Putting People at the Heart of Health Care, Research from AGS Advances Definition of Person-Centered Care
Person-centered care, an innovative approach to health care with roots in long-term care, took an important step forward this month, thanks to the work of an interprofessional panel of eldercare experts convened by the American Geriatrics Society (AGS) in collaboration with the University of Southern California (USC) and with support from The SCAN Foundation.
Person-centered care has risen to prominence in research and health policy, in part because of its proliferation in long-term care contexts. Culture change movements and emerging perspectives on expert care for serious health challenges have guided medicine toward more responsive and respectful means for promoting well-being, not just the absence of disease. And in this context, approaches that put people at the heart of their own care have excelled.
Yet, even as person-centered care has grown in distinction, it has, until now, lacked a cohesive definition. A literature review of studies published between 1990 and 2014 on person-centered care for older adults, for example, identified more than 15 distinct descriptions of the approach.
The expert panel convened by the AGS set about sifting through these and other perspectives to get at the heart of what we mean when we talk about person-centered care. Panelists assessed an extensive literature review conducted by Laura Mosqueda, MD, FAAFP, AGSF, and Alexis M. Coulourides Kogan, PhD, of the Keck School of Medicine of USC; as well as Kathleen Wilber, PhD, of the USC Davis School of Gerontology. They also evaluated interviews with leaders of community-based healthcare and social service organizations that reported providing person-centered care for older adults.
Based on this work, the expert panelists reached consensus on the following definition: “‘Person-centered care’ means that individuals’ values and preferences are elicited and, once expressed, guide all aspects of their health care, supporting realistic health and life goals.” Person-centered care begins by gathering specific information about a person’s preferences in light of health circumstances, with input from family members and other caregivers if the person wishes. Added to a comprehensive health and functional assessment, this information is used to help a person shape and articulate his or her health and life goals.
Person-centered care is achieved, furthermore, through a dynamic relationship involving individuals, others who are important to them, and all healthcare providers, based on care decisions. That relationship is intended to support several essential elements of person-centered care, identified by the expert panel as:
- An individualized, goal-oriented care plan based on the person’s preferences;
- Ongoing review of the person’s goals and care plan;
- Care supported by an interprofessional team in which the person is an integral member;
- One primary or lead point of contact on the healthcare team;
- Active coordination among all healthcare and supportive service providers;
- Continual information sharing and integrated communication;
- Education and training for providers and, when appropriate, the person and those important to the person; and
- Performance measurement and quality improvement using feedback from the person and caregivers.
“Using a standardized definition and essential elements…can assist healthcare providers, administrators, researchers, regulators, policy-makers, and consumer advocates in studying, implementing, and evaluating best practices in person-centered care,” the researchers observed.
The literature review and qualitative research conducted by USC, an expert panel statement, and an accompanying commentary by The SCAN Foundation have been published online in the Journal of the American Geriatrics Society and are available for free from GeriatricsCareOnline.org, the online home for AGS resources and publications.
