Issue 1 : Patient Centered Design

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Problem Definition

Many EDs are centered around physicians and do not take the patient's needs and comfort into consideration.


Discussion

Patient centered design encompasses a wide range of factors. One main focus is the layout of the patient's room. It incorporates the patient as well as the family into the decision process. Instead of treating and thinking of the family in the way of the doctors and nurses they are supposed to be there to be involved. By changing the focus of the care area it should make the patient feel safer, more comforted, and overall happier with the care given. Studies I have seen have shown that patient centered design is able to make the staff more efficient as well as give the patient a better experience at the ED.

Metrics

To study if the patient center design is effective surveys would be used to poll the patient, the family, as well as the staff. It is important that that staff is also in agreement with the procedure as well as are still able to perform their job to their best ability. Another metric that should be looked into is the turnaround time for the entire stay. The two of these metrics will be able to show two aspects that are important to the ED-- efficiency and patient satisfaction.


References

France, Daniel J PhD, MPH, Does Patient-Centered Design Guarantee Patient Safety?: Using Human Factors Engineering to Find a Balance Between Provider and Patient Needs. Journal of Patient Safety. http://www.journalpatientsafety.com/pt/re/jps/abstract.01209203-200509000-00006.htm;jsessionid=LHTTQDLJLWyjJTp17YTDCbGLv8TGhHkvNCkq52mMt8rxYWdvSzZb!-1101774500!181195629!8091!-1


Lambert, Bruce. Provider-Patient Communication, Patient-Centered Care, and Mangle of Practice. Health Communication; 1997, Vol. 9 Issue 1, p27, 17p. http://www.library.gatech.edu:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ufh&AN=7391990&site=ehost-live

Jaya K. Rao, MD, MHS; Morris Weinberger, PhD; Kurt Kroenke, MD. Visit-Specific Expectations and Patient-Centered Outcomes. Archives of Family Medicine. http://archfami.ama-assn.org/cgi/reprint/9/10/1148

Edward Krupat, PhDRobert A. Bell, PhDRichard L. Kravitz, MD, MSPHDavid Thom, MD, PhDRahman Azari, PhD. When Physicians and Patients Think Alike: Patient-Centered Beliefs and Their Impact on Satisfaction and Trust. The Journal of Family Practice. http://www.jfponline.com/Pages.asp?AID=2407&issue=December_2001&UID=

COMMENTS: Ackerman Is there any literature on Patient Centered Design in Emergency Medicine? The references you have here (good job by the way) are primarily from inpatient and primary care (you should note the journals that these articles and their references apppear in - it is nearly all internal and family practice journals...) I think it is very much open to question how patient centered design can be implemented in the Emergency environment.

While patient satisfaction is an important reason to use a patient centered approach, more important to me is the potential to increase compliance with treatment plans including medication and follow-up, and ideally outcome measures.. It might be possible to track making and going to follow-up appointments and things like fill rates for prescriptions as well as long-term issues. Turnaround time is important - in general I tend to believe that many of the elements of Patient Centered Care can be implemented in a way that improves through-put but... this is unproven as well but it would be good to have data to support this.