Safety And Quality Health Service Standards -Myassignmenthelp.Com

Question: Discuss About The Safety And Quality Health Service Standards? Answer: Introducation In the provision of healthcare, person-centred care (PCC) is the practice of patients caring and for their families in several ways that are valuable and meaningful for the individual patient. According to Institute of Medicine (IOM), treatment provided to patients that is responsive and respectful taking their values, needs and preferences into consideration where values of patients guide throughout all clinical decisions (Feinberg 2014). National Safety and Quality Health Service (NSQHS) Standards also explains that PCC is an important dimension of safety and quality where healthcare delivery is responsive to preferences and needs of patients (McCormack et al. 2012). In current literature, PCC is described as visit-based assessments that involve communication with healthcare professionals playing an important role in building relationships (Zhao et al. 2016). Therefore, the following essay uncovers the concept of PCC through patient interview linked to NSQHS and Registered Nurse St andards for Practice. PCC is different from patient centred care that former focuses on the accumulation of knowledge from patients and family members about needs and preferences over time and provides appropriate care regarding needs in the context of other needs (Carlstrm and Ekman 2012). Person-centred care demonstrates patient regarded as the person considering circumstances and standpoint for decision-making process (Eaton, Roberts and Turner 2015). This also extends beyond setting goals for the patient. PCC involves the doctor-patient encounter style characterized by specific responsiveness to preferences and needs of the patients using informed wishes guiding interaction, activity, information giving and participation in decision-making. PCC has health outcomes for patients and their family members. PCC interventions enhance the quality of care and self-care behaviour performances. In a study conducted by (Morgan and Yoder (2012) illustrated that communication that occurs during PCC is correlated with perceptions of patients helping them find common ground. Positive perceptions were found to be associated with fact and better recovery from pain and discomfort. During a visit, communication greatly influences the health of patients through perceptions especially when it is achieved through common good improving their health status and increasing efficiency of care and reduction of referrals and diagnostic tests. In a research, it was analysed that positive patient-centred care in a primary setting is associated with a decrease in healthcare services utilization (Munthe, Sandman and Cutas 2012). This is greatly associated with the reduction in annual medical care charges that is an important outcome in PCC regarding me dical visits. PCC has demonstrated a practical style that emphasizes on patient activation and reduction in care charges. Person-centred communication is associated with medical resources utilization demonstrating that patients who are patient-centred and perceived their visits have few diagnostic tests and referrals. The patient was admitted with the initial injury at the right toe that needed longer time to heal. The principles of PCC was applied in the given context to enhance the process of recovery. PCC carry out in settings encompassing visits. Interaction or communication is involved where the quality of interactions between healthcare professionals and patients that equate PPC with communication skills. Among fundamental component in care PCC is characterized by shared understanding, healing relationships, trust, emotional support, patient participation, activation, enablement and informed choices (Wildevuur and Simonse 2015). This is depicted in the patient interview that was undertaken during my current work placement at the rehabilitation ward. I interviewed a patient, Mr ABC, a 69-year-old male patient who is suffering from right below knee amputation (right BKA). The patients medical history depicts that there is non-healing wound @ R Leg, left 4th and 5th toe wound, type 2 diabetes mellitus (T2DM), underwent Stents Triple Bypass in 2009, Coronary Artery Bypass Surgery (CABS) in 2006, peripheral neuropathy, depression, hypertension and peripheral vascular disease (PVD). The patient is under a detailed health plan with ongoing physiotherapy, occupational therapy (OT) assessment, regular dressing of wound with more area infected on right side and monitoring of 4th 5th toe wound provided with weaning dose of Pregabalin. The patients social background depicted that he lived in a two-story building and was an ex-smoker until he gave up smoking in 2010. These details about the patient are important for patient-centred care in the provision of care. Before interview, informed consent was taken from the patient to know about his willingness to participate in the interview. As the infection of the patient spread throughout the legs, it is essential to provide patient centred care that was given to him in the orthopaedic ward. Hence, under the given situation, Mr..ABC were given the patient cantered care that was needed in the aspects of preventing further infection. As part of the PCC, the patient was given Knee Amputation treatment that are provided by the multi-disciplinary team. Regular family meetings were also held, which ensured that the family got proper information about the patient condition. They were also able to take part in the part of decision making process. This is believed to be a part of the education that are provided by the family as a part of the patient centred care. Through the education, it is also possible to promote the heath related facts to the patient family. Earlier, person-centred care was focused on the relationship between physician or care team and patient. In case of MR ABC, the same was provided to deal with the issues of anxiety and stress. This can also help to deal with the financial stress that are encountered by the family. This relationship is still integral. However, changes to healthcare system have taken place where broader factors are considered that also affect PPC and health experiences. The biopsychosocial model or framework as a paradigm that is used in PCC to understand the cultural and social environment along with the psychological impact that environment has on an individual as important as biological factors and genetics are important (McKay et al. 2012). This is the reason he social background of Mr ABC was asked. This person-centred model suggests using integrated patient knowledge within the ethical framework where patient's rights are respected and inculcate them in their provision of care. Five conceptual di mensions have been identified in biopsychosocial perspective comprising of patient as person, therapeutic alliance, and doctor as person and sharing of power and responsibilities (Hebblethwaite 2013). This perspective is crucial in understanding and honouring the needs and preferences of the patient and valuing their rights. Concisely, biopsychosocial model conceptualize illness and disorders as the interaction between hierarchical levels from biological to social to psychological levels. PCC uses five key principles; valuing people, autonomy, life experience, understanding relationships and environment. Valuing people suggests that healthcare providers need to treat individuals with respect and dignity and be aware of their supporting personal perspectives, beliefs, values and preferences (Munthe, Sandman and Cutas 2012). The healthcare provider and patient should listen to each other and work in partnership for designing and delivering healthcare services. Autonomy is the provision of choice, and there is respect for choices that are made that balances risks, rights and responsibilities. There is proper optimization of persons control as there is sharing of power and active participation in decision-making (Elwyn et al. 2012). This helps to maximize independence that is built on strengths, abilities and interest of individuals. Life experiences are the support that is provided to patients supporting their sense of self and understanding the importance of history of a patient until present-day experiences. This is greatly evident in the interview where the past medical history of Mr ABC was taken into consideration as it determines the plan of care and their hopes for the future. There is also understanding of relationships that make collaborative interactions between service provider and user, between staffing levels and their carers. Through local community, social connectedness is also promoted where one engages in meaningful activities. The environment encompasses organizational values underpinning the PCC principles. There is responsive support making healthcare provides responsive to individual needs. Organization-wide planning and efforts strengthen individuals and enhance organizational learning. These factors greatly help to guide PCC stimulating active consideration of persons preferences, needs and active participation in intervention selection, goal setting and have positive health outcomes. PCC has been recognized as a broad concept in high-quality healthcare provision. There should be safe, effective, timely, equitable and efficient quality of care for individuals by service providers. Care given should be responsive and respectful enduring that every needs and preference of individuals are governed. In the provision of quality of care, NSQHS suggests that PCC should be provided to individuals at every level of care. Patients experiences about the quality of care provided refer to the experience level where it is mandatory to provide care in such a manner where it should be respectful by careful demonstration of effective communication and sharing of information between service provider and user. The participation of patients and their families is greatly encourages and supported. At the clinical level, patients and their family advisors should also participate in the overall designing of services and programs. The members of quality improvement should take active part icipation in the program with redesigning of teams and participation in planning, implementation and evaluation of change (Entwistle and Watt 2013). At the organizational level, it is quite mandatory to include departments, services and programs for providing quality care. The patients and their families need to be encouraged to be fully active participants in organizational committees for designing and working of facilities for patient safety, patient or family education, quality improvement and research. At the environmental level, patients and their family members perspectives are taken into consideration informing local, federal, state policy agencies for program development. The reimbursements and expectations are set and incentives development encouraging and supporting engagement of individuals and their families in clinical decision making process in healthcare at all levels (Safetyandquality.gov.au 2012). PCC is greatly informed by Australian College of Nursing (ACN) and Nursing and Midwifery Board of Australia (NMBA) standards that promote professional behaviour and effective communication by nurses and midwives while communicating with the patient. Under the Principle 2 of person-centred care by ACN, there is recognition of power imbalances between nurse and person professional relationship in addressing the issue of supportive and collaborative practice in clinical-decision making (Safetyandquality.gov.au 2010). There should also be effective communication between service provider and user regarding health literacy. In PCC, health literacy between nurse and person is important and therefore, should avoid practices enhancing health literacy. For supporting shared-decision