Putting people at the center of their own health care may seem intuitive, but it is an approach that is not widely practiced in the medical community. 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, today released findings from a research project to better define 'person-centered care' and its key elements. This innovative approach to health care puts individual values and preferences at the heart of care decisions, measuring success by attention to people's health and life goals. Research findings, an expert panel statement, and a special commentary published in the Journal of the American Geriatrics Society add clarity to the characteristics of person-centered care, which has lacked a cohesive definition even as its prominence in research and health policy is growing.
"For too long, our medical system has focused on treatment of illnesses rather than on care of a person with illnesses," explained project Principal Investigator Laura Mosqueda, MD, FAAFP, AGSF, Chair, Department of Family Medicine, Professor of Family Medicine and Gerontology, Keck School of Medicine of USC. "The values espoused in person-centered care remind us of the importance of eliciting and acting on our patients' preferences and goals. We now have a clearer vision of how to translate the aspiration of person-centered care into a reality."
Added Bruce A. Chernof, MD, FACP, President and Chief Executive Officer of The SCAN Foundation, "Person-centered care is essential for older adults with chronic health conditions and functional limitations who need well-coordinated, team-based care. This concept shifts the success vision of health care on the things that matter most to people--how they are living every day with complex needs and achieving their personal goals. Person-centered care defines quality and value beyond technical measures of care toward dignity, respect of personal choices, and life outcomes achieved."
As outlined by the AGS expert panel, a person-centered approach 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. These goals are driven first and foremost by how a person wants to function and what he or she envisions for future well-being.
To arrive at its definition, the expert panel reviewed research conducted by Dr. Mosqueda; Alexis M. Coulourides Kogan, PhD, Keck School of Medicine of USC; and Kathleen Wilber, PhD, USC Davis School of Gerontology, including a comprehensive literature review supplemented by interviews with leaders of community-based healthcare and social service organizations that reported providing person-centered care for older adults. From this work, researchers observed that:
- Organizations often define and operationalize person-centered care in unique ways. For some, it is focused on creating "individualized plans" to meet client and family needs. For others, it reflects the belief that person-centered care is "not just a program but a culture...embedded in practice and mission-driven."
- Even in light of their differences, organizations employing person-centered care remain strongly committed to the approach in more than just words. It requires, as several interviewees noted, significant time and resources, but the effects extend across the health system: "Staff are able to build trust and a relationship with clients, clients get better, staff feel good about client outcomes," one respondent observed.
"This research will help healthcare professionals and older adults understand both how and why success entails fidelity to certain key elements of person-centered approaches," noted Steven R. Counsell, MD, AGSF, AGS President. "The findings highlighted in the four companion papers -- the literature review on person-centered care, report on qualitative research findings, expert panel statement defining person-centered care and its essential elements, and special commentary by The SCAN Foundation -- help to advance person-centered care as a field. We're confident this work will help health systems and providers implement person-centered practices with the goal of improving care quality for all, especially older adults with complex health needs."
The articles, published online in the Journal of the American Geriatrics Society, are free and open access at GeriatricsCareOnline.org, the online home for AGS resources and publications.
About the American Geriatrics Society
Founded in 1942, the American Geriatrics Society (AGS) is a nationwide, not-for-profit society of geriatrics healthcare professionals dedicated to improving the health, independence, and quality of life of older people. Its more than 5,900 members include geriatricians, geriatric nurses, social workers, family practitioners, physician assistants, pharmacists, and internists. The Society provides leadership to healthcare professionals, policymakers, and the public by implementing and advocating for programs in patient care, research, professional and public education, and public policy. For more information, visit americangeriatrics.org.
About Keck Medicine of USC
Keck Medicine of USC is the University of Southern California's medical enterprise, one of only two university-based medical systems in the Los Angeles area. Encompassing academic, research and clinical excellence, the medical system attracts internationally renowned experts who teach and practice at the Keck School of Medicine of USC, the region's first medical school; includes the renowned USC Norris Comprehensive Cancer Center, one of the first comprehensive cancer centers established by the National Institutes of Health (NIH) in the United States; has a medical faculty practice, the USC Care Medical Group; operates the Keck Medical Center of USC, which includes two acute care hospitals: 401-licensed bed Keck Hospital of USC and 60-licensed bed USC Norris Cancer Hospital; and owns USC Verdugo Hills Hospital, a 158-licensed bed community hospital. It also includes more than 40 outpatient facilities, some at affiliated hospitals, in Los Angeles, Orange, Kern, Tulare and Ventura counties. In 2015, U.S. News & World Report ranked Keck Medical Center of USC among the Top 10 in ophthalmology and among the Top 50 hospitals in the United States for urology and cancer care. For more information, go to keckmedicine.org/beyond.
About the USC Leonard Davis School of Gerontology
Founded in 1975, the University of Southern California Leonard Davis School of Gerontology is the oldest and largest school of its type in the world. The school offers the most comprehensive selection of gerontology degree programs found anywhere, a variety of outstanding research opportunities, and a challenging yet supportive academic environment. As a school rooted in a world-class research university located in Los Angeles, the Davis School and its research and services arm, the Ethel Percy Andrus Gerontology Center, are home to current and future leaders in the field. Faculty and students study the human lifespan by exploring the biology, psychology, sociology, policy, economics, medical, and business dimensions of adult life. For more information, visit gero.usc.edu.
About The SCAN Foundation
The SCAN Foundation is an independent public charity dedicated to creating a society where older adults can access health and supportive services of their choosing to meet their needs. Our mission is to advance a coordinated and easily navigated system of high-quality services for older adults that preserve dignity and independence. For more information, visit http://www.TheSCANFoundation.org.
Journal of the American Geriatrics Society