Learner Guide: Patient-Centred Practice 3A

Patient-centred practice (PCP) is an important part of providing health care in Canada.

In this unit, you will learn how patients and families experience patient-centred care and
how you can provide patient-centred care. You will also learn about patient advocacy
and self-care.

At the end of this session, you will able to answer the following questions:

ƒ What do patients expect from their healthcare providers?

ƒ What is patient-centred care?
ƒ What is self-care?
ƒ What is patient advocacy?
ƒ What do patients expect from you as an advocate?
ƒ Why might some patients not receive patient-centred care?
ƒ How is this approach to care (PCP) different from your experience and education
as a professional or as a patient?
ƒ What will you have to do differently in the future in order to provide patient-
centred care to your patients?

Preparation
ƒ Read the session materials, write down any questions you have, and bring your
questions to class.
ƒ Answer the reflective questions as you read.

Key Concepts for this Unit

h Patient-centred practice
h Self-care
h Patient advocacy

Orientation to the Canadian Health Care System, Culture and Context is licensed to
HealthForceOntario Marketing and Recruitment Agency.
Modification, copying or redistribution of any of the course materials is strictly forbidden
Learner Guide: Patient-Centred Practice 3A

Patient-centred Practice
In recent years, Canadians patients have become more involved in their own care. The
amount and type of involvement vary from one patient to the next, but at a minimum,
patients want to be kept informed of their progress and be involved in the decision-
making related to their care. Because every patient is different, it is important to learn the
most appropriate manner of handling care issues for each patient and recognize that this
will vary depending on the individual patient.

Patient-centred practice is an approach in which patients are viewed as whole persons

who are members of a family. A patient’s “family” can include his or her immediate family
members, friends, and even members of groups or communities that the patient belongs
to. Patients define for themselves who their family members are, and healthcare
providers must respect how each patient defines “family members.” The amount of
family involvement varies from one family to the next but, in general, families wish to
participate in the care of the patient in individual ways. In particular, families want to be
kept informed of the patient’s progress; they also want to be involved in decision-making
concerning the patient. The most appropriate manner for handling care issues is
determined through discussions with the patient and the patient’s family members. It is
important to clarify with patients and family members who they consider to be part of
their family.

Patient-centred care can also involve advocating on the patient’s behalf, for example, to
protect the patient’s rights or help the patient obtain needed information. Patient-centred
care also means respecting the patient’s autonomy, self-determination, voice, and right
to participate in decision-making.

Patient-centred care assumes that the patient is the expert on his or her own life, while
the health professional is the expert on healthcare issues. Patients may provide
information concerning cultural, spiritual, and personal beliefs about health care as well
as information about their personal situation. The health professional listens to the
patient while helping him or her reflect and determine what is important. As well, the
health professional can offer insights that the patient may not have previously
considered. A patient-centred approach begins with the patient’s own perspective.

Patient-centred practice involves developing collaborative relationships between

patients, their families, and health professionals, where each person’s role is determined
jointly rather than being dictated by health professionals.

What do patients tell us they want?

Patients want us to:
ƒ Treat them as whole persons, with physical and emotional needs and life issues.
ƒ Work with them as their partner.
ƒ Address the main reason for the visit as well as their concerns and their need for
information.

2 Orientation to the Canadian Health Care System, Culture and Context is licensed to
HealthForceOntario Marketing and Recruitment Agency.
Modification, copying or redistribution of any of the course materials is strictly forbidden.
Learner Guide: Patient-Centred Practice 3A

ƒ Help them identify their problem and agree on how to manage it.
ƒ Help them prevent illness and promote their health status.

What does that mean to us?

The values and beliefs that inform patient-centred practice are:
ƒ Respect- respecting patients’ wishes, concerns, and strengths.
ƒ Dignity- care for patients as whole and unique persons.
ƒ Expertise- letting patients be the experts on their own lives.
ƒ Patients as leaders- taking the lead from patients concerning decisions making
and the involvement and others.
ƒ Patient’s goals- allowing patients to define the goals that determine the work of
the healthcare team.
ƒ Continuity and consistency of care and caregiver.
ƒ Timeliness- acknowledging that the patient’s needs deserve a prompt response.
ƒ Responsiveness and universal access.

For some of us, these values and beliefs represent a major change in the way we
understand our role and interact with our patients.

How can you involve patients in their care?

Ask them! Here are some questions you can ask to find out how to involve patients in
their care:

ƒ What is more important to you?

ƒ What are your goals?
ƒ What are your concerns?
ƒ What do you expect from your healthcare team?
ƒ Who do you want to involve in your care?
ƒ What do you think your options are?
ƒ Is there anything the healthcare team should know?

What are the benefits of patients-centred practice?

When we work in a manner that is patient-centred, we see improvements in our
patients’:
ƒ Autonomy
ƒ Functional status

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HealthForceOntario Marketing and Recruitment Agency.
Modification, copying or redistribution of any of the course materials is strictly forbidden.
Learner Guide: Patient-Centred Practice 3A

ƒ Quality of life
ƒ Continuity of care
ƒ Health promotion behaviour

Reflective Questions #1
How might a patient’s cultural beliefs and practices influence the care that he or
she receives in a patient-centred care system? Give specific examples.

Reflective Question #2
Choose one of the values/beliefs listed above that inform patient-centred care.
Give a concrete example of how this value/belief might determine the type of care
you give to a patient.

Self-care
Self-care is all the things we do to take care of ourselves and keep ourselves healthy.
Self-care covers many different aspects of our lives and includes eating habits, sleeping
patterns, relationships, exercise, sexuality, knowing about community services, and
advocacy.

Every person is his or her own most important decision-maker in terms of both medical
self-care and health self-care because only the individual can attach a value to the
benefits or risks of the actions under consideration.

Everyone is involved in self-care differently. What people do to care for themselves is

influenced by both their personal situation and their culture. However, for everyone self-
care involves the capacity to act and make choices. Our self-care is affected by what we
know, what we can do, what we think is important, and what we think we can accomplish
in terms of caring for our selves. Self-care is both a goal of patient-centred practice and
condition required for patient-centred practice.

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HealthForceOntario Marketing and Recruitment Agency.
Modification, copying or redistribution of any of the course materials is strictly forbidden.
Learner Guide: Patient-Centred Practice 3A

Patient Advocacy
When you take on the role of patient advocate, you speak on behalf of your patients in
order to protect their rights and help them obtain needed information and services.
Health professionals and family members frequently assume the role of patient
advocate.

Reflective Question #3
What self-care do you and your family members practise to preserve and enhance
your own health? Is there any self-care that you think you should practise, but
don’t? In your opinion, how important it is that your patients practise self-care?

Reflective Questions #4
Think of a time when you have acted as an advocate for a patient. Describe your
actions and their outcome.

Summary
In the classroom session for this unit, we will explore patient-centred practice by
watching a video of a simulated encounter between healthcare providers and a patient.
We will also focus on how health providers collaborate to ensure patient-centred care.

To benefit fully from upcoming sessions, you will need to be familiar with the concepts of
patient-centred practice, self-care, and patient advocacy. Think about what these
concepts mean to you and how you can best integrate them with your previous
education and experience. You may be completely comfortable with this approach to
practice or it may be unfamiliar to you. We will explore this issue fully in the classroom.

5 Orientation to the Canadian Health Care System, Culture and Context is licensed to
HealthForceOntario Marketing and Recruitment Agency.
Modification, copying or redistribution of any of the course materials is strictly forbidden.