Improving quality and safety through partnerships …

1 Improving quality and safety through partnerships with patients and consumers Australian Commission on safety and quality in Health care 2011 This work is copyright. It may be reproduced in whole or part for study or training purposes subject to the inclusion of an acknowledgement of the source. Reproduction for purposes other than those indicated above requires the written permission of the Australian Commission on safety and quality in Health care , GPO Box 5480 Sydney NSW 2001 or 978-0-9870617-1-3 Suggested citation: Australian Commission on safety and quality in Health care (2011), Patient- centred care : Improving quality and safety through partnerships with patients and consumers, ACSQHC, discussion paper is available on the Commission s website: Page iIn a large and complex health care system striving for The patient- centred approach to health care treats each !

2 " A patient- centred approach makes care safer and of ethical imperative involving patients in their own care and in the planning and governance of the health # skills and capacity to involve and engage patients and Foreword $ % & ' & * W J Beerworth ChairmanPage ii PATIENT- centred care : Improving quality AND safety through partnerships WITH patients AND CONSUMERS# +/ ; # +< Advisory Committees= > ' +? patient- centred careF$ " % +? +J K & +JImproved complaints processes 20 Engaging patients in safety improvement 20M =+ to facilitate partnershipsPatient and carer engagement in personal care 22 Patient and carer engagement 23 at the governance levelM =>U% =># => ; =VX =V strategies =Y =Y' =Y# =/ Z # =< [ \ [ M = V ' =< organisations] \ ^ * =< \ =?]

3 K & =? K _ # # =?K =? [ =JForeword iExecutive summary 1 Summary of recommendations 2 Introduction 41 What is patient- centred care ? 6+ + # <+ = ` ?# ?K ?K ?_ ?z J+ { U J+ > K +| 2 Drivers, approaches and initiatives 12 for patient- centred care = + +{ for patient- centred care # +{ experience dataK +{_ +{= = K % +Y for patient- centred care # +Y; % +<` +<= { # +< and patient- centred care612 ContentsCONTENTS Page iii5 Making progress on patient- centred 46 care in AustraliaV + z & > < in health careV = K >?V { U >JV > ^ V| V| senior leadershipU V+ as partners` / V= & % V{ and environment$ V{ work environment' V> patient- centred care ' VV Acronyms and abbreviations 56 References 57 Appendix A Assessing organisational 63 readiness to implement patient- centred care +/ K Y> & =/ ] } YV An assessment tool for hospital and patient and family leaders ~ K_## =||?}}}}}}}}

4 Appendix B Select annotated bibliography 67 Appendix C Supportive resources 76 Appendix D Australian Charter 85 of Healthcare RightsAppendix E Australian safety and quality 87 Framework for HealthcareAppendix F Perth Declaration 90 for Patient SafetyIndex 9246 $ * # =J " _ =J3 The relevance of patient- centred 30 care to the Australian health system{ + {+ to a mixed healthcare system{ = {={ { {= promoting patient- centred care ' # \ z {=' _ & {{ for Health care \ {{ K \ # {> # ` {> _ & Z \ K {>_ # K ' {>' {V primary healthcare policies4 Current jurisdictional and 36 other activities in Australia> + X & {<> = ' K {? _ # # > { U% {?'# \ {? ] \ {J ` \ _ {J \ >| ' \ >| ` \ >| \ ; ` \ >+]' \ > +> > # >= ' # {/ # \ # >= $ K # >/ _ Z # >{ U ` z K !}}}}}}}}}}}}}}}}}}}}}}}}}}

5 # V/ _ & >{ ' [ K # Y/ K _ K >{# </ z K # >> Program# ?/ K >> ! 3036 Page iv PATIENT- centred care : Improving quality AND safety through partnerships WITH patients AND CONSUMERS ' # \ # ~ # & & /` X % ` ` K ` ` Z K The Commission also wishes to acknowledge the & Patient- centred care : Improving quality and safety by Focusing care on patients and Consumers # & & ` X % _ K # # & U / $ % # [ / # Z AcknowledgmentsEXECUTIVE SUMMARY Page + & & ' Australian Charter of Healthcare Rights Australian safety and quality Framework for Health care National safety and quality Health Service Standards ! ~ K ' _ & & ' for Improving patient- centred care is the expected K ' F " X \ & Z X $ & & ' " % service-oriented recommendations to foster patient- % K Research demonstrates that patient- centred care % ] & provider satisfaction increases and patient care % K & ' Z % +Patient- centred care is recognised as a dimension of Z Crossing the quality Chasm 2 % ' international organisations have also helped to develop K K & K _ # # Executive summaryPage 2 PATIENT- centred care : Improving quality AND safety through partnerships WITH patients AND CONSUMERSSYSTEM-ORIENTED RECOMMENDATIONSR ecommendation 1:K & Recommendation 2:' and comparison of patient care experience data in key Recommendation 3.]}}

