Integrated Care Management (ICM) model goals around person-centered care
- Advocate for the “patient” as “person.” The patient’s values, future plans and desires are honored and respected without exception.
- Position the person at the center of the care planning process. The patient’s personal goals drive care delivery.
- Form collaborative partnerships with individuals, families, caregivers and physicians. Partnerships promote informed, activated, and engaged self-management.
This ICM model principle holds that personal goals drive care and the achievement of those goals leads to improved outcomes. ICM trained clinicians’ partner with individuals, families and caregivers through evidence based practices and tools designed to:
Ensure patients derive the greatest benefits from the healthcare system:
- Shifting away from a care delivery model where the patient is a passive recipient of care, toward facilitation of active patient decision making.
- Providing guidance related to patient options, benefits and risks while considering patient preferences, psycho-social circumstances and lifestyle.
- Advocating for patients and families to ensure their healthcare needs are addressed and met through the alignment of patient skills/abilities with health system demand/complexity.
Engage patients and families:
- Providing a “patient activated” learning environment utilizing the principles of adult education.
- Viewing the patient as the most important person on the team.
- Communicating in health literate terms to facilitate engagement and empowerment.
Equip practitioners with the requisite skills to deliver person-centered care:
- Using the best resources to facilitate the shared decision making process, fostering patient autonomy and choice.
- Identifying, clarifying and supporting the patient’s personal goals using effective interpersonal communication.
- Building relationships through motivational interviewing.