4 Core Principles of Patient-Centered Care, Family Engagement

Treating patients with respect and incorporating them in all aspects of the healthcare industry will help foster a culture of patient- and family-centered care, according to a position paper published by the American College of Physicians.

The paper, published in the Annals of Internal Medicine, outlined not only the importance of patient- and family-centricity, but the action steps organizations can take to achieve patient-centered care.

“ACP’s principles position patients and their families in their rightful place at the center of care in partnership with their health care team with the goal of improving outcomes and satisfaction,” ACP President Dr. Ana María López said in a statement. “This partnership is critical for our rapidly changing health care system to be effective.”

These principles align with the overall industry trend of patient engagement in team-based care.

“Patients and families are playing a larger role than ever in health care, as partners in their own care and as advisors in improving care delivery,” ACP explained in a summary of the paper. “Although this concept is widely accepted among health care professionals, administrators, policymakers, and the public, defining and implementing patient and family partnership can be challenging.”

ACP established a working definition of patient- and family-centered care in an effort to address the challenges that saddle many organizations. Specifically, ACP defined patient- and family-centered care as “an approach to the planning, delivery, and evaluation of health care that is grounded in mutually beneficial partnerships among health care providers, patients, and families.”

Those tenets provided, ACP developed four core principles to patient- and family-centered care, including:

• Patients and families should be treated with dignity and respect.
• Patients and families should be active partners in all aspects of their care.
• Patients and families should contribute to the development and improvement of healthcare systems.
• Patients and families should be partners in the education of health care professionals.

ACP noted that patients often define a quality care encounter as one underpinned by dignity and respect, the organization wrote.

“Research indicates that patients commonly see dignity and respect in such behaviors as recognizing the patient as an individual, paying attention to her or his needs, and listening to and expressing empathy for the patient's situation,” ACP stated.

To achieve that end, ACP recommended providers learn more about a patient’s background and check in on the patient’s physical and emotional health. Specifically, providers can ask patients how they want to be addressed, be attentive to patient needs, use easy-to-understand language, listen to patients without interrupting them, and show patients the computer screen while speaking and documenting.

To integrate patients and family members as active care partners, providers can use decision aids, agree on treatment goals, engage in appointment agenda-setting, and promote patient self-management.

However, providers should also recognize that patients and families should only be encouraged to participate in care to the level of their own choosing. Some patients may not wish to direct their own care, and that choice must be respected. Motivational interviewing and questioning techniques can help providers understand patient preferences for shared decision-making.

Involving patients and families in health system improvement will be essential for bringing all viewpoints into development projects, ACP said.

“Patients and families can offer perspectives not always considered by health care professionals,” the organization wrote. “When patients participate, professionals do not have to make assumptions about their needs and preferences.”

Organizations can elicit and consider patient perspectives on different healthcare initiatives by developing a patient and family advisory council (PAC). Organizations can create PACs by recruiting a diverse patient panel with different degrees of experience with the healthcare system. Developing a strong provider and patient leadership team from the PAC will also strengthen the council and the decisions it comes to.

In addition to establishing a PAC, organizations can include patients and families in facility design, create opportunities for them to review educational materials, and involve patients and families in quality improvement activities.

Finally, involving patients and families in the medical training process can foster an entire culture of patient- and family-centricity.

“Historically, health professional education has focused more on diagnosing and treating disease than on incorporating the preferences, values, and beliefs of patients and their families,” ACP said. “To effectively educate today's clinicians and the next generation of health professionals in teamwork and patient partnership, patients should play a central role in planning and developing curricula.”

Specifically, industry leaders can include patients and families in faculty training programs, assign medical trainees a patient to shadow, involve patients and families in curriculum design and trainee assessment, and conduct patient-centered rounding that includes agenda-setting and shared decision-making.

As the healthcare industry continues to embrace a more patient-centric approach, organizations should consider embedding those principles into their overall system cultures. In doing so, they ensure better patient satisfaction as well as adherence to care plans and quality outcomes.