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Abstract

Details

Reconsidering Patient Centred Care
Type: Book
ISBN: 978-1-80071-744-2

Article
Publication date: 21 September 2015

Angelina Taylor and Oliver Groene

The spotlight has recently been placed on managers’ responsibility for patient-centred care as a result of Mid Staffordshire NHS Foundation Trust failings. In previous…

Abstract

Purpose

The spotlight has recently been placed on managers’ responsibility for patient-centred care as a result of Mid Staffordshire NHS Foundation Trust failings. In previous research, clinicians reported that managers do not have an adequate structured plan for implementing patient-centred care. The purpose of this paper is to assess the perceptions of European hospital management with respect to factors affecting the implementation of a patient-centred approach.

Design/methodology/approach

In total, 15 semi-structured interviews were conducted with hospital managers (n=10), expert country informants (n=2), patient organisations (n=2) and a user representative (n=1) from around Europe. Participants were purposively and snowball sampled. Interviews were analysed using framework analysis.

Findings

Most participants felt that current levels of patient-centred care are inadequate, but accounted that there were a number of macro, meso and micro challenges they faced in implementing this approach. These included budget constraints, political and historical factors, the resistance of clinicians and other frontline staff. Organisational culture emerged as a central theme, shaped by these multi-level factors and influencing the way in which patient-centred care was borne out in the hospital. Participants proposed that the needs of patients might be better met through increasing advocacy by patient organisations and greater staff contact with patients.

Originality/value

This study is the first of its kind to obtain management views from around Europe. It offers an insight into different models of how patient-centred care is realised by management. It indicates that managers see the value of a patient-centred approach but that they feel restricted by a number of factors at multiple levels.

Details

Journal of Health Organization and Management, vol. 29 no. 6
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 6 February 2020

Agnieszka Sobolewska, Amy-Louise Byrne, Clare Lynette Harvey, Eileen Willis, Adele Baldwin, Sandy McLellan and David Heard

The purpose of the paper is to explore how the national, state and organisational health policies in Australia support the implementation of person-centred care in…

Abstract

Purpose

The purpose of the paper is to explore how the national, state and organisational health policies in Australia support the implementation of person-centred care in managing chronic care conditions.

Design/methodology/approach

A qualitative content analysis was performed regarding the national, state and organisational Queensland Health policies using Elo and Kyngas' (2008) framework.

Findings

Although the person-centred care as an approach is well articulated in health policies, there is still no definitive measure or approach to embedding it into operational services. Complex funding structures and competing priorities of the governments and the health organisations carry the risk that person-centred care as an approach gets lost in translation. Three themes emerged: the patient versus the government; health care delivery versus the political agenda; and health care organisational processes versus the patient.

Research limitations/implications

Given that person-centred care is the recommended approach for responding to chronic health conditions, further empirical research is required to evaluate how programs designed to deliver person-centred care achieve that objective in practice.

Practical implications

This research highlights the complex environment in which the person-centred approach is implemented. Short-term programmes created specifically to focus on person-centred care require the right organisational infrastructure, support and direction. This review demonstrates the need for alignment of policies related to chronic disease management at the broader organisational level.

Originality/value

Given the introduction of the nurse navigator program to take up a person-centred care approach, the review of the recent policies was undertaken to understand how they support this initiative.

Details

Journal of Health Organization and Management, vol. 34 no. 2
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 18 May 2015

Rebecca Elvey, Karen Hassell, Penny Lewis, Ellen Schafheutle, Sarah Willis and Stephen Harrison

Research on patient-centred professionalism in pharmacy is scarce compared with other health professions and in particular with pharmacists early in their careers. The…

1952

Abstract

Purpose

Research on patient-centred professionalism in pharmacy is scarce compared with other health professions and in particular with pharmacists early in their careers. The purpose of this paper is to explore patient-centred professionalism in early career pharmacists and to describe reported behaviours.

Design/methodology/approach

This study explored patient-centred professional values and reported behaviours, taking a qualitative approach. In all, 53 early-career pharmacists, pharmacy tutors and pharmacy support staff, practising in community and hospital pharmacy in England took part; the concept of patient-centred professionalism was explored through focus group interviews and the critical incident technique was used to elicit real-life examples of professionalism in practice.

