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The philosophy of patient and family-centered care is founded on the belief that health outcomes are improved by partnering among health care providers, patients, and their families. This belief permeates the health care system and does not represent a specific therapy that is applied as part of a treatment plan. The patient/family-centered care (P/FCC) approach affects nearly every interaction and decision in our health care system. In the literature, there is no uniform definition of patient and family-centered care. Therefore, it is best described by its fundamental principles: respect and dignity, information, participation, collaboration, and flexibility.

Respect and Dignity

Treat each family with respect. Although individual physicians and nurses typically are respectful in their interaction with patients, the health care system was not designed to afford dignity and respect to patients. The system often values providers’ needs and time over that of patients (waiting rooms, double-booked schedules, etc). Patients are often referred to by numbers or diagnoses. Patients in a hospital setting are often asked to wear uncomfortable clothing and are subject to rules beyond their control. Many of the routine policies and procedures that seemingly disregard patients’ comfort and dignity are now changing. Treating patients and families with honor, addressing them as they wish to be addressed, asking permission to examine, and learning about their strengths and human history in addition to their medical history exemplifies this core principle of respect and dignity. Consideration must be given to physical comfort and modesty of patients and families. Families must be included in discussions regarding their care and treatment plan. This was successfully accomplished at one major children's hospital by instituting a system of “family-centered rounds” that included the family in all discussions and planning decisions regarding diagnosis and care. Family and care team satisfaction improved.1


Access to health information is a basic right of patients. Implementing the patient and family-centered care philosophy involves transfer of control of information from the health care system to the patient and family. Respecting the absolute confidentiality of information as it is used by the health care system is imperative.

Traditional paper charts kept separately by each provider and hospital are being replaced by interconnected electronic health records and databases. As the electronic system is implemented, designers are faced with the decision of who “owns” the information. Many hospitals now give patients complete access to their charts during a hospital stay. Some give the patient control of all information, and the patient or family grants access to hospitals or physicians. This is particularly helpful for families of children with chronic conditions who previously needed to wait for busy professionals to contact them with test results. They worried about delays in care and information being overlooked. Access promoted improved self-management and interaction with providers.2 The Internet allows patients to have nearly the same access as physicians to the health literature. Patients ...

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