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Patient Centered Care Delivery Workgroups HCM
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Patient Centred Care DeliveryWorkgroup 1: Patient Centred Care Delivery (PCCD)
1. Explain the two conceptual models (both Rathert and Jayadevappa) and their addition to the
literature.
The Donabedian Model (Rathert):
Good structure increases the
likelihood of good process and
good process increases the
likelihood of good outcome.
There are two elements of
process: technical process and
interpersonal process. Technical
process such as appropriate
diagnosis and judgement is
implemented in interpersonal
processes such as exchange of
information. The success of the
technical process depends on the
interpersonal process. Some
consistent variables play
moderating and mediating roles
in the conceptual model. There
are eight domains within the
process that need a certain level in order to have an effect. In addition to this level,
moderators can have a positive or negative effect on the outcome, whereas the mediators
are influenced by the domains/process, which leads to a positive or negative effect on the
outcome. The outcomes are patient satisfaction, patient clinical outcomes and organizational
outcomes. It could be that the dimensions have a desirable effect on the mediators. This
would have a direct influence on the outcome patient satisfaction. Mediators do not have a
direct influence. It is a detour to possibly improve the outcome.
Conceptual Model of Jayadevappa:
Patient Centred Care requires an
unanticipated level of commitment
and significant adjustments in
organization structures, physician role
and patients belief. This conceptual
model consists of multiple domains
that influence treatment choice, the
process of care and outcome. For
shared decision making, the patient
should understand the risk or
seriousness of the illness, understand
the preventive service, including risks,
benefits and alternatives, weigh its
values regarding potential benefit and
harms regarding the treatment and
, engage in shared decision making at a level that he or she desires and feels comfortable with.
Due to all the clinical differences, physicians and nurses should tailor the medical care to the
patients preferences. Taken this in account, the policy lowers the costs but maximizes
survival and patient satisfaction. Provider characteristics include the variety of specialists,
machines etc. the hospital provides. It shows the influence the process has on the outcome.
The costs should be minimized so that the outcomes can be maximized.
2. Explain the eight dimensions of PCC and give an example of care within each dimension.
Patient preferences The interaction between healthcare professionals and
patients. Treat each other with respect.
E.g. The patient can choose their own healthcare
professional.
Information & education The patient should understand the information that is given
and the professional should provide evidence-based
information.
E.g. Educational flyers in different languages.
Access to care How easy or difficult it is to go to the doctor. Availability,
transparency or waiting lists in the hospital.
E.g. Easy access for people with disabilities.
Emotional support Professionals should ask the patient about their mental
health.
E.g. A disease can have impact on the mental health of a
patient.
Family & friends Confide family and friends when the patient asks for it or
when the patient does not comprehend all the information
that has been given. Involve family and friends in the
decision making.
E.g. Rooming in parents or let family spend the night.
Coordination of care It is clear for patients who their healthcare professional is
and in what organization. It is a lot like continuity &
transition. There is one patient with multiple health care
professionals.
E.g. Patient with diabetes. The GP will tell you to have a
blood test. The nurse will draw the blood and send it to the
lab. The assistant will call you about the results of the blood
test. The communication between them is very important.
Coordination of care is within 1 organization and not with all
healthcare providers.
Physical comfort Try to make the treatment as painless as possible.
E.g. Are the seats in the waiting room comfortable? Can the
patient find all the routes (setting)? Can the patient have
access to painkillers? Are there supporting aids for walking?
Continuity & transition All correspondence between healthcare professionals
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