patient centered care glenda m. payne, ms, rn, cnn director of clinical services nephrology clinical...

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Patient Centered Care Glenda M. Payne, MS, RN, CNN

Director of Clinical ServicesNephrology Clinical Solutions

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Disclosures: None

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Objectives

1. State two main concepts of patient centered care

2.  Implement a patient centered care program  

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You Might NOT Be Patient Centered IF….

The thermostat in the treatment room is set at 62 

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You Might NOT Be Patient Centered IF…. 

Patients enter an unattended space and wait there for more than half an hour without even a greeting...

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You Might NOT Be Patient Centered IF…. 

Patients are addressed as “Mama,” and they aren’t related to you… 

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You Might NOT Be Patient Centered If…One chair is damaged, so you put “matching” duct tape on all the chairs so patients can’t tell which chair to refuse…

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You Might NOT Be Patient Centered IF…. 

The reason you give for not meeting quality indicator goals is that all your patients are “non-compliant…” 

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Disease Centered Vs. Patient Centered Care

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Focus of Care

Disease Centered

Patient is passive

Patient is a recipient of care

Provider dominates decisions

Patient Centered

Patient is active

Patient is a partner in his/her treatment plan

Decision making is collaborative

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Focus of Care

Disease Centered

Disease centered care (focus is dialysis)

Provider talks

Patient compliant (or not…)

Patient Centered

Quality of life centered (Family life is focus)

Provider listens more/talks less

Patient follows treatment plan: self manages

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Words Vs. Deeds

We say we are patient-centered

Yet patients experience:

Fear

Guilt

Anger

IntimidationBear, Robert, Sorrow’s Reward, 2010

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Core Concepts of Patient Centered Care

Dignity and respect

Information sharing

Participation

Collaboration

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Our Panel of Experts:

Adam Goldstein

Roy Graham

Dawn Lawlor

Jamie Roy

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Patient CenterednessCore Concept: Dignity and respect

Institute for Patient- and Family- Centered Care

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What experiences have you had that illustrate this concept?

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Patient Centeredness:Core Concept: Information sharing

Institute for Patient- and Family- Centered Care

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What experiences have you had that illustrate this concept?

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Patient Centeredness: Core Concept: Participation

Institute for Patient- and Family- Centered Care

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What experiences have you had that illustrate this concept?

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Patient Centeredness: Core Concept: Collaboration

Institute for Patient- and Family- Centered Care

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What experiences have you had that illustrate this concept?

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Your Own “Patient” Experience

Have you ever been a patient?

Do you remember how it felt to be on the “other side?”

What would be hard for you?

What would be critical for you to feel safe?

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Moving Toward Patient Centeredness:

Recognizing Challenges

Discomfort with Patient Empowerment:

Not trained for it

Threatened by it

Inconvenienced

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Your Ideas:

..

..

..

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What Are Some Immediate Steps You Can Take Toward Patient Centered Care?

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Immediate Steps…

…

…

…

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Immediate Steps

Listen more

Provide clear information at each step of care

Encourage patients to speak up and ask questions

Ensure all staff react positively to patient questions

Include the patient’s priorities in the plan of care

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I would like to introduce Mr. John Smith, a _______________________________**(gentleman, young man, engineer, grandfather, artist, bowler, grouch}

Who is 54 years old and in addition to kidney failure is managing diabetes and a sinus infection.

Patient Care Plan Participation

Thanks to Bonnie Greenspan

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__Mr. Smith reports that the concerns or goals with which he would welcome help from the team today are:

Would like to be able to play touch football with his kids for a half hour at their family reunion next month. He is currently too tired.He can’t resist cheese and ice cream lately and knows his phosphorous will show it

__ Mr. Smith has no requests of the team at this time

Thanks to Bonnie Greenspan

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Questions?

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Thanks for the Work You Do!

gpayneful@aol.comwww.nephrologyclinicalsolutions.com