This evolution demands retraining staff, revising existing policies, and redefining care delivery methods, often facing substantial resistance. Fostering an active collaborative culture within an organisation is the key determinant for a good atmosphere for patients and staff members.

Leadership Commitment: The effective execution of PCC begins when hospital leadership wholeheartedly embraces PCC as a fundamental value and guiding principle. This commitment involves establishing explicit expectations, allocating the required resources, and actively participating in the implementation process. Leaders must demonstrate their dedication through their actions and decisions. This “walk the talk” approach means embodying the principles of PCC in daily operations, visibly supporting initiatives, and setting a clear example for others to follow, thereby ensuring the successful integration of PCC into the organisational culture.

Navigating Regulatory Landscapes: Current healthcare policies and regulations may not fully support patient-centric approaches, making it challenging to integrate personalised care within existing frameworks. Implementing PCC involves navigating complex regulatory landscapes, aligning patient-centred practices with healthcare policies and laws. This requires constant adaptation and advocacy to ensure regulations support rather than hinder PCC initiatives, to enhance care quality and compliance, benefiting patients and providers alike.

Implementing PCC brings significant benefits to healthcare organisations, including enhanced patient outcomes and satisfaction, which boost reputation and loyalty. PCC contributes to operational efficiency by emphasising preventive care and reducing unnecessary interventions, leading to cost savings

Environment and Design: Hospital environments has to be designed to promote patient comfort and uphold dignity. This encompasses ensuring privacy within patient rooms, providing areas where family members can accompany patients, and making facilities accessible for individuals with disabilities. Ensuring patient privacy and confidentiality with fostering open communication and information sharing is a delicate balance that must be continuously managed.

Addressing Resource Limitations: PCC implementation may call for additional resources, including increased staffing levels to allow for more patient interaction, advanced technology for improved communication, and enhanced infrastructure. These resources must be made available to implement PCC effectively.

Staff Training and Development: Education and training of healthcare professionals on the principles of PCC is crucial. Staff training includes developing communication skills, empathy, and strategies for engaging patients in their care. Staff should be encouraged to see things from the patient’s perspective, understanding the patient’s lived – in experience. Physical and emotional well-being of the staff is also critical for implementing PCC in the care processes.

Integrated Care Teams: PCC necessitates collaboration across various healthcare disciplines. To meet the extensive needs of patients, integrated care teams—comprising physicians, nurses, technicians, pharmacists, social workers, and additional healthcare staff—must work together both within the hospital setting and in continuing care after discharge. Essential to this team-based approach is the effectiveness of communication among all involved parties.

Patient and Family Engagement: Patients and their families should be engaged in care planning and decision-making processes. This can be facilitated through patient and family centred advisory councils, and analysis of the satisfaction surveys, and feedback mechanisms that inform the need for service improvements. Patient and Family-Centred Advisory Councils (PFCAC) play a pivotal role in implementing PCC by serving as a bridge between patients, families, and healthcare providers. These councils are composed of patients, family members, and healthcare professionals who collaborate to provide insights and feedback on hospital policies, care practices, and service design from the patient and family perspective. By fostering open dialogue and partnership, these councils empower patients and families, encouraging shared decision-making and enhancing the overall healthcare experience

Accommodating Patient Diversity: Given the diverse backgrounds, needs, preferences, and levels of health literacy among patients, customising care to meet these individual requirements presents a considerable challenge, especially in diverse patient population settings. Engaging patients in their own care is a fundamental aspect of PCC, yet not all patients are prepared or able to take an active role. Overcoming barriers related to health literacy, language, and cultural differences is crucial for patient engagement.

Information and Technology: Technology can support PCC proactively by providing patients with access to their medical records, educational resources, communication tools, and home based monitoring devices, so as to stay in touch with their care team. The foundation of effective PCC lies in the uninterrupted flow of information among all healthcare stakeholders, including patients. Electronic health records ought to be utilised in a manner that facilitates collaborative decision-making.

