Abstract
Health care is shifting from volume to value, and there is a need to define the distinct value of services. OT is founded on the principles of person-centered care, and the intentional use of these strategies must be part of evidence-based outcomes in order to solidify the value of OT services. This study examined the use of person-centered care in clinical practice, and results were used to develop capacity-building strategies for implementation of a person-centered approach.
Primary Author and Speaker: Elizabeth Jayne Braun
Additional Authors and Speakers: Erin Casey Phillips, Hannah Corner
Contributing Authors: Shayla Murphy, Alayna Pullara, and Nathan Kies
Person-centered care is a holistic, individualized, respectful, and empowering means of engaging an individual and their family during the entire medical process (Morgan & Yoder, 2012). Person-centered care (PCC) has been shown to have widespread benefits to individuals and providers and is proven a cost-effective strategy for the healthcare systems (Chen et al., 2018). The person-centered treatment model has the capacity to increase client empowerment, increase self-efficacy, improve the performance of activities of daily living (ADL), increase adherence, and decrease the number of hospital readmissions (Chen et al., 2018). Person-centered care is an emergent solution to the challenges faced by clients, clinicians, and the healthcare system. The foundation of PCC is conceptualized in the OT Practice Framework, however, there may be a gap in the functional and intentional use of PCC strategies in direct clinical practice. Planetree (Planetree, 2018) operationalizes the concepts of PCC. Planetree is an organization that implements person-centered care through 10 components: human interaction; information and education; family, friends, and social support; nutritional and nurturing aspects of food; architecture and interior design; arts and entertainment; spirituality; human touch; complementary therapies; and healthy communities (Planetree, 2018). Each of these areas are evidenced-based and provide a scaffold for the development of occupation-based practice skills for implementation of PCC in occupational therapy practice. Person-centered care is being utilized as a quality measure for healthcare because of its beneficial outcomes and demonstration of improved client satisfaction with care (Agency for Healthcare Research and Quality, 2018). The purpose of this study was to evaluate the understanding and implementation of person-centered care in occupational therapy practice. A self-reflection survey design examined therapist use and perceptions of the Planetree modules in OT practice. In addition, this research explored the perception of person-centered care from the voices of clients receiving occupational therapy services. Two mixed-methods surveys were used to investigate client and clinician experiences of occupational therapy services. Researchers created the surveys based on the 10 components of the Planetree model including Likert scaled questions to examine the frequency of PCC use in practice and the importance of PCC to clinical outcomes. In addition, the survey included qualitative questions with regard to the supports and barriers to implementing PCC in occupational therapy practice. A total of 80 clinician and 13 client surveys were completed. Results indicated PCC is of high importance to both occupational therapists and clients. Occupational therapists desire to practice PCC but face barriers such as systemic factors and lack of self-efficacy. Systemic barriers included time, productivity, cost, and financial resources. Client perceptions of PCC identified a gap in services addressing components of spirituality and social support and a need to advocate for OT services in the areas of nutrition and complementary therapies. Researchers developed capstone projects to address specific PCC implementation strategies including core competencies for education. This proposal is important to practice as a pathway to operationalize the distinct value of OT as a person-centered service to improve patient outcomes. This study identified the need for occupational therapists to address all aspects of PCC through more intentional practice, the need for systemic change to create a person-centered healthcare system, and further education and awareness of the distinct value of OT services.
Agency for Healthcare Research and Quality. (2018). Chartbook on person and family centered care. Retrieved from https://www.ahrq.gov/research/findings/nhqrdr/chartbooks/personcentered/trends.html
Chen, L., Chen, Y., Chen, X., Shen, X., Wang, Q., & Sun, C. (2018). Longitudinal study of effectiveness of a patient-centered self-management empowerment intervention during predischarge planning on stroke survivors. Worldviews on Evidence-Based Nursing, 15(3), 197-205. https://doi.org/10.1111/wvn.12295
Planetree. (2018). Who we are. Retrieved from https://www.planetree.org/who-we-are
Morgan, S., & Yoder, L. H. (2012). A concept analysis of person-centered care. Journal of Holistic Nursing, 30(1), 6-15.