Title: The difference we make – caring for the whole person Presenter: Sue Hanson, National Director, Clinical Services - Calvary

Person-centred care means: Treating each person as an individual Protecting a person’s dignity Respecting a person’s rights and preferences: and Developing a therapeutic relationship between the care provider and care recipient which is built on mutual trust and understanding. CAN (November 2014) Person-centred care Position Statement Person – centered care is not the same as person-directed care (although this is a component )

I think we all believe……. Person-centred care should be the principle behind care for every person / every time – esp. vulnerable Care should be holistic – include emotional, spiritual, social and psychological needs and preferences Person-centred care is not just about satisfaction/experience Person-centred care is not just the responsibility of clinicians at the bedside. Standard 2 – Australian Safety & Quality Health Service Standards : Partnering with consumers

Making a difference – Catholic Social Teaching Preferential Option for the Poor Dignity of the Human Person Subsidiarity & Participation Recognise, respect, promote, reconcile, protect The Common Good Solidarity How well these align and give us a special focus on delivering person centred care

So why do we so often fall short of the mark?

Day of Death Snapshot Lobb, EA, Hanson, S, Liauw, W, Links, M,Tait, V, McGowan, N,Sanderson, C

What do we know - NSW 48,000 people died in NSW in 2011/12. 1 75% of these deaths are clinically ‘expected’2 70% of people want to die at home3 52+% of deaths occur in acute care hospitals3 In NSW care in the last year of life = 1Million bed-days at a cost of $900 Million+ 4 hospitalisations in LYOL – 24% had 10+ Average LOS – 10 days (excl. day only) 60% of all admissions in LYOL were via ED – 76% in those aged >85 years

Costs of care $977.4 million for inpatient admitted care (1.4 million bed days) $32.5 million for non-admitted presentations to ED Analysis undertaken by the Health Economics and Evaluation Team, ACI using NSW Combined Admitted Patient Epidemiology Data and ABS population estimates (SAPHaRI). Centre for Epidemiology and Evidence, NSW Ministry of Health

Embedding Person-Centred care Challenge: Not just a matter of changing practice Requires reorientation of health, aged and social care systems Numerous perverse incentives and disincentives across all sectors

Why do we so often fall short of the mark? Paid to deliver interventions regardless of person-centred needs Little control over the primary drivers – clinical decisions (appropriateness) Poor community knowledge/literacy – “do everything” Low value care Over-reliance on ACP / Directives Few mechanisms to have early GOC discussions