Patient- and Family-Centered Care: It's Not Just for Pediatrics Anymore

Abstract

Patient-and family-centered care (PFCC) is changing the way hospitals provide patient care, increasing staff satisfaction, decreasing costs, and improving patient outcomes [1, 2]. Although hospitals make unique, organization-specific PFCC principles, all of them tend to endorse similar core values by recognizing the importance of family members' roles in individual patients' health care experience, establishing relationships with and supporting patients and families, and helping patients discover how their own strengths and weaknesses influence their health and health care. When patients' needs are prioritized, they engage in treatment and the treatments are more effective [1-4]. Hospitals where PFCC is part of the organizational culture find not only that patient, family, and staff satisfaction ratings significantly increase, but also that patients' health outcomes improve [2, 5]. Implementation of PFCC is also correlated with a decrease in patients' emergency department visits, faster recovery, and decreased utilization of health care resources [2, 6-7]. PFCC has become widespread throughout health care [6, 8-12]. The PFCC concepts of patient-physician collaboration and treating the patient as a whole person are not new. Fifteen years ago, the Institute of Medicine (IOM) semi-annual report, Crossing the Quality Chasm [8], included PFCC as an initiative to improve quality in the list of ten rules for redesigning health care [13]. The IOM report emphasized the need to involve patients in their own health care decisions, to better inform patients of treatment options, and to improve access to information [8]. PFCC provides a holistic approach to patient care, including psychological, spiritual, cultural, and emotional considerations that contextualize experiences of illness or injury and go beyond a focus on disease processes only [1]. The term " family-centered " does not remove control from competent patients to make decisions concerning their own health care [11]. Instead, this concept emphasizes that a patient's health care decisions should be contextualized in terms of a patient's broader life experiences. This term also recognizes the role a patient's family members play in extended and at-home care planning and care giving.