making, nurses should take PCC approach for the management of person's concerns in a consistent manner by preferences and values of person. There should be safe nursing practice that is supported by shared-decision making in the provision of care. The PCC model is based on healthcare providers knowledge, confidence and understanding of collaborative care in planning for person. ACN believes that PCC principle is central tenet that underpins delivery of health and nursing care. This nursing standard states that every person should be treated as an individual and it is nurses moral duty to protect persons dignity. While providing care, nurses should respect the preferences and rights of person (Ross, Tod and Clarke 2015). As person-centred communication is involved in PCC, there should be development of therapeutic relationship between care recipients and care providers that are based on mutual understanding and trust. The ability of a nurse in delivering PCC is determined by their attributes, nursing practice and care environment. There should be well-developed interpersonal skills, commitment to person care, self-awareness and professional values. Nurses should also demonstrate professional competence like skills, knowledge, values, attitudes and judgment. They should empower person in making informed decisions and care planning providing holistic care. Care environment elements should support PCC having appropriate staff mix and transformational leadership enabling effective nursing teams development with shared power, supportive workplace and effective organizations. Concisely, ACN supports healthcare organizations in designing and implementing policies that support PCC achieving balance between q uality of care and economic imperatives (Pope 2012). From the above discussion, it can be concluded that PCC is a high priority where the person is involved in the provision of care providing the high quality of healthcare. The provision of care put people at central tenant improving the quality of healthcare services available. This model takes into consideration people needs and preferences while providing care and empower them to become more active in decision-making process. The discussion also explains that PCC improves the quality of care and promote safety by improving the health of people and reducing the burden of disease. The core elements of PCC include access to care and practices conducive towards patient experiences emerged from medical, nursing and health policy literature. PCC is built on biopsychosocial model taking social, psychological and biological levels into consideration concerning health. ACN also believed in PCC and nursing practice is built on this philosophy of emphasizing and strengthening individuals in th e provision of care. References Carlstrm, E.D. and Ekman, I., 2012. Organisational culture and change: implementing person-centred care.Journal of health organization and management,26(2), pp.175-191. Eaton, S., Roberts, S. and Turner, B., 2015. Delivering person centred care in long term conditions.Bmj,350, p.h181. Elwyn, G., Frosch, D., Thomson, R., Joseph-Williams, N., Lloyd, A., Kinnersley, P., Cording, E., Tomson, D., Dodd, C., Rollnick, S. and Edwards, A., 2012. Shared decision making: a model for clinical practice.Journal of general internal medicine,27(10), pp.1361-1367. Entwistle, V.A. and Watt, I.S., 2013. Treating patients as persons: a capabilities approach to support delivery of person-centered care.The American Journal of Bioethics,13(8), pp.29-39. Feinberg, L.F., 2014. Moving toward person-and family-centered care.Public Policy Aging Report,24(3), pp.97-101. Hebblethwaite, S., 2013. " I Think That It Could Work But...": Tensions Between the Theory and Practice of Person-Centred and Relationship-Centred Care.Therapeutic Recreation Journal,47(1), p.13. McCormack, B., Borg, M., Cardiff, S., Dewing, J., Jacobs, G., Janes, N., Karlsson, B., McCance, T., Mekki, T.E., Porock, D. and Van Lieshout, F., 2015. Person-centredness-the'state'of the art.International Practice Development Journal,5. McKay, R., McDonald, R., Lie, D. and McGowan, H., 2012. Reclaiming the best of the biopsychosocial model of mental health care and recoveryfor older people through a person-centredapproach.Australasian Psychiatry,20(6), pp.492-495. Morgan, S. and Yoder, L.H., 2012. A concept analysis of person-centered care.Journal of Holistic Nursing,30(1), pp.6-15. Munthe, C., Sandman, L. and Cutas, D., 2012. Person centred care and shared decision making: implications for ethics, public health and research.Health Care Analysis,20(3), pp.231-249. Munthe, C., Sandman, L. and Cutas, D., 2012. Person centred care and shared decision making: implications for ethics, public health and research.Health Care Analysis,20(3), pp.231-249. Pope, T., 2012. How person-centred care can improve nurses attitudes to hospitalised older patients.Nursing Older People,24(1), pp.32-37. Ross, H., Tod, A.M. and Clarke, A., 2015. Understanding and achieving person?centred care: the nurse perspective.Journal of clinical nursing,24(9-10), pp.1223-1233. Safetyandquality.gov.au. (2010).Patient-Centred Care: Improving Quality and Safety By Focusing Care On Patients And Consumers. [online] Available at: https://www.safetyandquality.gov.au/wp-content/uploads/2012/01/PCCC-DiscussPaper.pdf [Accessed 18 Jan. 2018]. Safetyandquality.gov.au. (2012).National Safety and Quality Health Service Standards. [online] Available at: https://www.safetyandquality.gov.au/wp-content/uploads/2012/01/PCCC-DiscussPaper.pdf [Accessed 18 Jan. 2018]. Wildevuur, S.E. and Simonse, L.W., 2015. Information and communication technologyenabled person-centered care for the big five chronic conditions: scoping review.Journal of medical Internet research,17(3). Zhao, J., Gao, S., Wang, J., Liu, X. and Hao, Y., 2016. Differentiation between two healthcare concepts: Person-centered and patient-centered care.International Journal of Nursing Sciences,3(4), pp.398-402.