Improving Healthcare through Person-Centered Care: An Action Plan

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Contents
PART 1...................................................................................................................................................2
RATIONALE FOR HOLISTIC APPROACH IN HEALTH CARE...................................................................2
PERSON CENTERED APPROACH IN MENTAL HEALTH CARE...............................................................3
BARRIERS IN APPLICATION OF PATIENT CENTERED CARE..................................................................4
CHALLENGES IN INTERPRETING DIFFERENT LEGISLATION IN PCC.....................................................4
ETHICAL CHALLENGES IN PATIENT CENTERED CARE..........................................................................5
EFFECTIVENESS OF SAFEGUARIDNG SYSTEM IN MENTAL HEALTH CARE...........................................6
PART 2...................................................................................................................................................7
ETHICAL DILEMMA IN PATIENT CENTERED CARE..............................................................................7
INTEROGATE OWN EFFECTIVENESS IN PROVIDING PERSON CENTERED CARE..................................9
EVALUATE THE OWN AND OTHER’S PRACTICE IN ENABLING HIGH QUALITY CARE.........................10
PART 3.................................................................................................................................................11
ACTION PLAN FOR IMPROVING OWN PRACTICE.............................................................................11
ANALYZE PRACTICALITY OF OWN PLAN...........................................................................................12
IMPLEMENT OWN SHORT TERM PLANS..........................................................................................13
MONITOR OWN IMPLEMENTATION OF PLANS THROUGHOUT MAKING SUGGESTIONS.................14
ELABORATED ACTION PLAN AFTER EVALUATION............................................................................14
PART 4.................................................................................................................................................17
1.......................................................................................................................................................17
2.......................................................................................................................................................17
REFERENCES........................................................................................................................................18
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PART 1
RATIONALE FOR HOLISTIC APPROACH IN HEALTH CARE
Holistic approach is defined as the process of looking at the person seeking care as a whole
and providing an integrated care for his physical, mental, emotional, social and spiritual
needs. The holistic approach also means to take into consideration the family, environment,
childhood, emotions, stress, work and past experiences while formulating a care plan.
According to the American Holistic Health Association (AHHA) holistic approach is beneficial
in health and social care as it focuses on the patient as a whole person and how he or she
interacts with the environment and emphasize the connection of body, mind and spirit
(Tsianakas et al., 2012). According to Papathanasiou et al (2013), holistic approach and
holistic nursing are aimed at healing and caring for the individual based on bio psychosocial
model of health. This study aimed at examining the correlation between the theory and
practice based on link of the approach to the medical model of health. According to medical
model of health the integrity of each person’s mental, physical, spiritual, social, emotional
and psychological context of health and illness is important (Olsson et al., 2013). The
approach uses a respectful partnership between the patient and the practitioner and utility
of techniques for delivery of holistic care integrating all the aspects. Modern medicine as
developed segmented its ways in specializations and different sectors but the introduction
and identification of holistic approach provided clear view on how important is the holistic
approach in health and social care. The current model of care works on disease oriented and
focuses system where the disease is focused on and is treated as per the mechanical
malfunction of the body rather than the disturbance of physiological functioning of the
body. The current system do not focus on convictions of the disease o the person’s life but it
focuses mainly on the limitations it cause. Holistic medicine includes modern as well as
ancient and alternative medicine (Cottrell., 2017). The approach used mild to low alternative
therapies that guarantee effects only without hindering the natural process of the medical
model of care and if not than they are simultaneously linked with the modern medicine and
aimed at providing holistic care and focus. Holistic approach also helps in satisfying the
curiosity of the healthcare professionals regarding the potential and benefits of the
alternative therapies in regard to modern therapies (Grenness et al., 2014). Taking in
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relevance the medical model of care it can be well understood that human beings are not
just the functioning mechanical model but have multidimensional aspects to wellbeing that
is to be considered while planning their care.
PERSON CENTERED APPROACH IN MENTAL HEALTH CARE
Person centered care is defined as the delivery of an integrated care where the patient is
kept in the chief center of the entire system. The approach uses a phenomenon to involve
the patient and empower them in their own care planning that will promote better health
and recovery to the patient. Baird et al (2014), stated that the new current system of
introduction of patient centred evolving care homes are the upcoming approach in the field
of mental and behavioural health care system. The joint principles of PCMH are the sound
and liable principles towards which the system aspire. Since the initiation of the patient
centred care the inclusion of behavioural aspect to it is well known. Some of the principles
that are well included in the mental health care based on patient centeredness includes
personal physician model, physician directed medical practice, and whole person
orientation, integrated practice, quality and safety, and enhanced access.
