A retrospective evaluation of the impact of the Planetree patient-centered model of care on inpatient quality outcomes

Abstract

Objective: This retrospective quasi-experimental study evaluated the Planetree patient-centered model of care on inpatient quality outcomes. The research questions to be addressed were: What is the impact of the Planetree patient-centered model of care (1) on patient satisfaction, (2) on clinical outcomes (length of stay and readmission), and (3) on the cost of providing care (cost per case and productive nursing hours per patient day)?

Background: Patients and their families have described a more patient-centered approach as key to meeting their needs. The Planetree model of care provides a framework and operational guidance on how to implement programs targeting these key areas. The link between patient-centered care and quality outcomes such as patient satisfaction, length of stay, readmission, cost per case, and productive nursing hours per patient day has been postulated; however, to date little to no research has been conducted examining this issue.

Methods: This was a retrospective, nonexperimental comparison study evaluating units with the same types of patients and the same skill mix, and with standardized organizational pay rates, supply costs, policies, procedures, contracts, and a regulatory compliance program. This provided a unique opportunity to evaluate the impact on inpatient quality outcomes of the Planetree patient-centered model of care as practiced in the Planetree unit. Data were analyzed using a 2 × 5 analysis of variance (ANOVA) and logistic regression (readmission only). This was a study of five separate cohorts grouped by calendar year rather than a study of repeated measures.

Results: No differences in demographic profiles were noted between the two groups. The patient satisfaction composite mean score evaluation, length-of-stay evaluation, and the cost-per-case evaluation demonstrated that the Planetree group was different from the comparison group (p = <.05 with Eta squared = >.01). This evidence validates that the Planetree patient-centered model of care had a positive impact on patient satisfaction, length of stay, and cost per case.

Conclusions: This evaluation of 869 hospitalized adults undergoing elective total-knee or total-hip joint replacement surgery indicated that the Planetree patient-centered model of care positively affected patient satisfaction, length of stay, and cost per case. Nursing and hospital administrators seeking to improve the inpatient hospital experience should consider implementation of the Planetree patient-centered model of care. Hospitals and healthcare organizations seeking an evidence-based approach to the implementation of patient-centered care will benefit from the information in this study.