[01.19] CMD - Patient-Centered Care and Shared Decision-Making V2.pdf

Integrated People-Centered Health Services

What does the acronym IPCHS stand for?

2016

In what year was the WHO IPCHS framework adopted?

Universal Health Coverage

Achieving what goal is considered the primary reason for adopting the IPCHS framework?

Disease- or institution-centric

IPCHS aims to shift healthcare away from being centered on what two things?

Comprehensive needs of people

What should healthcare systems be truly designed around according to IPCHS?

People at the Center

What is the overarching vision of a future where all people have equal access to quality health services?

Moving Beyond Silos

Which concept calls for shifting away from fragmented care models toward a holistic approach?

Fragmented and poor-quality healthcare

What global challenge does IPCHS aim to address as countries progress toward health coverage?

Engaging and empowering people and communities

Which strategic direction involves supporting people to take control of their own health and participate in policy decisions?

Strengthening governance and accountability

Which strategy focuses on building systems that ensure transparency, responsibility, and responsiveness?

Reorienting the model of care

Which strategy calls for defining service priorities based on life course needs rather than individual diseases?

Primary care-based systems

IPCHS emphasizes building what type of systems as the foundation of health delivery?

Outpatient and ambulatory care

Reorienting care involves a shift toward what type of settings where appropriate?

Coordinating services within and across sectors

Which strategy aims to reduce fragmentation by connecting healthcare providers with social services and housing?

Creating an enabling environment

Which strategic direction focuses on human resources, financing, and shared information systems?

Holistic and Life-Course Approach

Which characteristic considers physical, social, emotional, and spiritual well-being throughout a lifespan?

Co-production of Health

Which characteristic emphasizes an equal and reciprocal relationship between professionals and service users?

Continuum of Care

What term encompasses health promotion, prevention, diagnosis, treatment, rehabilitation, and palliative care?

Equity in Access

What is the term for striving to ensure everyone can access health services regardless of status?

Quality and Efficiency

Which IPCHS characteristic aims for safe, timely, and cost-effective care that avoids waste?

Person-centeredness

What foundational principle is considered a key component of systemic "people-centered health care"?

Respect for Patient Values, Preferences, and Needs

What is the bedrock component of person-centeredness?

Dignity, empathy, and without judgment

Person-centered care mandates treating every individual with what three qualities?

Tailored

Information and education should be what in relation to an individual's health literacy and learning style?

Primary care

What setting often serves as the central hub for a patient's healthcare journey?

Fragmentation

Seamless coordination across providers aims to minimize what?

Physical comfort and emotional support

Addressing pain management and alleviating anxiety are part of which core component?

Explicit consent and preference

Family and friends should be involved in decision-making only with the patient's what?

Continuity and Transition

Which component ensures smooth, well-supported movement between different care settings?

Timely, convenient, and equitable

Access to care involves ensuring access is what three things?

Empowerment and Self-Management Support

Equipping patients with knowledge and skills to manage their own health is known as what?

Self-advocacy

Person-centered care aims to foster what type of advocacy in patients?

Individual people in the context of their lived experiences

Moving from patient-centered to person-centered care represents an evolution to focus on what?

Patient-centered care

Which term generally refers to interactions specifically in visits or medical consultations?

Person-centered care

Which term refers to interrelationships over time?

Episode oriented

How is patient-centered care generally described in terms of its clinical orientation?

Part of life-course experiences

How are health episodes considered in person-centered care?

Management of diseases

Patient-centered care generally centers around what clinical focus?

Interrelated phenomena

How does person-centered care view diseases?

Number of chronic diseases

How is comorbidity generally viewed in patient-centered care?

Multimorbidity

What term is used in person-centered care to describe combinations of types of illnesses?

Distinct

How does patient-centered care view body systems?

Interrelated

How does person-centered care view body systems?

Professionally defined conditions

Patient-centered coding systems typically reflect what?

People's health concerns

Person-centered coding systems allow for the specification of what?

Evolution of patients' diseases

Patient-centered care is primarily concerned with the evolution of what?

Evolution of people's experienced health problems

Person-centered care is concerned with the evolution of what besides diseases?

Shared Decision Making

What is grounded on the combination of Evidence-Based Medicine and Patient-Centered Communication skills?

Evidence tyranny

Without Patient-Centered Communication (PCC), Evidence-Based Medicine (EBM) can turn into what?

Uninformed and unsafe decisions

Without EBM, patient preferences in shared decision making may result in what?

