Patient Safety / Quality

Key concepts in patient-centered care

A collaboration between the patient and the healthcare team, patient-centered care incorporates the patient’s values, beliefs, and preferences regarding overall health and well-being into the plan of care and implementation of all care activities. Most nurses are familiar with patient-centered care but may not know how to integrate it effectively into practice. This article presents five key concepts for implementation.

1. Respect

During the initial assessment, encourage patients to share their values, preferences, and needs related to health care because these will form the basis of the plan of care. Customize care to each patient, ensuring that it’s culturally appropriate. Be aware that patient preferences aren’t necessarily static, so care may need to change as circumstances do. To determine the patient’s values, preferences, and needs, you need good interpersonal and communication skills. (See Interviewing patients by clicking the PDF icon above.)

2. Care coordination and integration

Care activities of all disciplines involved in the patient’s care should be coordinated to heighten the focus on the patient. As most nurses know, though, this isn’t always possible. To smooth the coordination process, work with one member of the multidisciplinary care team to embed patient-centered care into the plan of care. Keep in mind that some team members may be unfamiliar with patient-centered care; you may need to teach them beforehand or mentor them during the process. As you work together with other team members, the multidisciplinary plan of care will come together more smoothly.

3. Information, communication, and education

To help patients understand patient-centered care, provide them with key information, communication, and education. Embed elements of patient-centered care into your discussions with them to teach them about the integral role they play in their overall health and well-being. Explain that the care they’ll participate in reflects their preferences. Ask for their help in designing the overall plan of care. Answer their questions in easy-to-understand terms, not jargon.

To boost patients’ engagement in the patient-centered care process, tailor your communication to reflect patients’ needs. To do this, ask open-ended questions to gain insight into their concerns, such as:

  • Can tell me how you’re feeling right now?
  • What would you like me to do for you at this moment?
  • Here’s a list of self-care activities that need to be completed before the end of the day. Do you have a preference as to which activities should be done first? Is anything missing from the list that you’d like me to add?

Make sure you have enough time available for this interaction so patients can express their concerns and needs freely. Provide opportunities for them to participate in choosing a treatment regimen. Shared decision-making is crucial because it puts the patient’s values and preferences center stage. Ideally, you, the patient, and other healthcare team members should discuss the pros and cons of various treatment options. Help patients understand the information you’re presenting by using visual images, analogies, or other means. Offer print, audio, video, Internet, and electronic resources to educate them about their health condition and help them choose appropriate treatments. For example, you could provide booklets, audio recordings, and videos that illustrate the pros and cons of a particular treatment. These decision aids help patients make informed choices that reflect their preferences, values, and beliefs.


4. Comfort

Ensure that the patient is physically and emotionally comfortable so he or she can actively engage in patient-centered care.

5. Family input

If the patient gives consent, incorporate input from family members and friends into the design of the overall plan of care.

Although patient-centered care has been well-defined, its integration across the discipline of nursing hasn’t been fully actualized. Using the strategies in this article can help you integrate patient-centered care principles into your daily practice.

Selected references

Abraham M, Moretz JG. Implementing patient- and family-centered care: part I – understanding the challenges. Pediatr Nurs. 2012;38(1):44-7.

Barry MJ, Edgman-Levitan S. Shared decision making—pinnacle of patient-centered care. N Engl J Med. 2012;366(9):780-1.

Berwick DM. What “patient-centered” should mean: confessions of an extremist. Health Aff (Millwood). 2009;28(4):w555-65.

Ford PE, Rolfe S, Kirkpatrick H. A journey to patient-centered care in Ontario, Canada: implementation of a best-practice guideline. Clin Nur Spec. 2011;25(4):198-206.

Hobbs JL. A dimensional analysis of patient-centered care. Nurs Res. 2009;58(1):52-62.

Aaron Bechtold is enrolled in the bachelor of science in nursing program and a research assistant at the Daphne Cockwell School of Nursing at Ryerson University in Toronto, Ontario, Canada. Suzanne Fredericks is an associate professor at Ryerson University.

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