A medical home: Changing the way patients and teams relate through patient-centered care plans.

2012 ◽  
Vol 30 (3) ◽  
pp. 190-198 ◽  
Author(s):  
Lora Schwartz Council ◽  
Dominic Geffken ◽  
Aimee Burke Valeras ◽  
A. John Orzano ◽  
Amanda Rechisky ◽  
...  
Keyword(s):  
Medical Home ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Care Plans ◽  
Centered Care ◽  
The Way

scholarly journals Facilitators and Barriers to Implementing a Patient-Centered Oncology Care Model

2020 ◽  
Vol 16 (12) ◽  
pp. e1441-e1450
Author(s):  
Manasi A. Tirodkar ◽  
Lindsey Roth ◽  
Shelley Fuld Nasso ◽  
Mark W. Friedberg ◽  
Sarah H. Scholle
Keyword(s):  
Care Coordination ◽  
Medical Home ◽  
Financial Incentives ◽  
Technical Assistance ◽  
Patient Centered Care ◽  
Self Report ◽  
Patient Centered ◽  
Leadership Support ◽  
Centered Care

PURPOSE: Oncology practices often serve as the “medical home” for patients but may not have systems to support all aspects of patient-centered care. We piloted a new set of oncology medical home standards that call for accessible, continuous, coordinated, and team-based care. We examined how adoption of the standards varies across a variety of practices and compared practice self-report with external evaluation of implementation. METHODS: Five medical oncology practices in southeastern Pennsylvania implemented the standards from 2014 into 2016. Implementation support included training webinars and technical assistance. External reviewers evaluated practices’ implementation of the standards. We conducted site visits to interview providers and patients. RESULTS: Between baseline and follow-up, practice self-assessments and independent audits showed practices increased implementation of the patient-centered oncology standards. The largest improvement was seen in continuous quality improvement (QI). Practices were less successful in implementing care coordination: achievement on two standards (access and evidence-based decision support) declined from baseline to follow-up. Qualitative analyses revealed that practices focused QI in five areas: goals of care, engaging patients in QI, financial counseling, symptom management, and care coordination. Interviewees talked about facilitators, such as leadership support and physician buy-in, and barriers to transformation, including inadequate resources and staffing. Health information technology both supported and limited implementation. CONCLUSION: Oncology practices showed some progress in their implementation of patient-centered care processes over the course of the pilot program. Systems for tracking and documenting improvement, training for staff and clinicians, leadership support, and alignment of financial incentives are critical to transformation.

Baseline evaluation of the patient-centered oncology care model.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 50-50
Author(s):  
Manasi A. Tirodkar ◽  
Sarah Hudson Scholle
Keyword(s):  
Patient Centered Care ◽  
Care Planning ◽  
Coordinated Care ◽  
Motivation To Change ◽  
Care Model ◽  
Patient Centered ◽  
Centered Care ◽  
Oncology Care ◽  
The Impact ◽  
The Way

50 Background: The patient-centered medical home (PCMH) model of care is being widely adopted as a way to provide accessible, proactive, coordinated care and self-care through primary care practices. During active treatment for cancer, the oncology practice is often the primary setting supporting the patient and coordinating cancer treatment. For this project, we are implementing a Patient-centered Oncology Care model in five oncology practices and evaluating the impact on cost, quality, and patient experiences. Methods: To determine the structures and processes present in the practices at baseline, we conducted a self-assessment on the standards, followed with an on-site “audit” for compliance with the standards. To get a sense for organizational culture and motivation to change, we conducted site visits which included interviews with providers, staff and patients and observation of clinical encounters and workflow. Results: Among the highest priority structures and processes, the most common were telephone triage, symptom management, advance care planning, and the use of evidence-based guidelines. The least common were patient/family orientation, availability of same day appointments, discussion and documentation of goals of therapy, symptom assessment, and tracking of appointments. All of the practices had made patient-centered care a priority and staff were motivated to change. There was variation in the way providers and the care team used health information technology during clinical workflow. There was also variation in which staff coordinated care for patients and whether or not financial counseling was offered. All of the practices stated that they needed to work on implementing survivorship care planning, shared decision-making, and patient engagement in quality improvement and practice transformation Conclusions: The pilot oncology practices have many structures and processes in common. However, there is little standardization within practices in the way these processes are established and documented. Practices vary in how they are implementing patient-centered care processes. However, with motivation to change, staff and providers are actively engaged in the transformation process.

Patient-Centered Care in a Medical Home

2011 ◽  
Vol 16 (2) ◽  
Author(s):  
Colette Carver ◽  
Anne Jessie
Keyword(s):  
Primary Care ◽  
Medical Home ◽  
The United States ◽  
Patient Centered Care ◽  
Patient Centered Medical Home ◽  
Patient Centered ◽  
Patient Centered Medical Homes ◽  
Medical Homes ◽  
Centered Care ◽  
Medical Home Model

There is general consensus that our current healthcare delivery system will not be able to supply an adequate workforce, contain costs, and meet the ever-increasing chronic-care needs of the growing and aging population in the United States (US). Some of the major challenges to the U.S. healthcare system are faced by those on the front lines, namely the healthcare workers in primary care. Part of the emerging solution for primary care is the adoption of the Patient-Centered Medical Home Model. The intent of this model is to provide coordinated and comprehensive care rooted in a strong collaborative relationship. Carilion Clinic in Southwestern Virginia is implementing this patient-centered model in which a proactive, multidisciplinary care team collectively takes responsibility for each patient. In this article we will elaborate on the concepts of patient-centered care and patient-centered medical homes, after which we will offer an exemplar describing the process that Carilion Clinic is using to establish patient-centered medical homes throughout their primary care departments. Limitations of the Patient-Centered Medical Home Model will also be discussed.

