Veterans’ experiences of patient-centered care: Learning from guided tours

摘要

In this paper the authors seek to examine Veterans’ experiences with patient-centered care (PCC) at 2 United States Veterans Affairs (VA) facilities. The authors conduct their research through a process of guided tours, in which the participant leads the evaluator through an environment and shares thoughts, feelings, and experiences. Tours were conducted in April 2013 with 30 Veterans receiving care at these VA facilities. Via the tours participants discussed aspects of the environment of care, and described some as ‘welcoming,’ while describing others as ‘chaotic.’ Participants provided multiple examples of PCC, frequently defining PCC in terms of accessibility of appointments, continuity and familiarity with providers, and shared decision-making and communication. They highlighted that their identity as Veterans influenced their preferences for care, including efficiency, need for compassion, and consideration of mental and social health needs. Some suggested VA expand upon this idea of shared identity by creating a ‘Veteran community,’ and including increased opportunities for socialization with other Veterans, and access to the arts. The authors conclude that the impact of shared identity on care preferences has received limited attention in the literature; further, the impact of identity may be unique to Veterans, who represent not only a group of patients being seen at the same facilities, but a social group with shared history and characteristics, as well. These results can be utilized to expand implementation of PCC innovations, to improve health and well-being of Veterans.