B1: Person Centred care

Question 1

What are the 4 principles of person centred care?

Answer 1

• PECT
  
  • Personalised
  • Enabling
  • Coordinated
  • Treating the patient with compassion, dignity and respect.

Question 2

What does personalised care involve?

Answer 2

• Seeing and getting to know the patient as a WHOLE person
• whole person approach
• putting the persons needs and preferences AS THEY DEFINE THEM first
• tailoring therapeutic plans and services to patients needs and desires

Question 3

What does enabling care involve?

Answer 3

1. Shared decision making
2. recognising the persons strengths in self care and management of their condition
3. supporting them to self manage: info, knowledge and support
4. patient and public involvement in design and delivery of services: Co production of health

Question 4

Coordinated care involves?

Answer 4

• Coordination across multiple episodes and over time
• integrated care to address health social and emotional needs:
  
  • intergration between health services and social services/ other
  • across primary/ community/ hospital/ tertiary care ( vertical integration).
  • through transitions eg child to adult services

Question 5

who is person centred care for?

Answer 5

EVERYONE

be aware children, older adults (dementia limited capacity), people w learning disability/ mental illness have been documented to not have needs met.

Question 6

Why do we need person centred care?

Answer 6

evidence of positive outcomes for patients

social and political drivers - patients want to be actively involved in care, much more informed public

concurs with ethical priniciples underpinning duties of dr (respect autonomy etc..)

Question 7

What are the GMC three main duties of Dr (related to person centred care?)

Answer 7

1. Make care of the patient your first concern
2. treat patients as individuals respect their dignity
3. work in partership w patients

Question 8

GMC states: “whatever context in which medical decisions are made you must: work in partership w patients to ensure good care. In doing so you must…?” (5 actions).

Answer 8

1. LISTEN to ps and RESPECT their views about their health
2. DISCUSS w P what diagnosis/ prognosis/ treatment and care involves
3. SHARE w P info they want/ need to make decision
4. MAXIMISE p opportunities and ability to make decision for themselves
5. RESPECT P decision

Question 9

What are the 5 fundametnal principles/ values underpinning person centred care?

Answer 9

Respect

Autonomy

Dignity

Care ( compassion)

Consequences

CCRAD = cuddly care is RAD

Question 10

Define respect

Answer 10

recognising the moral value of a person as an autonomous being.

Question 11

define autonomy

Answer 11

refers to the capacity to be ones own person

to live ones life according to reasons/ motives taken to be ones own

free from distorting external force

Question 12

define dignity in care

Answer 12

Dignity in care means care that:

Supports, promotes and does not undermine persons self respect.

Question 13

What is care?

Answer 13

Beneficence -> doing good from both patient and Dr perspective

Treating in best interests (past/ present and future values of patient)

Treat the condition whilst caring for the person ( I.e responsible for health whilst forming relationship.)

Question 14

What are the consequences of person centred care?

Answer 14

better patient outcomes

less complaints/ risk of litigation

increased trust in medical profesh

Question 15

What is the calgary cambridge model?

What tasks does it involve?

what functions does it serve?

Answer 15

Model which helps guide consultation around person centred care Has 5 tasks:

1. commence consultation
2. gather info
3. physical exam
4. explanations and planning
5. closing consultation

Achieves two functions

1) Build relationship
2) Provide structure

Question 16

Commencing consultation

Answer 16

establish suportive environment and initial rapport

develop awareness of P emotional state

identify problems to discuss

establish mutually agreed plan for consultation

develop partnership w P

Question 17

gathering info

Answer 17

Explore patients problems from 1) biomedical 2) patient 3) background perspectives

ensure info is 1) accurate 2) complete 3) mutually understood

ensure patients feel listened to and their info/ views are welcome/ valued

continue supportive environment and collaborative relationship

Structure consultation -> efficient info gathering, allow P to understand/ be involved in interview

Question 18

Building relationship

Answer 18

involve patient so comfortable w participating

develop rapport so they feel understood valued and supported

establish trust

maximises accurate and efficient initiation/ info gathering/ explanation and planning

develop and maintain continuing relationship over time

Question 19

How do you provide structure

Answer 19

Make organistation of consultation overt

attend to the flow

Question 20

explanation planning

Answer 20

provide correct type and amount of info

check patient understanding

achieve shared understanding

plan for future - shared decision making

Question 21

closing consulation

Answer 21

confirm plan of care, clarify steps for P and Dr, establish contigency plan.

maximise adherence and health outcomes to make efficient time use