Findings

Triangulation of the data revealed three constructs of pharmacy patient-centred professionalism: being professionally competent, having ethical values and being a good communicator.

Research limitations/implications

It is not known whether our participants’ perspectives reflect those of all pharmacists in the early stages of their careers. The data provide meaning for the concept of patient-centred professionalism. The work could be extended by developing a framework for wider application. Patient-centred professionalism in pharmacy needs further investigation from the patient perspective.

Practical implications

The findings have implications for pharmacy practice and education, particularly around increased interaction with patients.

Social implications

The data contribute to a topic of importance to patients and in relation to UK health policy, which allocates more directly clinical roles to pharmacists, which go beyond the dispensing and supply of medicines.

Originality/value

The methods included a novel application of the critical incident technique, which generated empirical evidence on a previously under-researched topic.

Details

Journal of Health Organization and Management, vol. 29 no. 3
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 10 May 2021

Nyree J. Taylor, Reeva Lederman, Rachelle Bosua and Marcello La Rosa

Capture, consumption and use of person-centred information presents challenges for hospitals when operating within the scope of limited resources and the push for…

Abstract

Purpose

Capture, consumption and use of person-centred information presents challenges for hospitals when operating within the scope of limited resources and the push for organisational routines and efficiencies. This paper explores these challenges for patients with Acute Coronary Syndrome (ACS) and the examination of information that supports successful hospital discharge. It aims to determine how the likelihood of readmission may be prevented through the capturing of rich, person-specific information during in-patient care to improve the process for discharge to home.

Design/methodology/approach

The authors combine four research data collection and analysis techniques: one, an analysis of the patient record; two, semi-structured longitudinal interviews; three, an analysis of the patient's journey using process mining to provide analytics about the discharge process, and four, a focus group with nurses to validate and confirm our findings.

Findings

The authors’ contribution is to show that information systems which support discharge need to consider models focused on individual patient stressors. The authors find that current discharge information capture does not provide the required person-centred information to support a successful discharge. Data indicate that rich, detailed information about the person acquired through additional nursing assessments are required to complement data provided about the patient's journey in order to support the patients’ post-discharge recovery at home.

Originality/value

Prior research has focused on information collection constrained by pre-determined limitations and barriers of system design. This work has not considered the information provided by multiple sources during the whole patient journey as a mechanism to reshape the discharge process to become more person-centred. Using a novel combination of research techniques and theory, the authors have shown that patient information collected through multiple channels across the patient care journey may significantly extend the quality of patient care beyond hospital discharge. Although not assessed in this study, rich, person-centred discharge information may also decrease the likelihood of patient readmission.

Details

Information Technology & People, vol. 34 no. 6
Type: Research Article
ISSN: 0959-3845

Keywords

Article
Publication date: 11 November 2014

Laura Lord and Nicola Gale

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…

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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.

Details

Journal of Health Organization and Management, vol. 28 no. 6
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 11 April 2016

Anja Svejgaard Pors

The purpose of this paper is to examine how strategic, patient-centred communication plays a part in the discursive management of expectations posed to patients and…

Abstract

Purpose

The purpose of this paper is to examine how strategic, patient-centred communication plays a part in the discursive management of expectations posed to patients and healthcare organizations.

Design/methodology/approach

The paper provides an analysis of four documents collected as part of an ethnographic case study regarding “The Perspective of the Patient” – a Danish Hospital’s patient-centred communication programme. Mapping methods inspired by Grounded Theory are used to qualify the analysis.

Findings

The paper shows that strategic patient-centred communication addresses both a care-oriented approach to the patient and deploys market perceptions of patients. Market and care is seen as co-existing organizing modes that entail expectations to the patient. In the communication programme the patient is constructed in six information-seeking patient figures: affective patient; target group patient; citizen with rights; patient as a competent resource; user as active partner; and consumer. As a result, the patient-centred communication programme renders the patient as a flexible figure able to fit organizational demands of both care orientation and market concerns.

