Client-Centred Rehabilitation - Arthritis Community Research ...

eyond other than allowing them to "choose,
somewhat, where they get their health care
needs fulfilled."(Myers, 1998, p.181) At the
system level, there seems to be a more
active involvement of patients, as some
hospitals have begun to borrow management
techniques from business; Chaplin described
the use of Quality Function Deployment to
capture the voice of the customer (Chaplin
et al., 1999, p.300)
Recently, some hospitals have adopted a
broader definition of client-centred care.
The Planetree model expands on the PFC
layout changes to establish environments
that are conducive to healing and account
for patient's emotional needs for comfort,
through the use of art and nature; Planetree
also stresses emotional support, patient
education, and patient and family
involvement in care (Lumsdon, 1996;
Weisman and Hagland, 1994; Damgaard,
1999; Planetree website). In addition to
their changes to the usual hospital layout
and procedures (Lumsdon, 1993; Weisman
and Hagland, 1994), Planetree centres have
implemented open-charting systems, in
which patients are allowed to review and
include their own comments (Damgaard,
1999). The Planetree model also calls for
medical resource centres with audio and
videotapes and easily comprehended reading
material on treatments, both traditional and
complementary (Damgaard, 1999).
However, as noted by Robin Orr, ex-director
of Planetree, although access to information
is intended to be the hallmark of Planetree,
there are few hospitals embracing this part
of the model (Lumsdon, 1993). Instead
many hospitals are restructuring their
organisation along the principles established
by Booz-Allen, while sometimes also
incorporating ideas on room and hall design,
and general consideration for patients from
Planetree (Mancini, 1995; Guinn, 1993).
2.4.2 Picker Institute: Patient-
Centred Care
17
The Picker Institute is an international leader
in the field of healthcare quality assessment
and improvement strategies. The
Picker/Commonwealth Program for Patient-
Centred Care was established in 1987. It is a
non-profit affiliate of Care Group in Boston,
Massachusetts. The Picker Institute’s
mission is to improve the quality of heath
care “through the eyes of the patient”. They
use a research-based approach to understand
issues that are most crucial to patients. In
addition, they assist healthcare providers and
organizations in developing patient-centred
approaches to providing care.
The term patient-centred care is used to
describe an approach that consciously
adopts the patient’s perspective (Gerteis and
Roberts, 1993). Picker grouped patient
concerns and care into eight dimensions of
patient-centred care.
♦ Respecting a patient’s values,
preferences and expressed needs
♦ Access to care
♦ Emotional support
♦ Information and education
♦ Coordination of care
♦ Physical comfort
♦ Involvement of family and friends
♦ Continuity and transition
These dimensions of patient-centred care
were developed through: an extensive
review of the literature; numerous structured
focus groups with patients, their families,
health professionals, and lay persons; pilot
interviews with patients and families; and,
intensive critiques by patients and health
care professionals. Patient-centred care
distinguishes itself from satisfaction surveys
by focusing on clinically important elements
of care.