TEDMED #GreatChallenges: Connect the dots in patient-centered care
care plan Even the most well thought out has the potential to fail if the circumstances of the individual patient's life are not taken into account. Consider these examples:
- A man who insists on antibiotics for an abscessed tooth because he is afraid of the dentist
- A woman who does not go to the hospital for tests because she has no one to take care of her cat
- a child going without prescription because her parents can not afford the copay
Moderator Kavita Patel, MD, is the executive director for clinical transformation and delivery to the Engelberg Center for reforming health care and economic study fellow at the Brookings Institution. Moreover, it is a practice of primary care internist at Johns Hopkins Medicine University and the former director of the Office of Intergovernmental Affairs and Public Engagement Policy for the Obama administration.
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The expert panel met to this hangout TEDMED Great Challenges Program each had a story about how they were affected by the problems created when contextual issues are not considered either as healthcare workers, patients or both.
Saul Weiner , MD, an internist and researcher of pediatrics at the University of Illinois at Chicago, was inspired by his experience in the supervision of medical residents and help them explore and identify ways to improve individualized treatment decisions. His research has led to the term "contextual errors" to describe "medical errors that result from failures to identify or take into account factors in the lives and circumstances of patients that are relevant to their care."
Alan Spiro , MD, used the experience gained from 25 years in the delivery of health care and management leadership to become a founding member of Accolade - an innovative approach to improve the experience of care of the health of consumers. the Accolade mission is "to help people get the right care the first time."
Susan Sheridan , MBA, MIM, is the director of patient participation at the Research Institute of patient-centered outcomes (PCORI). Sheridan became involved in patient safety and patient advocacy after experiencing the heartbreak of two distinct failures medical system that resulted in the death of her husband and brain damage in her baby.
Key Insights
Topics covered in the one-hour discussion ranged from consequences for research to practical advice and daily for stakeholders. Panelists shared the following ideas :.
- contextual errors can result from all the factors that are somehow relevant to the patient and affect treatment
- The best time to involve patients in care is before care is made.
- proof of both the market and research shows that contextual errors lead to unnecessary costs and waste.
- people need guidance through the complex health care system and fragmented.
with the patient-centered care, panelists also emphasized the need to search more patient-centered. They advocated the use of participatory research (CBPR) community-based methods to infuse wisdom of the patient in the research design to create meaningful results. A change to CBPR methods also benefit from a change in assessment measures to help physicians improve patient-centered skills. Panelists recommended to share this new research on informed patients directly with patients in an easily accessible way.
Strategies and Takeaways
Because the needs of each patient is different, there is no single strategy that will work in all cases. However, panelists discussed several strategies to improve individual care:
- Get the right care at the right place at the right time. Use teams e-medicine and telemedicine care to help patients to become involved and provide patients the attention they need.
- Provide continuing care team education on behavior change strategies to complete medical training.
- Encourage and enable patients to be "at the table", not only for their own care, but for research, policy and patient global commitment.
- Invite patients in their own care team. Or, as a patient advocate for the invitation.
- Provide and use information as a source of energy.
- Develop measures to see if the interactions are truly patient-centered.
This discussion great challenges concluded that there is no "one size fits all" regarding the patient-centered care, but simple changes can work a change paradigm, which can enable patients, providers and systems to work together toward positive individual results
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