The meaning of life in medicine: non-religious spiritual care in Japan

2017 ◽  
Vol 5 (4) ◽  
pp. 527 ◽  
Author(s):  
Clark Chilson
Keyword(s):  
Spiritual Care ◽  
Meaning Of Life ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Existential Suffering ◽  
Centered Care ◽  
Spirituality In Medicine ◽  
The Way

Within the context of a growing global interest in the role of spirituality in medicine, “spiritual care” has developed as a form of patient-centered care that addresses existential suffering. This paper provides an introduction to spiritual care in Japan. On the basis of publications by leading Japanese authors on spiritual care, it first shows how spiritual care developed in Japan and how it is understood as a way of providing meaning and comfort distinct from “religious care.” Then it introduces some common methods used for spiritual care in Japan. Overall, it argues that the way spiritual care is conceptualized and offered in Japan provides suggestions for how spiritual care might be offered to patients who are non-religious and do not see themselves as “spiritual”.

Association of medical home team-based care functions and perceived improvements in patient-centered care at VHA primary care clinics

Healthcare ◽  
2014 ◽  
Vol 2 (4) ◽  
pp. 238-244 ◽  
Author(s):  
Christian D. Helfrich ◽  
Emily D. Dolan ◽  
Stephan D. Fihn ◽  
Hector P. Rodriguez ◽  
Lisa S. Meredith ◽  
...  
Keyword(s):  
Primary Care ◽  
Medical Home ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Home Team ◽  
Primary Care Clinics ◽  
Centered Care ◽  
Team Based Care

scholarly journals Health Communication Cards as a Tool for Behaviour Change

ISRN Obesity ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Carrie L. Matteson ◽  
Thomas D. N. Merth ◽  
Diane T. Finegood
Keyword(s):  
Health Communication ◽  
Behaviour Change ◽  
Clinical Care ◽  
Patient Centered Care ◽  
Care Plan ◽  
Systems Science ◽  
Communication Tool ◽  
Patient Centered ◽  
Care Plans ◽  
Centered Care

Individuals seeking healthcare treatment in the context of obesity often experience difficulty engaging in discussions around their health and face challenges finding consensus with practitioners on care plans that best suit their lives. The complex set of biological, social, and environmental variables that have contributed to the higher prevalence of obesity are well illustrated in the foresight obesity system map. Effectively understanding and addressing key variables for each individual has proven to be difficult, with clinicians facing barriers and limited resources to help address patients’ unique needs. However, productive discussions inspired by patient centered care may be particularly effective in promoting behaviour change. Tools based on systems science that facilitate patient centered care and help identify behaviour change priorities have not been developed to help treat adult obesity. This project created and pilot tested a card based clinical communication tool designed to help facilitate conversations with individuals engaged in health behaviour change. The health communication cards were designed to help direct conversation between patients and healthcare providers toward issues relevant to the individual. Use of the cards to facilitate patient driven conversations in clinical care may help to streamline conversations, set realistic care plan goals, and improve long term rates of compliance.

scholarly journals Health Information Technology Coordination to Support Patient-centered Care Coordination

2015 ◽  
Vol 24 (01) ◽  
pp. 34-37 ◽  
Author(s):  
W. Gregg ◽  
O. Steichen ◽  
Keyword(s):  
Information Technology ◽  
Health Information ◽  
Care Coordination ◽  
Patient Centered Care ◽  
Unintended Consequences ◽  
Patient Centered ◽  
Care Plans ◽  
Number Of Factors ◽  
Centered Care ◽  
Health Information Sharing

Summary Objective: To select papers published in 2014, illustrating how information technology can contribute to and improve patient-centered care coordination.Method: The two section editors performed a literature review from Medline and Web of Science to select a list of candidate best papers on the use of information technology for patient-centered care coordination. These papers were peer-reviewed by external reviewers and three of them were selected as “best papers”. Results: The first selected paper reports a qualitative study exploring the gap between current practices of care coordination in various settings and idealized longitudinal care plans. The second selected paper illustrates several unintended consequences of HIT designed to improve care coordination. The third selected paper shows that advanced analytic techniques in medical informatics can be instrumental in studying patient-centered care coordination. Conclusions: The realization of true patient-centered care coordination is dependent upon a number of factors. Standardization of clinical documentation and HIT interoperability across organization and settings is a critical prerequisite for HIT to support patient-centered care coordination. Enabling patient involvement is an efficient means for goal setting and health information sharing. Additionally, unintended consequences of HIT tools (both positive and negative) must be measured and taken into account for quality improvement.

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