In the nineties, the Picker Institute sponsored research into the patient experience of healthcare.
Patients were surveyed on basic questions, such as what patients want and value. From this work came
the “Eight Picker Principles of Patient Centred Care”, which embody the idea that
“all patients deserve high-quality healthcare, and that patients’ views and experiences
are integral to efforts to improvement efforts”.
These principles are:
1. Respect for patients’ values, preferences, and expressed needs
Unsurprisingly, patients want to be involved in decisions affecting them. A patient’s values
and preferences should be considered when medical treatments are being planned.
2. Coordination and integration of care
Medical services are often delivered by more than one provider, especially in an
institutional setting. If the welfare of the patient is central, then care from all
providers should be coordinated in the interest of the patient.
If not, then care will be delivered on a schedule convenient to the providers,
which could result in poor treatment (for example, patients being forced to wake up
for therapy at one of a few moments they could get some sleep).
3. Information, communication, and education
Patients sometimes fear that information is being withheld from them - for example,
concerning their condition or prognosis. Also, a patient must properly informed
if they are to make the best decisions for themselves, and to provide meaningful consent.
The level of physical comfort has a profound effect on the patient’s experience of treatment.
Comfort includes such things as freedom from pain, assistance with basic daily living,
and a pleasant environment.
5. Emotional support and alleviation of fear and anxiety
Illness can prompt fear and anxiety over many things, including their condition and prognosis,
treatment, the effect on family, and financial implications. Alleviating these anxieties can
be as important as treating the illness itself.
6. Involvement of family and friends
The role of family and friends was regularly highlighted by patients, including the
need for support, and concern over the impact that the illness might have on them.
It is important for the medical service providers to acknowledge their role, accommodating
them wherever possible and providing support they might need.
7. Transition and continuity
Patients are often anxious about their care following a transition from one setting
to another; for example, when being discharged from a hospital. Patients should be informed
about what to expect when they go home, and what is expected of them. Ongoing treatment
needs to be coordinated in a way that’s clear to the patient. Also, they should be informed
about what continuing support they will have access to, including medical, emotional, and financial.
Patients need to know they can access care when they need it, and even knowing how to access it.
These eight principles form the basis of the “patient centered care” model of healthcare
that has become increasingly important in the design of healthcare systems.
It has, for some time, been widely accepted in the medical community (apart from the dental community).
Currently, in 2018, organisations in the United States such as the Center for
Evidence-Based Dentistry (part of the American Dental Association) are actively promoting
patient-centred care as a model for the dental community in the U.S.
At Evidental, we practice patient-centred care as part of our commitment to our core principles
of dental care. By our example, and with the support of our clients, we hope to accelerate the
adoption of patient-centred care in Canadian dental practice.
You can read more about the eight principles and the Picker Institute at their
website,
from which much of the above discussion was inspired.
