Patients centered care

It is our sincere hope that students and practitioners find this book helpful as they continuously strive to deliver highest quality patient-centered care. We invite your comments on how we may improve subsequent editions of this work. 

Mitchell, R, H., Patient-Centered Care—A New Focus on a Time-Honored Concept, The Journal of the American Academy of Nursing, Vol. 12, No. 34, 2008, pp. 45-52. 

Gerteis, M., and others. Through the Patient s Eyes Understanding and Promoting Patient-Centered Care. San Francisco Jossey-Bass, 1993. 

Ponte, P. R., and others. Making Patient-Centered Care Come NTwc." Journal of Nursing... 

Elements of patient-centered care include patient preferences, patient needs, and patient values. Integrated performance consists of clinical performance, operational performance, and financial performance. Restore patient and caregiver tmst throngh organizational transparency (Tables 13.4 and 13.5). 

Comprehensive patient-centered care models and coordinated access to multidisciplinary care services... 

Levinson W, Lesser CS, Epstein RM (2010) Developing physician communication skills for patient-centered care. Health Aff (Millwood) 29 1310-1318 Maggi CB, Griebeler IH, da Silva Dal Pizzol T (2014) Information on adverse events in randomised clinical trials assessing drug interventions published in four medical journals with high impact factors. Int J Risk Seif Med 26 9-22... 

Defining quality and safety competencies for nursing and proposed targets for the knowledge, skills, and attitudes needed in nursing pre-licensure programs for the competencies of patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics. 

Rehabilitation Clinically stable Weaning still possible Patient-centered care Reduced level of care... 

Nursing home Clinically stable Patient-centered care No weaning... 

Patient-centered care emphasizes the need to empower patients or the health care proxy to participate in medical decision making. Integrating the patient in the multidisciplinary team promotes patient participation in a therapeutic alliance, identifying stresses and maladaptive assimilation of their chronic condition. It is also a more compassionate format for communicating had news. 

Some staff arrived by choice, some by default due to seniority, and some stayed after covering a leave of absence. Those who stay, do so because they feel they are effective in delivering excellent, patient centered care. 

Hagel HP. 2002. Planning for patient care. In Hagel HP, Rovers JP (eds), Managing the Patient-Centered Pharmacy. Washington, DC American Pharmaceutical Association. 

Several key factors drive the need for automation. A national shortage of pharmacists in the face of ever-increasing prescription volumes is one major impetus. Another is the profound need to reduce the incidence of medication errors. Still another is the opportunity created by automation to enhance the role of pharmacists in patient care. Finally, consumers demand for speed and convenience further enhances the attractiveness of automation in pharmacy operations (Lewis, Albrant, and Hagel, 2002). Technology has the ability to accelerate the movement of pharmacists from the traditional dispensing focus to that of a patient-centered role. 

The job of a marketer (and the job of a health care professional as well) is not only to understand and respond to people s expressed needs but also to help customers learn more about what they need and want. In essence, marketers also must understand and respond to people s latentne ls. Narver, Slater, and MacLachlan (2004) call the former a responsive market orientation and the later a proactive market orientation. Marketers do not create needs, but they do help consumers to understand their latent needs and to translate needs into wants. An understanding of this issue is helpful in explaining pharmacy s current experiences with patient-centered services. 

When health care providers decide to supervise withdrawal from psychiatric drugs, they must pay careful attention to the feelings or emotions of their patients or clients. Not only do patients deserve this respect and concern, their emotional reactions are the best gauge of how well the tapering process is going. Drug withdrawal requires a patient-centered approach. 

To address the social need of drug-related morbidity and mortality based on a patient-centered approach that is built on the establishment of a therapeutic relationship, there must be clearly defined practitioner responsibilities. In pharmaceutical care, the practitioner is responsible for all drug-related needs of a patient. As discussed in detail in the next section, this means that a practitioner seeks to ensure that all therapies are appropriately indicated and that all medical conditions of a patient are appropriately treated, and that all therapies in use are effective, safe, and convenient for the patient. 

Burn Center Care Is the Most Efficient and Cost-Effective Care for Burn Injuries. Burn injuries are not like other trauma injuries burn injuries often require a lengthy course of treatment as compared with simple or even complex trauma patients. For example, for burn patients with 50% body surface area burn, the average length of stay in the intensive care unit is 50 days. In a mass casualty, the average burn is typically greater than 50% body surface area. 

With a decreased need for pharmacists to identify obvious problems associated with pharmaceutical therapy, the pharmacist should be free to concentrate on patient-centered therapy issues. Pharmacists can spend more time with patients identifying barriers that might prevent a patient reaching an optimal outcome. Pharmacists can then address these issues with education and proactive adjustments in the patient s therapy. The pharmacist can concentrate more time on educating patients to better monitor their therapy to increase the likelihood of maximal therapeutic benefit without troublesome misadventures. Furthermore, the pharmacist could concentrate on therapeutic outreach programs such as brown bag clinics, diabetic care clinics, and asthma screening. 

To enhance the quality, appropriateness, and effectiveness of health care services, and access to these services the federal government in the Omnibus Budget Reconciliation Act of 1989 (Public Law 101-239) established the AHCPR. The act, sometimes referred to as the Patient Outcome Research Act, called for the establishment of a broad-based, patient-centered outcomes research program. In addition to the traditional measures of survival, clinical endpoints and disease- and treatment-specific symptoms and problems, the law mandated measures of functional status and well-being and patient satisfaction. In 1999, then President Clinton signed the Healthcare Research and Quality Act, reauthorizing AHCPR as the AHRQ until the end of fiscal year 2005. Presently, its mission is to improve the outcomes and quality of health care, reduce its costs, address patient safety and medical errors, broaden access to effective services, and improve the quality of health care services. 

Completion of the evolution of the values system of pharmaceutical education toward producing graduates who are patient-centered providers of pharmaceutical care. 

The practice of pharmaceutical care has a clearly articulated philosophy that defines values and explains what all practitioners must do. According to this philosophy, the practitioner performs the following 1) takes responsibility for meeting society s need to reduce drug-related morbidity and mortality 2) employs a patient-centered approach that addresses all the patient s drug-related needs 3) establishes a caring therapeutic relationship with individual patients and 4) assumes a clearly defined set of responsibilities that directs patient care activities. These responsibilities are to ensure that patients receive the most appropriate, effective, safe, convenient, and economical therapy to identify, resolve, and prevent drug therapy problems and to ensure that optimal patient outcomes are achieved. 

Opportunities in psychiatric pharmacy continue to expand with specialists practicing in hospitals, clinics, longterm care facilities, developmentally disabled centers, prisons, academia, and the pharmaceutical industry. Although acute care facilities exist to treat the most severely ill patients, primary care clinics provide service for the majority of patients. Model practice settings exist for both acute and primary care, and are discussed later in this article. Other opportunities are discussed in this section. 

Pharmaceutical Care is a patient-centered, outcomes-oriented pharmacy practice that requires the pharmacist to work in concert with the patient and the patient s other healthcare providers to promote health, to prevent disease, and to assess, monitor, initiate, and modify medication use to assure that drug therapy regimens are safe and effective. The goal of Pharmaceutical Care is to optimize the patient s health-related quality of life, and achieve positive clinical outcomes, within realistic economic expenditures. To achieve this goal, the following must be accomplished ... 

The implementation of pharmaceutical care is supported by patient-centered communication. Within this communication, the patient plays a key role in the overall management of the therapy plan. 

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