Why the Patient's Perspective Counts

The adage that perception is reality has gradually invaded every sector of society, and healthcare is no exception.  In a time when adverse medical events are constantly appearing in media outlets, the role of the patient in these events cannot be ignored.  According to statistics, errors made by healthcare workers affect about 3-4% of patients (Oetjen, 2012).  Though this may still remain a small portion of healthcare patients, there is an increased urgency to diminish the amount of adverse medical events that occur each year. 

           

As Savitz and Bernard pointed out, medical errors now make up a significant portion of the quality of care problems that are seen in healthcare (1999).  These particular errors may be active errors, which are those that are readily observed which lead to immediate consequences.  A secondary form of medical errors is errors that are latent in nature, or involve problems in design, organizational issues, or a lack of training (Savitz & Bernard, 1999).  Whether the adverse medical event that a patient is involved in is characterized as an active or latent error, the patient plays an integral role in that medical event.     

The primary reason why the perspective of the patient is the most important determinant when it comes to adverse medical events is the fact that any allegation made by a patient that suggests that such an event has occurred must be quickly investigated.  Even in instances when the validity of such a claim is questioned, when a patient states that an adverse medical event has occurred, the healthcare organization must immediately investigate that claim and take further action if necessary.  The patient's perception of a medical event quickly becomes the reality of the event, whether positive or negative, for that patient.  Therefore, to ignore the perspective of the patient is to only bring further repercussions to the healthcare organizations. Additionally, now that more and more healthcare organizations are incorporating patient advocates, if a patient does not feel as though his or her opinion is being given proper attention, that patient may take further recourse until the patient feels that their claim has been justly investigated.  As such, it is in the best interest of the healthcare organization to acknowledge the perspective of the patient and grant the patient the attention that he or she deserves.  In doing so, the healthcare organization is not subjected to unnecessary scrutiny that could have been avoided if they had just listened to the patient when the issue began.   

Reference:

Oetjen, R. (2012). Impact of Quality on the Patient [PowerPoint slides]. Retrieved from   University of   Central Florida Webcourses Website: https://webcourses.ucf.edu/webct

/urw/tp0.lc4130001/cobaltMainFrame.dowebct

Savitz, L., & Bernard, S. (1999) Continuous Quality Improvement in Healthcare.   Gaithersburg, MD: Aspen Publishers, 211-225. 

Will Medical Homes Really Work?

In an age when health care expenses are growing exponentially, companies and healthcare organizations alike are examining every possible way in which to save money, while preserving quality care.  One interesting concept that is being adopted in both private and public sectors is this idea of establishing medical homes for patients.  The idea behind this concept is that a patient will be assigned to a team of healthcare providers that will coordinate their care.  The team may consist of a physician, physician’s assistant or nurse practitioner, nurses, and technicians.  Though this is a concept that is being adopted by many providers, the effect that it will have on the quality of care remains to be seen. 

Those in favor of this concept may make the argument that medical homes provide greater continuity of care for patients, due to streamlined care that is provided in a consistent environment.  Individuals in favor of medical homes argue the nostalgic effect of medical homes, where providers actually know the names of their patients, similar to days gone by when doctors still made house calls.  However, the argument could also be made that medical homes limit the patient’s ability to select providers, forcing them to receive care from members of their medical home, rather than having the flexibility to choose their own provider.  

In order to determine whether patients are receiving quality care in medical homes, the determination will have to be made as to whether quality is determined by the patient’s freedom of choice, or by the continuity of care provided.  Even TRICARE, the military health insurance program, has now adopted the concept of medical homes.  While it remains voluntary for some, other TRICARE sites have moved exclusively to medical homes (Miles, 2011).  Proponents of the medical home have said that this new model addresses the commonly held complaint that, especially for TRICARE recipients, patients rarely see the same provider, which forces them to oftentimes repeat the same basic information at each visit (Miles, 2011).  Whether medical homes will reduce healthcare expenditures, while maintaining the same quality of care, remains to be seen.  In the mean time, advocates of the medical home model are hopeful that improving the patient experience will in turn result in an improvement in the quality of care provided to patients.  

Reference: Miles, Donna. (2011, January 12). ‘Medical Home’ Concept Improves Care, Controls Cost. American Forces Press Service. Retrieved from: http://www.defense.gov/news/newsarticle.aspx?id=62424