1. Introduction to Patient Centered Care
IHI Open School PFC 101

2. Agenda Review IHI Lesson Model Exercise
Discussion of Patients and Providers as Partners
Wrap Up

3. milestones PCP #3 Reduce unnecessary hospitalizations
PCP #4 Encourage patients and families to collaborate in goal setting, decision making, and self-management
(#5 Incorporating pt and family feedback, #7 Continuity between pt and care team, #8 Pt empanelment, #17 Provider availability 24/7, #22 Technology for scheduling and communication options, etc.)

4. Models of the Patient-Provider Relationship
Paternalistic: physician or provider is viewed as an expert authority on health care
Informative: provider is a technical expert who simply provides information to the patient, and the patient holds the decision-making power about his or her care
Interpretive/deliberative: provider serves in the role of a counselor, advisor, friend, or teacher

5. The Partnership Model Health is determined by more than health care.
Clinical care makes up only about 20 percent of any person’s health outcomes.
To address disparities, providers must seek to address the social determinants of health as well.
Patients are diverse individuals who are active agents in their own health.
Providers play the role of facilitators who help patients achieve their own health goals.

6. What’s wrong with the traditional model?
Patients always have a choice to take medical advice.
Patients have assets to contribute to their own care.
Social conditions place limits on what patients can do for their health.

7. A Note about Trust The Tuskegee study (1930s‒1972) Internet
Many patients have had life experiences that lead them to distrust providers

8. Model Experiences
Tell about an experience you had or shared with someone using a traditional model that did or did not result in optimal care.
We will list the reasons you believed you had this care from each group on the board.

9. Patients as Partners There are always two experts in the room
The one who does not have expertise in medicine is an expert in:
Their life experiences
Their abilities
Their willingness
Their culture
Recommendations stop at the middle of the room
It is ultimately the patient who will live with care decisions

10. Providers/Patients as People
Agency Bias – thinking of people’s actions as primary cause of an outcome
Cultural Competence – ability of a system to provide care to patients who are diverse and tailor delivery of the system
Implicit Bias – unconscious and unintentional discrimination
Health Disparities – unfair differences in health due to inequitable social conditions

11. So What moves us forward
Using Shared Decision Making - a conversation based on
respect and dignity
information sharing
participation
collaboration
HCT Taking Steps - any provider can take steps such as
pausing to notice implicit bias
empathize by understanding without judging
practicing humility by acknowledging what you don’t know

12. Rethinking Compliance
Health care systems may label patients as “non-compliant” when patients don’t follow through with a plan of care. It may have been developed without their input or be possible in the context of their lives.
Who is failing?
Dr. Martin Bataldin – health care should be seen as a service that is co-produced by patients and providers.

13. Ask Me 3 registered
IHI and the National Patient Safety Foundation – May 2017
Ask Me 3 is an educational program that encourages pts and families to ask three specific questions of their providers to better understand their health conditions and what they need to do to stay healthy.
1. What is my main problem? 2. What do I need to do? 3. Why is it important for me to do this?

14. conclusion Patient-Provider models need change
There are a number of barriers for both providers (bias) and patients (literacy) to overcome
Ultimately patient centered care is up to the HCT to develop and direct

15. Communication is Key