6 K % recognised patient- centred care domains and assess F " Recommendation 4:F % " Recommendation 5: ' & & % Recommendation 6:K Summary of recommendationsRecommendation 7:U Recommendation 8:z & importance of patient- centred care to the health SUMMARY OF RECOMMENDATIONS Page 3 SERVICE-ORIENTED RECOMMENDATIONS\ % /Recommendation 9:U Recommendation 10:U Recommendation 11:` Recommendation 12:` Recommendation 13:K involved in governance to develop the necessary skills Recommendation 14:U \ FK # " Recommendation 15:U collection and reporting of patient care experience data Recommendation 16:U & % Recommendation 17:# & Recommendation 18:K Recommendation 19: Recommendation 20:_ & & satisfaction of staff as an integral strategy for Improving ] & & & Recommendation 21: % Recommendation 22:_ Page > PATIENT- centred care : Improving quality AND safety through partnerships WITH patients AND CONSUMERS & an overall framework that sets the strategic direction ' % The Australian safety and quality Framework for Health care contains strategies for providing care that is # < & ' Z & \ K & ' _ K % % ' ' " % ` !

7 ! 3' & =|+| # _ > of seven international health " \ & =||? |J ' " V It Y If health care skills and capacity of health professionals as evidence =|+| ' \ Z Australian safety and quality Framework for Health care < & ' & recognition of the importance of placing patients and & ' # \ # ~ # & IntroductionINTRODUCTION Page V M U \ ' arise as to whether the lessons learned and approaches # ' =|+| & % _ # & & Patient- centred care : Improving quality and safety through partnerships with patients and consumers & & who want to re-orient their systems and practices to # _ & & and examples of how to take a more patient- centred ' % ! ' ' % ] F " Australian safety and quality Framework for Health care F " =||J F " ^ ' emphasise the formation of partnerships and the & # ' Carer Recognition Act 2010 ?

8 ' concept of patient- centred care covers partnerships * & services more patient- centred and to integrate patient- + = % & { % ' > ' ' V ' & & & & on the evidence for patient- centred care and a list of This section provides an overview of the concept of patient- centred care as a 1 WHAT IS PATIENT- centred care ? Page <K % " care effectively for patients is compromised if they do +{^ & ' leading organisations promoting strategies for patient- = V ] \ ^ * ~]\^ F " F " z " % & +> WHO states that recognising responsiveness as an intrinsic goal of health systems reinforces the fact that health systems M +V (cited in Goodrich and Cornwell+Y / & involvement of family and friends of care respect for patient needs and preferences CONCEPTS OF PATIENT- centred care +| Z +JJ{ K & !)}}}

9 \ Z eight dimensions of patient- centred care that were through the Patient s Eyes: Understanding and Promoting Patient-Centered care .++ / " physical comfort coordination of care the involvement of family and friends & " K & % +=The concept of patient- centred care clearly recognises K F " JPage ? PATIENT- centred care : Improving quality AND safety through partnerships WITH patients AND DEFINITIONS OF ASSOCIATED TERMS F " ' Consumer- centred care F " F " & _ F " F " need to engage people as partners in health service =+ F " F " F " 22 Person- centred care F " F " F " F " 23 and ={ => =V =YPersonalised careFK " " FK " =<Family- centred care F " M +J?| & =? Z " M F " =J {| U # +< (cited in International Alliance K " ^ * +| z +? / informing and involving patients eliciting and respecting patient preferences engaging patients in the care process treating patients with dignity not providers ready access to health information ' ' K " ^ * +| While & " ~ Z \ " & +| =||| * ' Y> =J % K K & +J F " 20 Carer experience of patient- centred is an attitude that is innate in most practitioners particularly in those that give direct and personal service; [it is] an empathy with the patient and [an ability] to stand in the shoes of the patient, particularly those who, because of old age or disability, cannot answer back.)}}

10 [It is] an inherent attitude that can instinctively consider how another person will react when addressed in words or by some deed. An attitude which accepts that the patient has a mind as well as a received in the consultation on the draft patient- centred care discussion paperWHAT IS PATIENT- centred care ? Page J] & ~'Z {< >| One 'Z & >|^ % >+ >= >> >V >{ >Y improved adherence to treatment regimens> < >= >{ One and the responsiveness of medical staff were & 33 In & & & % >?' & >J V+ V= V{ greater patient satisfactionV| V= and greater V|U % >Y % M ^ % M & V> % F " " & 30 Relationship- centred care F " the importance of their relationships with one Fz " /+ personhood of the participants= of these relationships{ % > F " {+ {= EVIDENCE FOR PATIENT- centred CAREK / !}}}}}}}