The future of patient-centered care: scenarios, visions, and audacious goals.
The future of patient-centered care: scenarios, visions, and audacious goals.
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以患者为中心的护理的未来：情景、愿景和大胆的目标。
DOI：
10.1089/acm.2005.11.s-77
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发表时间：
2005
影响因子：
2.6
通讯作者：
C. Bezold
中科院分区：
文献类型：
--
作者：
C. Bezold
美国的医疗保健系统正在发生转变。必须的。以患者为中心的护理（PCC）是该系统应包含的核心品质。本文介绍了为 Picker Institute 创建的关于 PCC 未来的项目的亮点。作为未来工作的一个例子，该项目针对可能发生的事情制定了四个图像或故事，以及 PCC 应该发生的事情的愿景和大胆目标。第一种也是最有可能的情况是，随着当前趋势的变化，以患者为中心的程度有所增加。然而，在第二种情况下，医疗保健可能会变得更加紧张，并将 PCC 抛在后面，因为它寻求降低成本而不注重质量。第三个场景设想了更优秀的系统，将 PCC 无缝集成到他们的工作中。第四个场景是协作和分担责任，与先进的信息工具相结合，从而使 PCC 能够为预防疾病和降低医疗保健成本做出贡献。这些情景表明，以患者为中心的医疗保健可能会略有改善、停滞或显着推进。 PCC 愿景呼吁我们每个人都掌控自己的健康，并以符合我们价值观的及时、有效和个性化的方式获得我们需要的护理（不多也不少）。这些大胆的目标设定了 PCC 社区优先事项的议程。其中包括消费者共同决策、确保医疗保健专业人员接受支持活跃患者的培训、预测个人的健康和长期护理需求、采用医学研究所 (IOM) 的简单医疗保健规则，以及将患者的观点作为政策和规划的优先事项。我们每个人和我们的组织都面临着这一愿景和大胆目标的挑战。医疗保健专业人员和提供系统，无论是传统的还是替代的，都面临着这些问题。虽然补充和替代医学 (CAM) 提供者往往会因消费者的关注而获得更高的评分，但许多 CAM 模式很大程度上是由提供者决定的。以患者为中心的护理将需要患者和消费者更多地赋权和激活。
The U.S. health care system is transforming. It must. Patient-centered care (PCC) is a core quality that the system should include. This article presents the highlights of a project on the future of PCC created for the Picker Institute. As an example of futures work, this project developed four images or stories of what might happen, as well as a vision and audacious goals for what should happen to PCC. The first and most likely scenario is an increase in patient-centeredness as a function of current trends. However, in the second scenario, health care could become even more stressed and leave PCC behind as it seeks to lower cost without focusing on quality. The third scenario envisions more excellent systems that integrate PCC seamlessly into their work. The fourth scenario sees collaboration and shared responsibility, in association with advanced information tools, thereby enabling PCC to contribute to preventing illness and lowering health care costs. The scenarios indicate that the patient-centeredness of health care could improve slightly, stall, or advance significantly. The PCC Vision calls for each of us to be in charge of our health, and to get the care we need (not less and not more) in timely, effective, and personal ways consistent with our values. The audacious goals set an agenda with priorities from the PCC community. These include shared decision making by consumers, ensuring health care professionals are trained in supporting active patients, anticipating health and long-term care needs for individuals, adopting the Institute of Medicine's (IOM) simple rules for health care, and making the patient perspective a priority in policy and planning. Each of us and our organizations are confronted with the challenge of this vision and audacious goals. Health care professionals and provider systems, whether conventional or alternative in nature, face these issues. While complementary and alternative medicine (CAM) providers often get higher marks from consumers for their attention, many CAM modalities are largely provider-determined. Patient-centered care will require more empowerment and activation of patients and consumers.