A recent survey showed that 60% of Americans say that they have had a recent negative health care experience. With this troubling statistic in mind, understanding a patient’s individual needs is more important than ever, and can be facilitated through patient centered care.
A patient-centered approach takes patients’ preferences heavily into account, and builds trust by allowing them to guide their own health decisions. When it comes to cognitive health care, a patient-centered approach looks at brain health holistically, and may also involve families in decision making processes. This collaboration provides systemic benefits for family physicians, nurse practitioners, and other healthcare professionals, and ensures that patient values are honored in the process.
Read on to learn about patient centered care, the benefits, and practical examples of how to apply this approach.
The patient centered care model centers individual patient needs and goals, and can empower patients to participate in their care decisions. Within this model, health care professionals educate patients about their health, advise them on treatment options, and provide the tools they require to achieve better health outcomes. Ultimately, the details of the care plan are based on individual patient preferences.
Instead of focusing strictly on clinical decisions, a patient centered approach also considers a patient’s:
Emotional and social needs. For example, up to 85% of chronic pain patients live with depression. While identifying and treating the source of physical pain is important, simultaneously addressing mental health concerns can make for better overall health outcomes.
Religious and spiritual beliefs. A questionnaire from the American Pain Society showed that 76% of patients made use of personal prayer for pain management. Learning about patient values and belief systems can help provide patients of faith with additional comfort.
Financial capacity. Recognizing patients’ socioeconomic conditions can help providers recommend treatment options that don’t come with financial barriers. Understanding a patient’s socioeconomic context may also be a factor to consider when investigating the etiology of the patient's health concern in the first place.
Often, patient centered care is accomplished with active collaboration between healthcare providers, patients, and their family members. For example, for dementia patients, including caregivers in healthcare conversations helps determine what treatment and support options are most feasible.
Healthcare organizations that practice patient centered care reflect a few key commonalities:
Patients and their families are active participants in the care team, and guide the decision-making process
Patient values, preferences, cultural backgrounds, and socioeconomic backgrounds are recognized and respected by healthcare professionals
The physical comfort and emotional well-being of patients are equally prioritized
Healthcare services are organized and accessible, and reflect patient needs
All information is shared openly and in a timely manner so patients and their family members can make the most informed decisions possible
The systemic parts of the medical practice, such as the mission, vision, and values, reflect patient centeredness
Overall, this model of care prioritizes creating a positive patient experience rather than adhering to a solely prescriptive approach. In one survey, 35% of people stated that their experience as a patient influences their healthcare decisions (e.g. whether to follow a prescribed treatment regiment).
Within this survey, the top reported factors conducive to a positive patient experience came from healthcare providers who:
Actively listened
Clearly communicated
Provided a clear care plan with strong rationale
Took patients’ pain seriously
Were courteous and respectful
These behaviors were identified in 94 to 96% of surveyed patients’ responses, and strongly overlap with the philosophy of patient centered care. By taking the time to connect with patients, providers can present treatment options that align with their needs and values.
Another focus group study among migrant women explored six domains of patient centered care, and suggested practical approaches for delivering this care:
Fostering a healing relationship by including friendly discussion prior to healthcare delivery, and offering attentive patient communication throughout the visit
Exchanging information by allowing patients to fully explain their health issue, asking questions, and providing clear and detailed instructions. Along with this, honoring patient privacy was a priority.
Addressing concerns and actively checking in on patient comfort
Managing uncertainty by discussing risks and benefits of treatment, and explaining the rationale behind different treatment options
Shared decision making to empower patients to participate in their own care
Enabling self care through clear instructions, follow-up appointments, and offering brief counseling
Patient centered care plans are especially important for systemically marginalized patients. In the United States, racism is a major barrier to care. For instance, Black women are 3 to 4 times more likely to experience childbirth complications. Recognizing patients’ concerns about cultural healthcare barriers is a key part of providing high-quality care. This extends to other marginalized groups too, including women, people with disabilities, LGBTQ+ individuals, and more.
The patient centered care model has several benefits for patients, including:
Empowering patients to take greater initiative in their health care. Patient engagement is proven to improve health outcomes and adherence to treatment plans. As active participants in their own treatment plan, patients can impact the quality of their own preventive care and beyond.
Reducing instances of anxiety. A commonly-cited study showed that 40 seconds of compassion demonstrated by a doctor can significantly reduce patient anxiety. Patient centeredness prioritizes listening and validating patients, and can improve the emotional experience of receiving care.
Engaging patients with language barriers. One study showed that 20% of patients who did not speak their local language avoided healthcare services for fear of not being understood by providers. Patient centered communication prioritizes collaborating with families to be sure the patients are understood and their needs are met.
