How the Patient-Centered Medical Home Improve Care
When a patient arrives at a doctors appointment they expect to have the best care provided to them by the PCMH (patient centered medical home). The question is, does the PCMH improve care of the patient, and how? There has been many experiments and findings that the PCMH does in fact improve care. What is a Patient-Centered Medical Home exactly? The medical home is a model of primary care that is patient-centered, comprehensive, team-based, coordinated, accessible, and focused on quality and safety. (Defining the PCMH. Web. 26 Apr. 2016.) It is known as how primary care should be coordinated and delivered throughout the healthcare system. The model encourages the health care providers and teams to meet patients where they are, from the most simple to the most complex conditions. Many would think it means medical care at home. Home in PCMH is actually not a place at all. The medical home is not a destination, it is a model for achieving excellent primary care. It is a place where patients are treated with respect,
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In Early Evidence on the Patient-Centered Medical Home (Peikes D, Zutshi A, Genevro J, Smith K, Parchman M, Meyers D. 2012.) The purpose of their research was to see if the patient-centered medical home aims to breathe new life into primary care and attain better quality, lower costs, and improved care. This study reviews the early evidence on effectiveness of the PCMH.
Their conclusion was that improving primary care is the pillar to achieving the triple aim outcomes. The PCMH is an up-and-coming innovation, and the model is quickly growing. Stronger evaluations are needed to provide more information on how to clarify and target the model to establish that the ample efforts of practices needed to adopt the model are most effective. (Peikes D, Zutshi A, Genevro J, Smith K, Parchman M, Meyers D.
Some critics have stated that there is not yet any quantifiable improvement in patient outcomes in comparison to the traditional model. Additionally some critics have voiced that some “practices may receive recognition without making fundamental change”.4 Another prominent flaw is the lack of funding to convert practices into PCMH. The cost to cut down patient flow, reconfiguring medical record systems, and get approval from insurers is more than many sites can handle financially. For the PCMH model to be accessible to some practices with the hopes of implementing such a program, capital funding would need to be made available from federal, state, and local entities. This limits many providers because many practices are not able to provide the necessary capital to start such a program. In addition to medical practices not having the necessary capital, providers must then work with a decreased patient load with the anticipation of possible reimbursement in the future.3 These points make it clear that the transition to a PCMH model would require hard work and commitment from the involved providers to make it
Patient-centered care (PCC) is a healthcare model focused on actively involving the patient in all aspects of planning, implementation and monitoring of care. It integrates respect for the patient’s needs, values and beliefs into the health care process. Important aspects of PCC are collaborative care, Family-centered care, and comfort. PCC allows the patient to have autonomy and a more collaborative role in making decisions regarding their treatment.
Starfield, B, Cassady, C, Nanda, J, Forrest, C, & Berk, R. (1998). Consumer experiences and provider perceptions of the quality of primary care: implications for managed care. The Journal of Family Practice, 46(3), 216-226.
Furthermore, in the case of comparing the Patient Centered Medical Homes against Obamacare services the odd speak for combining some of the techniques that are used in the PCMH to build a more stable health care system. “Maria Vezina (2013) reports knowledge about the Patient Protection and Affordable Care Act (PPACA) passed in March 2010 and upheld by the Supreme Court in June 2012, is key in understanding the varied regulatory changes that have been made to our U.S. health care system. PPACA is the most significant regulatory overhaul of U.S. health care since Medicare and Medicaid in 1965. The entire health care team needs to be prepared for initiatives introduced to better manage the care for a greater population of people with improved
Buchbinder, S.B., & Shanks, N. H. (2007). Introduction to Health Care Management. Sudbury, MA. Jones & Bartlett Publishers. Performance Improvement in Health Care. 5, 81-135.
The second key point focuses on primary care. To be able to have health care that is functional and effective it starts with primary care. “A robust primary care system is the cornerstone for a more equitable health care system” (Fiscella, 2011). Restructuring of this program in certain areas is important “payment reform, enhancing the training pipeline, transforming practice, and buttressing the primary care safety net” (Fiscella, 2011).
It is no secret that the current healthcare reform is a contentious matter that promises to transform the way Americans view an already complex healthcare system. The newly insured population is expected to increase by an estimated 32 million while facing an expected shortage of up to 44,000 primary care physicians within the next 12 years (Doherty, 2010). Amidst these already overwhelming challenges, healthcare systems are becoming increasingly scrutinized to identify ways to improve cost containment and patient access (Curits & Netten, 2007). “Growing awareness of the importance of health promotion and disease prevention, the increased complexity of community-based care, and the need to use scarce human healthcare resources, especially family physicians, far more efficiently and effectively, have resulted in increased emphasis on primary healthcare renewal.” (Bailey, Jones & Way, 2006, p. 381).
Nursing should focus on patient and family centered care, with nurses being the patient advocate for the care the patient receives. Patient and family centered care implies family participation. This type of care involves patients and their families in their health care treatments and decisions. I believe that it is important to incorporate this kind of care at Orange Regional Medical Center (ORMC) because it can ensure that we are meeting the patient’s physical, emotional, and spiritual needs through their hospitalization.
...lthcare system is slowly shifting from volume to value based care for quality purposes. By allowing physicians to receive payments on value over volume, patients receive quality of care and overall healthcare costs are lowered. The patients’ healthcare experience will be measured in terms of quality instead of how many appointments a physician has. Also, Medicare and Medicaid reimbursements are prompting hospitals, physicians and other healthcare organizations to make the value shifts. In response to the evolving healthcare cost, ways to reduce health care cost will be examined. When we lead towards a patient centered system organized around what patients need, everyone has better outcomes. The patient is involved in their healthcare choices and more driven in the health care arena. A value based approach can help significantly in achieving patient-centered care.
Manning, S. (2011). Bridging the gap between hospital and home: a new model of care for
... is an abstract model that proposes an exploratory plan for health services and evaluating quality of health care. In accordance with the model, information about quality of care can be obtained from three categories: structure, process, and outcomes. In addition, not long ago The Joint Commission include outcomes in its accreditation valuations (Sultz, & Young, 2011, p. 378).
Today, many Americans face the struggle of the daily hustle and bustle, and at times can experience this pressure to rush even in their medical appointments. Conversely, the introduction of “patient-centered care” has been pushed immensely, to ensure that patients and families feel they get the medical attention they are seeking and paying for. Unlike years past, patient centered care places the focus on the patient, as opposed to the physician.1 The Institute of Medicine (IOM) separates patient centered care into eight dimensions, including respect, emotional support, coordination of care, involvement of the family, physical comfort, continuity and transition and access to care.2
The Health Foundation describes patient centred care as being a type of health system where patients take control of their
To promote this outcome, the institute suggested that medical professional seek the latest information on patient centered care, interdisciplinary teams, evidence based practices, quality improvement, and informatics. Patient centered care involves the identification of and respect of cultral differences, values, preferences, and needs. Nurses who practice patient centered care collaborate freely with organizational decision makers and advocate for community wellness by promoting health education. To maximize the utility of evidenced based practices, medical professionals must also collaborate freely with interdisciplinary peers. For optimum patient outcomes, practicing care providers must also commit to continuing learning and the ongoing incorporation on new evidence based
The society’s outlook towards healthcare has changed radically over the past three decades. First, there is an increased emphasis on patient autonomy and self-determination or patient-centered medicine whereby patients are the focus of the clinical interaction. The belief that doctors know what is best for patients is fast diminishing. Secondly, there is also growing recognition that improvements in healthcare require collaboration among many different stakeholders, including patients. Thirdly, health is