Patient-Centered Care Model at Emory Healthcare Organization
Introduction
Human resources are facing numerous challenges as the workplace and organizations are evolving. Writing from the perspective of a human resource business partner at Emory Healthcare, continuous organizational development challenges have been experienced in the organization. The project will be performed at Emory Healthcare, located in the state of Georgia. The hospital is part of Emory University, and it is the most extensive healthcare system in Georgia. Its expansive network of over 250 healthcare centers makes it the ideal place to study the PCC implementation impact on service provision. Most entities are grappling with the disruption fostered by technology and new models (NEJM Catalyst, 2017). Hence, Emory Healthcare Organization must remain competitive through an organizational change towards an improved patient-centered model that is equipped with efficient provision of patients’ services and treatment. And this is the primary research problem that the project will address.
Research Questions
In what ways does the implementation of Patient-Centered Care impact the provision of patients’ services at Emory Hospital?
What is the patient’s perception of their experience at the hospital?
How will the implementation of Patient-Centered Care (new model) impact healthcare providers’ performance at the hospital?
In the Patient-Centered Care model, patients are the main subject of consideration. The project is scheduled to begin in late 2021 to 2023.
Literature Review
This proposal report will be based on grey and peer-reviewed literature. Previous published papers and reports will be searched purposivelysed specific areas for improving healthcare services in various hospitals. They propose that any healthcare facility must be safe, efficient, effective, equitable, timely, and patient-centered (Liberati et al., 2015). PCC entails providing respectful and responsive care to individual patients with considerations to their values, needs, and preferences and ensuring that clinical decisions are guided by patient values (Gusmano et al., 2015). Other publications and medical practitioners have also described patient-centered care as the care that seeks a collective understanding of the patients’ world which basically entails their emotional needs, life issues and personality (Liberati et al., 2015). PCC is also described as a care which explores the patients’ concerns and needs for information, enhances the relationship between the doctor and the patient, and enhances prevention while promoting health (Tzelepis et al., 2015). It further finds the background of problems and agrees mutually on its management.
Based on other scholars’ previous proposals, the central feature of the PCC model, is the patient-doctor relationship in the form of the two parties’ behavioral interactions. This relationship is hypothetically influenced by factors related to both parties and the interaction’s setting or environment (Berghout et al., 2015). These elements, however, are related to medical culture, health systems, and socio-cultural environment. Two broad streams are distinguished based on promoting and investigating patient-centered care. The first stream describes patient-centered care at the micro-level, focusing on the patient-doctor relationship (Berghout et al., 2015). The second stream describes patient-centered care at the macro level, focusing on a healthcare facility’s system and organizational perspectives (Berghout et al., 2015).
In the context of Emory Healthcare Organization and based on the inspiration from the two approaches, I propose a basic Patient-Centered Care model constructed around two layers. The first layer of the PCC model relates to the nature of the interaction between a health worker and the patient due to clinical encounters (Zhao et al., 2016). This relationship’s nature is determined by factors that aim to shape and improve healthcare providers’ attitudes and performance. The second layer of the PCC model relates to the organizational and structural element of healthcare services in which the relationship between the healthcare provider and the patient is taking place (Zhao et al., 2016). Both layers of this Patient-Centered Care model proposal will be constructed around a single unit or department in the hospital.
Methodology
Sample Section
The research’s primary aim is to identify how PCC’s implementation impacts the provision of services and treatment of patients at Emory Healthcare Organization. Qualitative and quantitative data will be collected to determine the impact of implementing PCC into the hospital’s healthcare system (Brannen, 2019). The study will also employ the use of the explorative design in its methodology. The qualitative approach of data collection will involve one-on-one interviews with the patients at Emory Healthcare Organization (Brannen, 2019). A randomly selected sample of 125 participants will be included in the research to collect information on the impact of implementing PCC in the medical facility. Sampling will enhance the accuracy of the information and reduce the overload involved in data collection (Brannen, 2019). The qualitative data collection method will involve random sampling of participants and conducting surveys with the hospital’s sole permission.
