Patient and family centered care improves healthcare services by building partnerships between the interprofessional healthcare team and patients. For patient and family centered care to be effective, good collaboration, communication and strong leadership must be present. This paper will discuss differing perspectives on patient and family centered care as well as the leadership required for satisfactory patient outcomes.
Patient and Family Centered Care
The Institute for Patient- and Family- Centered Care defines patient and family centered care as “an approach to the planning, delivery and evaluation of health care that is grounded in mutually beneficial partnerships among healthcare providers, patients and families” (Frequently asked questions, 2010). This definition is in line with the view of the case manager that was interviewed. The case manager felt that patient and family centered care is care that is a collaboration between health providers and the family that keeps the patient and family’s values and opinions in mind when making medical decisions (M. Morrison, personal communication, March 31, 2016). These views are not dissimilar from my own views that patient and family centered care involves a partnership between the patient, the family and the healthcare team and that the patient/family and their beliefs, values, needs and wishes should be kept at the forefront of the care we provide and should guide clinical decision-making.
Morrison states that she implements patient and family centered care in all aspects of her job. She feels that as a case manger her job is to take the information provided by doctors, nurses and other professionals in the healthcare team, in conjunction with the patient and family’s health outcome goals, and present it in a way that the patient and family can understand so that they can make fully informed decision on their healthcare (personal communication, March 31, 2016). According to Molony and Bouma (2013), in order for patient and family centered case management to work, all parties must have mutual care goals and must value the patient and what they feel is important at that particular point in their life (p. 79). In both of these views on the role a case manager plays in patient centered care, communication is at the heart of what is most important. If people do not communicate effectively or are not on the same page, successful collaboration can prove to be difficult.
Interprofessional Leadership
Patient and family centered care may involve many health specialties working in collaboration to provide the best care possible for a patient. When many different people are working together, there needs to be some sort of leadership provided so that care can move forward in a systematic way. Morrison felt that when working in a health care team that is focused on patient and family centered care the nurse should be the one that is in charge. Her reasoning for this is that nurses are specifically trained to deal with patients and provide information in a way that is relatable for the patient and also by virtue of the job, can relate with other healthcare professionals as well (personal communication, March 31, 2016). My own feelings match up with Morrison’s in that I feel nurses should take on the leadership role. My opinion is due to the fact that because nurses spend so much time with the patient and family we are able to get a nuanced understanding of a patient’s and family’s values and beliefs, which helps in making clinical decisions that are patient/family centered. This information is vital when all the health professionals come together to develop medical options for the patient.
When describing her own leadership style Morrison states that she likes to present the problem or situation and then take all opinions of the group into consideration when coming to a solution. This sort of style is most closely related to a democratic style of leadership. According to Giddens (2013), democratic leaders involve followers in the process of making decisions (Giddens, 2013, p. 376). This type of leadership is also called participatory leadership. The fact that as a case manager Morrison uses a democratic style of leadership is a bit unusual. In a study conducted by Zydziunaite & Suominen (2014), research showed that nurse mangers use an autocratic or bureaucratic leadership style when dealing with ethical dilemmas (p. 159).
There are many techniques or competencies that may be utilized when acting as a leader in a collaborative healthcare setting. Some of these include: knowing what you want to achieve, caring about the team, acting ethically and with humility, and acting with integrity (Ellis & Abbott, 2014, p. 98). Having a clear vision of what you want to achieve as is vital because a journey without a clear vision will leave teams feeling lost. Techniques that demonstrate care for the team would include listening well to what everyone has to say so that everyone’s ideas are heard, and asking good questions so that one is aware of what is going on. Some other techniques for successful collaboration would include following through on commitments, recognizing when good work has been performed. With all of these techniques, communication is essential. An effective leader always ensured that the instructions they send out are understood and that team members have the resources and ability to undertake the roles they are given (Ellis & Abbott, 2014, p.98). Some of these techniques I would take into my own practice would include: acting ethically with integrity and humility, practicing effective communication, listening to what team members have to say, following through with commitments and making sure I have a clear vision of what we are trying to achieve.
Conclusion
Successful patient and family centered care requires good collaboration, communication and effective leadership. When at its best, patient and family centered care can lead to better patient satisfaction and health outcomes. Because nurses spend a great deal of time with patients and their families, they are in a unique position to bridge the gap between healthcare and the patient. They can accomplish this by providing leadership to the interprofessional healthcare team as well as proving healthcare information at a level that is appropriate for the family and patient. For all of this to occur smoothly, excellent communication is of utmost importance
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