It seems obvious that patients should be empowered to be at the forefront of their healthcare journey and to make informed decisions that fit with individual needs and values.
However, that’s not always the case. The focus on patient-centred care is an evolution still in the making, with patients, their families and healthcare providers navigating the relationship. The right tools are key to success.
What is patient-centred care?
On the surface, patient-centred care is an unspoken, agreed-upon practice in every patient appointment and interaction—healthcare professionals are trained to listen to the concerns of and care for their patients. However, what patient-centred care means may differ from patient to patient and physician to physician. Its definition, which is not universally agreed-upon, continues to change.
Today, a new kind of patient is emerging and chances are you’re one of them—an active team member who is involved and engaged in your health and corresponding care.
In a patient-centred setting, one’s specific health needs are the end goal of care, and the patient is armed with the right information to drive all healthcare decisions. For physicians, doing what’s needed to meet your goals becomes the guidepost for quality care.
Patient-centred care in action
Picture this: Mr. Tremblay just found out he has prostate cancer. He’s 65 and healthy. Now he has some big decisions to make. The urologist knows Mr. Tremblay has several treatment options: keeping a close eye on it, removing the growth in surgery, or trying external or internal means of radiation. What should Mr. Tremblay do? And who should make the decision?
According to this case study in Stacey and Légaré (1), Mr. Tremblay’s healthcare team took several steps to ensure they thoroughly informed him of the care map. They gave him consultations and decision-making tools, asked about his values and knowledge of his options. In return visits, his nurses with decision-coaching training checked his knowledge and walked him through his options. All this took place before Mr. Tremblay made his final decision in consultation with the urologist: he chose a prostatectomy. It was the right fit. It aligned with his desire for active treatment that didn’t include internal radiation or any risk of bowel problems.
Does it work?
Yes! There are many reasons why the World Health Organization has made patient-centred care a priority, but at its core, patient-centred care often makes for better care and outcomes.
There is great value in an environment with open communication, structured around setting goals that all stakeholders can contribute to and measure.
Patient health care becomes a partnership, a team effort. Patients are empowered to play a more active role when their healthcare team legitimizes their illness experience, acknowledges their lived expertise, offers hope, and provides advocacy to help patients and their families make the right decisions (2).
While the system is moving in the right direction, there are still myths to dispel when it comes to patient-centred care.
One is the misconception that patients don’t want to make these decisions and would rather ‘leave it the expert’: In reality, research shows more than 90% of patients want to be involved in shared decision making, but only 50% are. Too often, the patients who are less heard or feel less empowered to weigh in are those who more vulnerable or face systemic barriers (2).
Another myth is that it’s too time-consuming, both in terms of appointments and decision making, to adopt the patient-centred care model. In truth, focusing on patient-centred, team-directed goals showed no discernable difference in the length of the appointment time (2). In fact, patient-interactions can be more efficient with the right techniques and resources.
Laying the foundation for patient-centred care
Information is power. Making educational tools and resources more readily available to healthcare professionals to, in turn, share with patients and their families is essential for supporting patient-centred care practices.
These days, most patients faced with a health-related issue are hungry for information so they can better participate in disease management. Rather than turning to Dr. Google and having to weed through in the search for credible information, patients should be supported in their quest for credible evidence-based information.
At the clinical level, valuable tools include more decision aids for patients, disease management flowsheets, training in decision coaching for health-care teams, and more.
Let’s strive for patient-centred care to be the norm—the key is to provide both patients and practitioners with the tools, resources and training to create more formalized partnerships that follow a true patient-centred model that everyone can follow.
- Stacey D, Légaré F. Engaging clinical teams in an interprofessional approach to shared decision making. Canadian Oncology Nursing Journal. 2015;25(4):455-461.
- Montague T, et al. Patient-centred care in Canada: key components and the path forward. Healthcare Quarterly. 2017;20(1):50-56.