Data Capturing
The population of interest in the study will be patients that are receiving primary care services at Emory hospital. The main method of data collection for the qualitative data will be through the use of questionnaires, short interviews, and recording the verbal segments. The questionnaires will include open-ended and closed questions with the aim of exploring the feelings of the patients in regard to the care provided (Clark, 2018). Patient-centered care approaches such as discharge education, evaluation of cultural and spiritual needs, and emotional support during care processes will be used as the target intervention. The questionnaires will seek to explore the readiness of the care givers to provide care that is person centered and its impact on the satisfaction of the patients with the care processes. The short interviews will be useful in digging deeper into personal feelings on what could have possibly been done better.
Quantitative data of interest will be the patient care information in the electronic health records for the patients that will take part in the current study. The records will be reviewed to explore patient outcomes for correlation with the data obtained regarding patient-centered care. Of interest, will be the patient outcomes such as readmission, duration of stay at the facility, and the care outcomes attained before discharge and its maintenance after discharge. By analyzing these outcomes, it will be possible to directly compare the delivery of patient-centered care approaches to the outcome of the patient’s satisfaction. This will be helpful in showing if the interventions have met the targeted results.
The collection of data will adhere to the ethical requirements of research involving human subjects. Every participant will be educated on what exactly is being carried out in the research. Members will also be allowed to discontinue the participation based on personal preferences and choice. The data regarding the patients will also be reviewed with respect to the HIPAA regulations (Danielson, 2017). No patient will be identified by name and the use of a code for every participant will ensure that there is no chance of linking the information derived to the specific person. All the participants will be educated on what exactly will happen at each step of the research.
Data Transcription
Data transcription will be carried out on audio tapes and collated with the information presented on the questionnaires and the short interviews. Through the transcription process, it will be possible to capture information that was initially missed when recording the responses in the process of the interview. The transcription process will also make it easy to compare responses offered by different participants on the same topic. The patients will be briefed about the transcription as part of the research process. The data obtained will be confidential and only applied in the understanding of the variables identified in the current research.
The transcription of qualitative data will make it possible to compare results with those obtained following the quantitate data review. For instance, the data obtained in the interviews will need to be compared with the patient treatment outcomes. By making transcription notes of the interviews, it will be possible to show if there is notable impact in the attainment of the targeted outcomes such as low readmission rates amongst patients who have received discharge education.
Coding
The qualitative data will be coded further to ensure that the interpretation of the results was made easier for the researchers. In order to enhance the process of comparing findings, the data will be coded to capture common themes such as satisfaction with care and provision of necessary services such as discharge education. By providing a code for these variables, it will be easier to compare the data and capture deficits noted in the provision of patient-centered care. For instance, coding discharge education as green color and high satisfaction with care provided as red. It will be easy to compare if the patients who responded to have received variable green record higher levels of red.
The coding of the quantitative data will be conducted to ensure ease of comparison with the qualitative research findings. The codes will also be adjusted to ensure no conflict with the one selected for the qualitative data. For instance, by selecting code D for zero readmission rates, it will be easy to compare and correlate if patients who received service code green (discharge education), showed better achievement in the prevention of occurrence (D: readmission). The presence of the codes will make it easier to compare outcomes and establish a causal relationship with the identified service delivery approaches.
Analysis
Analysis of the qualitative data will mainly be carried through content review and the interpretation of the coded data. The main aim of the analysis will be to provide a correlation between the provisions of patient-centered care approaches and the rate of patient satisfaction. It will also aim at ensuring that there is a comprehensive understanding of the shortcomings present in the delivery of care. The interviews will be further summarized to capture the main points of concern for the patients and help Emory Healthcare Organization’s management in shaping the care delivery approaches to meet the expectations of the patients.
The analysis process will be based on SPSS (Statistical Package for the Social Sciences). The use of this application will make it possible to show the statistical significance in the attainment of the targeted patient care outcomes. It will make it easier to show progress in the achievement of target patient outcomes such as short hospital stay, following the implementation of patient-centered care approaches (Agha et al., 2018). It will be possible to show causal relationship between patient outcomes and the services provided by the primary care givers that aim at safeguarding patient-centeredness in care provisions. Through these results, it will be possible to shape the course of action to ensure support for the patients that ensures the best possible outcomes in the attainment of better health. It will also be possible to show if there are better patient-centered outcomes following implementation of patient-centered care approaches.
