The patient-centered approach is a focus of researchers’ careful attention on a worldwide basis. In this model of healthcare provision, the health needs, and desired treatment outcomes of a specific individual come to the forefront. In other words, a patient’s preferences become the driving force of the physician’s decisions, management strategy, and clinical outcomes. Recently, patient-centeredness has become “a key attribute of high-quality health systems” (Leslie et al., 2018, p. 2). Thus, the patient-centered approach has numerous benefits, which may provide it with the title of the new gold standard in healthcare delivery. However, this approach involves a range of challenges, which require close consideration. That is to say, a comprehensive analysis of this issue is needed.
First of all, it is necessary to observe that a shift to the patient-centered approach is an inevitable prerequisite for the effective functioning of healthcare systems. Indeed, there are urgent issues in modern healthcare around the world. These problems include ensuring the healthcare quality and equality, detecting the causes of dissatisfaction, cases of improper diagnosis and treatment, as well as “disrespectful care” (Leslie et al., 2018, p. 1). The scholars remark that the need for “universal health coverage” is an essential challenge for researchers and healthcare administrators (Leslie et al., 2018, p. 1). Consequently, the patient-centered approach may be a viable means to achieve these crucial tasks.
There have been numerous studies demonstrating the benefits of the patient-centered approach. The patient-centered approach strongly relies on the collaborative decision-making process, which implies active cooperation between patients, their families (i.e., health consumers), and healthcare providers. The patient-centered approach is “an important aspect of quality service,” since it “involves placing the patient first” (Hlongwane, Ngongoni, & Grobbelaar, 2019, p. 225).
Hence, the patient-centered approach prioritizes the preferences and needs of health consumers. This requirement ensures the implementation of a personalized treatment plan for each particular patient. Through establishing effective communication between patients and physicians, it facilitates patients’ participation in the medical care process, streamlines the process of anamnesis collection, and thus promotes the development of personalized medicine.
It is necessary to observe that patients’ emotional comfort is an essential basis for ensuring joint decision-making and coordinated collaboration between physicians and patients. This approach inherently respects patients’ values and preferences, with a focus on careful listening to patients during interviews. In this context, the physician’s communication skills and readiness to listen to patient’s opinion become an indispensable prerequisite for the patient-centered model, and thus are of paramount importance.
Moreover, patients’ family members are also engaged in the development of the treatment plan. All these features facilitate the process of sharing clinical information, which may be crucial for correct diagnostics and appropriate treatment. Consequently, this approach contributes to higher adherence levels in terms of patients’ following the physician’s treatment recommendations. Furthermore, it is an effective means of patient self-management in case of chronic diseases. As one can easily observe, the abovementioned benefits of the patient-centered approach possess a strong potential of improving treatment outcomes and increasing the patients’ overall satisfaction with healthcare services provided.
At the same time, the implementation of the patient-centered model involves a range of serious challenges. First of all, the patient-centered model is at risk of losing its strong potential without a due focus on the context of its implementation. In fact, the scholars remark that the patient-centered approach may become “a platitude unless research can operationalize this idea within a context-specific quality framework” (Leslie et al., 2018, p. 2).
In other words, the specific features of each clinical setting are vital. These peculiarities include the healthcare background in high-, middle- and low-income countries, as well as certain aspects characteristic for a particular group of patients. Hence, the patient-centered approach is not a rigid standard for each clinical setting worldwide. Instead, it must be tailored to each specific context to ensure its strong performance in the most effective manner.
One should also bear in mind that the practical introduction of the patient-centered approach requires specific managerial steps and change adoptions from each healthcare facility. For instance, the implementation of this approach may require the integration of new stakeholders at healthcare facilities, such as “the patient advisor” (Clavel et al., 2019, p. 2). The researchers emphasize that it is crucial to ensure that the patient advisor’s functions are not limited to the “tokenistic involvement without real contribution” (Clavel et al., 2019, p. 2).
As one can easily observe, the implementation of the patient-centered approach must strongly rely on “a more nuanced and powerful program” (Bergerum, Thor, Josefsson, & Wolmesjö, 2019, p. 962). Therefore, new managerial efforts and activities are essential to secure the feasibility and sustainability of the patient-centered approach.
Indeed, the introduction of this model requires numerous changes in management practices. For this purpose, “managers need to be supported through specific training on best practices” for patient engagement (Clavel et al., 2019, p. 11). In particular, there is a need for new health administration curricula and online training courses at medical universities and nursing schools. Furthermore, specific actions on recruitment, coaching, and team training of patient advisors within healthcare facilities are also necessary. In addition to designing the patient-centered healthcare setting, it is also essential to ensure the sustainability of this achievement over time.
For this purpose, several significant changes in management practices are indispensable. These steps include careful structuring of the implementation process across different administration levels, assigning new departments in charge of patient engagement, and incorporating patient-centeredness in the institution’s strategic objectives (Clavel et al., 2019). Moreover, adequate funding allocation is necessary to ensure the suitability of this model. As one can easily observe, the implementation of these changes in management practices may be a challenge for healthcare facilities.
