Welcome back to SpineIQ’s Back Blog! This week between November 17th and November 19th the Patient Centered Outcomes Research Institute (PCORI) will be presenting their annual meeting. PCORI has a mission to make research and healthcare more patient centered. This blog will discuss what patient centered care is and how clinicians can make subtle changes in their care to be more patient centered.
Patient centered care
Patient centered care is multi-dimensional with numerous factors including patient as a person, shared decision making, and therapeutic alliance.1 Healthcare professionals can improve their care to be more patient centered by being respectful to patient preferences, listening to their needs and values, and making sure that the patient is informed enough to be able to help guide the clinical decisions in their care.2 A systematic review evaluated the recommendations that are most commonly reported in clinical practice guidelines for musculoskeletal pain.3 The only recommendation that was consistent throughout all 44 clinical practice guidelines was that care should be patient centered by providing individualized care based on patient values, shared decision making, and communication.
Tips to increase patient centeredness in low back pain care
The cornerstone of patient centered care is effective communication between the healthcare professional and patient.4 Some ways to increase effective communication is by incorporating active listening to explore the patients’ beliefs and goals while expressing empathy for their situation and concerns. Some communication tips that clinicians can begin to incorporate to increase the patient centeredness in their care are:
- Show greater interest in the patient compared to the condition
- Validate the patients experience
- Use a mix of both open and closed questions
- Summarize and properly inform the patient
- Explore potential barriers and remaining concerns
- Seek patient involvement by asking the patient to reflect about what they have taken from the assessment and/or understanding of their care options and prognosis
- Use metaphors and analogies to adequately explain ideas to patients
- Elaborate on options for care and the risks/benefits of all the management possibilities
Patient centered care underpins high quality care for musculoskeletal pain. Clinicians spend years in school and practice to improve their knowledge and skills to treat patients. Patient centered care through effective communication has to be seen as a skill that needs to continue to be worked on just like exercise progression, increased knowledge of potential differential diagnosis, and manual therapy techniques. Along with the tips on this blog and our past blogs, we are attaching other resources such as low back pain communication website and Calgary Cambridge communication guide that can help clinicians increase the patient centeredness in their care.
- Institute of Medicine (US) Committee on Quality of Health Care in America. Crossing the Quality Chasm: A New Health System for the 21st Century. National Academies Press (US); 2001. Accessed February 13, 2021. http://www.ncbi.nlm.nih.gov/books/NBK222274/
- Mead N, Bower P. Patient-centredness: a conceptual framework and review of the empirical literature. Soc Sci Med 1982. 2000;51(7):1087-1110. doi:10.1016/s0277-9536(00)00098-8
- Lin I, Wiles L, Waller R, et al. What does best practice care for musculoskeletal pain look like? Eleven consistent recommendations from high-quality clinical practice guidelines: systematic review. Br J Sports Med. 2020;54(2):79-86. doi:10.1136/bjsports-2018-099878
- Lin I, Wiles L, Waller R, et al. Patient-centred care: the cornerstone for high-value musculoskeletal pain management. Br J Sports Med. 2020;54(21):1240-1242. doi:10.1136/bjsports-2019-101918