Primer on Patient and Family Centered Care
Radiology is changing and not in the way you may think. Advances in imaging technology have always shaped our chosen profession and will continue to do so throughout our training and during our future practice. But it is not a new technology or imaging modality that is bringing change to radiology. Rather, it is a concept that is not new at all: patient- and family-centered care (PFCC).
PFCC is a model of health care in which patients are viewed as partners and collaborators. It emphasizes the patient’s health care experience and it values direct patient involvement in design of his or her care. PFCC is based upon principles of dignity and respect, information sharing, participation, and collaboration. Although as a term PFCC may be more recent in adaptation, incorporation of a patient’s health care experience dates back through the centuries. Hippocrates recognized patient privacy and the impact of his treatments on a patient’s family and economic stability, defining features of PFCC.
Radiologists in general historically have little direct interaction with patients, save the few exceptions such as pediatric radiologists, interventional radiologists and breast imagers. So why then is PFCC important to our field? Well, health care is experiencing continued reform in the era of the Patient Protection and Affordable Care Act and recent healthcare legislation, including MACRA (the Medicare Access and CHIP Reauthorization Act). This legislation puts emphasis on value for reimbursement. How our value is defined remains a work in progress, but tackling the ever-increasing workload and providing high-quality reports will not be enough.
More importantly, adopting the principles of PFCC in the design of the health care experience is the best thing to do for our patients. I am fortunate enough to have the unique experience of completing a residency at a facility that actively endorses and enacts ideologies of PFCC. Extensive renovations and workflow redesigns have resulted from the dedicated work of collaborative groups including physicians, technologists, nurses, administrators, and importantly, patients.
Patient contribution to these redesigns was evident in my four-year-old son’s patient experience — he recently underwent a tonsillectomy and adenoidectomy. My son’s fears were diminished as he marveled at the electronic styled ceiling tiles, dinosaur etchings on the walls, and brightly colored furniture. He chatted with me about how cool it was that the hospital was built “out of legos” and that he wanted to see the dolphin fountain outside. All of these design elements were chosen by children, both previous and current patients of the children’s hospital. Patient involvement in redesign led to an experience that alleviated my son’s fears and anxiety. These are principles of patient-centered care. Experiences like mine reflect incorporation of PFCC principles into practice and the increased patient satisfaction that comes with it.
Patient- and family-centered care is gaining traction within the medical community and continually recognized by various organizations on a national level. Specifically within radiology, the ACR has charged ahead with the Imaging 3.0® campaign to “provide radiologists the tools and resources necessary to help shape the national health care shift and protect the vital role of radiology.” The ACR Commission on Patient- and Family-Centered Care (CPFCC) was established to ensure “high-quality radiologic care is provided in a manner that incorporates the needs, wants, and values of our patients and communities and leads to improved health care satisfaction.” The CPFCC includes subcommittees comprised of patient advisers, physicians, residents and medical students working together to promote patient- and family-centered care both within and outside of the radiology community. The entire December issue of the JACR® was dedicated to patient- and family-centered care.
As residents and fellows we may get bogged down in reviewing detailed anatomy, understanding radiology physics, and trudging through a high volume call schedule and preparing for the radiology board exams, but it is important for us to remember the patient is the central focus of all our hard work. Without them, we would have no work at all.
For further reading on patient- and family-centered care, I highly recommend the following: