Core principles of patient-centered care

Patient-centered care is based on the idea that patients and their physicians are partners in their medical care, and the treatment should center on the patient’s desires while also addressing all areas of their well-being, including physical, emotional, social, spiritual, and financial. The Institute of Medicine defines patient-centered care as "providing care that is respectful of, and responsive to, individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions." Patient-centered care allows patients to be more active in their treatment plans by emphasizing the importance of their voices and their right to be involved in decision-making that affects their lives. In patient-centered care, the physician invites the patient to actively participate. There should be conversation and deliberation between the physician and patient that ultimately leads to a joint decision.

The eight principles of patient-centered care were introduced by the Picker Institute, whose philosophy was used in the development of the Hospital Consumer Assessment of Healthcare Providers and Systems patient satisfaction survey, a CMS requirement for all hospitals in the country. The Picker Institute, established in 2000, is an international not-for-profit charity that is well known across the healthcare community and works across both social care and health systems to identify patient experiences and support organizations to improve quality and delivery of patient-centered care.

The eight principles of patient-centered care are as follows:

1. Respect for patients’ values, preferences, and expressed needs
2. Coordination and integration of care
3. Information and education
4. Physical comfort
5. Emotional support and alleviation of fear and anxiety
6. Involvement of family and friends
7. Continuity and transition
8. Access to care

An increased focus on patient-centered care is evident in the fact that fewer hospitals today have restrictions on visiting hours and rules about who is allowed to visit. Some hospitals say that only family may visit, but family may also include anyone the patient chooses, regardless of blood relation. Allowing patients to choose who is allowed in their hospital room gives them autonomy and emphasizes their role in treatment. No longer are patients meant to passively accept doctors’ orders; instead, they are encouraged to listen and to make their voices heard.

Another example of patient-centered care is a situation in which a patient asks, "Is this the best decision for me based on my lifestyle?" A runner, for instance, may choose to have a leg amputated so that he may run with a prosthetic again, instead of living with a pain-stricken limb that may never fully recover from an injury. Patient-centered care encourages these kinds of conversations and debates.