Introduction
Person-centered care is an essential topic in nursing research, as it has the potential to improve patient outcomes, autonomy, and satisfaction with services rendered. In caring for diverse populations, a person-centered approach to care is critical to ensuring that the plan of care is devised under patients’ needs, beliefs, and values. The study by Brummel-Smith et al. (2016) sought to enhance the definition of person-centered care and review the considerations regarding its implementation in primary care settings. The present paper will provide an overview of the research study and the informal presentation, as well as explain the clinical application of person-centered care.
The Research
The importance of person-centered care, or patient-centered care, is acknowledged in many research studies. However, as explained by Brummel-Smith et al. (2016), the variability of definitions provided in academic literature contributes to the lack of a clear understanding of the practice and its implementation in clinical settings. The researchers attempted to solve this problem by conducting a qualitative study using a literature review, interviews, and a consultation of the interprofessional expert panel as the principal sources of data collection.
The authors found fifteen definitions of person-centered care and similar terms (e.g., patient-centered, patient-directed, and person-focused care) and utilized them to provide a composite definition and determine the essential elements of person-centered care (Brummel-Smith et al., 2016). The study also outlined barriers to the implementation of person-centered care in primary care settings and additional considerations.
Based on the research, person-centered care was defined as the process where “individuals’ values and preferences are elicited and, once expressed, guide all aspects of their health care, supporting their realistic health and life goals” (Brummel-Smith et al., 2016, p. 16). This process requires a dynamic relationship between patients, family members, and close ones, and care providers, including interdisciplinary teams.
The authors also defined the main elements of person-centered care that can serve as a framework for implementing it in practice. These include an individualized, goal-oriented plan of care tailored to the person’s preferences. The patient’s goals and the plan of care should be subject to an ongoing re-evaluation (Brummel-Smith et al., 2016). The involvement of an interprofessional team with one primary point of contact, as well as active coordination of services, information sharing, and communication are also essential prerequisites of person-centered care (Brummel-Smith et al., 2016). Lastly, this approach to care also involves patient and provider education and performance management to achieve optimal outcomes.
Because person-centered care is a complex process, there are numerous barriers to its implementation in primary care settings. For example, Brummel-Smith et al. (2016) state that provider workload, payment systems, concerns for patient health and safety, poor continuity of health records, and the lack of advance care planning contribute to difficulties in the implementation of person-centered care.
Moreover, problems in communication, teamwork, coordination, and organizational culture could create further obstacles to its application (Brummel-Smith et al., 2016). As a result, the research shows that person-centered care requires a well-organized effort throughout the organization to yield successful outcomes. The findings described by the authors can be used to develop a plan for implementing person-centered care in primary care settings.
The Presentation
The presentation aimed to explain the concept of patient-centered care, its components, and critical considerations to an interdisciplinary team working in a primary care clinic. The presentation was followed by a discussion that highlighted some important issues. First of all, the team agreed that person-centered care is often overlooked in favor of the traditional care model. As the majority of the team members suggested, the traditional model of care is less complicated and does not always require the involvement of multiple staff members, which reduces the workload. Secondly, the discussion also stressed that the current health system in the U.S. does not allow to execute the principles of person-centered care successfully while remaining cost-effective. Care providers are not reimbursed for the excess time spent with patients, which means that the implementation of patient-centered care would result in financial losses for the organization.
Nevertheless, the audience agreed on the potential benefits of the approach, stating that it could be used to improve patient outcomes and satisfaction with care. The discussion also showed the care providers’ willingness to adopt the proposed model of care to enhance care quality and results. Thus, the discussion supports the results of the study, as it emphasized the importance of considering the providers’ workload and the costs of implementing patient-centered care while also acknowledging its benefits for patients.
Clinical Application
The chosen setting is a primary care clinic serving a predominantly Hispanic population with a high rate of chronic diseases and conditions, such as hypertension, diabetes, hyperlipidemia, chronic obstructive pulmonary disease, and more. In chronic disease care, person-centered care could be especially helpful because aligning the care plan with patients’ goals, needs, and beliefs increase adherence to the plan of care (Conn, Enriquez, Ruppar, & Chan, 2014).
Besides, culturally sensitive care, which can be facilitated using a person-centered approach to care planning, can help to build a trusting relationship between patients, family members, and care providers (Douglas et al., 2014). Therefore, one of the most significant benefits of applying person-centered care to the chosen setting is that it would help to ensure cultural relevance, thus positively influencing treatment adherence, self-care behaviors, and patient outcomes.
Patient education and involvement in decision-making are also essential components of this practice when applied to culturally diverse patients. Mansyur, Rustveld, Nash, and Jibaja-Weiss (2015) found that the lack of knowledge and support were the two most significant barriers to self-care adherence in Hispanic people. Hence, patient education and involvement can help to increase the continuity of care in Hispanic patients and achieve better patient outcomes.
As suggested by the discussion, carrying out a full-scale effort for implementing person-centered care in the chosen setting is not advisable due to the increased provider workload and associated financial costs. Nevertheless, some of the essential principles of person-centered care could still be applied in practice. For example, care providers could carry out short discussions during each patient visit to determine the patient’s health goals and beliefs about care. It would also be useful to conduct patient education during appointments to improve adherence to care plans and treatment. To accommodate these changes, the facility should consider implementing efforts to enhance internal communication, which would help to reduce provider workload and allow medical professionals to spend more time with each patient.
Conclusion
A person-centered approach to care would be beneficial in primary care practice settings, as it would help to promote culturally relevant care, adherence to treatment, and health literacy of patients. The research highlights the importance of patient care to the chosen setting and provides a useful framework for applying it in primary care. Nevertheless, provider workload and the associated costs remain among the key barriers to implementing person-centered care in the facility. The recommendations provided in the paper would help to improve patient outcomes and the overall quality of care by applying the principles of person-centered care.
References
Brummel‐Smith, K., Butler, D., Frieder, M., Gibbs, N., Henry, M., Koons, E.,… Vladeck, B. (2016). Person‐centered care: A definition and essential elements. Journal of the American Geriatrics Society, 64(1), 15-18.
Conn, V. S., Enriquez, M., Ruppar, T. M., & Chan, K. C. (2014). Cultural relevance in medication adherence interventions with underrepresented adults: Systematic review and meta-analysis of outcomes. Preventive Medicine, 69(1), 239-247.
Douglas, M. K., Rosenkoetter, M., Pacquiao, D. F., Callister, L. C., Hattar-Pollara, M., Lauderdale, J.,… Purnell, L. (2014). Guidelines for implementing culturally competent nursing care. Journal of Transcultural Nursing, 25(2), 109-121.
Mansyur, C. L., Rustveld, L. O., Nash, S. G., & Jibaja-Weiss, M. L. (2015). Social factors and barriers to self-care adherence in Hispanic men and women with diabetes. Patient Education and Counseling, 98(6), 805-810.