Apart from organizational changes, attitudinal modifications are also crucial. The scholars assert that healthcare organizations should be guided not only by the principles of “tailoring, interaction, and partnership,” but also behavioral change among the stakeholders (Bergerum et al., 2019, p. 962). In particular, the concept of behavioral change is of paramount importance. Bergerum et al. (2019) remark that the increased patient involvement in the clinical setting, such as in guideline development, becomes a useful tool for behavioral change among both health consumers and providers. Hence, behavioral change is an inherent element of the patient-centered approach implementation.
It aims at ensuring a respectful context of equal rights and mutual understanding, which will eventually enhance the quality of healthcare delivery. Creating a shared vision of patient engagement among all stakeholders is another fundamental aspect (Clavel et al., 2019). In this context, the organization of subject-oriented workshops and seminars is indispensable. These training activities will ensure the development of a shared vision among patients and health professionals and administrative staff. Besides, they will facilitate the dissemination of its implementation results.
Moreover, the implementation of the patient-centered approach requires carefully elaborated tools for monitoring its output. The scope and effectiveness of this model are “difficult to objectively measure” (Peoples, 2015, para. 4). The scholars emphasize the necessity to validate “tools for efficient assessment of patient experience” (Leslie et al., 2018, p. 2). Indeed, it is possible to assess the effect of patient-centered healthcare utilizing patient satisfaction surveys and the system of health services ratings. However, these methods are inherently subjective and, therefore, cannot provide a non-biased representation of healthcare quality.
Consequently, there may be a “danger of dissipating into inconsistent assessments” instead of improving the entire healthcare framework (Leslie et al., 2018 p. 5). The survey method can potentially jeopardize healthcare providers since patients can manipulate their role in the treatment process. For example, patients may handle an opportunity to force the physicians into “giving them what they want,” such as prescribing stimulant medications to an addict (Peoples, 2015, para. 6). Thus, along with establishing an atmosphere of patient-centeredness, it is also essential to ensure a physician-safe and friendly environment based on mutual respect.
Furthermore, the intensified focus on an individual sometimes impedes the consideration of the broader context. An excessively patient-centered approach can contribute to physicians’ burnout, resentment, and overall job dissatisfaction (Peoples, 2015). Instead of “identifying the patient as the center,” it would be more appropriate to prioritize the relationships between the physicians and the patient (Peoples, 2015, para. 16). Thus, “relationship centeredness” rather than “patient-centeredness” should be the real gold standard of 21st-century healthcare delivery. One can observe this focus shift in recent researches.
For instance, Hlongwane et al. (2019) developed a Six-Sigma-based decision-making system to monitor quality improvement at healthcare facilities. In this context, the scholars take into account dissatisfaction factors among physicians, nurses, and support personnel “as an indicator for taking corrective action” (Hlongwane et al., 2019, p. 226). Thus, patient feedback and employee satisfaction constitute an integral and interrelated unity. One cannot focus exclusively on the patient’s preferences without due consideration of the physician’s comments and suggestions as to the treatment process and the clinical setting organization. In other words, a medical facility must be a benign environment for both health consumers and providers.
In general, a patient-centered model is a promising approach to modern healthcare, and it possesses numerous benefits. However, it is necessary to bear in mind that the patient-centered approach, as such, is not necessarily the gold standard, which is fully ready to be applied. Instead, it requires a range of careful conceptual and managerial decisions before its implementation in practice. In other words, patient-centeredness is a highly beneficial and viable model, but in the case of improper management, its strengths can transform into weaknesses and shortcomings. In fact, an ill-considered and poorly planned implementation can potentially result in unfavorable outcomes both for patients and physicians.
Therefore, a meticulously planned system of internal quality assurance is necessary, aimed at protecting all stakeholders of the healthcare system and preventing any possible adverse results. Thus, the patient-centered model must rely on prudent and elaborated management, which will ensure the feasibility and effectiveness of this approach. In such a manner, the patient-centered approach will undoubtedly be the gold standard in modern healthcare.
References
Bergerum, C., Thor, J., Josefsson, K., & Wolmesjö, M. (2019). How might patient involvement in healthcare quality improvement efforts work-A realist literature review. Health Expectations, 22(5), 952–964. Web.
Clavel N., Pomey, M.P., & Ghadiri, D.P.S. (2019). Partnering with patients in quality improvement: towards renewed practices for healthcare organization managers? BMC Health Services Research, 19(1), 1–12. Web.
Hlongwane, S., Ngongoni, C., & Grobbelaar, S. (2019). A patient-centric six-sigma decision support system framework for continuous quality improvement in clinics. South African Journal of Industrial Engineering, 30(3), 224–237. Web.
Leslie, H.H., Hirschhorn, L.R., Marchant, T., Doubova, S.V., Gureje, O., & Kruk, M.E. (2018). Health systems thinking: A new generation of research to improve healthcare quality. PLOS Medicine, 15(10), 1–4. Web.
Peoples, R. (2015). Is patient-centered care part of the problem? KevinMD. Web.