Assessing and responding to patient needs is the most effective way to build trust between patients and their providers. A 2022 study showed that this doesn’t only help patients—it also leads to a sense of professional fulfillment for physicians.
Other benefits for healthcare providers include:
Better resource allocation. The patient centered care model may reduce the need for diagnostic tests and referrals, which can potentially result in more efficient healthcare delivery.
Reducing healthcare burnout. Improved resource allocation from patient centered care can help decrease the intense workload associated with burnout among healthcare employees.
Overall cost-effectiveness. Patient centered care is often cost effective for the provider. One randomized trial found that person centered care led to larger expected quality-of-life benefits and lower expected healthcare costs. These results come from applying patient centered communication to tools like virtual primary care.
Despite the many benefits, patient centered care is not the norm within the current healthcare system. One study from the University of Florida found that physicians interrupted patients after a median of only 11 seconds.
There are several barriers to delivering the patient centered care model, including:
Misunderstanding the meaning of patient centeredness. Many hospitals have invested time and money into better amenities, including greeters, greenery, and updated technology for patients. While these steps improve the hospital environment, they do not necessarily reflect the culture shift required within the patient centered model.
Staff shortages. By 2050, the population of people over 60 is expected to double worldwide, requiring additional healthcare resources to support age-related disease or cognitive decline. However, following the COVID-19 crisis, high rates of healthcare worker burnout, employee turnover, and even death due to illness, have strained the medical system.
Limited time during visits. While patient centeredness requires extra time and attention given to patients, brief visits can make that difficult to achieve—particularly when considering the above-mentioned staff shortages.
Social barriers between patients and providers, such as language differences, educational gaps, and culture differences regarding non-verbal communication.
Lack of tools for providers. Gathering and documenting the details of patients’ lives and concerns can be challenging to do without the right tools. At Creyos, our patient questionnaires and cognitive assessments can gather key medical insights, leaving more time for providers to get to know patients’ emotional needs.
These barriers often result in task-orientated care, where providers focus more on completing medical tasks than interpersonal relationships. While this model helps healthcare workers reach as many patients as possible, it loses the opportunity to deliver patient centered care.
Here are three examples of patient centered communication in healthcare settings:
Imagine a patient’s family member privately reports concerns about their relative’s cognitive function. This situation can pose a challenge, as 64% of patients with mild-moderate dementia over-estimate their cognitive performance.
Including a cognitive function test as a standardized part of intake for all patients can help ensure that objective data is collected, but patients are not singled out only when there is a concern, potentially helping to ease anxiety. When data reveals cause for concern, having objective reports can facilitate difficult conversations that would otherwise only be based on subjective opinions.
Efficient and routine cognitive testing ensures physicians can use the time allocated in their visits to manage the emotional aspects of potentially difficult conversations, and collaborate with families on treatment and support options.
Fear of negative side effects, addiction, and costs of medication are often barriers to pharmacological pain therapy for patients. In a situation where a patient presented these fears and was resistant to treatment through medication, a physician would not dismiss their concerns.
Instead, they would dedicate time to:
Fully listen to the patient’s concerns without interrupting
Consider the social and emotional reasons behind their fear
Provide clear pain management education with ample opportunity for questions
Offer alternatives to medication for patients who ultimately do not wish to take it
During follow-up visits, patient centered communication would include initiating check-ins on how a patient is feeling about their treatment plan.
Imagine a patient enters their visit displaying intense signs of anxiety. The provider has them fill out the General Anxiety Disorder (GAD-7) or Perceived Stress Scale (PSS) questionnaire, and discovers that they are experiencing significant anxiety and stress in their daily lives.
Before responding with solutions like yoga or lifestyle changes, this provider would begin by asking questions, including:
If there are specific factors contributing to their current stress levels
What strategies they have tried so far to manage their stress
What their current support system looks like
What their desired health outcomes would be
As they receive these answers, the provider would provide emotional support by displaying empathy and validating their emotions. A simple phrase like “that sounds like a very difficult situation to be in” or “I’m sorry that you’re going through this right now” can make a difference in a patient feeling safe with their doctor.
With the current barriers in the healthcare system, transitioning to a culture of patient centered communication can feel challenging. However, small steps like implementing active listening, displays of empathy, and asking one or two extra questions can make all the difference in patient satisfaction.
Looking for ways to quickly gather key insights, freeing up time for the emotional aspects of patient care?Connect with Creyos today to learn more about our healthcare solutions.
This post was edited by Mike Battista, Director of Science and Research at Creyos (formerly Cambridge Brain Sciences).