Advancing PCC across the continuum of care

Abstract

Person-centered care—also referred to as patient-centered care—(PCC) is a complex and multi-dimensional concept that is increasingly recognized as the optimal form of care in all types of health care venues, including primary, acute and long-term care settings (Berwick, 2009; Koren, 2010; Stange et al., 2010). Identifying person-centered care as one of the six determinants of high quality care, the Institute of Medicine (2001) defines it as: health care that establishes a partnership among practitioners, patients, and their families (when appropriate) to ensure that decisions respect patients’ wants, needs, and preferences and that patients have the education and support they require to make decisions and participate in their own care. Despite this definition’s depiction of nearly universal needs and desires that transcend specific patient populations and health care settings, oftentimes discussion of PCC is limited in scope to patient-centered care in acute care environments or person-centered care in long-term care (LTC) settings. In hospitals, patient-centered care largely emphasizes the role of the patient and their loved ones as integral members of the care team who are actively involved in making clinical decisions (Institute for Healthcare Improvement, 2011). In LTC settings, PCC is recognized as supporting personalized care and empowerment of staff while making home environments for residents (Quality Partners of Rhode Island & Nursing Home Quality Improvement Support Center, 2005). While the emphases may vary, fundamentally, these PCC priorities are portable across health care settings. Nonetheless, the tendency to classify PCC barriers, facilitators, best practices and innovations in setting-specific silos may inhibit cross-setting learning and collaboration that could advance PCC across the health care continuum. With a focus on the users’ experience with health care, Planetree’s Patient-/Resident-Centered Designation Program™ provides a comprehensive framework for defining, implementing and measuring PCC across the continuum of care. Organized around a set of 66 actionable criteria that drive outcomes across eleven PCC dimensions, the program defines PCC through the perspective of the healthcare consumer versus the perspective of the setting where that care is provided. Of the 66 experience- and evidence-based criteria, 51 are transportable, i.e. applicable across the care continuum, effectively establishing a common thread of expectations for any PCC health care experience—regardless of setting. This paper details the development of the designation program, the only program to assess PCC excellence across the health care continuum, and explores how the program’s inclusive and integrated approach is advancing the practice of PCC by accelerating innovation and inter-organizational, cross-setting learning. Finally, this paper demonstrates how the designation program is positioning organizations for success at a time when PCC has emerged as a national health care priority.