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Patient Centered Care: An Interactive session
Linda Delo, D.O. Delo Medical Associates
Delo Medical Associates:
Level 3 Patient Centered Medical Home since 2013
Our practice: Family Physician, Podiatrist, Physical Therapist and PTA, 3 full-time Nurse Practitioners, One full-time and one part-time Physician Assistant, with 35 total employees
Services we offer: Moderate complex lab, ultrasound and echocardiography, Bone Density Testing, Hearing testing: hearing aides, PFT’s, EKG, Allergy testing and treatment and more
Same day appointments, Patient portal, electronic messaging via text, email and phone
Member of The Palm Beach Accountable Care Organization
What is patient centered care?
• “Understanding and respecting patients’ values and preferences and expressed needs are the foundation of patient centered care.”
• Harvey Picker of the Picker Institute
Personized care
coordination and integration
Education, informed decision
making
Emotional support: empathy and emotional
well being as important at evidence based medicine in a HOLISTIC APPROACH
Involvement of family, friends, other care team members not
just the doctor
Care Transitions and continuity
Are patients wanting and expecting more?
• Comprehensive care to meet ALL their needs
• Coordination of care: someone in charge to help navigate the system
• TIMELINESS
• Functioning e-health
• Clear and reliable communication-listen, explain, clarify, consistency of messages across care team
• Convenience: open access, same day scheduling, respect for time
• Empathy and time to be heard
How do YOU feel about patient demands?
• Frustrated about the demands of your patients
• Overwhelmed trying to see and treat patients and clicking boxes in the computer
• Irritated with the questions your patients are asking after their DR GOOGLE consultation
• A fragmented system with lack of communication
• Where do your values lie: with your organization, your clinical autonomy or is caring for the patient truly your goal?
What we need
• Organizational changes that promote systems thinking, collective accountability and team-based care
• Willingness to work as a team player with one goal to care for the patient.
• Willingness to commit to organizing the system to provide timely care
• Willingness to own the failures and pursue remedies
• Embrace e-health to expedite communication and efficiency
Audience Participation
Can anyone share things they have done in their practice to promote team based care?
System changes to improve timeliness in your operations?
How did you correct failures or shortcomings?
How are you using e-Health to expedite communication, efficiency and education?
Collective accountability & team based care
• What things have you done?
• Profit sharing
• ?????
• Delegation of work
• Empowering staff
• Protocols
Organizing the system to provide timely care
• Work flow
• Reducing wait times
• Same day access to providers
• Open access scheduling
• Audience: suggestions on implementation
Failures and Solutions
Open access schedule
Wait times for patients
Data flow between
specialists
Patient education Empowering patients
Encourage patient
Portal use
How do we get there? Are we making progress?
• Primary care is key: prioritize prevention, self-care, taking control of one’s health • Fit bits, health apps that integrate with
health records
• Access and convenience: Urgent care vs ER vs same day appt with their own doctor. Timely referrals
• Financial incentives: PCMH, ACO’s, VALUE over quantity
• Does the public understand the importance of Primary CARE
https://www.youtube.com/watch?v=xgOFi0NzemU&feature=youtu.be INTEROPERABILITY: between physicians, hospitals and patients
Interoperability
Are you providing information with referrals: HOW
What works and what doesn’t
work? Audience???
Stepping stones to the future
Expansion across continuum of care
Meaningful patient engagement
Staff engagement and restoration of joy in work
Focus on system design and accountability
Putting measurement in proper perspective
Supporting patient centered professional practice
• Ensuring training and education is aligned to the delivery of patient care
• Re-orientating and diversifying the nature of the consultation process
• Encouraging coordinated multidisciplinary working
• Establishing a new role for general practice in the changing and expanding primary care landscape
• Collaboration between practices and providers of services
• Improving hours providing care
What it takes to provide patient centered care
• Empowering patients, caregivers and communities through:
• Improving health literacy
• Support of self management
• Personalized care planning
• Embracing new means of accessing care and technologies
• More transparent data on primary care
• Strengthening the patient voice in primary care
HOW can we promote the process?
More money on collaborative models and community based care than hospital based care
Prioritizing information systems and technology for better sharing of information across organizational and professional boundaries
PRIMARY CARE PHYSICIANS: LEAD THE TEAM
Allied health professionals
-Community nursing
-Patient representatives
-Pharmacists -Behavioral health
BEST PRACTICES
Evidence based medicine
Quality: Measure and improve on shortcomings
Informed decision making process: education
Mechanisms of soliciting and acting on patient feedback:
reviewing the surveys and implementing change
Support patients to access services and engage in self care
CLINICAL GUIDELINES
PROMOTE PATIENT CENTERED CARE
PERSONALIZED CARE CARE PLANNING FOR PATIENTS WITH MULTIPLE LONG TERM
CONDITIONS
resources
Royal College of General Practices
https://www.healthissuescentre.org.au/images/uploads/resources/Inquiry-into-patient-centred-care-in-the-21st-century.pdf
Improving the referral process for patients and clinicians
American College of Physicians
If you would like copy of slides or have further questions: [email protected]