Patient and person-centred care

Patient-centred care can be 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)

Principles of patient-centred care

The widely accepted dimensions of patient-centred care are:

  • respect
  • emotional support
  • physical comfort
  • information and communication
  • continuity and transition
  • care coordination
  • involvement of family and carers
  • access to care.

These dimensions form the backbone of numerous quality improvement programmes and surveys measuring patients’ experience of health care.

Principles of patient-centred care Picker Institute(Image source: Picker Institute, Europe)

Is patient-centred care evidence-based?

There is now clear research demonstrating that patient-centred care improves patient care experience and creates public value for services. (1)

"When healthcare administrators, providers, patients and families work in partnership, the quality and safety of health care rise, costs decrease, and provider satisfaction increases and patient care experience improves. Patient-centred care can also positively affect business metrics such as finances, quality, safety, satisfaction and market share." (1)

People-centred and integrated health services: an overview of the evidence

World Health Organisation, May 2015

Patient-centred care and quality improvement

Patient-centred care has been increasingly recognised as a critical dimension of high-quality health care since the landmark Institute of Medicine report, Crossing the Quality Chasm (2) included it as one of the six quality aims for improving care. These aims are built around the core need for health care to be:

  • Safe: avoiding injuries to patients from the care that is intended to help them.
  • Effective: providing services based on scientific knowledge to all who could benefit, and refraining from providing services to those not likely to benefit.
  • Patient-centered: providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions.
  • Timely: reducing waits and sometimes harmful delays for both those who receive and those who give care.
  • Efficient: avoiding waste, including waste of equipment, supplies, ideas, and energy. 
  • Equitable: providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.

How is patient-centred care supported by policy?

In many countries,  a patient-centred approach is now supported by national policies and Consumer Rights Charters. Within New Zealand, professional authorities such as the NZ Medical Council (NZMC) and the The Code of Health and Disability Consumers’ Rights uphold the importance of patient-centred care and a useful chapter in Cole's Guide to Good Medical Practice (NZMC) discusses the relationship between patient-centred care and cultural competence. (3) 

The Health Quality and Safety Commission has a programme of work focused on Partners in Care and the new NZ Health Strategy has a related concept of people-powered as a core theme. 

Internationally, in May 2016 at the Sixty-ninth World Health Assembly (WHA) Member States adopted, with overwhelming support, resolution WHA 69.24 “Strengthening integrated people-centred health services” that supports the “Framework on integrated people-centred health services”. (4)

References

  1. Australian Commission on Safety and Quality in Healthcare. Patient-centred care: Improving quality and safety by focusing care on patients and consumers. Discussion paper Sept 20 
  2. Institute of Medicine: Crossing the Quality Chasm: A New Health System for the 21st Century, 2011 
  3. Hera J 2013. Cultural competence and patient centred carre Chapter 4 in St George IM (ed.). Cole’s medical practice in New Zealand, 12th edition. Medical Council of New Zealand, Wellington
  4. Framework on people-centred integrated health services 2016 World Health Organisation
  5. People-centred and integrated health services: an overview of the evidence, May 2015, World Health Organisation
Reviewed By: Editorial team