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Colleges Patient centered care delivery (Cijfer 8,4)
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Colleges Patient centered care delivery (Cijfer 8,4)
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COLLEGE 1 | 03.09.2021 | INTRODUCTION ; PATIENT CENTERED CARE DELIVERYContext matter, different settings and contexts.
1) Innovative models, medical homes
2) PCC, definitions, elements, how relates to outcomes
Interaction patients and health care professionals
Shared decision making, also legal point of vies
Co-creating and pros and cons
3) Team context
Teamwork required, communicate and collaborate effectively
4) Organizational context
Procedures differ between hospitals, differ best type of care for patients
-> Field sessions, patient centred in health care.
5) Context of patients
Educational, cultural, resources
6) Community context.
Striving healthy population
vestjens@eshpm.eur.nl
esc@eshpm.eur.nl
,COLLEGE 1 | A: WHAT IS PATIENT CENTERED CARE
Patient centered care delivery
Door vele overgenomen, geïmplementeerd
2001, een van de 6 kwaliteit domeinen, nieuwe vondsten
Strategie en beleid op meerdere niveaus nodig.
-> informed and shared decisions making
-> Respect en reageert op preferences, needs en values.
Overeen, en consensus over significantie er van
Is patient-centered care easy to deliver?
- ‘Patients are always at the center of our care delivery’
- ‘Patient-centered care is our top priority’
- ‘Every decision is made with the involvement of patients’
Niet alleen care delivery maar ook op organisatie niveau, hogere organisatie niveau
Amepoort; cliënten doen mee in besluitvormen op hoger niveau; aannemen professionals, geven de
voorkeur in de keuze. Logisch, patiënten leven in de faciliteit, moeten er mee leven
Vaak voelen alsof niet serieus genomen of geluisterd wordt
While 94% wants to participate, 48% of Dutch patients find it hard to take an active role in their care
willen, en wordt ook gestuurd dat actieve rol innemen, maar weten niet goed hoe
Weten soms niet eens dat ze mogen kiezen. Opties niet neutraal of gelijk gepresenteerd
Professionals moeten macht delen, ook als dit ongemakkelijk voelt.
Veel diversiteit care delivery op individueel niveau
,Healthcare professionals’ views on PCCD
Delivery of PCC
- ‘Very often patients are not supported to set their own goals; it is the doctor telling them’
Professionals moeite met bieden van mogelijkheid
- ‘When they [patients] tell their story to different people, different information comes out’
- ‘Bad communication, not ineffective and miscommunication is probably the most significant reason
why errors happen’
In Europe almost half of the population (47%) has trouble understanding healthcare information
Limited health literacy, gelinkd aan de communicatie, ook medicatie brochure en voorschriften.
Niet goed begrijpen, en niet goed uitvoeren
Professionals niet op de hoogte dat ze niet begrijpen
Proportion health limited literacy verschilt per land,
Bewust van need voor diversity in healthcare
Patient centered care is hard; we know it works but are clueless to what it looks like
Studies wijzen dit uit. Organisaties die goed doen in PCC, doen beter in patiënt uitkomsten
Andere op communicatie, andere op toegang tot zorg. Zijn verschillende componenten
Care coordination. Hoe kunnen we al deze interventies vergelijken? Wat maakt het pcc en wat niet
Shared decision making, maar is meer dan dat.
Professionals kennen je als persoon.
Wat bijdraagt: Coordinatie, familie en vrienden betrekken, ook mentale gezonheid meenemen
Interventies in ziekenhuis
90% niet sure dus of effectief is..
Lastig om interventies te evalueren. Niet zelfde voor alle groepen patiënten.
Bepaalde protocollen missen, bijvoorbeeld verschillend educatie niveau, lager gezondheidsniveau
- Only 11% of treatments is proven to be effective
- 24% is probably effective
- 7% has both positive and negative effects
- 8% is likely not effective
- 50% is unknown
Movement from authority based care to evidence based medicine leading to context based medicine
Ontrafelen voor verschillende populaties. Kennis van patienten en de context en voorkeuren nodig.
Aanpassen shared decision making naar context van hen aanpassen
What patient-centered care really means
sit wish to stand, alone need wife hand, eat not want to, told want to be asked, woken wish to sleep…
, COLLEGE 1 | B: EIGHT DIMENSIONS OF PCC
Social Production Function theory
- Physical: Niet in pijn, goed kunnen slapen
- Social well being: nog te weinig gedaan, daar in investeren
Patient centered care
“healthcare that establishes a partnership among
practitioners, patients, and their families (when
appropriate) to ensure that decisions respect patient´s
wants, needs, and preferences and that patients have
the education and support they need to make decisions
and participate in their own care”
Care die nodig heeft op de manier hoe die wil op de tijd
dat patient het wil. Deel zijn van proces
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