Need For Patient-centered Care Research Articles

CPhA and other health care professions

The results of a 2010 survey of CPhA members revealed that one of the most highly valued roles for the CPhA to play was to represent the perspective of pharmacists to other health care professionals. This was an astute observation—pharmacy represents one piece of a very complex health care puzzle, and so strengthening relationships with Canada’s physicians, nurses, dentists, mental health workers and other practitioners is a key step towards improving real interdisciplinary care across Canada. The CPhA devotes a great deal of effort to engaging with other health care providers to provide pharmacists’ views on key health-related issues. Contacts with other health provider organizations have allowed the CPhA to build coalitions on key issues, strengthen and promote the role of the pharmacist and advocate more strongly with governments on the need for patient-centred care. Ongoing dialogue with the broader health community also helps provide valuable intelligence and information on developments of interest and concern to the pharmacy community. Although examples of engagement with other health care providers occur on a daily basis, here are some noteworthy instances of recent interdisciplinary efforts: Following decades of resistance to increasing scopes of practice for pharmacists, more recent statements by the Canadian Medical Association (CMA) have promoted the idea of enabling allied health professionals such as pharmacists to practise to the full extent of their training and ability. As a leading member of HEAL, a coalition of 40 health provider organizations, discussions have already begun about positioning and messaging for the 2015 election, in an attempt to have the parties discuss relevant issues surrounding health care. Through its strong partnership with the Canadian Nurses Association (CNA), CMA and the Health Action Lobby (HEAL), the CPhA has been a contributor to the Council of the Federation’s effort to promote team-based models of care throughout Canada, with an eye to ensuring that models of care include pharmacists where warranted. There have been weekly discussions and updates between CPhA, CMA, CNA and HEAL representatives to update each other on the progress of the Council of the Federation and relevant developments. The Canadian Medical Association and CPhA will shortly issue a joint policy statement on the need for e-prescribing in Canada, which will speak to the benefits of and need for investment in e-prescribing. We also work with other health provider groups to advocate for greater progress on the implementation of electronic health records in Canada. The CPhA is a leading member of the G-7, a group of 7 allied health professional organizations that discuss issues relevant to our joint sectors. Recent discussions within the G-7 have helped inform efforts by pharmacy to advocate with third-party insurers for better coverage of pharmacy-related services. The CPhA led an effort among 8 national health provider organizations to oppose federal elimination of supplemental health benefits for refugees. These efforts helped restore supplemental benefits, including pharmacy benefits, to approximately one-third of refugees in Canada. Although not directly advocacy related, the therapeutic information provided to other medical practitioners via CPhA’s various publications and products (e.g., the Compendium of Pharmaceuticals and Specialties, Therapeutic Choices and e-Therapeutics+) is an invaluable source of information for practitioners on evidence-based drug therapy. One important note is that our partners in other health organizations recognize the key role and contribution that pharmacists play in the health field. They recognize the accessibility, the relevance and the expertise that pharmacists bring to the health system, which is why the CPhA is called upon so frequently to discuss and participate in issues of relevance to the Canadian health care system. Although this is not an overly visible or celebrated function of the national association, it is a responsibility that the CPhA takes very seriously and will continue to prioritize in the years to come. ■

Exploring Care Transitions From Patient, Caregiver, and Health-Care Provider Perspectives

Care transitions involve coordination of patient care across multiple care settings. Many problems occur during care transitions resulting in negative patient outcomes and unnecessary readmissions. The purpose of this study was to describe the experience of care transitions from patient, caregiver, and health-care provider perspectives in a single metropolitan Midwest city. A qualitative descriptive design was used to solicit patients', caregivers', and health-care providers' perceptions of care transitions, their role within the process, barriers to effective care transitions, and strategies to overcome these barriers. Five themes emerged: preplanned admissions are ideal; lack of needed patient information upon admission; multiple services are needed in preparing patients for discharge; rushed or delayed discharges lead to patient misunderstanding; and difficulties in following aftercare instructions. Findings illustrated provider difficulty in meeting multiple care needs, and the need for patient-centered care to achieve positive outcomes associated with quality measures, reduced readmissions, and care transitions.

Men at Risk: Considering Masculinity During Hospital-Based Social Work Intervention

The needs of hospitalized male patients are often unrecognized and unmet. Men occupy greater than half of all inpatient hospital beds and incur a broad array of illnesses and injuries at higher rates than women—yet often receive health care that pays surprisingly little attention to the concept of patient masculinity, or to masculinity's influence on the male patient's perspectives, behaviors, goals, interests, needs, and challenges. Little emphasis is placed on considering hospitalized male patients as men, understanding their need for patient-centered care within this context, and intervening in ways that regularly allow strengths to be adequately recognized and utilized. In this article, we explore how hospital social workers can reconsider masculinity as a vibrant and formative component of male patients' lives and actively view its characteristics as comprising more than just potential challenges to medical treatment—but also as untapped sources of resilience and strength.

Understanding Clinical Work Practices for Cross-Boundary Decision Support in e-Health

One of the major concerns of research in integrated healthcare information systems is to enable decision support among clinicians across boundaries of organizations and regional workgroups. A necessary precursor, however, is to facilitate the construction of appropriate awareness of local clinical practices, including a clinician's actual cognitive capabilities, peculiar workplace circumstances, and specific patient-centered needs based on real-world clinical contexts across work settings. In this paper, a user-centered study aimed to investigate clinical practices across three different geographical areas-the U.K., the UAE and Nigeria-is presented. The findings indicate that differences in clinical practices among clinicians are associated with differences in local work contexts across work settings, but are moderated by adherence to best practice guidelines and the need for patient-centered care. The study further reveals that an awareness especially of the ontological, stereotypical, and situated practices plays a crucial role in adapting knowledge for cross-boundary decision support. The paper then outlines a set of design guidelines for the development of enterprise information systems for e-health. Based on the guidelines, the paper proposes the conceptual design of CaDHealth, a practice-centered framework for making sense of clinical practices across work settings for effective cross-boundary e-health decision support.

Compassion and Cultural Transformation in Chronic Pain

Compassion and Cultural Transformation in Chronic Pain

The Use of Humor to Promote Patient-centered Care

Medical practitioners and scholars are increasingly seeing the need for patient-centered care (PCC) which emphasizes both medical and emotional needs, patients’ reasons for seeking care, and the enhancement of the patient–provider relationship. This ethnographic report examines the use of humor as a means to promote PCC within a hospital unit designed to encourage therapeutic humor. The three distinct themes emerging from this study have implications regarding the use of humor to help facilitate PCC. The three themes are (a) taking a complete patient profile, (b) freeing patients from the label of “bad patient,” and (c) de-emphasizing power disparities.