A Patient-Centered Model to Improve Metrics Without Cost Increase

Abstract

The need for patient-centeredness in care delivery has been articulated for decades, yet meaningful progress toward patient-centered healthcare has been hobbled by the lack of a replicable patient-centered care model and method. The authors describe the patient- and family-centered care method, built around viewing every care experience through the eyes of the patient and family, and its outcomes proving the approach is replicable and sustainable while improving outcomes without additional cost. A follow-up article on patient and family shadowing will be published in the January 2011 issue.

Patient satisfaction with obstetricians and gynecologists compared with other specialties: analysis of US self-reported survey data

“…This study has implications for health care policy makers as well. Research has shown that a patient-centered focus is also one of the strategies to achieving cost-effective quality of care 30. Pay for performance has been shown to have an impact on patient satisfaction by enhancing physician knowledge, increasing awareness of guidelines, encouraging prevention and follow-up, reducing errors and costs, ensuring a uniform level of care, and motivating physicians to deliver better care.…”

Determining the True Cost to Deliver Total Hip and Knee Arthroplasty Over the Full Cycle of Care: Preparing for Bundling and Reference-Based Pricing

“…Combining TDABC + PFCC M/P proved to be an effective means of identifying the major cost drivers, capacity utilization, areas of opportunity for improving efficiencies, and experiences for this patient population, and all of the information required to participate successfully in bundling and RBP programs for THR and TKR. While the PFCC M/P has already been shown to improve value in health care [4][5][6][7][8][9][10][11], knowing the major cost drivers over a full cycle of care and having the tools to drive down these costs while protecting outcomes and experiences provides the mechanism to further improve value in health care. We are now beginning to build teams to pilot and operationalize identified improvement opportunities.…”

“…Identifying the current state of a care experience through the PFCC M/P approach involves process mapping (which in PFCC terms is called Care Experience Flow Mapping) using a tool called Shadowing, which is the real-time observation of patients and families through each segment of their health care journey. The PFCC M/P has been found to improve all three components of value in health care -experience, outcomes, and costs [4][5][6][7][8][9][10][11] -what we call the PFCC Trifecta.…”

“…Identifying the current state of a care experience through the PFCC M/P approach involves process mapping (which in PFCC terms is called Care Experience Flow Mapping) using a tool called Shadowing, which is the real-time observation of patients and families through each segment of their health care journey. The PFCC M/P has been found to improve all three components of value in health care -experience, outcomes, and costs [4][5][6][7][8][9][10][11] -what we call the PFCC Trifecta.Our goals for this project were three-fold, to: (1) identify the true cost of care delivery for THR and TKR over the full cycle of care (the full bundle being defined as 30 days before surgery to 90 days postsurgery), (2) take advantage of the inherent synergies between TDABC and the PFCC M/P by using Shadowing (prior to face-to-face discussion among department heads and subject experts) as the link between the two approaches, and (3) show how one tool with a patient centered focus can determine the necessary information to drive improvements …”

Turning Patient-Centeredness From Ideal to Real

“…Many of the improved outcomes based on these metrics have been published, including findings of decreased staff turnover and decreased costs (DiGioia et al, 2010;Meyer, 2011) in trauma services and improvements in process efficiency . Many of the improved outcomes based on these metrics have been published, including findings of decreased staff turnover and decreased costs (DiGioia et al, 2010;Meyer, 2011) in trauma services and improvements in process efficiency .…”