Nelson William A, Forcino Rachel C, Elwyn Glyn
Author Affiliations: Department of Medical Education (Dr Nelson), The Dartmouth Institute for Health Policy and Clinical Practice (Ms Forcino), Geisel School of Medicine at Dartmouth (Dr Nelson and Dr Elwyn), Dartmouth College, Lebanon, NH.
Health Care Manag (Frederick). 2017 Oct/Dec;36(4):342-346. doi: 10.1097/HCM.0000000000000186.
Health care organizations have embraced the concept of patient-centered care, but there is concern that the mere inclusion of those words in mission and value statements does not equate to implementation at the health care delivery level. Despite initiatives to align the patient-clinician encounter with broader patient-centered values, there have been mixed results, often creating a gap between practice and the organization's stated position. This preliminary study aims to assess the extent to which patient-centered values are reflected in actual patient care. The survey was sent electronically to Dartmouth's Masters in Health Care Delivery Science alumni, leaders in health care management. A majority of 49 survey respondents acknowledged the importance of patient-centered values to their organizations. However, 90% of respondents identified a gap between patient-centered values and day-to-day patient care. Thematic analysis of respondent comments showed a misalignment of organizational incentives with patient-centered care, a lack of leadership priority given to patient-centered values, and a failure to clearly define patient-centered values. Quantitative and qualitative data indicated that patient-centered statements represented rhetoric rather than the reality of patient care. Consistently achieving patient-centered care will require leaders to adopt a systematic approach to move beyond rhetoric.
医疗保健机构已经接受了以患者为中心的护理理念，但有人担心，仅仅在使命和价值观声明中包含这些字眼并不等同于在医疗服务层面的实施。尽管有举措使医患互动与更广泛的以患者为中心的价值观保持一致，但结果喜忧参半，往往在实践与组织声明的立场之间造成差距。这项初步研究旨在评估以患者为中心的价值观在实际患者护理中的体现程度。该调查以电子方式发送给达特茅斯医疗服务科学硕士校友，他们是医疗保健管理领域的领导者。49名调查受访者中的大多数承认以患者为中心的价值观对其组织的重要性。然而，90%的受访者指出以患者为中心的价值观与日常患者护理之间存在差距。对受访者评论的主题分析表明，组织激励措施与以患者为中心的护理不一致，对以患者为中心的价值观缺乏领导层面的重视，以及未能明确界定以患者为中心的价值观。定量和定性数据表明，以患者为中心的声明只是说辞，而非患者护理的现实情况。持续实现以患者为中心的护理将要求领导者采取系统方法，超越空谈。
