Centering

Centering is a model of group healthcare delivery that is changing how people think about their care. Centering is a rewarding way for patients to participate in their care and for providers to have a dynamic partnership with their patients. Group participants spend more time with their provider and with others with similar health concerns, giving them an opportunity to learn together and from each other.

Outcomes

Outcomes for women receiving care in Centering are uniformly better than for those in traditional care. In a randomized control trial conducted through Yale University on 1047 women in public clinics, there was a 33% reduction in preterm birth for women in Centering groups. In addition, satisfaction with care was significantly higher, there were increased breast feeding rates, and improved knowledge and readiness for birth and parenting.

Centering model

The Centering model has three components: health care assessment, education, and support, provided in a group facilitated by a credentialed health provider and a co-facilitator.

  • Assessment is provided by a licensed healthcare provider during the group time and in the group space. Each participant has a brief individual check-up with the provider. For privacy reasons, these health assessments occur:
    • In a private corner of the group room
    • On a mat/mattress on the floor or slightly elevated comfortable area below knee level
    • With background music playing
    • Optional: a large plant or decorative piece may designate the assessment space
  • Patients participate in self-care activities including assessing their own weight and blood pressure. Parents in weigh and measure their babies. Both patients and provider contribute to the data on patients’ charts.
  • Education is conducted by facilitators who use content guidelines for every session, but allow the actual group discussion to be determined largely by the interests, needs, and concerns of the group.

    Each patient receives a Centering Notebook with educational material for at-home reference. Critical to the empowering design of Centering are the Self-Assessment Sheets (SAS) which are used by participants at the beginning of each session. These SAS introduce the topic(s) for that session and provide a springboard for the facilitated discussion

  • Support, friendships, and community-building are important to the Centering model. These are fostered by the use of nametags, stability of the group, interactive activities, and refreshments at every session. Because the facilitators and the group participants meet for 90-120 minutes on a regular basis, trust and camaraderie develop. Often members choose to meet socially outside the appointment time

The Centering model is on the forefront of system reform and responds to the Institute of Medicine’s Rules for Redesign of the healthcare system. It provides care that is culturally appropriate, often in language-specific groups, and promotes the building of health communities. We invite you to explore further to get additional information on how the Centering Healthcare Institute can help you to change your paradigm of health care delivery to one that is more efficient and satisfying for all.