Patient centered care Flashcards
(28 cards)
Lean into discomfort because
it is how you learn and grow
Why to study patient-centered care
- ethical obligation as health professionals to ensure this for patients and families
- cognitive errors can disrupt patient centered care
- errors in health care can be based on overlearned false ideas about people
How to improve patient centered care
- critical thinking, research, and using other parts of the brain
To care is human, to err is human, and striving to do better is also human
…
Patient Centered care core ideas
- mission and values aligned with patient goals
- care is collaborative, coordinated, and accessible
- physical comfort and emotional well-being are top priorities
- patient and family viewpoints respected and valued
- patient and family included in decisions
- family is welcomed in the care setting
- full transparency and fast delivery of information
What the eyes see… what the brain understands
- don’t always align
Cognitive errors can ______ patient centered care
disrupt
What is a cognitive error
- mental shortcut our brain takes to deal with a lot of information quickly
- part of our brains is designed to make decisions quickly
What to know about cognitive errors
- AKA cognitive biases
- pattern of thinking errors that are systematic and not random
- are a common-place
- often committed unintentionally
- people tend to not be aware of cognitive biases until they are taught to recognize them
- practice catching errors and challenging them
- we catch errors using the prefrontal cortex
- we learn and remember by storing new memories in the temporal lobe
- vulnerable to cognitive biases under time pressure, and when tired or stressed
Availability bias
- decide something based on the first thing that comes to mind
- idea that is most “available”
- recent or memorable experience has extra influence on patient centered decision making
Confirmation bias
- tendency to give greater weight to data that support a preliminary diagnosis while failing to seek or dismissing contradictory evidence
________ _____ _____ about different social groups can also negatively affect patient centered care
overlearned false ideas
groups more likely to be misunderstood in healthcare
- rural, disabilities, LGBTQ, people of color, obese, lower socioeconomic status, older adults, teens, recent immigrants, limited english, religious minorities, women, and men
How men and women are misunderstood in health care
- men: should be strong and stoic, so not seeking help
- women: viewed as emotional and hysterical or too sensitive
Lower quality care occurs systematically for some groups
- not every single person from a group in every situation will experience bad treatment
- on average there is a pattern of some groups receiving worse care
- not always intentional
- cognitive errors are sometime unconscious
- sometimes they are intentional because of overlearned false ideas
- the IMPACT leads to negative health outcomes
Social biases about those from rural areas
- seen as a country bumpkin, redneck, naive, or slow
___ hospital closures if Missouri since 2014
21
- 12 rural hospitals lost
- 12 acute care hospitals lost
Providers misinformed about causes of obesity and experiences of those who are obese
- seen as “lazy” - health care professional won’t listen to patient and make assumptions about weight - results in increased rates of depression and anxiety and decreased self-esteem
- seen as “waste of time” - health care professionals will spend less time with that patient - results in eight bias internalization and will increase levels of disordered eating
- seen a “disgusting” - health professional will misdiagnose the patient - results in patient feeling judged and will be less likely to attempt or succeed at weight loss
Causes of obesity
- genetics are a major cause
- hormonal changed and imbalances
- medications have side effects that contribute to weight gain
- sleep disorders and stress
- bad advice
Limited knowledge on those with disabilities causes
- false assumptions of incompetency - automatically talk to family member
- false assumptions of lack of sexuality - don’t think to have safe sex conversations or reproductive health care discussions
- concerns that those with disabilities are too expensive to care for - don’t invest in accessible equipment
Impact of errors
Risk of wrong diagnosis increase
- patient gets inadequate results or treatment
- patients get delayed referrals for screening and tests
- increased mortality and morbidity
People are disrespected, not believed, misunderstood, and hurt
- health care experience is stressful
- decreased trust for provider
- less likely to return
- health professionals have effectively decreased access to health care
Evidence that white patients are more likely to receive better care than…
- black
- native Americans
- Alaskan natives
- Hispanics
- Native Hawaiian/pacific
eGFR test and race
- GFR test measures how your kidneys are working, but is complicated
- often calculated using math based on creatinine to estimate
- belief that black people have a higher muscle mass than white people
- so, a normal range of eGFR in blacks is much higher than whites
- leads to blacks not getting the medical treatment or not getting a transplant when needed
Race is a social construct
- race is not biological
- there is no race gene
- genetic diversity in humans is .01%
- Human Genome Project in 1990’s confirmed that race is not biological
