October 26, 2011
“This paper focuses on care coordination in the patient-centered medical home; however, to cultivate a coordinated patient-centered health care delivery system, the PCMH model must be connected to the medical neighborhood. Coordinating care across providers means connecting with specialty and subspecialty providers, many of whom are essential to the successful treatment of chronic illnesses.
The report features three core elements:
- Expert-authored articles on the definition, role and function of care coordination, as well as tools for implementation, and measurement and monitoring of its effectiveness
- Case examples
- Summary of survey responses from select practices.”
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Posted in READ Portal, Reports & Papers | Tagged with Chronic disease, Patient-centered care | No Comments
October 13, 2011
“Hospitals have long tracked patient satisfaction ratings, but they didn’t always carry great significance. While all hospitals want happy patients, hospitals have been historically plagued with the “doctor knows best” mentality — a mentality where clinical outcomes outweigh “touchy-feely” indicators such as patient satisfaction or overall patient experience.
However, in recent years, some leading institutions have begun to focus more heavily on providing an outstanding patient experience. Part of this has been driven by the public reporting of Hospital Consumer Assessment of Healthcare Providers and Systems [HCAHPS] scores, which will soon be incorporated into Medicare reimbursement rates through CMS’ Value Based Purchasing Program. Other drivers include growing consumerism and transparency for healthcare services and increased interest from both consumers and providers in patient-centered care.”
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Posted in Journal Articles, READ Portal | Tagged with Patient satisfaction, Patient-centered care | No Comments
September 26, 2011
Objective: Study objective was to evaluate and discuss the interplay of components of patient- centered care by developing a conceptual model of patient-centered care.
Methods: Comprehensive literature review was conducted using Medline, CINAHL, and Cochrane databases. Included were English language studies addressing issues related to patient-centered-care and patient reported outcomes.
Results: Though the concept of patient-centered care emerged in the early 50s, it exploded in the health care research policy arena exponentially in the late nineties. The conceptual model described here can aid objective and subjective evaluation of patient-centered care. As we strive to improve the quality of care, patient-centered care can play a pivotal role in this process. This however requires changes in our healthcare system so as to improve overall quality of care by minimizing wasteful health resource consumption.
Conclusions: With healthcare costs projected to continue their rapid increase, the current paradigm of healthcare is unsustainable. More research is needed to explore the various attributes of patient-centered care, its acceptability, and comparative effectiveness in the healthcare arena.”
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Posted in Journal Articles, READ Portal | Tagged with Patient-centered care, Quality of care | No Comments
September 22, 2011
“Major discrepancies exist between patient preferences and the medical care they receive for many common conditions. Shared decision making (SDM) is a process where a patient and clinician faced with more than one medically acceptable treatment option jointly decide which option is best based on current evidence and the patient’s needs, pref- erences and values. Many believe shared decision making can help bridge the gap between the care patients want and the care they receive. At the same time, SDM may help con- strain heath care spending by avoiding treatments that patients don’t want. However, barriers exist to wider use of shared decision making, including lack of reimbursement for physicians to adopt SDM under the existing fee-for-service payment system that rewards higher service volume; insufficient information on how best to train clinicians to weigh evidence and discuss treatment options for preference-sensitive conditions with patients; and clinician concerns about malpractice liability. Moreover, challenges to engaging some patients in shared decision making range from low health literacy to fears they will be denied needed care. Adding to these challenges is a climate of political hyperbole that stifles discussion about shared decision making, particularly when applied to difficult end- of-life-care decisions.”
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Posted in READ Portal, Reports & Papers | Tagged with Patient satisfaction, Patient-centered care, Primary health care | No Comments
September 16, 2011
“Not long ago, when my father was about to undergo a heart procedure, I hinted to the cardiologist, a colleague, that I wanted to be there, too, not just to offer comfort but also to be present for the play-by-play that would lead to a critical decision: whether to open his blocked arteries with a stent or to perform bypass surgery. Draped in an X-ray-shielding body suit over his blue scrubs, the doctor hesitated.
I understand why.
I’ve stood in his shoes and listened to family members say they want to be present 24/7 with their loved ones, often in the most challenging of hospital environments, such as the intensive care unit.”
