ELO 5 – A New Take on Patient-Centered Care: Making Partnerships with High Utilizing Disadvantaged Patients

Summary

This workshop will be an introduction to a language for building partnerships in care with patients who cope with significant complexity (physical, psychological, and social). Participants will hear how current “patient-centered” approaches have difficulty making partnerships with these patients. They will practice reframing professional language for writing open notes and for having team clinical conversations in the presence of the patient. They will practice using empowering language as part of trauma-informed care, and learn attributions that support increased patient self-efficacy. Finally, they will practice creating patient-centered care plans in which patients are truly partners.

The concept of “patient-centered care,” along with its “sibling” concept “the medical home” were created to be guiding principles for positive transformation in medical care. Unfortunately, after all the time and money expended to bring about this transformation, the medical home effort, (changing practice patterns to improve information management, increase coordination of care, and promote access) has been more successful than the patient-centered care effort, (changing the doctor-patient relationships to improve transparency, accommodate to patient preferences and values, and make partnership with patients. This is especially true for patients we term “multiply-disadvantaged,” (patients called “complex” in literature about high utilizing people with multiple chronic illnesses, also called “disadvantaged patients” who cope with poverty and bias, and finally, described in literature on victims of trauma. These are patients who tend to experience interaction with healthcare professionals more as encounters with authorities who want to control them rather than as time with highly trained benevolent helpers. The possibility of partnership with their doctor is not attractive to many of these people.
Using evidence-based methods, it is possible to create a process for interacting with these patients that builds their self-efficacy in regard to their health and their healthcare. These methods promote an experience of care for health team members and for patients that is transparent, empowering, activating and mutual. This workshop will be an introduction to language for building partnerships in care with multiply-disadvantaged patients. Participants will practice reframing professional language for writing open notes and for having team clinical conversations in the presence of the patient. They will practice using empowering language as part of trauma-informed care, and learn attributions that support increased patient self-efficacy. Finally, they will practice creating patient-centered care plans in which patients are truly partners. Time will be 1/3 lecture and 2/3 audience interaction.