The American College of Physicians is promoting principles that are designed to support authentic participation of patients and family members in clinical care.
Patient- and family-centered care is an approach to healthcare featuring partnerships between healthcare providers, patients, and family members, according to an American College of Physicians position paper published this month in Annals of Internal Medicine.
Research has shown that patient-centered care is essential to achieve the Triple Aim—improving patient experience and health outcomes while simultaneously reducing costs. Patient-centered care also generates other benefits such as reducing hospital admissions and surgical procedures.
"Increasing evidence shows that patient and family partnership in care can improve health outcomes, practice efficiency, and patient and professional satisfaction. Patient- and family-centered strategies have been shown to reduce use of healthcare resources, result in fewer referrals and diagnostic tests, and lower healthcare costs," the ACP position paper says.
The four ACP principles for patient- and family-centered care include enacting strategies.
Principle 1: Treat patients and families with dignity and respect
The unique nature of every patient and family should be respected, and their preferences and values should be incorporated into delivery of healthcare. Research has shown that patients consider dignity and respect in behaviors such as recognizing the patient as an individual and paying attention to the patient's needs.
- Communicating respectfully with the patient as a whole person during interviews and office visits
- Listening to patients without interrupting
- Asking patients whether they want family members and caregivers involved in healthcare discussions
- Inquiring about whether patients have religious or cultural beliefs that should be accounted for in treatment
Principle 2: Include patients and families as active partners in care
Patients and families should participate in care to a degree of their choosing, and their perspectives should be recognized. Patients should be engaged in their care through shared decision making and collaborative goal setting.
- Promote self-management of chronic illnesses
- Set care goals in consultation with patients
- Include patients and family members during bedside-rounds discussions
- Honor patient preferences on following recommendations
- Provide educational material such as after-visit summaries to increase patient knowledge
Principle 3: Give patients and families chances to impact health systems
Patients and families should help design, improve, and evaluate health systems and hospitals. Patients and families can contribute in ways that augment the perspectives of healthcare professionals. For example, patients and families have helped redesign waiting rooms, evaluate educational materials, as assess patient portal functionality.
- Seek patient and family perspectives through surveys or focus groups
- Establish a patient and family advisory council
- Invite patients and families to participate in quality improvement projects
- Include patients on committees for performance measurement and clinical guidelines
- Request patient comments on purchases of capital equipment
Principle 4: Enlist patients and families in educating healthcare professionals
As the healthcare sector shifts toward team-based care, patients and families can play a key role in educating clinicians and other staff members. As opposed to a focus on diagnosis and treatment of disease, medical education is increasingly directed at teamwork and patient partnership, which are well-suited for involvement of patients and families.
- Include patients and family members in teaching rounds
- Pair medical students and residents with chronic-illness patients to help them navigate their care
- Invite patients and families to serve on curriculum committees
- Feature patient perspectives in case studies
Christopher Cheney is the senior clinical care editor at HealthLeaders.
Patient-centered care is associated with multiple benefits such as improving patient experience and reducing hospital admissions.
Researchers also have linked patient-centered care with lower healthcare costs.
Treating patients and families with respect is a common theme in patient-centered care principles.