At its core, patient-centered care is defined as health care that establishes a partnership among practitioners, patients, and their families to ensure that care decisions respect patients’ needs and preferences and that patients have the education and appropriate support to help manage and participate in their own care. It is through this lens that the American College of Cardiology (ACC) over the last several years has focused on developing partnerships, programs and tools to help bridge the gaps that currently exist between clinicians and their patients or patients’ families to make patient-centered care a reality.
Nearly three out of four cardiologists (73%) strongly agree that patient participation in planning and decision making is important. Almost as many cardiologists (68%) also feel strongly that they are able to discuss preferences, priorities, concerns and goals with their patients and their families. But while there is a strong belief in having the patients play an active role in their care, less importance is placed on the significance and understanding of patient satisfaction/experience scores. Only one out of three (35%) cardiologists believe that capturing patient satisfaction scores is important to their practice. Even fewer (24%) understand clearly the distinction between patient satisfaction and patient experience.
"If everyone is moving forward together, then success takes care of itself." — Henry Ford
Furthermore, significant gaps exist in key areas involving what cardiologists view as a critical component of patient-centered care and what their practice is able to provide. The two most pronounced gaps are in the areas of care coordination and integrated/comprehensive team care. More than one out of four cardiologists (26%) feel that each of those areas are critical aspects of patient centered care that unfortunately are not being adequately achieved in their practice today. Additionally, one out of five cardiologists (20%) cite a need for more routine patient feedback and for clinical information systems that support high-quality care and quality improvement.
In terms of boosting their practice’s ability to provide patient-centered care, cardiologists indicate that increased time (73%) and reimbursement (66%) would definitely be helpful. Slightly more than half of practices (52%) also value having more patient education materials. In terms of what practices are most commonly providing to patients about their care, the top three items are educational materials (79%), printed materials (76%), and 3-D visual aide models (57%).
For today’s cardiology practice, the pursuit of effective patient centered care means confronting the difficult challenges of managing care internally within the practice team and with other care providers in order to get a clearer picture of the patient. It means having a robust and well-utilized pipeline of feedback/communication from patient to care team – a critical component not often in place at a majority of practices.
Compounding these issues is also a lack of clinical information systems that can help to provide high-quality care and quality improvement to enhance the cardiologist-patient relationship. Given the time and resource constraints facing cardiology practices, the goal of effective patient-centered care could seem unattainable.
To assist with this challenging situation, the ACC is currently developing methods and tools to infuse patient perspectives into its quality initiatives and educational programming and exploring the best way to form a patient advisory board to help with these efforts. Examples of these initiatives include credo (the Coalition to Reduce Disparities in CVD Outcomes), the Patient-Centered Medical Home (PCMH), “Hospital to Home” (H2H) and CardioSmart. Additionally, the ACC is exploring shared decision-making which is another patient-centered care model, where a patient is able to weigh the costs/benefits involved in their care and obtain further guidance in making optimal healthcare decisions, after receiving information from their physician. So, while the road to patient-centered care is filled with challenges and lofty expectations, by understanding the varied perspectives and developing products which can effectively improve practices, the ACC is truly seeking to assist cardiologists and the entire care team in reaching this goal with their patients and families.