As with other forms of value-based health care, patient-centered care requires a shift in the way provider practices and health systems are designed, managed, and reimbursed. In keeping with the tenets of patient-centeredness, this shift neither happens in a vacuum, it driven by traditional hierarchies in which providers or clinicians are the lone authority. Everyone, from the parking valet and environmental services staff to c-suite members, are engaged in the process, which impacts hiring, training, leadership style, and organizational culture. Patient-centered care also represents a shift in the traditional roles of patients and their families from one of passive “order taker” to one of active “team member.” One of the country’s leading proponents of patient-centered care, Dr. James Rickert, has stated that one of the basic tenets of patient-centered care is that “patients know best how well their health providers are meeting their needs.” To that end, many providers are implementing patient satisfaction surveys, patient and family advisory councils, and focus groups, and using the resulting information to continuously improve the way health care facilities and provider practices are designed, managed, and maintained from both a physical and operational perspective so they become centered more on the individual person than on a checklist of services provided. As the popularity of patient- and family-centered health care increases, it is expected that patients will become more engaged and satisfied with the delivery of their care, and evidence of its clinical efficacy should continue to mount.

Will turn to me at midnight with a cry

“The change we made in January was in recognition of the fact that we needed to shift resources from capturing knowledge — which we've been doing almost exclusively for the past five years — toward packaging and distributing knowledge into easy-to-consume formats like video and Spotify Behind the Lyrics,” Lehman told The Verge.

prosum-ers

the one that patients and families often have the greatest control over is making decisions that are in the patient’s best interest

one can obtain good indications for theexistence of alternative attractors from field data, but theycan never be conclusive. There is always the possibilitythat discontinuities in time series or spatial patternsare due to discontinuities in some environmental factor.Alternatively, the system might simply have a thresholdresponse (Figure 2b).

Catastrophic regime shifts inecosystems: linking theory toobservation

A graphical model of a vegetation-water feedback

The obvious intuitive explanation for a sudden dra-matic change in nature is the occurrence of a sudden largeexternal impact. However, theoreticians have long stressedthat this need not be the case. Even a tiny incrementalchange in conditions can trigger a large shift in somesystems if a critical threshold known as ‘catastrophicbifurcation’ is passed[11].

To answer your unspoken thought here, I am not responsible for your being in this position. Nor could I be, if I wanted to. I am simply telling you where you are by virtue of your own unfolding Being, and to that extent, at least, you are not in the dark. I have nothing to do with it one way or the other. I cannot hold you to it or relive you of it, put you in it, or get you out of it. Being as Conscious Being, and not as three-dimensional man, is the shift which you are experiencing at this time. It cannot be altered in any way, just as the three-dimensional, objective delivery of a baby, once begun, is not a matter of choice in any way.

When you are observing the three-dimensional universe, and you are interpreting it as existing and functioning on its own, then substance, as you are seeing it, has absolutely nothing to do with Substance as It Is. The flaw in your interpretation—the distortion of this partial or finite view—causes what is seen, heard, felt, tasted, and smelled to seem to be capable of sickness, decay, and death. These are dysfunctions which the Actuality of what you see, hear, taste, smell, and feel is totally incapable of. The shift we have been discussing for the past few months involves a shift of the point of awareness from an objective placement to a subjective placement, wherein each and every Actual idea of Mind is experienced and recognized as being absolutely mental.

I recognize fully from my own experience that this is not an easy step to make, because it is not a head trip. Rather, it is a matter of being willing to be—without conscious thought processes being used for any purpose other than relating or describing what your Being is being. Fundamental to your being able to let go is going to be your willingness to trust what you already theoretically know. That the entire Nature of your Being is absolutely and totally constructive—that It is actually fulfilling Itself at this very moment in all Its completeness with absolute perfection. If you are able to trust that Fact, even though it may require some imagination, rather than some believing, you will find it easier to let go of any vestige of control that you think you ought to be able to exercise. As soon as you are able to do this, you will find the picture change, as we have talked about before. In effect, you will be seeing from the Center of your Being, rather than from the surface of your concepts.