Person-centered care is becoming increasingly important in all care settings, as the U.S. Centers for Medicare & Medicaid Services continues to prioritize value-based care and individual care outcomes. In hospice care, this approach is in some ways even more crucial due to the nature of serving each individual at the end of his or her life.
What is person-centered care?
As defined by CMS, person-centered-care is “integrated health care services delivered in a setting and manner that is responsive to individuals and their goals, values and preferences, in a system that supports good provider–patient communication and empowers individuals receiving care and providers to make effective care plans together.”
In other words, the person or the patient and his or her needs drive the care plan. In this way, the patient can be viewed as a “partner,” says Jacque Lopez-Devine, RN, and Chief Clinical Officer at national hospice provider Gentiva.
“Person-centered care means treating the patient as an individual and treating them as equal partners in the business of caring, in the art of caring, and the science of caring,” Lopez-Devine said in a recent webinar hosted by Hospice News and Homecare Homebase.
The approach also means that the patient is empowered based on his or her needs.
“It’s personalized, and it refers to coordinated care that ultimately empowers the patient,” Lopez-Devine says. “It empowers them by informing them and keeping them involved in the care. It’s also recognizes that each patient has individual preferences on how they want to be cared for.”
How to achieve person-centered care
Through a vast array of experiences delivering hospice care to tens of thousands of individuals across the country, Gentiva and others have found success in delivering person-centered care by focusing on a few areas. These span culture, training and communication, to name a few.
Culture: Hospice care organizations, by the nature of the care they provide, often have a person-centered care approach as part of their culture. Reinforcing and developing that culture, however, is essential to ensuring it is delivered. It can also have additional benefits to the organization, such as staff retention and satisfaction, Lopez-Devine says.
“[Research shows] that operationalizing person-centered care in a long-term care facility resulted in less staff burnout, lower turnover, and a greater job satisfaction,” she says. A cultural shift back toward care planning as close to the patient as possible is another critical element, explains Donnette Threats, Director of Product Management – Hospice at Homecare Homebase.
“Care planning needs to move [more] to the bedside, and that can be a cultural change,” she says. “How do you rethink clinical documentation to ensure that you’re capturing what is being said and done in the EHR in a timely manner?”
Training: Despite the fact that it often is second nature to those delivering hospice care, person-centered care training can help reinforce principles around documenting as well as gathering information that is specific to the individual.
“One thing you may find is that you’re training your clinicians on how to listen, how to show up and how to make sure that as they’re doing their assessments, how they are assessing the whole person,” Threats says. “Are you there really looking at all aspects of care, what’s going on with the patient, what they’re saying, but even more importantly, what they’re not saying?”
Threats recommends training clinicians to actively listen and to know when to ask a question and when to pause.
“Yes, Homecare Homebase and other software provide tools, but you also have to teach your clinicians how to effectively use those tools,” Threats says.
Communication: Gentiva has developed several best practices specific to communication as it relates to person-centered care, which is particularly important due to the interdisciplinary nature of hospice care and the functions across the IDG team. The first is real-time communication.
“It’s a challenge for all of us in hospice care, but the real-time communication about intake, admissions, visit findings…. I can’t overemphasize how important and critical this is to the process of the care journey,” Lopez-Devine says. “Real-time communication leads to more timely updates to the patient’s plan of care. This creates confidence within the care team that the plan of care is up to date and in line with the patient’s current condition and wishes.”
Second, Gentiva focuses on communication around the expectation of who is doing what function across disciplines.
“It’s not just the nurse that touches the plan of care,” she says. “The other disciplines do as well. All the care team members have a unique perspective and role and it’s critical we’re clear on our roles and responsibilities.”
Finally, documentation of the process is essential, including what is expected of each role, including IDG meetings and the documentation process at large.
“I’ve found that when there’s that level of shared understanding, there’s a lot more collaboration, teamwork, and ultimately better patient outcomes,” Lopez-Devine says.
How technology supports the path to person-centered care
Accurate and timely documentation is a critical component of person-centered care, as individual needs may change over time during the course of care. Partnering with a technology platform that enables this real-time record and understands the goals of person-centered care can be an important differentiator.
“How can you use your technology to help, not only with the output but also help at the bedside?” Threats says. “Have you built your assessment in ways that they can help guide the discussion? Think through what you’re asking of your clinicians. Are you helping the clinician by prompting them as they’re going through that process? Your software can definitely help with that.” Make sure that as you’re implementing person-centric care you’re looking at every tool that they’re going to be using.
Technology also can serve as a framework for education on person-centered care, both in terms of internal processes and philosophies, as well as guidelines from CMS. Building clinical prompts into your documentation can also help your team support patient decision-making about his or her care plan — and support family members through that process as well.
“Make sure that your clinicians have the information and reminders they need in order to help patients make informed decisions,” Threats says.
This article is sponsored by Homecare Homebase. Homecare Homebase is a software leader offering hosted, cloud-based solutions to streamline operations, simplify compliance and boost clinical and financial outcomes for home-based care agencies. Our customized mobile solutions enable real-time, wireless data exchange and communication between field clinicians, physicians and office staff for better care, more accurate reporting and improved revenue cycle management. To learn more, visit hchb.com.