Transferring Knowledge on Patient-Centered Care through the Establishment of an International Network

Abstract

Background

Patient-centered care (PCC) is a key principle of high-quality health care and is becoming increasingly relevant in many countries. In 2006, Chile declared PCC as a fundamental pillar of its health care system. However, PCC implementation in the Chilean healthcare system is still lagging. Some factors contributing to this are 1) the complexity of the concept, 2) the interdependence between healthcare activities and policy regulations, and 3) the need for a cultural change in health politics and care. This paper shares experiences of how we have tried to address some of these challenges by establishing an international network for PCC.

Methods

As part of a collaborative project between researchers and clinicians based in Chile and Germany, have established the International Network for Patient-Centered Care (PCC NET) that enables knowledge exchange and trainings through different means.

Results

A website was developed and launchedas a platform to share knowledge. Furthermore, a series of online seminars on PCC was organized, each conducted by an international expert in the field. In January 2023, several face-to-face were held in Chile attended by 51 participants, comprising health care professionals responsible for implementing PCC in the country, those working for the Ministry of Health or those in primary care in Chile. Workshops were evaluated by assessing the participants' reactions via surveys, and the participants rated the workshops positively. In January 2024, the first Latin American Conference on Patient-Centered Care was implemented in Santiago de Chile. There were four keynotes, two roundtables, five workshops, 31 oral and 19 poster presentations from both research and clinical practice during the two conference days with 196 participants on location.

Conclusion

Establishing the PCC NET has facilitated international collaboration, knowledge exchange, and capacity-building for PCC implementation in Chile. Through different communication strategies, such as workshops, seminars and a conference, it was possible to enhance awareness and practical knowledge among healthcare professionals and policymakers. These initiatives represent significant steps toward advancing PCC in Chile, although continued efforts are needed to address remaining challenges and sustain momentum in policy and practice.

Keywords

patient-centered care - shared decision-making - network - transfer of knowledge - evaluation

Schlüsselwörter

Partizipative Entscheidungsfindung - Netzwerk - Wissenstransfer - Evaluation - patientenorientierte Versorgung

