Patient-and family-centered care has emerged as an important concept in healthcare during the second half of the 20th century, at a time of increasing awareness of the necessity of meeting the psychosocial and developmental needs of pediatric patients and of the role of families in promoting the health and well-being of their children. Considered as an extension of patient-focused care – a concept recognized in the early 1990’s where delivery of care was based on the needs of the patient, moving away from the traditional organizational focus – patient-and family-centered care simply took patient-focused care to another level, expanding to include the family in all levels of the planning and delivery of healthcare. Recognizing the central role that family plays in the patient’s life as their primary source of strength and support, this approach to care acknowledges that the perspectives and information provided by families and children are essential components of high-quality clinical decision-making. Patient-and family-centered care acknowledges that the parent and family have the ultimate decision-making power in regards to their healthcare and that the healthcare professionals are there to provide expert support and guidance to them as they proceed on this journey.
At the heart of patient-and family-centered care is the belief that healthcare staff and the family are partners, working together to best meet the needs of the child.
“Children whose mothers were involved in their post tonsillectomy care recovered faster and were discharged earlier than were children whose mothers did not participate in their care.”
It is not defined by a singular intervention or even a group of interventions, but instead a philosophical approach focusing on ensuring the best possible care and support is provided to patients and families. The practice of patient and family-centered care can only be productive so long as the healthcare professionals recognize the vital role that families play in ensuring the health and wellbeing of theirchildren. It is critical, therefore, that health practitioners acknowledge that emotional, social and developmental support are integral components of healthcare. Susan D. Block, Professor of Psychiatry at Harvard Medical School, emphasizes the importance of the art of negotiation in the hospital environment, where clinicians refrain from convincing patients and families to do what they want them to do, but rather focusing on being open to learning the patients and family’s perspective to create a common ground and to agree a mutually acceptable plan.
Terri L. Shelton, Association for the Care of Children's Health
begin to view our work with families as a partnership in which we are the consultants but the families are in charge, and it is on the care of their child that we are in fact consulting them. "
When successfully implemented, patient and family-centered care shapes healthcare policies, programs, facility design, evaluation of healthcare, and day-to-day interactions among patients, families, physicians, and other healthcare professionals. An accumulating body of research demonstrates that patient and family-centered care benefits everyone involved – patients, families, healthcare providers – and, moreover, these benefits are substantial. It is being increasingly accepted that such an approach produces better health outcomes, wiser allocation of resources, reduced medical errors and litigation, greaterpatient, family and staff satisfaction and improved medical/health education.
Kathryn E. Barnard, Center on Infant Mental Health and Development, University of Washington
"It was, in many cases, like a Martian speaking to an Earthman. Parents and professionals must find ways to understand each other's language."
The Institute of Family Centred Care’s 2009 publication highlights four core principles for the successful implementation of patient-and family-centered practice; dignity and respect, information sharing, participation, and collaboration. These principles have driven patient-and family-centered care to become the first of six priorities in the National Priorities Partnership’s (NPP) Action Agenda to Improve Healthcare, a report developed by a partnership of 52 major healthcare organizations within America, notably including The Institute for Healthcare Improvement, The Joint Commission International and the American Medical Association.
Robin B. Thomas, Seattle Children’s Hospital
The Four Core Principles of Patient-and Family-Centered Care