Potential Causes that Led to the introduction of patient and family-centered care initiative
Through a quest to identify the perception of patients regarding high-quality healthcare, the term ‘patient-centered healthcare’ was coined (in 1969) (Conway, 2006). The patient-centered healthcare model was therefore designed to address patient needs. By expanding the models of healthcare to better address patient needs in healthcare, the family unit was also included in qualitative studies. However, it should be understood that the entire concept of patient and family-centered healthcare developed from the growth of different segments of healthcare (Conway, 2006).
The most significant contribution to the growth of patient and family-centered healthcare occurred in the US when there was a strong need to synchronize family input and nurse healthcare in maternity services. Conway (2006) explains,
“Early in the 1980s, families of children dependent on technology who were living in hospitals sought to work in a more collaborative manner with health care professionals and successfully advocated for legislation that would enable them to care for their children in home and community settings” (p. 2).
By the late 80s, there was a lot of contribution from several surgeons in the US to promote a family-centered model that could synchronize the contribution of nurses and family members in healthcare provision (Conway, 2006). Primarily, these efforts moved from providing child-bearing women with family support to providing children with specialized needs, the same support. This shift was mainly motivated by the need to meet the emotional and psychosocial needs of children with special needs.
During the first years of applying the patient and family-centered healthcare model, a lot of focus was given to hospitals as the primary zone for the provision of such services (Conway, 2006). Many healthcare facilities, therefore, shifted their programs to allow for round-the-clock support of family members (to patients).
However, as the concept gained acceptance, patient and family-centered healthcare was not only limited to the hospital setting. Healthcare was given in different social contexts including the community setup and at home. By the late 80s, other healthcare segments such as the provision of healthcare services to AIDS patients also operated from the patient and family-centered healthcare model (Conway, 2006).
Another main contributor to the growth and acceptance of the patient and family-centered healthcare model is the approval and push for the concept, by consumer-led groups (in the late 60s and early 70s) (American Academy of Pediatrics, 2003). Different professional organizations also threw their weight behind legislation that was developed to support patient and family-centered healthcare. A combination of effective legislation and third-party support, therefore, saw an increased acceptance of the patient and family-centered healthcare model.
Over the past decade, the concept of patient and family-centered healthcare has quickly evolved (but it is deeply enshrined under the principles of collaboration). Conway, (2006) explains that “Patient- and family-centered care places an emphasis on collaborating with patients and families of all ages, at all levels of care, and in all health care settings” (p. 3). Furthermore, the same concept (of patient and family-centered healthcare) acknowledges that families are an important addition to the provision of quality healthcare and as such, family contribution is considered an ally of safety within the healthcare system.
Critical Analysis of Causes
This paper cites maternal care, the care of chronically ill patients and the care of children with special needs as the primary causes for the introduction of patient and family-centered healthcare. These health conditions were treated without much thought (in the past) because of limited information regarding the methodologies for achieving optimum success in patient care. However, today, many studies have shown that patient-care is holistic and there needs to be a complete paradigm shift in the way patients are treated (Kawasaki, 2005).
Indeed, when we look at maternal care, we see that the role of providing effective maternal care starts before the child’s birth to about the time when the baby reaches 12 or 15 months (Kawasaki, 2005).
The quality of the relationship between the mother and the child depends on several factors including physical care and emotional support. However, at the center of this analysis is the support that the mother gets while providing this care to the child. Concisely, we see that a mother’s care is subject to the support of other family members. For example, it is very important for the spouse of the mother to be present during all stages of motherhood.
This way, the mother feels cared for and she can reciprocate the same care to the infant. Research studies have affirmed that high stress levels can be caused by pressure from family members and in the long-term, such an environment can be unhealthy for the baby (Kawasaki, 2005). Therefore, the support of family members in maternal care is of utmost importance.
Assessing maternal care in the context of a specific organization is difficult. However, there are specific tools which can be used to achieve an accurate assessment. Conducting a survey on mothers who have received care in a hospital is an effective way of obtaining accurate information regarding the quality of care. This strategy is beneficial because it gathers the contribution of the patients (who are at the center of the study) (Kawasaki, 2005).
Taking care of chronically ill patients is also a sensitive matter in the healthcare sector. Indeed, this paper, sights the provision of care to AIDS patients as a key motivator to the adoption of family and patient-centered healthcare. Since most chronically ill patients suffer the risk of death, it is important to incorporate patient-specific healthcare services alongside the contribution of family members. Patients who suffer from chronic diseases such as cancer and AIDS usually also have high risk of developing depression-related symptoms which may further complicate their recovery process.
Mainly, their psychosocial wellbeing is affected by their medical condition and it therefore becomes difficult to solely depend on nursing care to provide an appropriate environment for recovery. Here, the input of family members provides the right moral support for healing (American Academy of Pediatrics, 2003). Analyzing the recovery rate for a healthcare institution (comparatively) is an effective way of assessing the impact of family-centered healthcare. Precisely, a high recovery rate (or low death rate) shows that family-centered healthcare has a positive impact on the patients’ health.
Finally, when we analyze pediatric care as an important cause to the establishment of patient and family-centered care, we see that there is not much difference with the previously discussed two causes. However, the main difference between pediatric care and the other causes is the fact that children often need parental care (especially during infant years) (American Academy of Pediatrics, 2003).
It is therefore almost impossible to institute quality healthcare in pediatric care if the parents (or other family members) are unavailable. More so, a mother’s care is very important. Carrying out an audit of the quality of care offered by the nurses is an effective way of analyzing the quality of care offered to small children (in a specific healthcare facility). This instrument has been proved to have a high efficacy level (American Academy of Pediatrics, 2003).
Implications
The implications of failing to observe patient and family-centered healthcare are spread across all stakeholders of the institution. For the hospital administration, there will be poor decision-making because of limited collaboration between the patient/family and the healthcare facility. This disadvantage will be informed by the fact that there will be a poor understanding of the contribution that family members can offer to the patient’s recovery process (American Academy of Pediatrics, 2003).
To the patients, there will be poor services given by the healthcare professions. Mainly, healthcare facilities which fail to include patient-centered (or family-centered) care do not approach the concept of healthcare comprehensively. The lack of a holistic approach to the provision of healthcare services therefore informs the low quality healthcare that patients are likely to suffer (Papps, 1994, p. 59).
To the community, there will be a sense of contempt for the services provided by the healthcare providers. More importantly, the community is likely to develop a bad attitude towards nursing services and other aspects of care given by healthcare institutions. Comprehensively, the community will feel their healthcare facilities are not addressing their needs or the needs of the patients (American Academy of Pediatrics, 2003).
To the hospital staff, a sincere sense of contempt is equally likely to develop among them. Indeed, the hospital staff is going to feel unsatisfied and unappreciated in their work because they will be giving a lot of effort to healthcare service provision with unsatisfactory results. Of all the stakeholders identified above, the biggest implication will fall on the patients. Patients will experience first-hand effects of poor quality healthcare and this may have a long-term impact on their health. However, the biggest burden of establishing a sound patient care plan rests on the hospital’s management.
References
American Academy of Pediatrics. (2003). Family-Centered Care and the Pediatrician’s Role. Pediatrics, 112(3), 691 -696.
Conway, J. (2006). Partnering with Patients and Families To Design a Patient- and Family-Centered Health Care System. Wisconsin: Institute for Family-Centered Care.
Kawasaki, M. (2005). Mothering With Breastfeeding And Maternal Care. Michigan: Universe.
Papps, E. (1994). How Do We Assess Good Nursing Care? International Journal for Quality in Health Cart, 6(1), 59.
