PATIENT CENTRED CARE Empowering patients to become active participants in their care.

INTRODUCTION Morris Moses Foundation is a patient’s rights organisation based in Nairobi, Our vision is the realization of quality healthcare for all Kenyans regardless of their socio-economic status. Our work is to agitate for change in the public health sector MMF was actively involved in the creation of the first patients rights charter in Kenya. MMF believes that patients should be active participants in their own care.

What is Patient Centered Care? It is a standard of practice that demonstrates a respect for the patient, as a person (Binnie and Titchen, 1999; Shaller, 2007). It is very much about considering the patient’s point of view and circumstances in the decision-making process, (Ponte et al, 2003). Responsiveness to patient needs and preferences, using the patient’s informed wishes to guide activity, interaction and information-giving, and shared decision-making (Rogers et al, 2005). It is a way of viewing health and illness that affects a person’s general well- being and an attempt to empower the patient by expanding his or her role in their health care. Making the patient more informed, and providing reassurance, support, comfort, acceptance, legitimacy and confidence are the basic functions of PCC (Fulford et al, 1996).

Why Patient Centered Care? It improves patients health outcomes and increases patient satisfaction as a result of better communication with the patient and better understanding of their needs. PCC delivers more holistic care; enhances communication skills between relatives, patients and healthcare providers; shifts emphasis from body care to total care; facilitates a team approach; and facilitates reflection, learning and sharing of skills and abilities among health professionals.

Pillars of Patient Centered Care SAFETY. Patient safety is the highest priority of PCC. Risk management requires a system of managing and monitoring patient safety and quality assurance, including an incident reporting system that is transformative rather than punitive. COMPASSION. Patients are treated with respect and compassion as well as given all accurate and relevant information to make informed health care decisions. Patient care is based on “cura personalis” and healing partnerships with the entire health care team and family members. CLINICAL EXCELLENCE. PCC involves standardizing care and development of evidence-based clinical guidelines to achieve optimal clinical outcomes. EFFICIENCY. All members of the hospital team work together to create a seamless process throughout the hospital experience to minimize patient burden and wait time. ACCESSIBILITY. Health care is affordable and accessible

Implementing Patient Centered Care Keep patients (or family ) informed Involve the patient (or family) in decision making Provide patients (or family) with counselling and support Gain informed consent for all procedures and processes Elicit feedback from patient (or family) and listen to their views Be open and candid when adverse effects occur Improve communication with patients( of family)

Challenges in implementing PCC Lack of a clear understanding of what Patient Centered Care is Unwillingness of the medical professional to involve the patient in their treatment because of the traditional “Doctor knows all mind frame” Shortage of staff- Owing to time and staff constraints medical professional's hurriedly listen to patients concerns. Absence of good teaching curricula on Patient Centered Care model- there is inadequate emphasis of PCC in education.

Conclusion Achieving high patient satisfaction should be the goal of every hospital. Organization transformation should help staff members question every hospital routine even those held most sacred so that they work for both themselves and the patient. An important aspect of patient centered care is patient advocacy implementation of PCC requires a planned and coordinated approach, with sufficient staff, efficient teamwork, and adequate education of healthcare providers.