Patient Centered CareObjective: The purpose of this study is to establish the baseline opinions and attitudes of Military Treatment Facility (MTF) providers and health care leaders regarding their understanding and support of principles of Patient Centered Care (PCC). This study will identify important factors of the MTF organizational environment, structural layout, and provide background and training that may be important indicators of and methods to improve the quality of health care such that it is consistent with recent Institute of Medicine objectives for patient centered approaches to health care delivery.
Results: This study developed a valid and reliable survey to examine clinicians’ PCC attitudes and practices in military hospitals, and examine organizational factors that may affect them. On a 0-100 scale where 100 is the best: Adoption of PCC Attitudes = 80; Adoption of PCC Practices on Establishing a Therapeutic Alliance with Patients= 79; Adoption of PCC Practices on Shared Decision Making = 69; Absence of Management/Staffing Barriers to PCC = 54; and Absence of Military-Related Barriers to PCC = 78 in a sample of MTF providers (not nationally representative). Adjusting for service, duty status, profession, years in profession and gender the following comparisons were noted: Army vs. Air Force: No statistically significant differences on reported PCC attitudes or practices; Lower military-related barriers to PCC in Air Force than Army (6%); and No differences in reported management/staffing barriers to PCC; Active Duty vs. Civilian: Higher PCC practices related to establishing a therapeutic alliance and shared decision making among civilian than active duty clinicians (both 9%) and No differences in reported PCC attitudes or reported barriers to PCC; Registered Nurses vs. Attending Physicians: Higher PCC practices on shared decision making for MDs than RNs (13%); Lower management/staffing barriers to PCC for RNs than MDs (11%); and No differences in reported PCC attitudes or military-related barriers to PCC.