Quality Factors

Patient centered care is defined 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” (Institute of Medicine, 2001, 3). There are a number of factors that influence delivery of patient centred care, broadly falling under the umbrellas of management & leadership, the care environment, and, medical factors. For these factors to work efficiently, and towards the best possible healthcare outcome for the patient, effective communication is necessary. Patient centered care is dependant on a number of factors. First, by the effective coordination of service overseen by efficient and visionary management and leadership.  Second, creating well-appointed care environments for both staff and patients. Third, by providing an appropriate level of care in terms of medical practice, thereby enabling successful patient care. Finally, through the continuous effective use of communication and use of technology; this latter factor important to the functioning of the prior factors. Effective patient centered care is dependant on the decisions of the management and leadership of healthcare organizations and professionals (Shaller, 2007; Parand, Dopson, Renz, & Vincent, 2014, 1-2).  Management must be supportive of the lower levels of management and leadership in the healthcare facility, and must implement policies and practices supportive of these individuals.  This occurs through strategic business plans and goals, which incorporate feedback from staff and other stakeholders. There must also be recognizable and measurable benchmarks for all stages of the patient centered care delivery practice of the organization. There must be technology supportive of the healthcare environment, of staff, patients, and patients’ families. Supportive technology includes  electronic patient records; the ability of new technology to ‘talk’ to old technology, and training for staff. Staffing, at the appropriate levels, including sufficient technology staff to address the technology needs of the healthcare facility, is also very important. The care environment must be supportive of the needs of staff, patients, and patients’ families (Stone, Hughes, & Dailey, 2008, 2-10). There needs to be constant awareness of patients’ concerns together with staff concerns, i.e., staff continued professional education, multidisciplinary care teams for patients.  This involves shared information and skills of all the healthcare professionals, that is, a collaborative care team working in a collegial collaborative care teams. The involvement of the patient’s caregivers in any supportive care of the patient is also important, and technology can help facilitate this. This also applies to the family and friends, with the patient’s approval, in the care of the patient. Awareness and sensitivity to patient’s non-medical needs, as well as the patient’s spiritual beliefs and practices are also important. Technology in the form of phones and televisions in rooms, as well as Internet access, will enhance the care environment for the patient. For staff, technology that enables interaction with other healthcare professionals and with patients also facilitates a comfortable and welcoming environment. In terms of medical factors, important to the duty of care of the patient, issues such as following medical guidelines regarding medical directives, policies, following personal protective equipment policies, are among the elements of ensuring appropriate medical care for the patient (Carayon & Wood, 2010, 1-8). On-going training of staff and education regarding current medical practices and research, should be consistent and a supportive environment for staff, e.g., awareness of issues like violence in the workplace, play an important part in ensuring appropriate patient centered care. Communication & technology enables the foregoing factors to function effectively. Supportive technology facilitates both the healthcare professional and the patient; that is, technology “…engages patients and families directly in the care process” (Shaller, 2007, 17). Technology can be used to allow better communication between healthcare professionals and their patients, as well as the patients’ families (Shaller, 2007, 2). Electronic patient records also allow multi-disciplinary healthcare teams to better share patient information, in a timely manner. Electronic patient records goes beyond simply patient records. If healthcare professionals can digitize x-rays, test results, and other pertinent patient medical information, this enables more efficient transfer of information between health care departments and even healthcare systems (Shaller, 2007, 6).

• Technology also facilitates outpatient care in terms of self-care, as well as health promotion. This allows a certain amount of patient autonomy as a part of a self-care program (Shaller, 2007, 6)

* Technology * Communication * Collaboration * Shared decision making * Laws, regulations, and policies 2. Analyze changes in technology and their effect on quality patient care. 3. Explain the roles of communication, collaboration, and shared decision making. 4. Consider communication and collaboration between health care team members, between the patient and staff, and involving insurance companies.

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