Introduction: Client-Centred Care

This is how one client described her experience of client-centred care.  As health care providers, we know how important calm surroundings can be for a client… and ourselves.  As human beings, we also know how crucial it is to feel that there is room to “be ourselves”, fully resourced within our own uniqueness, especially in the face of personal crisis and change.  Client centred care (CCC) can help us, and our clients, accomplish this… and more.

Sounds great.  So why not stop reading this blog and just send out a memo?

The reality is that implementing and maintaining CCC effectively takes hard work, reflection and skillful application.  Health care practices must undergo a transformation from the traditional medical model (paternalism- doing things “to” and “for” people for their “own good”) to dialogue and partnership, “with” clients.  While the health care worker remains the “technical” expert, the client steps up as the expert on themselves and their complex reality.  Transition to this kind of relationship, however worthwhile, brings challenges.  Here are just a few of them:

  1. Front line workers (and management as well) may need to change deeply ingrained habits; give up some control; negotiate new roles; reset boundaries; and address conflicts between opposing values and beliefs.
  2. CCC practices may conflict with the model of care workers are used to, or that other local agencies provide.  Staff need to be fully committed for it to work.
  3. Even when front line workers are willing and eager to practice CCC, they may still fall into old patterns when tired, stressed or confused.
  4. Time constraints, especially if workers lack the knowledge and skill to apply CCC efficiently, may inhibit dialogue with clients
  5. Clients are also accustomed to the medical model and have to consciously make a shift.  Furthermore, some people simply prefer a passive role or, for cultural reasons, believe in deferring to authority.
  6. Language barriers can also make dialogue a challenge
  7. Ill clients may not have the energy or internal resources to participate easily.

So, how do we overcome these roadblocks and any others that we encounter?

 

First let’s get the vision clear

Let’s make sure we know the destination.  What does success with CCC look like?  It helps to keep this in mind, as inspiration, a way to measure progress, and to gauge whether we are heading in the right direction.  Here is what we are looking for:

  1. Satisfied, empowered clients

Through the lens of CCC, we see the client as a multi-levelled (physical, mental, emotional, social and spiritual) individual with unique needs.  Their personal values and preferences inform and guide all care decisions.  We foster and safeguard their autonomy, rights and self-determination. The result is that clients feel heard and validated. They come to trust that their needs will be recognized and addressed.  Furthermore, they don’t expend precious energy trying to maintain their sense of self or resisting avoidable loss of control.  This leaves more reserves for functioning and healing.  As active participants, clients are more invested in following the care plan.  Health literacy grows through dialogue about options and resources. Finally, clients emerge from the experience empowered, equipped to manage on their own after discharge.

  1. Engaged, fulfilled staff

For health caregivers, CCC is an opportunity to grow, personally and professionally.  Effective communication with emphasis on the client’s input helps keep us from inadvertently doing harm through incorrect assumptions.  Interactions with clients become more meaningful.  We come away with a feeling that we have given the client what they really need – that we are truly making a difference.  Consequently, we love our jobs because this is why we entered the field to begin with.

  1. Quality service, employee recruitment and retention

Increased client satisfaction means that your agency is fulfilling its mandate.  As you gain a reputation for giving quality service, revenue and increased staff recruitment follow.  Your employees want to stay because they feel that their work is meaningful.  Quality workers also love the learning and professional development involved.  Team relations improve as communication skills develop.  You can reassure your board of directors or governing body that you are using resources efficiently, on what your clients truly need.  As one client stated:

“I’d like the kind of care that’s in tune with my illness, my history and social context.  That’s the kind of care that’s efficient and effective”

How do we realise this vision?  With the right knowledge, tools and support.

Commitment to CCC at all levels of an agency is key to supporting front line staff in making the change. All agency management and staff need ongoing education and training on CCC.  This includes the opportunity to grow in understanding and to practice new skills.  Consensus on the meaning and practice of CCC among diverse professions and agencies also helps.  Clients and their families need to understand CCC and how it works.  They need knowledge and the tools to help them make good decisions.  Furthermore, they need to be invited to give input at all levels.  Effective IT solutions can help bring this all together.

So, what next?                                                           

How do we deepen our understanding of CCC and its significance?

How can we make sure that we’re on track, and staying on track with our CCC practices?

How can we overcome the barriers?

Where do we look for solutions?

How do we ensure that staff have the knowledge and tools they need?

Where do we find the best resources to support our staff and clients?

One thing you can do is subscribe to this blog. When you do you will receive inspiration and encouragement along with research-based information on:

  • CCC theory and practice
  • barriers and how to overcome them
  • ideas and recommendations for staff and client education
  • helpful internet resources
  • IT solutions

Our goal is to help agencies and health caregivers grow and flourish with CCC.  Join us in this adventure by clicking on the link below.

Coming up

Before we get into the applications, we need to understand CCC itself: where it comes from, why it makes a difference and how it is defined.  Thus, our next two blogs will focus on the history and theory of CCC.  If you want to learn more, subscribe here.

Sources

1.Brookman C, Jakob L, DeCicco, J, Bender, D. (2011). Client-centred care in the Canadian home  and community sector: A review of key concepts, final report. Saint Elizabeth. Retrieved  from: https://www.saintelizabeth.com/getmedia/4aba6e8e-0303-4b9c-9117-a8c22a43f8bd/Client-Centred-Care-in-the-Canadian-Home-and-Community-Sector.pdf.aspx

2.RNAO (rev. 2006). Client centred care best practice guidelines. Retrieved from: https://rnao.ca/sites/rnaoca/files/Client_Centred_Care.pdf

3.Schoot, C.M. (2005). client-centred care: Balancing between perspectives of clients and nurses in home care. Holland: Datawyse boekproducties Maastricht.

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About the Author:

Carol Casey, BEd is a Client-Centred Care Educator working with Invorg.  She has degrees in Adult Education and Gerontology.  Her background is in nursing, where she has worked in the community for many years.  She has been passionate about client-centred care since her days as a health activist in the 1990s.  She loves to read, write and learn new things.  

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