Originality/value

This study contributes to qualitative research in organizational health communication by combining two subfields – patient-centredness and health communication – in an empirical study of how market and care are intertwined in a patient-centred communication programme. The argument goes beyond the prevalent prescriptive approaches to patient-centredness and healthcare communication, instead providing a critical analytical perspective on strategic communication and patient-centredness and showing how expectations are posed to both patient and organization.

Details

Journal of Health Organization and Management, vol. 30 no. 2
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 29 August 2008

Lidia Del Piccolo, Maria Angela Mazzi, Silvia Scardoni, Martina Gobbi and Christa Zimmermann

The prupose of this paper is to present the development of the Verona PatientCentred Communication Evaluation (VR‐COPE) scale, together with its psychometric properties…

1230

Abstract

Purpose

The prupose of this paper is to present the development of the Verona PatientCentred Communication Evaluation (VR‐COPE) scale, together with its psychometric properties. The nine item rating scale assesses the content and relational aspects of patientcentred communication during medical consultations on the basis of a multidimensional evaluation as suggested by the more recent literature in the field. Each item is defined by operational definitions.

Design/methodology/approach

A sample of 246 transcribed primary care consultations was rated with the VR‐COPE. Explorative factor analysis, Pearson correlation coefficients and internal consistency using Cronbach's alpha were calculated. Convergent validity with the Verona Medical Interview Classification System (VR‐MICS) was also tested. A sub sample of 32 consultations was used to assess inter‐rater reliability.

Findings

Interrater reliability and internal consistency were good (overall Cronbach alpha=0.75). Four factors (explaining 74 per cent of the variance) were extracted by exploratory factor analysis. Six items of the VR‐COPE correlated significantly with specific communication skills evidenced by the VR‐MICS and pertained to the physician's ability to explore medical or psychosocial issues. The VR‐COPE items on interview structure and shared decision, more related to process than to specific skills, had no equivalent in the VR‐MICS.

Originality/value

The new rating scale responds to the need in communication research for a multidimensional scale that combines the evaluation of specific skills and process aspects.

Details

Health Education, vol. 108 no. 5
Type: Research Article
ISSN: 0965-4283

Keywords

Article
Publication date: 1 June 2010

Signe Vikkelsø

This paper seeks to explore the challenges and transformations in healthcare resulting from building information infrastructures for patientcentred care.

1401

Abstract

Purpose

This paper seeks to explore the challenges and transformations in healthcare resulting from building information infrastructures for patientcentred care.

Design/methodology/approach

Four types of information infrastructures are analysed with special attention given to the efforts and controversies related to their mobilization and to their consequences for patientcentred care. Data are gathered through a literature review and by empirical research.

Findings

The development of information infrastructures for patientcentred care requires mobilization of technical, legal, clinical and ethical standards as well as a change in organizational and professional boundaries. Furthermore, the mobilization of information infrastructures entails unexpected transformation in the nature of patients, professionals, health records and consultations.

Practical implications

Patientcentred information infrastructures call for institutional innovation and decision making regarding basic structures and relationships in healthcare. At the same time, the ambitions of patientcentred care should be broad enough to learn from the consequences of emerging infrastructures for the patient and professional identities and for the quality of care.

Originality/value

The paper contributes to the understanding of healthcare governance by conceptualizing and empirically exploring the role of information infrastructure as a formative part of patientcentred care.

Details

International Journal of Public Sector Management, vol. 23 no. 4
Type: Research Article
ISSN: 0951-3558

Keywords

Article
Publication date: 1 February 2000

Kerry‐Ann Gilmore and Owen Hargie

Watson and Gallois have argued that “at the very core of health communication is the interaction between health professionals and their patients”, and thus effective and…

1041

Abstract

Watson and Gallois have argued that “at the very core of health communication is the interaction between health professionals and their patients”, and thus effective and quality communication between doctor and patient is imperative.

Details

International Journal of Health Care Quality Assurance, vol. 13 no. 1
Type: Research Article
ISSN: 0952-6862

Keywords

1 – 10 of over 4000