Current Situation
With the organization’s permission, data on general primary care, HIV/TB care, and maternal healthcare were assessed. Patients visiting Emory Healthcare Organizations receive low general primary care from healthcare providers due to effective patient-doctor relationships. As a result, patient trust in healthcare providers has been undermined. Some patients visiting the maternity section report some level of negligence and discrimination from healthcare providers even though many reported a positive response from the healthcare providers. Some individuals showcase a lack of confidentiality of information and ignorance of their needs and preferences. Some of the patients who visit the Emory Healthcare Organization report a low level of satisfaction attributed to healthcare providers’ poor attitude, lack of respect for patients, and long waiting times. Most HIV/TB patients reveal that they receive the utmost respect, care, and excellent services. However, a few individuals complain of mistreatment and lack of proper communication except for substantial psychosocial support. Structural and organizational constraints at the Emory Healthcare Organization may be due to inadequately qualified staff and weak information systems. Inadequacy of essential equipment may also contribute to the structural and organizational constraints of the medical facility. Underfunding may also be a factor in the offering of poor services to patients at the hospital.
The Way Forward
This section highlights the way forward to develop PCC at Emory Healthcare Organization following the proposed three-layered PCC model. The approach requires action at the individual patient-caregiver interaction level while addressing Emory’s organizational and structural constraints (Flagg, 2015). Different strategies and techniques employed in the implementation of PCC at the medical facility may have both positive and negative impact on healthcare providers and patients’ attitudes. The introduction of the new clinical methods at the organization is of greater scope and can capture people’s complexity. These PCC clinical methods focus on exploring patients’ ideas, concerns, and expectations (Agha et al., 2018). This method explains how one responds to medical advice based on their complex beliefs. Ideas in this context are rational thoughts perceived by patients about the cause of a physical and psychological phenomenon. These ideas of a person tend to induce health-seeking responses to the said individual. For instance, a patient who has had a severe injury on the hand may think it is broken and needs plastic surgery. Concerns are emotions that result from the psychological and physical perception of a patient. For example, a person becomes anxious due to pressure on the chest (Agha et al., 2018). The expectations of a patient depend on past experiences and beliefs about health services at the organization. Exploration of this PCC method will ensure effective implementation of PCC and patient satisfaction at Emory Healthcare Organization.
Similarly, PCC endeavors to stabilize healthcare structural and organizational systems, which will require communal support and participation. Investing in the primary healthcare system is a better approach to stabilizing Emory’s structural and organizational healthcare systems. Government support will also steward organizational and structural systems towards implementing PCC at the medical facility (Agha et al., 2018).
Results and Decision-Making
Decision-makers in Emory Healthcare include the owners, investors, and departmental heads. Healthcare providers at the medical facility and other healthcare hospitals are under pressure to implement a Patient-Centered Care model in the healthcare systems and their daily practice. Therefore, decision-makers at the Emory Healthcare Organization will identify determinants from the results that facilitate the implementation of the patient-centered care model. The study results address all the core elements of the patient-centered care model. Therefore, a few initiatives will be launched or adopted by decision-makers at Emory healthcare organization.
Human resource availability is perceived as the most critical resource in the organization due to its linkage with other resources such as finance and qualified healthcare providers and the fact that it can be influenced by the Emory Healthcare Organization (You et al., 2017). The results indicate that healthcare providers provide patient-centered care with good health and qualified experience. Decision-makers will, therefore, ensure that the healthcare providers’ needs are met to their satisfaction. They will foster their staff- healthcare providers’ well-being and provide an opportunity for continuous training and education to increase their staff members’ skills and expertise. For better service provision to meet patients’ needs to their satisfaction, it is paramount that the decision-makers highlight the recruitment of more staff into the organization, since it is an individual characteristic that is influenced directly by entity organization. Continuity of patient care within the facility is also crucial for consideration by the decision-makers. Due to healthcare providers’ work schedules, continuity of patient care, especially patient appointments with the healthcare providers, cannot always be ensured. Improving organizational and structural systems through enhanced information technology monitors patient and healthcare providers’ activities and stores, both patients’ and caregivers’ relevant information. This IT approach is an option in reducing the problem. Decision-makers will, therefore, need to discuss opportunities for improving IT structures within the entity.
