3. Person-centred practice and shared decision making

Person-centred practice

Person-centred practice is at the heart of the Case coordination placement model.
Goals have been described as “the essence of rehabilitation” (Barnes & Ward, 2000) and are a key element of person-centred practice.

Person-centred practice

Person-centred practice is treatment and care provided by health services that places the person at the centre of their own care (Victorian Department of Human Services (2003).

Principles of person-centred practice

1. Getting to know the person
2. Sharing of power and responsibility
3. Accessibility and flexibility
4. Co-ordination and integration
5. Having an environment that is conducive to person-centred care

The main barriers to person-centred health practice:
  • Time
  • Dissolution of professional power
  • Staff lacking the autonomy to practice in this way
  • Lack of clarity about what constitutes person-centred care
  • People with communication difficulties
  • The constraining nature of institutions and funding models
  • The risk of the person making a poor decision or a decision that results in harm
Facilitators of person-centred health practice:
  •  Skilled, knowledgeable and enthusiastic staff
  • Involving the service user, their carers, family and community
  • Organisational culture that supports mutual respect and trust and reflects on own values and beliefs
  • Staff training and education, including feedback from service users
  • Organisational support for this approach to practice
  • Being in their own environments (work and home).

Ref: National Ageing Research Institute (2006)

“Managed services” to “self-directed services”

More recently, there has been a world-wide shift away from “managed services” to “self-directed services”, a concept sharing many of the above principles, with a primary focus on flexibility, service choice and self-determination. This approach is derived from health care and disability services, with application to employment services.


Steve's self determination

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