• References

• 1 Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington, D.C.: National Academies Press; 2001.
• 2 Stewart M, Brown JB, Donner A. et al. The impact of patient-centered care on outcomes. J Fam Pract 2000; 49: 796-804
• 3 Robinson JH, Callister LC, Berry JA. et al. Patient-centered care and adherence: definitions and applications to improve outcomes. J Am Acad Nurse Pract 2008; 20: 600-607
• 4 Rathert C, Wyrwich MD, Boren SA. Patient-centered care and outcomes: a systematic review of the literature. Med Care Res Rev 2012; 70: 351-379
• 5 Bravo P, Härter M, McCaffery K. et al. Editorial: 20 years after the start of international Shared Decision-Making activities: Is it time to celebrate? Probably…. Z Evid Fortbild Qual Gesundhwes 2022; 171: 1-4
• 6 Scholl I, Zill JM, Härter M. et al. An integrative model of patient-centeredness - a systematic review and concept analysis. PLoS One 2014; 9: e107828
• 7 Epstein RM, Street RL. The values and value of patient-centered care. Ann Fam Med 2011; 9: 100-103
• 8 Macinko J, Montenegro H, Nebot Adell C. et al. La renovación de la atención primaria de salud en las Américas. Rev Panam Salud Publica 2007; 21: 73-84
• 9 Alarcón-Yaquetto DE, de Ferrari A, Málaga G. The road to patient-centred care in Peru: The difficulties and opportunities to achieve participatory health care. Z Evid Fortbild Qual Gesundhwes 2022; 171: 113-116
• 10 Armenta-Arellano S, Muños-Hernández JA, Pavón-León P. et al. An overview on the promotion on patient-centered care and shared decision-making in Mexico. Z Evid Fortbild Qual Gesundhwes 2022; 171: 93-97
• 11 Bravo P, Dois A, Martínez A. et al. Advancing towards the implementation of patient-centred care in Chile: An opportunity to effectively practice shared decision-making. Z Evid Fortbild Qual Gesundhwes 2022; 171: 30-35
• 12 Riganti P, Victor Ariel Franco J, Victoria Ruiz Yanzi M. et al. Shared decision-making in Argentina in 2022. Z Evid Fortbild Qual Gesundhwes 2022; 171: 11-14
• 13 Ministerio de Salud. Orientaciones para la implementación del modelo de atención integral de salud familiar y comunitaria (12.08.2013). In the internet https://www.enfermeriaaps.com/portal/orientaciones-para-la-implementacion-del-modelo-de-atencion-integral-de-salud-familiar-y-comunitaria-minsal-chile-ops-2013 Accessed: 11.01.2024
• 14 Hahlweg P, Bieber C, Levke Brütt A. et al. Moving towards patient-centered care and shared decision-making in Germany. Z Evid Fortbild Qual Gesundhwes 2022; 171: 49-57
• 15 Bravo P, Dois A, Contreras A. et al. Participación de los usuarios en las decisiones clínicas en la atención primaria de salud en Chile. Rev Panam Salud Publica 2018; 42: e133
• 16 Zeh S, Christalle E, Hahlweg P. et al. Assessing the relevance and implementation of patient-centredness from the patients’ perspective in Germany: results of a Delphi study. BMJ Open 2019; 9: e031741
• 17 Barry MJ, Edgman-Levitan S. Shared decision making — the pinnacle of patient-centered care. N Engl J Med 2012; 366: 780-781
• 18 Damschroder LJ, Aron DC, Keith RE. et al. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci 2009; 4: 50
• 19 Bravo P, Martínez A, Fernández L. et al. Figuras de autoridad médica: tensiones y quiebres. En Figuras de autoridad: Transformaciones históricas y ejercicios contemporáneos (Ed Kathya Araujo). Ediciones LOM; 2022
• 20 International Network for Patient-Centered Care (PCC NET). Vision and mission (11.10.2020). In the internet https://www.pcc-network.org/vision-and-mission-2/ Accessed: 11.01.2024
• 21 Merriam-Webster. Dictionary: workshop. In the internet https://www.merriam-webster.com/dictionary/workshop Accessed: 11.01.2024
• 22 Powell BJ, Waltz TJ, Chinman MJ. et al. A refined compilation of implementation strategies: results from the Expert Recommendations for Implementing Change (ERIC) project. Implement Sci 2015; 10: 21
• 23 Klimesch A, Martinez-Pereira A, Topf C. et al. Conceptualization of patient-centered care in Latin America: a scoping review. Health Expect 2023; 26: 1820-1831
• 24 Elwyn G, Laitner S, Coulter A. et al. Implementing shared decision making in the NHS. Bmj 2010; 341: c5146
• 25 Kwame A, Petrucka PM. A literature-based study of patient-centered care and communication in nurse-patient interactions: barriers, facilitators, and the way forward. BMC Nursing 2021; 20: 158
• 26 Kurtz S, Silverman J, Benson J. et al. Marrying content and process in clinical method teaching: enhancing the Calgary-Cambridge guides. Acad Med 2003; 78: 802-809
• 27 Elwyn G, Durand MA, Song J. et al. A three-talk model for shared decision making: multistage consultation process. Bmj 2017; 359: j4891
• 28 Elwyn G, Frosch D, Thomson R. et al. Shared decision making: a model for clinical practice. J Gen Intern Med 2012; 27: 1361-1367
• 29 Christalle E, Zeh S, Hahlweg P. et al. Assessment of patient centredness through patient-reported experience measures (ASPIRED): protocol of a mixed-methods study. BMJ Open 2018; 8: e025896
• 30 Christalle E, Zeh S, Hahlweg P. et al. Development and content validity of the Experienced Patient-Centeredness Questionnaire (EPAT)—a best practice example for generating patient-reported measures from qualitative data. Health Expect 2022; 25: 1529-1538
• 31 Kriston L, Scholl I, Hölzel L. et al. The 9-item Shared Decision Making Questionnaire (SDM-Q-9). Development and psychometric properties in a primary care sample. Patient Educ Couns 2010; 80: 94-99
• 32 Scholl I, Hahlweg P, Lindig A. et al. Evaluation of a program for routine implementation of shared decision-making in cancer care: results of a stepped wedge cluster randomized trial. Implement Sci 2021; 16: 106
• 33 Kirkpatrick D. Revisiting Kirkpatrick's four-level model. Training & Development 1996; 50: 54-57
• 34 Ministerio de Salud de Chile (2024). Instrumento de evaluación y certificación del Modelo 2024 (v22012024). In the internet https://www.saludcallelarga.cl/descargas/maisf/OT_%20Instrumento%20de%20Evaluaci%C3%B3n%20 y%20certificaci%C3%B3n%20del%20Modelo%202024_%20v22012024.pdf https://www.saludcallelarga.cl/descargas/maisf/OT_%20Instrumento%20de%20Evaluaci%C3%B3n%20 y%20certificaci%C3%B3n%20del%20Modelo%202024_%20v22012024.pdf