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Posted in Mass Media Articles, READ Portal | Tagged with Patient-centered care | No Comments
September 14, 2011
“Shared service practices involve the integration of service activities across various areas of an organization, or across different organizations, into a single entity. The main purpose of shared services is to improve efficiencies and help manage costs. A shared service can be defined as “the concentration or consolidation of functions, activities, services or resources into one stand-alone unit. The one unit then becomes the provider to several other client units within the organization.”
Shared service practices are used in both the public and private sectors, and are more commonly seen in larger and more complex organizations. There are various shared service models that can be adopted, with each offering its own benefits and concerns. Governments in the United States, Australia, the United Kingdom, and Ireland have successfully implemented shared service initiatives. In response to the increasing demands placed on health care funding, several Canadian jurisdictions, namely Ontario, British Columbia with Alberta as a partner, and New Brunswick, have introduced new approaches to coordinate and integrate the procurement of services and supplies required by their health care systems.
The intent of these “health shared service” models is to maximize the value of expenditures in health care through more efficient practices in the management of resources. The goal is to generate savings that can be reinvested into respective provincial health care systems.”
The UBC Centre for Health Care Management has offered two seminars on Shared Services. Visit Creating Value Through Shared Services or Patient Services Consolidation to learn more.
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Posted in READ Portal, Reports & Papers | Tagged with Canada, Cost effectiveness, Funding, Integrated care, Patient-centered care | No Comments
August 30, 2011
The study found that “collaborative capacity”—the researchers’ term for an organization’s ability to foster teamwork even in the presence of rigid occupational hierarchy and the absence of formal teams—varied by patient care unit. In particular, it varied according to the presence or absence of a clear direction or mandate, a supportive organizational context, and leadership that promotes teamwork. Moreover, an emphasis on patient-centered care—which shifts the focus away from providers to put patients’ needs and preferences first—was associated with collaborative teamwork .
Posted in Journal Articles, READ Portal | Tagged with Health human resources, Patient-centered care, Teamwork | No Comments
August 25, 2011
As private and public employers strive to improve workforce health and control healthcare costs, the patient centered medical home (PCMH) is emerging as an important strategic component
to achieve these goals. The PCMH enables clinicians to deliver better quality care more efficiently. Central attributes of the PCMH include a holistic, team-based approach to primary care that is accessible, coordinated, and comprehensive. PCMH incorporates re-engineering of office processes and payment systems to reward an ongoing primary care physician-patient relationship and high-quality, coordinated care. Through better informa- tion management, use of guidelines and coordinated care, PCMH can contribute to better quality of care, which, in turn, drives cost reductions through avoided hospitalizations and emergency department visits.
While employer interest in PCMH continues to rise, an important issue facing employers concerns the measurement of value of PCMH implementation. From a pragmatic perspective, this information is necessary to help justify initial and ongoing employer investments in PCMH. And despite this observation, there is no consensus regarding specific measures or metrics to evaluate PCMH program effectiveness.
Posted in READ Portal, Reports & Papers | Tagged with Cost effectiveness, Indicators, Patient-centered care, Program evaluation | No Comments
August 22, 2011
“Achieving the triple aims—higher-quality patient-centered care, improving population health, and moderating per capita costs—will require fundamental change… To succeed, organizations contemplating participation in ACOs will need to develop and improve organizational capabilities necessary to meet program requirements. Hospitals and physician organizations will need to forge new relationships and take on new responsibilities. Success will require adaptation and change, learning quickly from mistakes, and developing an ability to transfer knowledge among participating entities. This will require ACOs to become learning organizations that can comprehend and expand what works and move to correct things that do not.”
Posted in Journal Articles, READ Portal | Tagged with Patient-centered care | No Comments
August 15, 2011
“Making shared decision-making a reality: No decision about me, without me aims to… clarify what is meant by the term shared decision-making and what skills and resources are required to implement it and it also outlines what action is needed to make this vision a reality.
The principle of shared decision-making in the context of a clinical consultation is that it should:
- support patients to articulate their understanding of their condition and of what they hope treatment (or self-management support) will achieve
- inform patients about their condition, about the treatment or support options available, and about the benefits and risks of each
- ensure that patients and clinicians arrive at a decision based on mutual understanding of this information
- record and implement the decision reached.
The paper outlines the importance of communication skills and sets out how clinicians might approach consultations to arrive at shared decisions. It also suggests that tools that help patients in making decisions are just as important as guidelines for clinicians.”
Posted in READ Portal, Reports & Papers | Tagged with Patient satisfaction, Patient-centered care | No Comments
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