FACE-off for Patient-Centered Care

The acronym FACE is a quick and easy way to remember that Patient-Centered Care (PCC) involves the four factors that make PCC possible.

F is for Focused. This requires that the HCP be focused on the patient, not on faculty, academia, research or on publications.1 The HCP must be fully present, mentally and physically and pay attention not only to the patient’s body language but also their own.

A is for Awareness and Avoiding Assumptions. Realization that communication can be a minefield, the HCP avoids stereotyping patients; ensures that communication takes place by asking open ended questions; asks the patient to explain what has been told to them and ensures that the patient participates and understands what has been discussed. The HCP solicits the patient’s key concerns and addresses them specifically.

C stands for Communication and Cultural Consideration. Communication and counseling are the keys to success for both teamwork and for trust in relationships. Patient-HCP communication is enhanced when it is non-judgmental, compassionate and based on the five A’s of patient counseling: that of assessing patient needs, advising, agreeing on what can and should be done, assisting patients and making all necessary arrangements to help the patient.2

While awareness is the first step, cultural consideration involves negotiating with the patient and family and realizing that management beliefs and behaviour are tied to both inflammatory profiles and clinical outcomes.3

Culture strongly influences choices for treatment.

 E stands for Empathy in the Encounter.  It involves the realization that every encounter is a cultural encounter. Beyond sympathy, empathy implies that the HCP tries to see everything from the patient’s perspective. Recommendations for treatment are negotiated with the patient in keeping with their beliefs, customs and expectations.

The asthma educator is in a remarkable position to offer patients with a chronic disease the chance to control their own health initially under guidance; to move from dependence on HCP to independence in management of this chronic disease. There is no greater success for an educator than to teach a patient so that one is no longer needed.

It is time to move from a service-oriented delivery of health care to a patient-centered one. Dr Irwin, in his convocation speech to the American College of Chest Physicians read their pledge on patient-focussed care (PFC). It states that: “PFC is compassionate, is sensitive to the everyday and special needs of patients and their families, and is based on the best available evidence. It is interdisciplinary, safe and monitored. To ensure the provision of PFC in my professional environments, I shall willingly embrace the concepts of lifelong learning and continuous quality improvement.”1 It is a pledge that every health professional can and should take for PCC is an on-going process that requires practice, persistence and commitment.

References

  1. Irwin, RS.  Patient-Focused Care: the 2003 American College of Chest Physicians Convocation Speech. Chest 2004; 1125: 1910-12)
  2. Teutsch C. Patient-doctor communication. Med Clin North Am. 2003;87(5):1115-45.
  3. Walker HA, Chim L, Chen E. The role of asthma management beliefs and behaviors in childhood asthma: immune and clinical outcomes. J Ped Psych 2009; 34(4): 379-388