Hensley (2012), examined the importance of the psychiatric rehabilitation linkage to the
patient centred care. Person centred care is the primacy approach that voice the concerns
and requirements of the individual in care. The mental health practitioners suggested that
not following patient centred care has made the field lack quality as they take away the
rights of clients to take decisions for their own health and voice their concerns. Researches
have made it evident that the person centred care is important in the delivery of mental
health care with including aspects of higher patient satisfaction, adherence to care
outcomes, experience of physical symptoms and sticking to the care regimes. The whole
concept of patient centred care is focused on the delivery of care that involves the
requirements of the patients and does not focus on the needs of the organization or the
provider in general (Eaton, Roberts and Turner., 2015). I mental health care empowering the
patient, giving them control over their care, considering their autonomy, respect and dignity
are essential. Patient centred care helps in maintaining these aspects and delivery high
quality care (Pulvirenti eet al., 2014).
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4

BARRIERS IN APPLICATION OF PATIENT CENTERED CARE
Moore et al (2017), examined various barrier that the health and social care practitioner
faces while delivering patient centred care in the care setting. The study developed a
qualitative framework using interviews where the participants were interviewed to provide
their perceptions regarding patient centred care and the factors leading to challenges in
delivery of such care. The results showed how the barriers to cover person centred care
covered three basic themes including traditional practices and structure, stereotypical and
sceptical attitude from the providers, and factors influencing the development of person
centred care (Marshall, Kitson and Zeitz., 2012). Professionals working according to the
traditional care pathways restrict the freedom and flexibility of the patient centred care
model and do not accept to do things differently as per new and contemporary approaches
in care (Ovretveit et al., 2013). The traditional values and ways followed by the individual
usually are the major challenges and barriers to change and delivery of person centred care.
Professional attitudes are major element that presents barriers in the delivery of new
policies and approaches. It was also seen that consciously or unconsciously practitioner’s
slips back into usual ways keeping aside new strategies of patient centeredness (Eaton,
Roberts and Turner., 2015). Professionals are needed to be trained and repeatedly
reminded of the new ways and approaches set as per the new policies to change their
stereotypical and sceptical attitude towards the professional delivery of services. Hence it
was concluded that the approaches and policies are majorly affected by internal as well as
external barriers that hinder the smooth delivery of care involving the individual’s attitude
to the resources and funding as well as training of the staff and the organization.
CHALLENGES IN INTERPRETING DIFFERENT LEGISLATION IN PCC
According to the Health and Social Care Act (2008), Regulation 9 the person centered care is
essential to be followed in health and social care setting. The main of this regulation was
that the individual in care and services are able to receive the services that are specialized
and individualized as per their needs. This regulation was set to make it a rule in health and
social care to be followed by the organization and professional to involve the patient in their
own care planning and produce a person centered care plan that is required for better
recovery and practice (Feo and Kitson., 2016). Some of the challenges that are faced while
interpretation of this legislation influencing patient centered care in practice is the lack of
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communication, partnership working, lack of training and unskilled staff. Person centered
care is the phenomenon where the entire concept works on better rapport building and
providing care with help of patient involvement and support.
Lack of communication between the client and the professional is the major barrier in
delivery of the patient centered care approach (Kerr, Lu and McKinlay., 2014). The health
care providers should be well trained and skilled to have excellent communication skills that
are used to communicate with the patients and involve them in the care process during the
planning, it is also important for them to identify the needs of the patient and address those
needs appropriately. Lack of partnership working is another barrier that disables the
effective interpretation of patient centered legislation (Ovretveit et al., 2013). The
collaborative working is a necessity for the health and social care function where patient is
kept in chief center of care. Lack of this team work will enable the individual to interpret the
phenomenon in an ill manner and provide challenges in proper implementation (Fox and
Reeves., 2015). Training and knowledge is another crucial element for delivery of optimized
care. Lack of training and knowledge will create the challenges for further interpreting the
laws related to patient centered care.
ETHICAL CHALLENGES IN PATIENT CENTERED CARE
Ethical challenges and dilemmas are the situations that are presented because of the
conflict of interest and issues that arise between the right and wrong of the practice. Many
of the times in the health and social care practice the issues arise where the options
regarding patient’s care are present and both the options provided are not competent
enough to address their needs individually. The health and social care staff in this case
undergoes dilemma (Olsson et al., 2013).
1. Conflict of interest
Usually during the delivery of person centered care the professionals work together from
different fields and they come together to promote common goal. During the delivery of
care with partnership working many of the times related to the situation off patient care the
difference of opinion occurs among the professionals and this creates dilemma for which
approach to be encouraged and whose opinion to be valued more. Such dilemma creates
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the difference between the teams and encourages difference within the practice that
compromises the quality of care (Cottrell., 2017).
