Person-Centered Care Awareness Month (PCCAM), observed every October worldwide, is an awareness-building campaign designed to engage healthcare stakeholders in adopting and advancing person-centered approaches to care. It is also a time devoted to celebrating the progress toward providing patient-centered care and building momentum for future improvement.
During the month, healthcare organizations and patient groups are encouraged to participate by providing patients, family members, healthcare professionals, and communities with skills and tools to deepen and strengthen their partnerships
What Is Person-Centered Care?
Person-centered care is the practice of caring for patients (and their families) in meaningful and valuable ways to the individual. That includes showing respect for patients’ values, preferences, and expressed needs. It shifts the clinician's mindset from working “for” the patient to working “with” the patient.
Person-centered care is more than mere hospitality, amenities, and inviting surroundings, however. Its goal is to improve patients' lives and health outcomes and unite communities around health and wellness.
What Effect Has COVID-19 Had on Person-Centered Care?
COVID-19 has affected person-centered care in several ways: reduced access to in-person care, restricted family visitation to hospitalized patients, fear and mistrust from widespread misinformation, feelings of isolation—the list goes on.
One primary effect is COVID's exacerbation of current healthcare disparities suffered by socially, economically, or environmentally disadvantaged communities. Such disparities include lack of health insurance coverage, access to healthcare facilities, lower-quality care, and higher mortality rates due to chronic diseases (e.g., diabetes, heart disease, and hypertension).
A timely article from Healthcare Information and Management Systems Society, Inc. (HIMSS) shines a spotlight:
"COVID-19 has become the catalyst that intensified the existing fragile relationship between healthcare providers and the at-risk population. This mistrust is compounded by the information gap that exists in these communities. This gap prevents the population from receiving care specific to their needs [emphasis ours]."
HIMSS warned that people with chronic diseases in underserved populations must continue to receive medical care due to their higher chance of contracting COVID-19.
The Substance Abuse and Mental Health Services Administration (SAMHSA) agrees. Its whitepaper, "Double Jeopardy: COVID-19 and Behavioral Health Disparities for Black and Latino Communities in the U.S.," citing data from the Kaiser Family Foundation (KFF) and Health Affairs, says people of color are at an increased risk for serious illness if they contract COVID-19 due to higher rates of underlying health conditions, such as diabetes, asthma, hypertension, and obesity.
In the whitepaper, SAMSHA notes a lack of health insurance as the chief impediment to accessing COVID-19 testing and treatment. It also points out that many people in these populations work in at-risk industries—restaurants, retail, and hospitality—and live in overcrowded public housing, further increasing their risk.
Why Do Person-Centered Healthcare Disparities Matter?
According to the Kaiser Family Foundation, healthcare-related disparities affect these at-risk groups and limit overall gains in quality of care and health for the broader population, resulting in unnecessary costs.
KFF states that addressing health disparities is "increasingly important" as the population becomes more diverse. It projects that people of color will account for over half (52 percent) of the population in 2050, resulting in disparities amounting to approximately $93 billion in excess medical care costs and $42 billion in lost productivity per year.
How Can Hospitals Address Healthcare Disparities?
The Affordable Care Act led to coverage gains for many people in socioeconomically-challenged communities. The federal government, through HHS, along with many states, local communities, and private organizations are also engaged in efforts to reduce health disparities. There is much local hospitals and health systems can do to affect change, as well.
Educating providers is one such step.
“Importantly, we need to educate our providers about seeing a person and not a color," HIMSS says. "We are aware that unconscious bias is real, but as a healthcare worker, you must slow down and move your thinking from the primitive, reactive parts of the brain to a more reflective level mind.”
According to Health Affairs, part of that education is understanding the broad range of underserved populations that healthcare disparity covers: race and ethnicity, gender and identity, socioeconomic status, and geography.
Related resource: Embracing Diversity in Healthcare
Based on that understanding, Health Affairs prescribes that hospitals and providers take the following actions:
Promote Patient Dignity and Personal Responsibility
This action hearkens back to the concept of working "with" patients to foster health outcomes.
"For instance, a person with a chronic illness such as diabetes must essentially 'own' that illness if he or she is to have any hope of effectively managing it," Health Affairs says. “Providers can help with high-quality treatment and the best recommendations, but patients must act on those recommendations.”
Effective communication between healthcare providers and their patients is also essential for high-quality care.
Improving communication is a major emphasis at SCP Health due to its effect on patient satisfaction—certainly a component of person-centered care. We understand that effective communication, combined with compassionate, quality care, fosters improved provider-patient relationships and promotes better outcomes.
Focus on Cultural Context
One’s community and cultural background affect perceptions of health. Therefore, providers must understand the communities they serve.
In its whitepaper, SAMSHA recommends a wide range of actions hospitals can take. Here is a shortlist (read the whitepaper to see the full list):
- Disaggregate COVID-19 data including testing, hospitalizations, ICU admissions, and fatalities, by race and ethnicity;
- Increase flexibility in treatment and payment policies;
- Expand telehealth coverage;
- Provide language translation to communicate COVID-19 information;
- Tailor messaging to fit the various cultures.
What Can Hospitals Do to Affect Community Health?
The CDC says that preventing COVID-19's spread mandates that hospitals and communities work together to ensure people have the resource to "maintain and manage their physical and mental health, including easy access to information, affordable testing, and medical and mental healthcare. We need programs and practices that fit the communities where racial and minority groups live, learn, work, play, and worship.”
One impactful strategy is to view the community as your patient and take substantive measures to improve population health. That starts with assessing the community's social determinants of health and targeting resources to assist those who live in areas of greatest need.
Other actions include:
Partnering with Faith-Based Leaders, CBOs, Business
"Faith leaders and places of worship play a key role in providing support, information, and spiritual leadership among Black and Latino communities," the SAMSHA whitepaper says. “They are trusted messengers and influencers who often have a history of addressing health and mental health promotion."
Ethnic and racial-specific community-based organizations (CBOs) also have established track-records in the community and are often multi-service providers that integrate health and social services. They are well-positioned to convey COVID-19 information and serve as outposts to offer health education, free screenings, vaccinations, and health fairs.
Business partnerships are yet another way to invest in the community. SCP Health offers a direct-to-employer program that links healthcare facilities with local businesses and serves as a community liaison to coordinate employer and community relationships on behalf and as part of your hospital.
Expanding Telehealth and Telemedicine Opportunities
This is already happening. Outpatient clinics, CBOs, and urgent care centers have ramped up the use of telephone and video visits, and insurance companies are expanding coverage for telehealth and telemedicine. These changes have helped reduce barriers to accessing care—transportation and cost in particular.
Augmenting the Workforce
As mentioned, healthcare professionals need to understand cultural differences in how patients interact with providers and the healthcare system. Given workforce demands, there is an opportunity to tap previously unused healthcare talent.
"Fast-tracking immigrant, refugee, and bilingual health care professionals who have until now been closed out of the health professions would create a pool of over 200,000 potential health care workers in the U.S.," SAMSHA notes.
The spotlight that COVID-19 has shined on healthcare disparities presents an opportunity to achieve greater equity in all vulnerable populations’ care.
What better time than Person-Centered Care Awareness Month for hospitals and health systems to start finding ways to address the disparities, both inside the four walls and outside in the local community.
Contact SCP Health to discuss how we can support your organization in telemedicine, community partnerships, patient engagement, provider education, and more.