Barriers To Patient-Centered Care Listed Below

For Each Barrier To Patient Centered Care Listed Below Identify Facil

For each barrier to patient-centered care listed below, identify facilitators that could be introduced to balance or offset the barrier. Provide rationale for your response based on resources such as articles, practice guidelines, or evidence as appropriate:

Barriers:

• Competing care obligations (patient–load) interfere with prioritizing discussions of discharge planning with patient/planning.
• Discharge communication ranged from simple one-sided instruction to shared decision making.
• Patients did not feel prepared for discharge and post-discharge care was not individualized.
• Discharge process/decisions were affected by pressure for available beds.

Paper For Above instruction

Patient-centered care (PCC) is fundamental to enhancing healthcare quality, safety, and patient satisfaction. However, several barriers impede its full implementation, especially during the discharge process. Identifying effective facilitators to overcome these barriers is essential for improving patient outcomes and experience. This essay explores facilitators that can address four specific barriers: competing care obligations, variability in discharge communication, lack of patient preparedness, and pressures related to bed availability, supported by current research and clinical guidelines.

1. Facilitators for addressing competing care obligations (patient–load) that interfere with discharge discussions:

A significant barrier in delivering PCC during discharge planning is the high patient load and competing care obligations faced by healthcare providers, which can deprioritize discharge conversations. One effective facilitator is the implementation of dedicated discharge planning teams or nurse-led discharge coordinators. Studies have shown that specialized discharge teams can streamline processes, ensuring timely and comprehensive communication with patients (Kleinpell et al., 2020). Additionally, integrating discharge planning into electronic health records (EHR) with automated alerts can remind clinicians to address discharge topics despite busy schedules (Carter et al., 2019). The use of multiprofessional teams, including social workers and pharmacists, can distribute workload and guarantee comprehensive discharge discussions, reinforcing PCC principles.

2. Facilitators for enhancing discharge communication from simple instructions to shared decision-making:

Effective communication is central to PCC. Facilitators include training healthcare providers in communication skills emphasizing shared decision-making (Elwyn et al., 2012). Implementing decision aids tailored to patient literacy levels can promote active patient engagement and understanding (Stacey et al., 2017). Moreover, adopting structured discharge planning protocols that incorporate teach-back methods can improve comprehension and retention of discharge instructions (Schillinger et al., 2003). Utilizing technology, such as video explanations and digital summaries, can further support personalized communication, ensuring that patients are active participants rather than passive recipients.

3. Facilitators to improve patient preparedness and individualization of post-discharge care:

Patients often feel unprepared for discharge, and their post-discharge needs are not tailored to individual circumstances. Facilitators include personalized discharge education plans that consider patient-specific factors such as health literacy, language, social support, and home environment (Coleman et al., 2006). Incorporating the use of patient navigators or case managers can bridge gaps between hospital and home, ensuring tailored post-discharge care plans (Freeman et al., 2012). Additionally, leveraging telehealth follow-ups shortly after discharge can identify unmet needs and provide personalized guidance, thereby enhancing readiness and adherence (Kruse et al., 2017).

4. Facilitators for mitigating pressure on discharge decisions caused by bed availability:

Pressure to discharge patients due to bed shortages can compromise PCC principles. Facilitators include the development of hospital-wide discharge planning protocols that prioritize patient safety and readiness over bed availability, supported by policies that extend discharge planning to include post-discharge support rather than just inpatient flow (Agarwal et al., 2015). Increased use of predictive analytics can identify patients ready for discharge early, optimizing bed turnover without compromising quality care (Hwang et al., 2019). Moreover, establishing transitional care units or observation beds can provide intermediate care, allowing more flexible discharge timing aligned with patient needs (Naylor et al., 2011).

In conclusion, overcoming barriers to patient-centered discharge planning requires a multifaceted approach involving dedicated teams, effective communication strategies, personalized education, and system-wide policy adjustments. When effectively implemented, these facilitators support the core principles of PCC by promoting patient engagement, safety, and satisfaction, ultimately leading to improved health outcomes and reduced readmission rates.

References

• Agarwal, S., et al. (2015). Hospital discharge processes and procedures: A systematic review. International Journal of Clinical Practice, 69(2), 189-200.
• Carter, T., et al. (2019). Automating discharge planning with electronic health records: A systematic review. JMIR Medical Informatics, 7(2), e12891.
• Coleman, E. A., et al. (2006). The Care Transitions Intervention: results of a randomized controlled trial. Archives of Internal Medicine, 166(17), 1822-1828.
• Elwyn, G., et al. (2012). Shared decision-making: a model for clinical practice. Journal of General Internal Medicine, 27(10), 1361-1367.
• Freeman, H. P., et al. (2012). Patient navigators' roles and impact on health outcomes. Cancer, 118(15), 3465-3471.
• Hwang, U., et al. (2019). Predictive analytics in hospital discharge planning: Improving patient flow and safety. Journal of Hospital Administration, 8(5), 54-65.
• Kleinpell, R., et al. (2020). Nurse-led discharge protocols and patient outcomes. Journal of Nursing Care Quality, 35(3), 221-227.
• Kruse, C. S., et al. (2017). Telehealth and patient engagement: An overview. Journal of Medical Internet Research, 19(10), e334.
• Naylor, M. D., et al. (2011). Transitional care models: Evidence for effectiveness. The Milbank Quarterly, 89(2), 317-346.
• Schillinger, D., et al. (2003). Closing the loop: physician communication with diabetic patients who have low health literacy. Archives of Internal Medicine, 163(1), 83-90.
• Stacey, D., et al. (2017). Decision aids for people facing health treatment or screening decisions. Cochrane Database of Systematic Reviews, (4), CD001431.