Abstract
AimThe objective of this study was to identify and synthesize models of patient-centered care in Canada and compare them with the normative models described in the literature.Subject and methodsPatient-centered care has gained momentum in the twenty-first century as a component of quality care. During the Covid-19 pandemic, the crisis often shifts the focus to the disease rather than the patient. The multiplicity of Canadian systems, including the federal, provincial, and territorial contexts, made a good case to search for a variety of models. This study was conducted using a scoping review method supported by an environmental scan to identify patient-centered care models in Canada.ResultsThe study identified 19 patient-centered interventions across Canada. The interventions included bedside interventions, patient-engagement projects at the organizational level, and citizen advisory panels at the system level. The organizational model was the most common. The goals of interventions ranged from enhancing the patient’s experience of care to identifying ways to cut costs. In most organizational-level projects, there was a marked tendency to engage patients as members of quality improvement committees. Respecting patient dignity and autonomy in one-on-one clinical interactions was minimally addressed in the models.ConclusionHealth systems are not only technical, biomedical organizations but also socio-political institutions with goals of financial protection, the fair distribution of services and resources, and the meaningful inclusion of the citizens in the system, and thus patients need to be respected as individuals and as collectives within the healthcare system.
Highlights
Patient-centered care (PCC) is an increasingly important component of quality healthcare systems
This study aims to review and critique some real-world models presented as PCC in the Canadian context and to offer recommendations to refine the concept
We started the review with the broad question: (1) What are the models of PCC in healthcare settings in Canada? This question supported the primary focus of this study on patient-centeredness within the Canadian health system
Summary
Patient-centered care (PCC) is an increasingly important component of quality healthcare systems. The Institute of Medicine defines PCC as “care that is respectful of and responsive to individual patient preferences, needs, and values” (Bergeson and Dean 2006). Researchers have proposed a number of normative models of PCC. Picker’s eight principles, aligned with Gerteis et al.’s (1993) dimensions of PCC are access to care, continuity and transition, involvement of family and friends, emotional support, physical comfort, information and education, coordination and integration of care, and respect for patients’ preferences (Shaller 2007). A scoping review of patient-centered approaches identified 25 unique PCC models emphasizing communication, partnership, and health promotion (Constand et al 2014). A narrative review of the literature on patient-centered models identified three
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