What We Want to Achieve Through Systems Changes

Patient-Centered Care

This section covers the advantages of a care model that is focused on the patient's individualized needs, both physical and emotional.

Examples, resources, references and tools are provided to help the health care planner or provider transition toward a patient-centered system of care. Tools can be used to develop a strategy, train staff and reinforce concepts on a daily basis.

• Introduction
  When informed patients take an active role in managing their diabetes, and providers are prepared, proactive, and supported with time and resources, their interaction is likely to be productive.1 This patient-centered interaction can lead to better diabetes care, more efficient and effective practices, healthier patients, and more satisfied patients and providers. The goal is "to customize care to the specific needs and circumstances of each individual, that is, to modify the care to respond to the person, not the person to the care."2 Because patients are highly variable in their preferences, they and their families need to be involved with the health care provider or health care team in diabetes management decision-making.
  

  This section defines patient-centered care based on the U.S. Institute of Medicine's Quality Chasm report and reviews the following dimensions of patient-centered care as they relate to people with diabetes.2

  • respect for patients' values, preferences, and expressed needs
  • coordination and integration of care
  • information and communication
  • education -- including strategies for providers to help patients manage their diabetes
  • physical comfort
  • emotional support -- relieving fear and anxiety
  • involvement of family and friends.
    
• Definition of Patient-Centered Care
  

  Note

  Experts agree that it is the patients who in reality make the important choices that affect their health and well being, and indeed it is the patient who is in control and experiences the consequences of his or her choices.

  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." 2 Similar terms are consumer- or person-centered, personalized and individualized. Experts agree that it is the patients who in reality make the important choices that affect their health and well being, and indeed it is the patient who is in control and experiences the consequences of his or her choices. Collaborative diabetes management, with the patient as the key player, will help to improve communication and encourage shared decision-making, thus improving the likelihood that the patient will succeed in self-care.2 3 4

Patient-centered care differs significantly from provider-centered care that is based on a paradigm for the treatment of acute illness. Provider-centered care in which clinicians operate from their own agenda and try to get patients to do behaviors to meet goals that the clinicians believe are in their best interests is not conducive to success with a chronic disease such as diabetes.5 Once patients with diabetes leave the clinic or office they can veto any of the multiple self-care recommendations that providers make. Their failure to do as recommended can lead to "nonadherent" or "noncompliant" labels and associated frustrations for providers and patients.5

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Continue to Patient Care: Dimensions