Person-Centered Coordination Care, Essay Example

What are the critical components for, and obstacles to, implementing Person-centered coordinated care? Where possible, illustrate this with examples from your workplace

Introduction

The implementation of person-centered may appear like a straightforward objective, but in reality, that is not the case. The complex nature of person-centered practice makes it challenging to ensure that people receive care, which focuses on their personal needs. Different perspectives of person-centered care exist between nursing and resident staff. In most cases, nursing and resident staff have different perspectives concerning their interaction with person-centered nursing. Health care practitioners refer to person-centered care as a gold standard for the delivery of medical services (Yang, Li, XIAO,  Zhang, Xia and Feng, 2019)

The increasing complexity in the interpretation of person-centered makes its implementation challenging for medical practitioners. According to the World Health Organization (WHO), person-centered involves the incorporation of individuals, communities, and family perspectives in the administration of health services using methods, which respond to preference and needs holistically and humanely (Hannan, 2020). The language used by WHO is significant as one can notice the categorical use of the term “people” rather than ‘patients.’ A people-centered healthcare system implies that the community and relative of the patient play a role in the person’s wellbeing. Apart from debates by medical practitioners’ staff, self-management, and self-decision making have evolved to separate concepts (Ahmad, D., Ellins, Krelle, and Lawrie, 2014).

The conceptual disparities, which revolve around the implementation and practice of person-centered care, makes it an exciting topic. The varying perspectives play a crucial role in medical practitioners who hold the patient as the most significant person in their practice. The shared decision came emerged as a result of clinical practice, while self-management evolved from theoretical debates and propositions.

This study intends to create a discussion focused on tacking issues related to the implementation of person-centered coordination, together with barriers that inhibit its effective practice. The study will also reflect on leadership practice relating to person-centered practice.

Person-Centered Coordination Care Critical Components

Definitions of Person-Centered Coordination Care

The understanding of critical components necessary for effective person-centered coordination care requires the exploration of various interpretations of the concept. A critical review of multiple concepts will result in highlighting the crucial differences and similarities, which will inform the ideal concept.  Table 1 gives an insight into various definitions, which will inform the literature used in this paper.

A first-hand account of serving at a local clinic provides an exciting picture representing personal-centered coordination hangs on the walls based at the resident doctor’s office. Although the description focuses on the treatment of chronically ill patients, it illustrates the components involved in the implementation of person-centered coordination care.

The WHO’s definition of a person-centered model, does not focus on the patient but takes a holistic approach of incorporating other stakeholders such as medical practitioners, decision, and self-management support.

This paper focuses on the critical components required for the effective implementation of a person-centered concept. The understanding of subsets features for the application of the approach is necessary to understand the interaction person-centered approach with all stakeholders, including medical practitioners, patients, and the community. A critical review of the subsets for a person-centered approach will play a crucial role in developing the ideal practice.

Critical Components Necessary for the Implementation of Share-Decision Making

The time spent by patient consulting with the doctors provides an ideal opportunity for them to engage with the doctors concerning their health issues in the process of shared decision-making. Propagators of shared-making argue that it is an ideal method of improving patient and population health while minimizing care costs (Légaré and Witteman, 2013). Shared-making relies on three components, namely: acknowledging and recognizing that a decision is necessary, understanding and knowing the best accessible evidence; and the incorporation of patients’ preferences and values in the decision-making process (Légaré and Witteman, 2013).

The translation of best practice involves the utilization of clinical practice provisions or guidelines. In the current format, the provisions reflect that real-life practice and sometimes overlook the patient’s preferences and realities (Légaré and Witteman, 2013). The implication of this implies that practice depends on pay-per-performance and fewer choices to patients. Scientific uncertainty and evidence complexity demand that shared decisions are necessary to incorporate patients’ preferences and values (Légaré and Witteman, 2013). Although the patients’ preferences and values in critical in a shared decision, it raised an ethical dilemma about whether doctors can question patients’ choices. After the acknowledgment that a decision is necessary or required, all parties involved in care must look into the best available evidence (Légaré and Witteman, 2013). Shared decision-making involves the clarification of patient preferences and values (Heath, 2020). Although it is essential to incorporate patient choices, most clinical practices continue to ignore their preferences.

Figure 2: Implementation of Shared Decision Making Approach

A visit to Mayo Clinic reveals how patients use the shared decision-making model. The clinic utilizes flashcards, which contain information concerning the prescribed wellness practice or behavior, the components of treatment, and the quality that patients will receive. Although the clinic uses flashcards for shared decision-making, the clinic has not abandoned the use of the patient-medical practitioner communication skills. An interesting finding at the clinic is that doctors allocate patients adequate time to peruse through available literature to assist them in making an informed decision.

The patient shared decision model does not only involve the patient but incorporates members of the public or community. According to WHO, a patient and public involvement (PPI) ensures that clinical practice takes a holistic approach and goes beyond the concern of treating patients to ensuring the wellbeing of the entire society (Western Health and Social Care Trust, 2012). Table 2 shows the critical elements necessary for the implementation of PPI.

Self-Management Critical Components

Self-management supports the transfer of decision making from patients suffering from chronic diseases to their families or relatives (The King’s Fund, 2013). A typical occurrence among patients suffering from long-term medical health conditions involves family members making decisions on behalf of the patient, which contribute to their wellbeing. In most cases, people manage their health without the involvement of health services or professionals. Changes in the health policy and increase advocacy by the NHS encourage people to manage their health without the assistance of medical practitioners (McDonald, Campbell and Lester, 2009). Self-management with excellent clinical care ensures that people receive full support for the management of their social, emotional, and physical impact concerning their long-term medical or health status at various ages and stages of their lives (Hanlon et al., 2017). For self-management to remain effective, it must comply with four principles namely: ensuring people have dignity, respect, and compassion; offering coordinated treatment, support, and care; offering personalized treatment, care and support; and supporting people develop and recognize their abilities and strengths, which will lead to a fulfilling life (The Health Care Foundation, 2014).  Figure 3 shows the four principles, which govern the implementation of a self-management approach in healthcare.

The implementation of self-management practice is challenging but practical. One of the ideal ways for the implementation is using motivation, coaching, and listening for supporting skills, which are necessary for strengthening the relationship between patients and clinicians (Pollak, Back and Tulsky, 2017). Studies by The Health Foundation and the Institute for Healthcare Improvement (2020) on 9348 patients indicated that although self-management resulted in the under-utilization of health facilities, patients recorded significant growth (Baker et al., 2018). An interesting finding from the study is that effective self-management practice requires community and family involvement to attain optimal results.

The Critical Components Necessary for Coordinated Working

According to the NHS coordinated support involves an integrated system, which for medical and support (Shaw, Rosen and Rumbold, 2017). The integration of social and healthcare aims to address the issue of fragmentation, which surrounds the healthcare system. The rising rates of multi-morbidity and chronic disease forms the primary reason for the increasing demand for coordinated working. Different studies indicate that coordinating duties involves multifunctional teams, which perform distinct operations making it necessary for an individual team to enforce concepts of effective leadership to ensure appropriate delivery of health care services (Morley and Cashell, 2017)

Observation made on the treatment of a relative suffering from anxiety disorders led to the realization that his treatment involved many players, including a psychiatrist, community caregiver, and psychologists. The primary patient hospital lacked a psychiatrist, and they had to go to a different hospital to receive medical care and prescription then return to their main hospital for counseling and cognitive treatment. The observations made on the patient led to the realization of the significance of coordinated working in the provision of healthcare services.