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Group medical visits can deliver on patient-centred care objectives: results from a qualitative study

BACKGROUND: Patient-centred care emerged in the late 1960s as a framework to guide providers and decision-makers towards the provision of more effective health care and better outcomes. An important body of literature has since emerged, reporting mixed results in terms of outcomes. To date, assessme...

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Autores principales: Lavoie, Josée G, Wong, Sabrina T, Chongo, Meck, Browne, Annette J, MacLeod, Martha LP, Ulrich, Cathy
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3679867/
https://www.ncbi.nlm.nih.gov/pubmed/23627609
http://dx.doi.org/10.1186/1472-6963-13-155
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author Lavoie, Josée G
Wong, Sabrina T
Chongo, Meck
Browne, Annette J
MacLeod, Martha LP
Ulrich, Cathy
author_facet Lavoie, Josée G
Wong, Sabrina T
Chongo, Meck
Browne, Annette J
MacLeod, Martha LP
Ulrich, Cathy
author_sort Lavoie, Josée G
collection PubMed
description BACKGROUND: Patient-centred care emerged in the late 1960s as a framework to guide providers and decision-makers towards the provision of more effective health care and better outcomes. An important body of literature has since emerged, reporting mixed results in terms of outcomes. To date, assessments of the effectiveness of patient-centred approaches have focused one-on-one consultations. The purpose of this article is to explore dimensions identified as key in the patient-centred literature in the context of primary health care services delivered in a group setting. Group Medical Visits (GMVs) offer a novel format for the delivery of patient-centred primary health care services, especially for patients living with complex morbidities. METHODS: Drawing on a large study of GMVs, we report on key format and process-oriented elements identified in GMVs, and on their link to improved outcomes. For the purpose of this study, we interviewed 34 providers and 29 patients who have been engaged in GMVs, delivered in rural, northern and First Nation communities in British Columbia, Canada. RESULTS: Our analysis shows that the delivery of PHC in a group format results in a shift in the role of the provider, from that of an adjudicator involved in imparting norms of self-care, to that of a facilitator who assists the group in defining norms of self-care that are based on medical knowledge but also on the broader context of patients’ lived experience and on their pragmatic experience. In a group process, peer-patients take on the role of promoting these norms to other patients. This results in a significant shift in the role of the provider, increased trust, increased knowledge for the providers and the patients and better patient self-management. Our results also show increase satisfaction for patients and providers. CONCLUSIONS: GMVs offer an alternative format for the provision of PHC that brings together the benefit of a group process and of a clinical encounter. This format can successfully deliver on the promises of patient-centred care.
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spelling pubmed-36798672013-06-13 Group medical visits can deliver on patient-centred care objectives: results from a qualitative study Lavoie, Josée G Wong, Sabrina T Chongo, Meck Browne, Annette J MacLeod, Martha LP Ulrich, Cathy BMC Health Serv Res Research Article BACKGROUND: Patient-centred care emerged in the late 1960s as a framework to guide providers and decision-makers towards the provision of more effective health care and better outcomes. An important body of literature has since emerged, reporting mixed results in terms of outcomes. To date, assessments of the effectiveness of patient-centred approaches have focused one-on-one consultations. The purpose of this article is to explore dimensions identified as key in the patient-centred literature in the context of primary health care services delivered in a group setting. Group Medical Visits (GMVs) offer a novel format for the delivery of patient-centred primary health care services, especially for patients living with complex morbidities. METHODS: Drawing on a large study of GMVs, we report on key format and process-oriented elements identified in GMVs, and on their link to improved outcomes. For the purpose of this study, we interviewed 34 providers and 29 patients who have been engaged in GMVs, delivered in rural, northern and First Nation communities in British Columbia, Canada. RESULTS: Our analysis shows that the delivery of PHC in a group format results in a shift in the role of the provider, from that of an adjudicator involved in imparting norms of self-care, to that of a facilitator who assists the group in defining norms of self-care that are based on medical knowledge but also on the broader context of patients’ lived experience and on their pragmatic experience. In a group process, peer-patients take on the role of promoting these norms to other patients. This results in a significant shift in the role of the provider, increased trust, increased knowledge for the providers and the patients and better patient self-management. Our results also show increase satisfaction for patients and providers. CONCLUSIONS: GMVs offer an alternative format for the provision of PHC that brings together the benefit of a group process and of a clinical encounter. This format can successfully deliver on the promises of patient-centred care. BioMed Central 2013-04-29 /pmc/articles/PMC3679867/ /pubmed/23627609 http://dx.doi.org/10.1186/1472-6963-13-155 Text en Copyright © 2013 Lavoie et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Lavoie, Josée G
Wong, Sabrina T
Chongo, Meck
Browne, Annette J
MacLeod, Martha LP
Ulrich, Cathy
Group medical visits can deliver on patient-centred care objectives: results from a qualitative study
title Group medical visits can deliver on patient-centred care objectives: results from a qualitative study
title_full Group medical visits can deliver on patient-centred care objectives: results from a qualitative study
title_fullStr Group medical visits can deliver on patient-centred care objectives: results from a qualitative study
title_full_unstemmed Group medical visits can deliver on patient-centred care objectives: results from a qualitative study
title_short Group medical visits can deliver on patient-centred care objectives: results from a qualitative study
title_sort group medical visits can deliver on patient-centred care objectives: results from a qualitative study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3679867/
https://www.ncbi.nlm.nih.gov/pubmed/23627609
http://dx.doi.org/10.1186/1472-6963-13-155
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