To read the full version of this content please select one of the options below:

Subjective experience or objective process: Understanding the gap between values and practice for involving patients in designing patient-centred care

Laura Lord (Department of Health and Population Sciences, University of Birmingham, Birmingham, UK)
Nicola Gale (Primary Care and Clinical Sciences, University of Birmingham, Birmingham, UK)

Journal of Health Organization and Management

ISSN: 1477-7266

Article publication date: 11 November 2014

Abstract

Purpose

Patient-centred care and patient involvement are increasingly central concepts in health policy in the UK and elsewhere. However, there is little consensus regarding their definition or how to achieve “patient-centred” care in everyday practice or how to involve patients in service redesign initiatives. The purpose of this paper is to explore these issues from the perspective of key stakeholders within National Health Service (NHS) hospitals in the UK.

Design/methodology/approach

Semi-structured interviews, covering a range of topics related to service redesign, were conducted with 77 key stakeholders across three NHS Trusts in the West Midlands. In total, 20 of these stakeholders were re-interviewed 18 months later. Data were managed and analysed using the Framework Method.

Findings

While patient-centred care and patient involvement were regularly cited as important to the stakeholders, a gap persisted between values and reported practice. This gap is explained through close examination of the ways in which the concepts were used by stakeholders, and identifying the way in which they were adapted to fit other organisational priorities. The value placed on positive subjective experience changed to concerns about objective measurement of the patients as they move through the system.

Research limitations/implications

Increased awareness and reflection on the conceptual tensions between objective processes and subjective experiences could highlight reasons why patient-centred values fail to translate into improved practice.

Originality/value

The paper describes and explains a previously unarticulated tension in health organisations between values and practice in patient centred care and patient involvement in service redesign.

Keywords

Acknowledgements

This project was funded by the National Institute for Health Research (NIHR) through the Collaborations for Leadership in Applied Health Research and Care for Birmingham and Black Country (CLAHRC-BBC) programme. The views expressed in this publication are not necessarily those of the NIHR, the Department of Health, NHS Partner Trusts, University of Birmingham or the CLAHRC-BBC Management Group.

Citation

Lord, L. and Gale, N. (2014), "Subjective experience or objective process: Understanding the gap between values and practice for involving patients in designing patient-centred care ", Journal of Health Organization and Management, Vol. 28 No. 6, pp. 714-730. https://doi.org/10.1108/JHOM-08-2013-0160

Publisher

:

Emerald Group Publishing Limited

Copyright © 2014, Emerald Group Publishing Limited