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Best Practices in Patient-Centered Care
A research project to identify innovations for improving the patient experience.
Enhancing the patient experience and delivering patient-centered care is on the agenda of virtually every hospital today. Yet, while hospitals’ performance on national patient-experience surveys gains greater public attention—and is increasingly tied to financial rewards—the pathway for improvement is far from clear.
The Best Practices in Patient-Centered Care research and dissemination project sought to identify concrete innovations and promising practices of United States hospitals that are top performers in delivery of patient-centered care, or who have made remarkable strides in this area. Culminating in a conference in September 2013, it brought together hospital leaders, clinicians, patient-family advocates, researchers and policymakers to share successful strategies.
How Top Performers Were Identified
To identify these hospitals, the Armstrong Institute for Patient Safety and Quality research team mined the comparative database of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS), a validated national survey sent to patients after discharge about their hospital experiences.
Through this analysis of more than 3,000 hospitals, the team identified 176 facilities of various sizes that achieved top ranking or made major improvements in the HCAHPS domains of communication, staff responsiveness, discharge planning and pain management.
Hospital leaders from these hospitals were invited to present their work in the conference. In addition, leaders from 52 of these hospitals completed an anonymous survey about their organizations’ practices.
How Do High Performers Deliver Patient-Centered Care?
The study found several common approaches among successful hospitals.
- Hourly rounds. Nurses and other clinical staff members make rounds in the patient’s room every hour to address pain, bathroom needs and positioning and to make sure that personal items are within reach.
- Communication/care boards in patient rooms. The boards list important information, such as new and existing medications, discharge goal, tests and procedures, and how to easily contact care providers.
- Bedside shift report. Nurses conduct reports at shift change in the presence of the patient and family, giving them the chance to ask questions, understand the care plan and correct any inaccurate information.
- Discharge folder. On admission, patients receive a folder with a checklist of information they will need when they get home, such as the purpose of their medications and symptoms to look out for.
- Postdischarge phone calls. Nurses call patients within two to three days to check on their status and answer questions about instructions and self-care.
- Multidisciplinary rounds. Involve all members of the care team, as well as patients and families, in rounds.
- Standards of performance. Create standards for all employees to follow, such as quickly responding to patients and how to respond to patient concerns or complaints.
Resources for Improving the Patient Experience
The conference revealed many interventions for delivering patient-centered care and improving HCAHPS scores.
- Read the conference proceedings, released in June 2015, for summaries of all keynote and best practices presentations from the two-day event.
- Review presentations and abstracts for slides from podium presentations, 30 poster abstracts and other abstracts submitted to the conference organizers.
Aboumatar H.J., Chang B.H., Danaf J.D., Shaear M., M.D., Namuyinga R., Elumalai S., Marsteller J.A., Pronovost P.J. Promising Practices for Achieving Patient-centered Hospital Care: A National Study of High Performing United States Hospitals. Medical Care. 2015 Jun 30.
Funding for this study was made possible, in part, by grant 1R13HS021921-01 from the Agency for Healthcare Research and Quality (AHRQ). The views expressed in written conference materials or publications do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices or organizations imply endorsement by the U.S. Government. Principal Investigator: Hanan J. Aboumatar, M.D., M.P.H.