Student Proficiency in Conducting Independent Research
Research requires a healthy plan of activities to engage in, which is present in the proposal. The use of appropriate sample that will not overwhelm the researcher is highlighted in the project, which is a clear indicator of the researcher’s preparedness in conducting the research. The choice of data collection methods is recommended to make the investigation credible and reliable when applying research. As a result, qualitative and quantitative data collection will deliver outcomes applicable and correspond to the investigator’s desire. Based on the grades scored in the previous courses relevant to the subject area of this proposal, I have the necessary skills to conduct this independent research. I have successfully completed a Master’s program of Science in Human Resource and Development. I had excellent grades in the following courses relevant to the subject area of the research proposal:
Subject Course Level Title Grade Credit hours Quality Pts GPA
HRD 8101 Graduate Art & Science Introduction to HR in Business World B+ 3 9.99 3.67
HRD 8102 Graduate Art & Science Critical Eval & Research Writing A 3 12.00 3.67
HRD 8003 Graduate Art & Science Financial & Human Capital B+ 3 9.99 3.44
HRD 8215 Graduate Art & Science Employment Law B+ 3 9.99 3.44
HRD 8419 Graduate Art & Science Foundations of Strategic HR B+ 3 9.99 3.44
PSY 8475 Graduate Art & Science Training and Development B+ 3 9.99 3.44
HRD 8006 Graduate Art & Science HR Analytics C 3 6.00 3.34
HRD 8213 Graduate Art & Science Total Rewards: Benefits A- 3 11.01 3.40
HRD 8214 Graduate Art & Science HR Technology A- 3 11.01 3.40
PSY 8875 Graduate Art & Science Organization Development A 3 12.00 3.40
HRD 8210 Graduate Art & Science Strategic Workforce Planning B 3 9.00 3.36
HRD 8212 Graduate Art & Science Total Rewards: Compensation B+ 3 9.99 3.36
Finally, the topic was chosen to deal with the current trend among most healthcare facilities to deliver quality healthcare among patients. A patient-centered model is a recommendable approach to improving healthcare quality among hospitals.
References
Agha, A. Z., Werner, R. M., Keddem, S., Huseman, T. L., Long, J. A., & Shea, J. A. (2018). Improving patient-centered care. Medical Care, 56(12), 1009-1017.
Berghout, M., van Exel, J., Leensvaart, L., & Cramm, J. M. (2015). Healthcare professionals’ views on patient-centered care in hospitals. BMC Health Services Research, 15(1), 385.
Brannen, J. (Ed.). (2017). Mixing methods: Qualitative and quantitative research. Routledge.
Clark, K. R., & Vealé, B. L. (2018). Strategies to enhance data collection and analysis in qualitative research. Radiologic technology, 89(5), 482CT-485CT.
Danielson, E. S. (2017). Privacy and the Past: Research, Law, Archives, Ethics. The American Archivist, 80(2), 488-490.
Flagg, A. J. (2015). The role of patient-centered care in nursing. Nursing Clinics, 50(1), 75-86.
Gusmano, M. K., Maschke, K. J., & Solomon, M. Z. (2019). Patient-centered care, yes; Patients as consumers, no. Health Affairs, 38(3), 368-373.
Liberati, E. G., Gorli, M., Moja, L., Galuppo, L., Ripamonti, S., & Scaratti, G. (2015). Exploring the practice of patient centered care: The role of ethnography and reflexivity. Social Science & Medicine, 133, 45-52.
NEJM Catalyst. (2017). What is patient-centered care? NEJM Catalyst, 3(1).
Tzelepis, F., Sanson-Fisher, R. W., Zucca, A. C., & Fradgley, E. A. (2015). Measuring the quality of patient-centered care: Why patient-reported measures are critical to reliable assessment. Patient Preference and Adherence, 9, 831.
You, J., Kim, J., & Lim, D. H. (2017). Organizational learning and change: Strategic interventions to deal with resistance. In Handbook of research on human resources strategies for the new millennial workforce (pp. 310-328). IGI Global.
Zhao, J., Gao, S., Wang, J., Liu, X., & Hao, Y. (2016). Differentiation between two healthcare concepts: Person-centered and patient-centered care. Journal of Nursing, 2352, 0132.