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BMC Fam Pract. 2019 Feb 25;20(1):35. doi: 10.1186/s12875-019-0918-7.

Actions and processes that patients, family members, and physicians associate with patient- and family-centered care.

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Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave., Ste. 1600, Seattle, WA, 98101, USA.
Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave., Ste. 1600, Seattle, WA, 98101, USA.
National Partnership for Women & Families, 1875 Connecticut Ave., NW, Ste. 650, Washington, DC, 20009, USA.
Institute for Patient- and Family-Centered Care, 6917 Arlington Road, Ste. 309, Bethesda, MD, 20814, USA.
Center for Patient Partnership in Healthcare, American College of Physicians, Washington, DC, USA.
X4Health, Washington, DC, USA.
Palo Alto Medical Foundation Research Institute, 795 El Camino Real, Palo Alto, CA, 94301, USA.
Department of Rehabilitation Medicine, University of Washington, 325 Ninth Avenue, Box 359612, Seattle, WA, 98104, USA.
TrilliumHealth Partners, 100 Queensway West, 6th, Mississauga, ON, L5B 1B8, Canada.



Patient- and family-centered care (PFCC) is increasingly linked to improved communication, care quality, and patient decision making. However, in order to consistently implement and study PFCC, health care systems and researchers need a solid evidentiary base. Most current definitions and models of PFCC are broad and conceptual, and difficult to translate into measurable behaviors and actions. This paper provides a brief overview of all actions that focus group respondents associated with PFCC in ambulatory (outpatient) care settings and then explores actions associated with the concept of "dignity and respect" in greater detail.


We conducted nine focus groups with patients, family members, and physicians in three metropolitan regions across the United States. Group discussions were transcribed and analyzed using a thematic analysis approach.


We identified 14 domains and 47 specific actions that patients, family members, and physicians associate with PFCC. In addition to providing a detailed matrix of these domains and actions, this paper details the actions associated with the "dignity and respect" concept. Key domains identified under "dignity and respect" include: 1) building relationships, 2) providing individualized care, and 3) respecting patients' time. Within these domains we identified specific actions that break down these abstract ideas into explicit and measurable units such as taking time, listening, including family, and minimizing wait times. We identified 9, 6, and 3 specific actions associated, respectively, with building relationships, providing individualized care, and respecting patients' time.


Our work fills a critical gap in our ability to understand and measure PFCC in ambulatory care settings by breaking down abstract concepts about PFCC into specific measurable actions. Our findings can be used to support research on how PFCC affects clinical outcomes and develop innovative tools and policies to support PFCC.


Ambulatory care; Clinical training; Health care improvement; Health care performance measurement; Patient-centered care; Qualitative research

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