B1: Person Centred care Flashcards
What are the 4 principles of person centred care?
-
PECT
- Personalised
- Enabling
- Coordinated
- Treating the patient with compassion, dignity and respect.
What does personalised care involve?
- 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
What does enabling care involve?
- Shared decision making
- recognising the persons strengths in self care and management of their condition
- supporting them to self manage: info, knowledge and support
- patient and public involvement in design and delivery of services: Co production of health
Coordinated care involves?
- 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
who is person centred care for?
EVERYONE
be aware children, older adults (dementia limited capacity), people w learning disability/ mental illness have been documented to not have needs met.
Why do we need person centred care?
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..)
What are the GMC three main duties of Dr (related to person centred care?)
- Make care of the patient your first concern
- treat patients as individuals respect their dignity
- work in partership w patients
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).
- LISTEN to ps and RESPECT their views about their health
- DISCUSS w P what diagnosis/ prognosis/ treatment and care involves
- SHARE w P info they want/ need to make decision
- MAXIMISE p opportunities and ability to make decision for themselves
- RESPECT P decision
What are the 5 fundametnal principles/ values underpinning person centred care?
Respect
Autonomy
Dignity
Care ( compassion)
Consequences
CCRAD = cuddly care is RAD
Define respect
recognising the moral value of a person as an autonomous being.
define autonomy
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
define dignity in care
Dignity in care means care that:
Supports, promotes and does not undermine persons self respect.
What is care?
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.)
What are the consequences of person centred care?
better patient outcomes
less complaints/ risk of litigation
increased trust in medical profesh
What is the calgary cambridge model?
What tasks does it involve?
what functions does it serve?
Model which helps guide consultation around person centred care Has 5 tasks:
- commence consultation
- gather info
- physical exam
- explanations and planning
- closing consultation
Achieves two functions
1) Build relationship
2) Provide structure
Commencing consultation
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
gathering info
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
Building relationship
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
How do you provide structure
Make organistation of consultation overt
attend to the flow
explanation planning
provide correct type and amount of info
check patient understanding
achieve shared understanding
plan for future - shared decision making
closing consulation
confirm plan of care, clarify steps for P and Dr, establish contigency plan.
maximise adherence and health outcomes to make efficient time use
