Why Patient-Centred Care?

Patient-centred care is about treating patients as they want to be treated, with knowledge about and respect for their values and personal priorities. Health care providers who take the time to get to know their patients can provide care that better addresses the needs of patients and their support network and improves quality of care. A patient-centred approach allows patients greater responsibility over treatment decisions and recovery planning.

Employment is an important part of patient-centred care and recovery for people with mental health and addiction problems. Dr. Sean Kidd, a psychologist at the Centre for Addiction and Mental Health, is researching social entrepreneurship models that provide employment and address mental health disparities. The video Pathways to Wellness through Social Enterprise illustrates the role of meaningful work and supportive employment in recovery.

Definition

Patient-centred care, as described by the Insititute for Patient and Family-centred Care:

• Respect and Dignity: Health care practitioners listen to and honor patient and family perspectives and choices. Patient and family knowledge, values, beliefs and cultural backgrounds are incorporated into the planning and delivery of care.
• Information Sharing: Health care practitioners communicate and share complete and unbiased information with patients and families in ways that are affirming and useful. Patients and families receive timely, complete and accurate information in order to effectively participate in care and decision-making.
• Participation: Patients and families are encouraged and supported in participating in care and decision-making at the level they choose.
• Collaboration: Patients, families, health care practitioners, and health care leaders collaborate in policy and program development, implementation, and evaluation; in facility design; in professional education; and in research; as well as in the delivery of care.

Patient-centred care also:

• Advocates safety and promotes interventions that minimize or reduce potential harms to the patient
• Supports care plans that allow patients to express their self-identified needs and choices.

Balancing Risk

Patient-centred practices facilitate the development of strong therapeutic relationships and enable care providers to understand how to maximize patients' strengths and minimize challenges in achieving treatment and recovery goals. Care providers negotiate between patients' decisions and ongoing risk assessments. The care plan reflects safe practices and promotes interventions that minimize or reduce potential harms to the patient.

Principles of Patient-Centred Care

Patient-centred care involves practice built on the following principles:

• Patients' wishes, concerns, values, priorities, perspectives and strengths are respected.
• Patients are considered as whole, unique human beings, not as problems or diagnoses.
• Patients know themselves the best.
• Care providers follow the lead of patients around providing information, making decisions and involving others.
• Patients define the goals that determine the practices of the health care team. All team members support the patient in achieving these goals.
• Care is founded on continuity and consistency of care and caregiver.
• The needs of patients and communities deserve a prompt response.
• Care is universally accessible and responsive to patients' wishes, values, priorities, perspectives and concerns.
• Patients' rights are essential to good care.

Collaboration

Patient-centred care requires health care workers to collaborate with patients at four stages.

1. Identify concerns and needs

Initiate discussions or implement strategies to help you understand your patients' perspectives on their health and quality of life.

2. Make decisions

• Recognize that patients are the rightful decision-makers in planning care and services.
• Give patients what they need to provide informed consent about any proposed treatment.
• Spend time with patients to understand the situation from their perspective.
• Follow the lead of patients in terms of their desire to participate in decision-making.

3. Provide care and service

• Involve patients throughout the caring and service process.
• Acknowledge patients' expertise and encourage patients and communities to share their knowledge and skills.
• Respect and honour patients' choices and decisions.

4. Evaluate outcomes

Engage patients in evaluating care delivery and health-related outcomes.

Resources

Toolkits and Professional Education

Self-Management Toolkit: A Resource for Health Care Providers teaches professionals to support patients in becoming better managers of their health care. It was developed by the South West Community Care Access Centre and South West Local Health Integration Network in Ontario.

Resources for your patients and their families

Patient and Family Learning Space: An interactive hub for patients, families and the community to access reliable information about mental health, substance use and recovery.

Patient and Family Engagement at CAMH: learn more about resources for patients and families dealing with mental illness.

HeretoHelp is a project of the B.C. Partners for Mental Health and Addictions Information. It provides information for patients and the general public about mental health and addiction.

Health Education Fact Sheet (RNAO): Offers tips for preparing for a visit with a health care provider and what to ask during the visit.

Evidence summary

Kokorelias, K.M., Gignac, M.A.M., Naglie, G. et al. Towards a universal model of family centered care: a scoping review. BMC Health Serv Res 19, 564 (2019).
Registered Nurses' Association of Ontario. (2002). Person and Family Centred Care. Toronto, ON.