Patient-centered care 101
“Patient-centered care" is one of the buzzwords of modern healthcare. It's also a cornerstone of the Affordable Care Act. But what does it mean? And can it be taught?
National University, in San Diego, California, is looking for answers. The private university has partnered with the not-for-profit Planetree, Inc. — which collaborates with healthcare organizations to develop patient-centric strategies and services — to help train students in its School of Health and Human Services in the art and science of patient-centered care.
athenaInsight spoke with Gloria McNeal, Ph.D., dean of National University's School of Health and Human Services, about this collaboration and its importance for the healthcare leaders of the future.
At our university, we have many adjunct faculty members, folks who work in the field as well as teach, and one of our adjuncts is in a leadership position at a Planetree-designated hospital. He suggested we reach out to Planetree to get a sense of where they were regarding academics.
Up to this point, Planetree designations have been assigned to medical centers — it is a gold standard of recognition for patient-centered care. We reached out to them and learned they were thinking about looking at the academic environment, because they wanted to prepare students to assume leadership roles with an understanding in patient-centered care.
We offer baccalaureate and master's degrees and are developing a doctor of nursing degree, all in the nursing practice. We also have public health and health sciences degrees — 19 total programs. We have a very diverse student population, so they already recognize the importance of [patient-centered] work and by and large recognize that we need to move in this direction.
Traditionally, the patient has not been seen as the center of his or her healthcare team. The orientation has been to allow professionals and scientists to determine the needs of the patient and how to address their health issues. But it has become recognized in studies that patients do much better when they are at the center of those decisions. That contributes to the better outcomes that everyone is seeking.
We want students to interact with patients, who speak many languages and come from different ethnic backgrounds, and we want them [to be] sensitive to language and cultural differences. Students do cultural assessments, and based on those findings create treatment plans that are consistent with the culture of the patient.
In the end it facilitates things, because the outcomes are so much greater. Many things we do in healthcare are time-consuming and are often in direct opposition to what patients might want or need. If the approach is, up front, to put the patient at the center, you save a lot of time because you are addressing their needs early on.
A large part of it is due to the spiraling cost of healthcare. We are now at 20 percent of GDP, and we can't go on this way. We are looking at bankrupting the economy. Everyone recognizes that something needs to be done, and urgently. Our healthcare dollars are incredibly overspent because we don't have that focus at the moment.
I would also say it's because outcomes in the U.S. are abysmal, especially in underserved populations. I am a provider, an advanced practice nurse, and in addition to my role as dean, I oversee a nurse-managed clinic. I have been in nursing 40 years. It is time now that we change some of our strategies to put patients first. The literature is beginning to look at patient-centered care and outcomes, and it overwhelmingly demonstrates that patients do better this way. When we have positive outcomes, it is win-win for everyone.
David Levine is a regular contributor to athenaInsight. This interview was edited and condensed. Photo credit: David Mclain