Defining and implementing patient-centered care: An umbrella review

Area of Science:

• Healthcare Delivery
• Patient-Centered Care Research
• Health Systems Implementation

Background:

• Patient- or person-centered care (PCC) is crucial for integrating patient preferences, values, and beliefs into healthcare decision-making.
• Existing gaps in defining and implementing PCC necessitate further research into its core components and practical application.

Purpose of the Study:

• To identify the core elements of person-centered care (PCC).
• To synthesize facilitators and barriers for implementing PCC in community and primary care settings.
• To inform future definitions and practical integration of PCC.

Main Methods:

• An umbrella review of 10 systematic reviews was conducted, including peer-reviewed literature for adult primary care settings.
• Data extraction and quality appraisal were performed by two independent reviewers.
• Thematic analysis and narrative synthesis were used to analyze findings from 2371 screened citations.

Main Results:

• Ten definitions of PCC were identified, sharing common elements like patient empowerment, individuality, and a biopsychosocial approach.
• Key implementation factors included communication strategies, healthcare provider training, and organizational structures.
• The review identified clinician empowerment and system-level culture change as areas for future focus.

Conclusions:

• A synthesis of core PCC elements provides a foundation for a future, comprehensive definition.
• Understanding implementation facilitators and barriers is essential for integrating PCC into routine practice.
• Prioritizing clinician empowerment and system-level culture change will advance the routine integration of PCC.