Striving for Person-Centered Care

By Ann Hwang, MD, Director, the Center for Consumer Engagement in Health Innovation

A person-centered approach prioritizes individuals’ goals and preferences in all aspects of care. Care delivery is designed around the whole person, their needs and their convenience, rather than around the priorities of institutions. And while many of us as clinicians or health system leaders strive to deliver person-centered care, it can be hard to keep this goal front and center amidst the relentless barrage of demands of clinical practice.

Yet person-centered care is of critical importance in the care of people with the most complex needs. This is why my organization, the Center for Consumer Engagement in Health Innovation (the Center), has worked to strengthen the voice of consumers in advocating for a health system that better serves the needs of the most vulnerable. And this is why we recently teamed up with Dr. Robert Master and other clinician and consumer leaders to create a series of video modules for health system leaders and clinicians. The modules introduce and reinvigorate the idea of person-centered care for those with complex health, social, and functional needs.

The video series, Re-envisioning Care for People with Involved Disabilities, is available on our website and IHI’s Open School. It is meant to spur reflections and dialogue among clinicians and health care leaders about how to more meaningfully put patients at the center of the delivery and design of care.

In the videos, consumer leaders and providers with expertise working with person-centered care models talk about the need for person-centered care, provide examples of how it can be translated into practice, and share some of the challenges that might be encountered.

Module A, “Shifting the Paradigm,” introduces learners to the barriers faced by people with involved disabilities in accessing primary care in traditional settings. A different set of values — derived from the Independent Living Movement — is presented as the foundation for building a primary care delivery system that is accessible and responsive. These values include respect for the expertise of people living with disabilities; the dignity of risk; and self-determination.

Module B, “Creating Culture Change,” discusses the differences in the values implicit in a traditional medical model compared to an independent living model. The module explores opportunities to infuse the values of the independent living model into daily practice.

Module C, “Redesigning Primary Care,” provides insights into how to design an interdisciplinary team, facilitate communication, and support clinicians in adopting the independent living paradigm.

Module D, “Primary Care is a Service, Not a Building,” discusses the benefits of home-based primary care, both for people with involved disabilities and for clinicians. It reviews evidence for comprehensive home-based primary care and describes how home-based care is critical for understanding care for the whole person.

I hope you find these videos to be of interest and that you will share them with your colleagues. Please tweet or email us your feedback and suggestions for topics to cover in future modules. We hope that these videos will help more clinicians and health care leaders to see how patients can truly be partners in care and care redesign. We hope they will lead to more recognition of the expertise of patients and caregivers in their own conditions and their own health. Ultimately, the ability of a practice to make the shift to person-centered care requires system redesign as well as broad-based cultural change. With the goal of person-centered care as our guide, clinicians, policymakers, and advocates have the opportunity to work in partnership with consumers to change the system.