Medical evidence, Clinician's Expertise, and Patient's Values

What are the three elements of EBM practice that result in well-informed decisions?

Understand the patient's experiences and expectations

Which communication task involves identifying a patient's fears and expectations?

Build partnerships/relationships

Which task involves building trust and showing empathy?

Unconditional positive regard

What attitude should a clinician show for their patient when building a partnership?

Provide evidence including uncertainties

Which task involves being honest about the lack of available information?

Descriptions, numbers, graphics, decision aids, or analogies

What are five tools used to present evidence to a patient?

Present recommendations

Which task involves objectively presenting options, including risks and benefits, so the patient can decide?

Check for understanding and agreement

Which task asks the patient to summarize the reason for the decision?

Shared Decision Making

What is the collaborative process where doctors and patients jointly select treatments based on evidence and informed preferences?

Medical paternalism

SDM moves the consultation process away from what type of style?

Therapeutic alliance

SDM is based on what type of alliance between the doctor and patient?

Ultimate expression

Shared Decision Making is often considered what in relation to person-centered care?

Operationalization

SDM provides the practical framework for person-centered care, known as its what?

Bridge

SDM is described as the crucial what between clinical evidence and personal values?

Clinically sound and personally meaningful

SDM ensures the chosen treatment path is both of what?

Open, respectful, and two-way

What kind of communication does the SDM process necessitate?

Autonomy and Self-Efficacy

SDM inherently respects and enhances which two patient qualities?

Patient decision aids

What tools are frequently used in SDM to facilitate structured discussion?

Three-talk model and S.H.A.R.E. approach

What are the two specific models of SDM mentioned?

Three-talk model

Which SDM model is endorsed by the UK-NICE?

Team talk, Option talk, and Decision talk

What are the three steps of the Three-talk model?

Team talk

Which step explains the need to consider treatment options as a team?

Choice talk

What is another name for Team talk?

Option talk

Which step involves describing alternatives, risks, and benefits in detail?

Decision talk

Which step helps the patient make an informed decision based on personal preferences?

Agency for Healthcare Research and Quality (AHRQ)

Which organization promotes the S.H.A.R.E. approach?

Five

How many steps are in the S.H.A.R.E. consultation process?

Seek patient’s participation

What does the 'S' in S.H.A.R.E. stand for?

Help patient explore treatment options

What does the 'H' stand for in S.H.A.R.E.?

Assess patient’s values and preferences

What does the 'A' stand for in S.H.A.R.E.?

Reach a decision with patient

What does the 'R' stand for in S.H.A.R.E.?

Evaluate patient’s decision

What does the 'E' stand for in S.H.A.R.E.?

Current knowledge and insights

What should the physician explore during the "Seek" step of S.H.A.R.E.?

Patient education

What is especially important during the "Help" step of the S.H.A.R.E. approach?

Catharsis

Which part of the CEA method is noted as important for assessing values and preferences?

Set realistic goals

What is a key action when reaching a decision with a patient in the S.H.A.R.E. model?

Determine level of satisfaction

What is one objective of evaluating a patient's decision on follow-up visits?

CEA, SPIKES, and Motivational counseling

Which three techniques are useful throughout the SDM process for clarifying what is important?

Art and science

Communication in medicine is described as being both what?

Prepare, Practice, and Use models

What are three general strategies recommended for communicating with patients?

High-quality healthcare

Person-centered care is universally recognized as a fundamental dimension of what?

Improved Patient Experience and Satisfaction

Which quality outcome is a direct measure from the patient's perspective when they feel heard and respected?

Better Health Outcomes

Which outcome results from patients being more likely to adhere to treatment when care is co-created?

Increased Patient Safety

How does involving patients in decision-making and encouraging questions contribute to the medical environment?

Identifying misunderstandings and reducing medication errors

In what two ways does SDM contribute to patient safety?

Efficiency and Reduced Waste

Shared decision-making can lead to less invasive and potentially less costly choices, resulting in what?

Conservative and less invasive

In preference-sensitive conditions, SDM often leads to what type of treatment choices compared to traditional care?

Enhanced Provider Satisfaction and Reduced Burnout

How does practicing person-centered care affect the healthcare professional's well-being?

Meaningful patient interactions and reduced moral distress

What are two reasons provider satisfaction increases with person-centered care?

Reduced Health Disparities

By emphasizing individualized care and diverse backgrounds, person-centered care helps achieve what?