Person-focused Care

An expert geriatrician recently listened to my TED-like talk. That 15-minutes summarized 25 years of work. It covered why and how I consult with health care organizations. The work entails applications using 4 simple domains to think efficiently about patients and improve the care delivered. This geriatrician was a long-time used of these domains. (The domains’ plain names are Body, Mind, Activities, and Surroundings.)

“Wow, this is very polished.” Then he added, “Have you heard about person-centered care?” No, I hadn’t. “You should find out about it.”

The domains’ applications have evolved to improve individual patients’ care and be easy for clinicians to use. They support important themes – patient-centered care, health care literacy, self-management, and so on. What about “person-focused care”?

Good articles were easy to find.1 Among the core concepts are:

  • Individuals’ priorities or preferences for their care must be known.

  • The person’s care must be viewed over time, beyond the few days or weeks of an acute illness.

  • Added to the care of the patient (when an individual is sick) is an awareness of the whole person (the individual when not sick).

So too in our work:

  • Patient/person preferences are an explicit sub-domain.

  • The 4 domains remain consistent over a person’s lifetime regardless of health status. Health-related issues evolve within each domain.

  • The domains are extended to patients/persons through a health care notebook they own. To it clinicians and/or they add, over time, their key health-related information organized by the 4 domains (Health Issues, Taking Care of Your Mind & Feelings, What You Do, and Where You Live and Work ã). This Notebook helps bring important aspects of their personal lives more reliably into the clinical world.

Good… our work supports another important theme - person-centered care - in health care delivery.

1 Barbara Starfield, MD, PhD, a well-known professor in health policy, wrote about it in 2011 in The Permanente Journal. The American Geriatrics Society published an expert panel’s definition in 2016.

Christina Gleixner