|October 2012 · Vol. 24, No. 10
Patient-centered care: What does it mean and how to implement it?
Jennifer Iannaconne is interviewed by Carol Lesser, Editor of this newsletter series
Carol B. Lesser, MSN, RNC, NP, is a Nurse Practitioner at Boston IVF, Boston, MA.
Carol B. Lesser, MSN, RNC, NP, reports that she has served as a consultant and on the Speakers Bureau for Watson Pharmaceuticals. She received compensation from Watson for her participation in preparing this newsletter.
Improving the quality of medical and emotional care in IVF
A recent article in Human Reproduction concluded that while patients and physicians put considerable emphasis on a clinic’s pregnancy rates, there is insufficient value placed on the importance of patient-centered care.1 The study demonstrated that patients are willing to trade a slightly lower pregnancy rate for care that was more responsive to their needs. The investigators reported that a lack of patient-centered care was the most common nonmedical reason for switching clinics. Patients were also willing to travel a greater distance for what they perceived to be better quality care.
IVF success rates have been steadily improving since the birth of Louise Brown in 1978. Improved patient screening, stimulation protocols, laboratory conditions and techniques, transfer catheters, and training have all contributed to advancement of our field and better pregnancy rates.
The greatest rate-limiting variable appears to be advanced maternal age and oocyte quality. While exciting new research is underway that will attempt to improve oocyte quality through mitochondrial regeneration, it will be years before we know if this, or other approaches, will be clinically relevant.
What vary considerably are how we deliver our care and what role nurses play in humanizing this part of the patient experience. We all work in a competitive economic environment, trying to attract the greatest number of new patients and to retain them once they see us. We can best accomplish this by constantly improving the quality of both medical and emotional care.
The physicians I am fortunate to work with at Boston IVF are representative of reproductive endocrinologists around the world and strive to achieve the highest success rates possible. Equally important is their commitment to offer care in a patient-friendly manner, as long as quality is not compromised. With this in mind, our nurses have been trained to offer medication regimens, patient education, and access to care.
Specifically, this means we offer extensive online patient education and medication instruction. In-person teaching is available for those who learn best that way, but it is not required. Our busy patients appreciate the choice and most opt to review their regimen online and by phone, which our nurses find to be effective.
When it comes to medication delivery, our center was the first to popularize the technique of mixing all injectables together in a single injection, thus eliminating the need for more than 1 shot in most instances. We have demonstrated that success rates do not suffer and patients are immensely grateful for the simplification in medication delivery.
We are able to respond to oncologists who request fertility preservation consults for their distraught patients within 24 hours, offering them prompt egg or embryo cryopreservation when appropriate. Our staff identified a need, and a program was established incorporating a prompt response.
As a large center we are fortunate to be able to offer stress reduction techniques, acupuncture, genetic counseling, nutritionist and weight loss services, as well as support groups and individual counseling. We believe that this array of services and the way we provide them has contributed to our success.
In this issue we explore the approach and services provided by another center: IVF New Jersey. I interview Jennifer Iannaconne, Director of Nursing, to examine how her center approaches the issue of patient-centered, patient-friendly care.
This supplement is supported by
1. van Empel IW, Dancet EA, Koolman XH, et al. Physicians underestimate the importance of patient-centeredness to patients: a discrete choice experiment in fertility care. Hum Reprod. 2011;26(3):584–593.Continue to article
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