What is Patient Centered Care and Why It Matters

Patient centered care is a healthcare philosophy that puts the patient at the center of care. It involves viewing patients as whole persons, understanding their priorities and perspectives, and empowering them to take an active role in their own care. In this model, healthcare providers partner with patients to understand their values, needs, and preferences to make collaborative care decisions Patient centered care leads to better health outcomes, wiser spending, and more satisfied patients and providers. In this article, we’ll explore what patient centered care means, why it matters, and how it can transform healthcare.

The Definition and Principles of Patient Centered Care

The Institute of Medicine defines patient centered care as “providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions” [1]

Some key principles of patient centered care include [2]

• Understanding the patient as a whole person, not just a disease or condition. This means knowing about their life, values, family, and preferences.

• Seeing patients as partners in care, encouraging their involvement in shared decision making.

• Fostering open communication between patients, families, and the care team.

• Coordinating care seamlessly across the healthcare system.

• Providing education and support for patients to self-manage their health.

• Ensuring physical comfort, emotional support, and respect for patient needs.

Patient centered care emphasizes the partnership between providers and patients. It’s about moving from doing things “to” and “for” patients, to working “with” them as active participants in their care.

The History and Evolution of Patient Centered Care

The origins of patient centered care date back to the 1950s when Balint and colleagues promoted a more humanistic approach between doctors and patients. [3] In the 1970s, Enid and David Mechanic wrote about the importance of understanding patients’ attitudes and behaviors. [4]

But the modern patient centered care movement really began in the late 1980s. This is when the Picker/Commonwealth Program for Patient-Centered Care conducted research to define eight principles of patient centered care from the patient perspective. Their surveys found that aspects like coordination, education, and emotional support mattered more to patients than parking or hospital food. [5]

In 2001, the Institute of Medicine’s landmark “Crossing the Quality Chasm” report cemented patient centered care as one of six aims for healthcare improvement. Since then, patient centered care has become widely embraced. Professional societies, accrediting bodies, and government agencies have promoted it through guidelines, standards, measures, and policies.

For instance, the American College of Physicians says that patient centered care is “the linchpin of high-quality health care.” [6] The National Academy of Medicine has an expert roundtable on patient centered care. [7] And the Affordable Care Act established a national strategy for quality improvement centered on patient engagement.

Patient centered care has also spread globally, with the International Alliance of Patients’ Organizations and other groups advancing it internationally. [8] So while originally focused on doctor-patient relationships, patient centered care now also encompasses how care is designed and delivered across healthcare organizations and systems.

Why Patient Centered Care Matters

There is strong and mounting evidence that patient centered care improves health outcomes, enhances the patient experience, and reduces costs.

For instance, a landmark study in 2004 found patient centered care was associated with better recovery from discomfort, better emotional health, and fewer diagnostic tests and referrals. [9] A 2009 systematic review showed patient centered approaches reduced hospitalizations and emergency department visits. [10] And a 2012 Cochrane review concluded that interventions promoting patient centered care improved mortality, quality of life, and patient satisfaction. [11]

Research also reveals patient centered care enhances patient engagement and self-management. A 2010 study found patients who believed their providers were more patient centered expressed greater participation in their care and adherence to treatment. [12] Patient centered communication is also linked to improved sharing of information and decision making. [13]

For providers, patient centered care boosts professional satisfaction. A 2009 study found primary care physicians who had more patient centered communications scored lower on burnout. [14] Patient centered approaches have also been shown to improve teamwork and reduce medical errors in hospitals. [15]

There are financial benefits too. A growing body of evidence indicates patient centered care lowers health services utilization and costs. [16] One study estimated enhancing support for patient self-management could produce over $2 billion in savings annually just for diabetes, heart disease, and hypertension. [17]

Finally, patient centered care aligns with ethical principles about respecting patient autonomy. [18] Patients consistently rate compassion, empathy, and shared decision making among their top priorities. [19] Patient centered care answers that call.

Strategies to Implement Patient Centered Care

So how can healthcare organizations and clinicians actually become more patient centered? Here are some key strategies:

Train providers in patient centered communication: Programs like Three Function Model and Four Habits Model teach providers to build rapport, elicit patient perspectives, and involve patients in decisions. [20]

Involve patients and families: Create partnerships through activities like patient and family advisory councils, including patients on committees, and partnering with patients to design processes.

Measure the patient experience: Use surveys like CAHPS and tools like patient journey mapping to solicit patient feedback and understand their experiences.

Promote shared decision making: Provide decision aids, train providers in shared decision making, and integrate tools into EHRs to engage patients.

Support patient self-management: Offer education classes, coaching, support groups, and tools to help patients manage conditions.

Focus care on what matters to patients: Ask “What matters to you?” Use motivational interviewing to understand patient goals and priorities to personalize care plans.

Improve care coordination: Assign patients a care coordinator, facilitate warm hand-offs between providers, communicate across teams; share medical records.

Make care more accessible: Offer extended hours, virtual visits, same-day appointments, and other conveniences patients want.

Enhance shared medical records: Give patients access through patient portals and tools like OpenNotes so they can review records and share information.

Modify the care environment: Evaluate and improve physical comfort, wayfinding, emotional support, and policies through the patient’s eyes.

Develop patient-centered leaders: Promote leaders who embrace patient partnership, transparency, compassion, diversity, and employee well-being.

Adopting patient centered care takes commitment at all levels of healthcare. But it drives powerful improvements in quality, experience, outcomes, and affordability. At its foundation, patient centered care recognizes healthcare exists not to serve the system, but to serve patients. It’s about getting back to the heart of medicine.

The Future of Patient Centered Care

While adoption of patient centered care is growing, work remains to make it standard practice. Surveys indicate many patients still do not experience healthcare as patient centered. [21]Troubling disparities in care quality, outcomes, and experiences for disadvantaged patients persist. [22] And entrenched healthcare models resist change.

But the push for patient centered care is gaining momentum. The swell of consumerism, technological advances enabling transparency and consumer access, and value-based payment models all incentivize patient centering. A wave of innovative startups are introducing new consumer-focused services. Expectations are rising.

Ultimately, patient centered care is not just an aspiration but a necessity. Healthcare costs continue to climb. Chronic disease burdens are mounting. And empowered healthcare consumers are demanding better. Patient centered care is essential to build a healthcare system efficient, effective and equitable enough to meet these converging challenges. The need has never been greater to reorient healthcare around what patients truly value.

Patient centered care means reimagining healthcare through the patient’s eyes. It is founded on patient partnership, compassion, communication, empowerment, and respect for patient needs and perspectives. When consistently practiced, patient centered care transforms healthcare. It improves quality, both technical and interpersonal. It elevates outcomes that matter to patients. And it curbs waste to rein in costs. Patient centered care is recognized globally as an ethical imperative and vital strategy. While progress has been made, dedicated efforts to implement patient centering across healthcare are still needed. But the compelling evidence of its benefits for patients and providers alike should galvanize all those striving to build healthcare systems worthy of our humanity. Truly patient centered care is within reach.

References

[1] Institute of Medicine (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: The National Academies Press.

[2] The Beryl Institute. (2015). Defining Patient Experience. http://www.theberylinstitute.org/?page=DefiningPatientExp

[3] McWhinney, I. R. (1972). Beyond diagnosis: An approach to the integration of behavioral science and clinical medicine. The New England Journal of Medicine, 287(8), 384-387.

[4] Mechanic, D., & Meyer, S. (2000). Concepts of trust among patients with serious illness. Social science & medicine, 51(5), 657-668.

[5] Gerteis, M., E