2. Handling mental incompetent patients
During the delivery of mental health care most of the patients a nurse and doctor
encounters are having lack of mental capacity. These patients usually are eligible for mental
capacity act and are dependent for their decision making on the health and social care staff.
During this care process at times the patient human rights becomes subject of violation for
the delivery of the care that helps them in their management (Ovretveit et al., 2013).
Professionals come across the confusion of whether maintain the rights of individual or to
deliver care as per the plan.
3. Dilemma during the care delivery to the patient and their preferences of the choice for
care they require. Many of the times the healthcare professionals find it hard to explain to
the individual that what is good for their health and how the proposed interventions are
able to help them. In such confusion the healthcare professional encounters the dilemma to
whether maintain the patient’s rights or follow the protocol (Kerr, Lu and McKinlay., 2014).
EFFECTIVENESS OF SAFEGUARIDNG SYSTEM IN MENTAL HEALTH CARE
The safeguarding policies and protection laws are well formed and followed in the health
and social care of the UK. It is seen that as the system in UK is evolving and developing
towards more holistic and integrated care the safeguarding policies and protection laws are
strengthening. Also these laws are helpful in maintaining the integrity of the system and
allow maintaining and well implementation of the legislative requirements. The Health and
Safety at Workplace Act is the widely accepted legislation that aims at protecting every
individual in health and social care setting from any perceived or assessed risk (Feo and
Kitson., 2016). This regulation aims at protecting every individual in health and social care
setting as well as the mental health individuals from any harm and abuse. The Mental
Health Act is another legislation system that is effectively followed in order to maintain the
security and protect the mentally ill and incompetent individual from any harm and abuse
from the environmental stimulus. These systems are working effectively to ensure the
health and wellbeing of the mentally ill individual and safeguard their rights and respect.
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PART 2
ETHICAL DILEMMA IN PATIENT CENTERED CARE
Working in health and social care has developed my practice throughout years and I have
been focusing on incorporating person centered care in my current practice. Explaining how
the person centered care provides better results for the patient as well as professional I
have been developing a comparative account of my contributions towards the mental
health care and the primary health care services determining patient centered care.
Mental health care
Mental health care is one of the most important and crucial areas of care where the patient
is highly vulnerable and is to be handled in a very sensitive manner. My experiences in this
setting has been defined by inclusion of the three components of patient centered care
process that are respect and value of the patient’s expressed and identified needs,
coordination and integration of serviced and emotional support (Eaton, Roberts and Turner.,
2015). It was seen that majority of the patients that were present in the mental health care
unit were incompetent for their decision making ability and required assistant with their
routine tasks. To ensure this I used the person centered approach by identifying their
expressed and identified needs and tried to address those needs with my services. The
emotional support is crucial in mental health care and I try to provide the emotional support
by counseling and talk therapy that enhances the openness and rapport building with the
patients.
Primary health care
While working in the primary health and social care unit I encountered many cases that
were of young individuals and prone to drug abuse and overdose. In order to provide
competent and appropriate care environment to them the person centered care support is
provided by incorporating physical comfort, involvement of family with counseling and easy
access to care (Vincent et al., 2016). In primary health care it is important to have easy
access to care and this promotes better health. Involvement of family usually enhances the
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recovery and allows the patient to collaborate well with the new setting (Ovretveit et al.,
2013).
INTEROGATE OWN EFFECTIVENESS IN PROVIDING PERSON
CENTERED CARE
Person centered care is the approach that is included in my practice currently to enhance its
efficacy and outcomes. While a good health and social care professional follows the entire
legislative framework it is also one of the abilities to self-evaluate own practice for its
efficiency and scope (Ip et aal., 2013). While I evaluated my effectiveness towards following
person centered care I found that the practices that I follow includes some aspects of
person centeredness for example inclusion of the respect, dignity and rights of the
individual while planning the care, involvement of the patient in care planning, promoting
better health through assessing and addressing specific needs and managing the care
planning according to individual requirements. I also found that my practice requires
improvement in some areas where my skills are yet to be developed as per the high
standard care protocol. My conversation skills are good but it can be enhanced by attending
some programmes and training and be able to communicate better with the patients. I also
am competent in providing good emotional support to people while their significant life
events and stages, but I have to work on providing individualized and focused care (Feo and
Kitson., 2016). My services are also aimed at promoting the patient satisfaction and to
achieve that my goal is always to involve the patient and their families with the meetings
the team members have throughout the course for the care planning of the patient. The
collaboration between team members is the main element of patient centered care
(Cottrell., 2017). The team member’s efficiency and effectiveness is to be evaluated to
measure the quality of services. While managing my work load as a part of patient centered
care team I found that I was able to frame proper schedule and manage my time as per the
priority of my patient. I also could analyze that the effects of patient centered care was not
only on my patients but provided help to me by providing more collaborative working with
my team.
