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  3. Erasmus Universiteit Rotterdam (EUR)
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  5. Patient Centered Care Delivery (GW4002MV)

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Complete summary PCCD
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  • Vak
  • Patient Centered Care Delivery (GW4002MV)
  • Instelling
  • Erasmus Universiteit Rotterdam (EUR)

Complete samenvatting waar alle essentiële concepten worden besproken die nodig zijn om het tentamen goed te volbrengen. Duidelijk onderscheid tussen hoofd- en bijzaken waardoor je nog efficiënter kan studeren!

Voorbeeld 3 van de 17  pagina's

Document informatie

  • 21 november 2021
  • 17
  • 2021/2022
  • Samenvatting

Onderwerpen

  • donabedian model
  • conceptual model
  • eight dimensions of pccd
  • evidence based care
  • shared decision making
  • informed consent
  • autonomy
  • chronic care model
  • relational coordination
  • patient centered medical home

Geschreven voor

  • Erasmus Universiteit Rotterdam (EUR)
  • Health Care Managment
  • Patient Centered Care Delivery (GW4002MV)
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Voorbeeld van de inhoud

Theme 1
Patient Centered Care (Lacy)
- Exploration of both the disease and illness experience
- Understanding the whole person
- Finding common ground
- Incorporating prevention and health promotion
- Enhancing the patient-doctor relationship
- Being realistic

Two conceptual models (Rathert and Jayadevappa)
Rathert: Donabedian model
o Model focuses on good structure > good process > good outcome
o Patient journey focused, patient perspective
o Interpersonal processes: exchange of information, determine accurate diagnosis,
preferences and acceptability of care
o Technical: appropriate diagnoses and strategies for care
o Technical processes are implemented through interpersonal interactions, therefore, the
success of technical care depends on interpersonal processes
o Eight domains within the process
o Moderators affect direction of strength of the relationship
o Mediators are influenced by the process domains, but do not have a direct influence
on outcome
o Outcomes: patient satisfaction, patient clinical outcomes and organizational outcomes.




Jayadevappa: Conceptual model
o States that PCC requires level of commitment and adjustment in organization
structure, physician role and patient beliefs (integrating culture competence)
o Organization focused: how to organize patient centered care
o Domains that influence treatment choice, the process of care and the outcome
o Shared decision making, the patient:
1) understands the risk or seriousness of the disease;
2) understands the preventive service, including the risks, benefits, alternatives and
uncertainties;
3) has weighted his or her values regarding the potential benefits and harms
associated with treatment; and

, 4) has engaged in decision making at a level that he or she desires and feels
comfortable
o Tailored care to patient preferences; that takes into account clinical characteristics and
clinical convenience to minimize the costs and maximize the outcomes of survival
and satisfaction, integrating:
1) understanding the patient and the illness,
2) arriving at mutual understanding regarding illness management and therapeutic
alliance,
3) providing valued information,
4) enhancing hospital, doctor and patient relationship; and
5) sensitivity about resource allocation and cost.

Model integration:




Integration:
o Organizational outcomes are similar to costs
o Moderators and mediators are similar to patient characteristics and clinical
characteristics
o Patient and clinical outcomes are similar to outcomes presented
o The eight domains/dimensions can be integrated between provider characteristics as
part of the process to patient centered care

Jayadevappa:
 Applicable in management/organizations setting because focus on cost as outcome
Rathert
 Focuses mostly on interpersonal relationship and patient journey, making it best
applicable in the GP practice/consultation practice where there is a direct relationship
between the physician and the patient

Eight dimensions of PCC with examples
1. Patient preferences: The interaction between healthcare professionals and patients
Example: routine feedback/evaluations, ability to modify own schedule with respect to
food/visiting hours/sleep times etc
2. Information and education: understanding of information, evidence-based
information provided
Example: Publicly available information (e.g., flyers in different languages), modified information,
patient education, guidance

, 3. Access to care: care availability and transparency
Example: GP that visits you instead of you visiting them, short waiting times on the phone/email,
whatsapp helpline, disabled access
4. Emotional support: care should not only focus on physical elements but also
mental
Example: emotional support dogs in anxiety, psychologist visit for people with terminal disease
5. Family and friends: involve in decision making, provide structure for easy support
system
Example: elderly home combined with student homes, family guidance or counseling, opening
visiting hours
6. Coordination of care: clear communication between professionals and to patient
Example: follow-up, good communication to prevent
7. Physical comfort: think of emotional/physical needs that increase comfort
Example: beds in hospitals, air-conditioning, special service to patients with special needs
8. Continuity and transition: all correspondence between professionals
Example: sharing of data, scans etc to eliminate duplication of testing




Patient Centered Medical Home
“Holy grail” for transforming primary care; featuring comprehensive care, patient centered
care, coordinated care, accessible service, quality and service.

1. Comprehensive: The medical home is set up to meet the majority of patients physical
and mental needs. It works through a team of care providers, linking their patients to
providers and services in communities.
2. Patient centered: Active support in patient self-management, relationship-based care,
inclusion of families.
3. Coordinated care: Clear and open communication, broader health care system
coordination, facilitating transition between sites of care.
4. Accessible services: shorting waiting times, longer in-person hours, 24/7 access to
care team
5. Quality and safety: clinical decision support tools, measuring patient experience and
satisfaction, transparence of improvement activities

 While all patients can benefit, majority only needs basic assessment, context matters!
 No reductions in healthcare utilization, quality or costs
 Difficult to assess over short-time period, volunteerism also plays a role

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