Patient-Centered Care Shortens Length of Stay

Healthcare professionals partnering with patients in their own care management can help reduce their hospital stay by one-third, according to a new study.

Researchers at the Sahlgrenska Academy at the University of Gothenburg (Sweden) conducted a study involving 248 consecutive patients hospitalized for symptoms of worsening chronic heart failure (CHF) during 2008 to 2010; 123 of these patients were recruited according to predefined criteria to map usual CHF care and assess outcomes at five designated hospital wards. Based on the mapping, a panel of in-house clinicians and researchers developed measures aimed at aligning usual care with basic person-centered care (PCC) principles. These measures were incorporated into a study protocol to guide care procedures at the same five wards, and PCC was then implemented and evaluated in the remaining 125 patients, with respect to the length of hospital stay (LOS), activities of daily living (ADL), health-related quality of life (HRQL) and 6-month readmission rate.

The results showed that LOS was reduced by one day, while retaining the same ADL measures. When the PCC protocol was fully implemented, LOS was reduced by 2.5 days, and the ADL-level better preserved. Health-related quality of life and time-to-first readmission did not differ. The findings suggest that despite the shorter hospital stay, patients in the PCC groups showed no improvement in quality of life or readmission rate, but did present a significantly improved daily functional capacity. The study was published early online on September 15, 2011, in the European Heart Journal.

“Person-centered care leads to effective and high-quality health care. However, only 60% of the patients in our study actually did receive consistent person-centered care during their entire stay,” said lead author Inger Ekman, MD, PhD, director of the Centre for Person-Centred Care (GPCC) at the Sahlgrenska Academy. “It shows the difficulty of rearranging the healthcare culture since it is based on a person with an illness and not on the person's illness alone. The biggest challenge will be to break the traditional and rigid structure of healthcare.”

PCC takes as its starting point the patient's own experience of the treatment, and begins with a healthcare plan based on the patient's individual condition and limitations. This includes a partnership between the patient and the healthcare professional: the first is an expert in living with the illness and the latter is an expert in the illness itself. The patient's social network is also involved in this process.

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Sahlgrenska Academy at the University of Gothenburg