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EVALUATE THE OWN AND OTHER’S PRACTICE IN ENABLING HIGH QUALITY CARE
Patient centred care is the process where the individual receives high quality services as the
aim of service is focused at the individualized needs of the patient. In order to critically
evaluate the practices that enhance the quality of services in health and social care setting
the professionals utilize various strategies including self-reflection and evaluation (Siebert
and Walsh., 2013) The duty of a health and social care practitioner in ensuring high quality
services is to assure best policies, legislation and procedures for the patient’s care planning
with good communication, partnership and integrated service production. These aspects
enhance the quality of care and helps in achieving higher quality of services. The aspects of
patient centred care includes respect, values of service user’s needs, integration of services,
accessibility, continuation of services, physical comfort, involvement of patients and their
families, and emotional support (Pinto et al., 2012). These aspects of patient centred care is
achieved appropriately allows the delivery of high quality care. In order to achieve these
aspects in my services I try to include the code of conduct and ethical standards as well as
patient centred legislation in my practice. This helps me to improve the care planning and
services that I provide to the patients. According to Delaney (2018), inclusion of patient
centred care in the contemporary practice is the step towards enhancing the quality of care.
Patient centred care is categorized as a dimension of high quality care. Different legislation
are introduced in order to strengthen the effects of patient centred care in current practice
and provide better quality services to the individual.
Some basic recommendations that are to be made to improve the efficacy of this health
care system and evaluate the practices of professional includes regular monitoring and
regulation of the patient centred model in the health care system. Training and skill
enhancement of professionals for better inclusion of services with patient centred care
model. Developing and implementing policies and procedures for involving the patients and
families of the patients for better and individualized care. Focus on work environment,
workplace culture, setting and surrounding that should include patient centred care and use
it as integral strategy for improvement and enhancement. Also integration of accountability
is essential for this approach and can be measures to evaluate the effectiveness of services
as per the standards.
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PART 3
ACTION PLAN FOR IMPROVING OWN PRACTICE
To implement any practice into action a proper planning and organized way of
implementation is important. After evaluating my own practice I found that some of the
aspects of care that I provide require improvements and for this I would like to produce an
action plan with short, medium and long term goals.
Goal Resource Expected
outcomes
Evaluation Time duration
Short terms goal
To enhance my
communication
skills and achieve
better practice
outcomes
Effective
multitasking that
will help in
prioritizing my
work
I will attend
language
enhancement
programmes and
the training
sessions that will
help me enhance
my language base
and provide
better
opportunities for
skill development
Managing time
and prioritizing
the work
Using
communication
skills for the
better outcomes
and promotion
of patient
centred care
Working in
accordance to
the priorities of
the patients.
Evaluation
by self and
by
measuring
the
outcomes.
Teacher’s
mentors and
family
feedbacks.
6 months
Medium term goal
To enhance skills
for management
of clients and
providing them
emotional support
during their
Attending
seminars,
workshops, and
simulation based
programmes to
develop the skills
Communicating
well with the
clients and
learning about
their needs and
feeling in better
way using better
Feedback
from
experts,
counsellors,
and patients
1 year
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traumatic
experiences
skill
development
programmes
and observation
and simulation
Long term goal
To achieve a
qualification in
order to enhance
patient centred
care
Attending a
degree course in
order to achieve
better
qualification and
skills for the
delivery of patient
centred care.
The outcomes
are expected to
be developing
competency
within health
care setting t be
able to follow all
the health and
social care
policies and
legislation
regarding
patient centred
care
Teachers
mentors and
patents
feedbacks
3 to 5 years
ANALYZE PRACTICALITY OF OWN PLAN
The action plan set by me in order to improve my practice is developed to provide better
outcomes or the organization and the team at the workplace setting. As I work at mental
health unit the action plan needs to be well managed and focused on enhancing and
encouraging the wellbeing of mental health of the individual with parity to their physical
and social wellbeing (Kerr, Lu and McKinlay., 2014). The practicality of the action plan
framed can be evaluated by implementing the ideas and measuring its compliance with the
existing current scenario. Clarification of the goals and objectives is one way to measure its
practicality and developing the evaluation question and method on its base is the next
stage. Evaluating the actions taken up by own self to reflect on the whole scenario of before
and after implementation of services and its effects on the outcomes. Some easy steps to
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