Outcome Measurement: There’s a critical need for effective mechanisms to evaluate the impact of PCC interventions. Developing metrics that accurately reflect quality, patient satisfaction, and outcomes from the patient’s viewpoint remains a complex task. Availability of the outcome data would help in convincing the management to implement and sustain PCC practices. Establishing mechanisms for patients to report safety concerns or adverse events through surveys or feedback forms creates a feedback loop that can contribute to continuous improvement in healthcare quality.

Ensuring Sustainability: Maintaining the momentum of PCC demands constant commitment and resources, with staff motivation fuelled by the positive impact of their work and strong patient-provider bonds. Financially, PCC’s sustainability is secured through efficient resource use and preventive care, leading to significant cost savings from unnecessary treatments and hospital readmissions. For PFCAC, sustained success hinges on regular communication, continuous training, and recognition of members’ contributions. Involving the council in significant projects and decisions also keeps their engagement and effectiveness high.

Benefits of PCC Implementation

Improved Patient Outcomes: Patient-centred care prioritises the individual’s health preferences and values, leading to tailored and effective treatments. Involving patients in their own care decisions fosters a deeper understanding and engagement with their own health journey and improves compliance. This collaborative approach can significantly improve health outcomes.

Increased Patient Satisfaction: Adopting patient-centred care significantly improves patient satisfaction by ensuring that their needs and preferences are central to the care process. The continuity of care is ensured. This approach creates a more respectful and responsive healthcare environment .Patient satisfaction with care improves. As patients feel heard and valued, their trust and confidence in the healthcare system increases exponentially.

To shift healthcare practices towards PCC, strategic planning and execution are essential. This involves redefining care delivery models to prioritise patient needs and values, fostering collaboration among healthcare teams, and integrating patient feedback into continuous improvement efforts.

Increased Patient Safety: Engaging patients in healthcare is a crucial aspect of ensuring patient safety. When patients actively participate in their care, they become partners in the healthcare process, contributing valuable insights, information, and perspectives that can enhance safety measures. Patient safety can be improved by effective communication, informed consent processes, and collaborative decision-making. Patients who are empowered, are better equipped to identify potential safety issues and they actively participate in their care

Enhanced Staff Satisfaction and Retention: Implementing PCC can also have a positive impact on healthcare professionals by creating a more rewarding and less stressful work environment. This can improve staff satisfaction, team communication, reduce burnout, and increase retention rates by creating a healthy conducive environment to work. These factors collectively contribute to a more motivated, engaged, and fulfilled healthcare workforce.

Cost-Effectiveness: Through an emphasis on preventive care, collaborative decision-making, and fine-tuning treatment strategies to minimise unneeded interventions, PCC plays a key role in enhancing the cost-efficiency of care over the long term. This is especially useful in chronic care models. In managing chronic care, cost-effectiveness is achieved by implementing proactive, patient-centred strategies that emphasise preventive care, regular monitoring, and patient education. This approach helps prevent complications, reduces hospital admissions, and minimises the need for expensive interventions, making chronic care management more economically sustainable.

Organisation’s Benefits: Implementing PCC brings significant benefits to healthcare organisations, including enhanced patient outcomes and satisfaction, which boost reputation and loyalty. PCC contributes to operational efficiency by emphasising preventive care and reducing unnecessary interventions, leading to cost savings. Additionally, it improves staff satisfaction and retention, creating a more positive and stable work environment. Overall, PCC strengthens the financial and operational health of healthcare institutions.

Summing Up
Implementing patient-centred care in hospitals is a complex but profoundly rewarding endeavour. It requires a systematic approach, starting with strong leadership and involving comprehensive staff training, patient and family engagement, thoughtful design and use of space, integrated care teams, and effective use of technology. Essentially, PCC demands a committed shift towards holistic, patient-focused healthcare practices.
While challenges exist, the potential benefits in terms of improved patient outcomes, increased satisfaction among patients and staff, and overall cost-effectiveness make it a worthwhile investment. As healthcare continues to evolve, adopting a patient-centred approach will be critical to meeting the changing needs and expectations of patients and positioning hospitals for success in a competitive healthcare landscape.

(The author is Executive Director, Sree Renga Hospital, Chengalpattu, TN, India |Board Member, ISQua | Board Member, ASQua | Principal Assessor, NABH | Chair – Quality Professionals Wing, CAHO)

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