Hammerly

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Person-Centered Care THE Organizing Principle for Healthcare Milt Hammerly, MD

IOM Principles - STEEEP: 

IOM Principles - STEEEP Safe Timely Effective Efficient Equitable Patient-Centered

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patient n. One who, or that which, is passively affected; a passive recipient.Malice is a passion so impetuous and precipitate that often involves the agent and the patient. --Gov. of Tongue. A person under medical or surgical treatment; -- correlative to physician or nurse.Like a physician, . . . seeing his patient in a pestilent fever. --Sir P. Sidney.In patient, a patient who receives lodging and food, as treatment, in a hospital or an infirmary.Out patient, one who receives advice and medicine, or treatment, from an infirmary.Source: Webster's Revised Unabridged Dictionary, © 1996, 1998 MICRA, Inc.

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patient adjective Synonyms:  accommodating, calm, composed, easy-going, enduring, even-tempered, forbearing, forgiving, gentle, imperturbable, indulgent, lenient, long-suffering, meek, mild, mild-tempered, persevering, persistent, philosophic, philosophical, quiet, resigned, self-possessed, serene, stoical, submissive, tolerant, tranquil, uncomplaining, understanding, unruffled, untiring noun Synonyms:  case, convalescent, emergency, inmate, invalid, outpatient, shut-in, sick person, subject, sufferer, victim Source:  Roget's New Millennium™ Thesaurus, First Edition (v 1.0.5)Copyright © 2004 by Lexico Publishing Group, LLC. All rights reserved.

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per·son n. A living human. The composite of characteristics that make up an individual personality; the self. The living body of a human. Physique and general appearance. Source: The American Heritage® Stedman's Medical DictionaryCopyright © 2002, 2001, 1995 by Houghton Mifflin Company. Published by Houghton Mifflin Company. Person Noun Synonyms:  being, bird, body, cat, chap, character, dude, fellow, guy, human, identity, individual, individuality, joker, lad, life, living soul, man, mortal, party, personage, personality, self, somebody, soul, specimen, spirit Source:  Roget's New Millennium™ Thesaurus, First Edition (v 1.0.5)Copyright © 2004 by Lexico Publishing Group, LLC. All rights reserved.

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(Person-Centered) Integrative Healthcare Philosophy Therapies Safety Science

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Unifying Taxonomy (based on presumed mechanisms of action) Comprehensive Personalized Collaborative in scope by design of necessity Patient triage (risk-stratification) Contextually ranked evidence (Person-Centered) Integrative Healthcare Biochemical Structural Movement Environment Mind-Body Energy Pharmacy Surgery CAM Biochemical CAM Structural Less Aggressive More Aggressive Less Risky More Risky Less Costly More Costly Less Passive More Passive

Potential Mechanisms of Interactions(good or bad): 

Potential Mechanisms of Interactions(good or bad) Pharmacokinetic (A.U.C.) E Absorption Binding Permeability Brush border transport Circulation Precipitation Transit time E Metabolism-½ life Liver P-450 system Renal Other tissues Metabolite modulation Pharmacodynamic Receptor site competition Additive therapeutic effect Same mechanism/active ingredient Other mechanism/active ingredient Reduced therapeutic effect Opposite mechanism Other mechanism Additive toxicity Same mechanism/active ingredient Other mechanism/active ingredient Reduced toxicity Repletion/depletion Altered physiology/other

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When did it become illicit to elicit … … the mind-body response? “A mind is a terrible thing to waste.” (UNCF)

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Medical Care Mind-body Medicine Self- Care Healthcare (per Dr. Herbert Benson)

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Professional Care Coaching Self- Care Healthcare What supports the stool? What the stool supports ... Disintermediate whenever possible Empower however possible If needed

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Professional Care Coaching Self- Care Healthcare What supports the stool? What the stool supports ... … a person! Solid Ground Collaborative Coalition (stakeholders to include: employers, insurers, policymakers, providers, NGOs, manufacturers, vendors, etc.)

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Person Products Payers Purchasers Providers Policy (Products can include foods, programs, info, decision support tools, etc.)

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Person Products Payers Purchasers Providers Policy Actualization is the capstone

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Maslow’s Hierarchy Person-centered care strives to meet all of a person’s needs. Body Mind Spirit