Person-centred care in patients with heart failure
A first-ever, ‘proof of concept’ study has proven that person-centred approaches can improve health outcomes in heart failure. The study took place in five designated wards of the Sahlgrenska University Hospital in Gothenburg, working with patients with chronic heart failure (CHF) who had been admitted for worsening heart failure.
What they did
A person-centred intervention was developed by a team of nurses, physicians, physiotherapists and occupational therapists, as well as representatives from the local patient association and the research team.
The intention was to systematically engage patients in planning their own care and discharge, ensuring that the maximum possible information was gathered on their symptoms and circumstances, and that patients aspirations for health and wellbeing featured in their care plans.
What they achieved?
The study demonstrated that a person-centred approach shortened hospital stay, without increasing the risk of readmission or worsening patients’ health related quality of life. In particular it noted that:
- The mean length of stay in the usual care group was 9.22 days, compared with 8.22 days in the PCC group. 1
- Activities of daily living levels were better in the PCC group at hospital discharge.1
- In addition, PCC in patients had a positive effect on reducing self-reported uncertainty in their illness, which was likely to help equip and empower patients to better manage their illness.2
Resources and other practical implications
The authors highlighted several aspects of practical learning from the study:
- Despite the success of the initiative, only 60% of the patients received the entire PCC intervention according to the protocol, highlighting the various barriers to adoption of person-centred approaches in the healthcare setting
- Ongoing effort was required to explain concepts of ‘person-centredness’ and convince medical staff that engaging in person-centred practice was distinct from everyday practice
- Ongoing support was needed to ensure staff made sufficient time for the person-centred model, particularly in the face of busy schedules and competing priorities, suggesting such models require ‘whole organisation’ commitment (e.g. including management)
- Healthcare staff will need support to understand the importance of documenting person-centred feedback (i.e. patients’ preferences for, feelings, and beliefs about their illness or treatment such information) and to understand its purpose and value in improving care and discharge planning.
Links, references, and key reading
- Ekman I, Wolf A, Olsson L-E, et al. Effects of person-centred care in patients with chronic heart failure: the PCC-HF study. European heart journal 2011.
- Dudas K, Olsson LE, Wolf A, et al. Uncertainty in illness among patients with chronic heart failure is less in person-centred care than in usual care. European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology 2013;12(6):521-8.