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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.

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.

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.

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.

The purpose of this paper is to explore how the patient comes to be seen as a solution to governance problems.

The paper studies health policy discourse in Denmark from 1970 to 2000. Based on an analysis of national policy documents, the paper traces how the patient is redefined as part of governance problems.

The paper suggests that “the new patient” coincides with changes in healthcare governance and is not just a clinical concern. The persona of the patient has been mobilized in dissimilar ways in addressing specific policy problems, resulting in both a duty-based idea of a socio-economically responsible patient and a rights-based idea of a demanding health-service consumer.

The study is limited to policy documents that address healthcare governance in one country. It does not describe the broader evolution of patient ideas or the practical impact of political discourses.

Practitioners should expect to encounter conflicting views of patient responsibilities, interests and involvement. Such conflicts are not only related to a lack of conceptual clarity but are indicative of how the new, active and responsible patient has become a key clinical concern and a central element of health policy governance.

The paper contributes to the understanding of “the new patient” in discussions on patient-centred healthcare and empowerment by emphasizing the definition of the patient in a political context. The latter has often been ignored in existing research.

Recent developments in healthcare contexts increasingly emphasize patient-centred approaches to service quality measures; however, few studies consider this dimension explicitly. The present study develops and psychometrically validates a scale of healthcare service quality explicitly incorporating a patient-centred care dimension from a communicational perspective. The paper also enriches the traditional content of service quality by including equity items and presents the underlying structure of service quality in an emerging country.

The final sample consisted of 869 healthcare users (complete cases in the service quality items derived from 917 surveys received) from Colombia. The authors used a psychometric analytics framework comprising seven processes incorporating exploratory factor analysis, structural equation modelling, and machine learning methods to examine construct plausibility, reliability, construct validity, equity, and criterion/predictive validity (e.g. explaining/predicting subjective well-being and behavioural intentions).

The final scale consists of 17 items and satisfies all psychometric properties. Its validation allows for the discovery and psychometrical confirmation of two essential dimensions: patient-centred communication (eight items) and process quality (nine items).

The authors illustrate three practical uses of the scale: the possibility for diagnoses; hypothesis contrast based on confidence intervals; and estimation of the capacity of the service to satisfy specifications.

Both dimensions reveal users' relevant needs and complement previous studies that have focused on process aspects of healthcare service quality.

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.

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.

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.

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.

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.

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.

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.

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.

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.

The last few years have seen a stronger emphasis on patient-centred care within the international healthcare setting. Patient-centred care is clearly perceived to be important to optimise the satisfaction and well-being of patients. The purpose of this paper is to review current patient-centred practices for outpatients in both private clinics and public hospitals in Dubai. Such a comparison contributes to the identification of best management practices as a means of enhancing healthcare delivery.

This study is based on an independent survey consisting of self-administered questionnaires, in which patients were asked to rate several aspects of private clinics or government hospitals in Dubai. The questionnaire used has been drawn from the Consumer Assessment of Healthcare Providers and Systems Clinician and Group Survey, Version 3.0. Responses from 420 patients form a data set that is analysed quantitatively.

In total, 420 respondents took part in this survey. The results of the survey show that there is a considerable difference between the expectation levels of patients from government hospitals and patients from private clinics. Patients from government hospitals consistently show that time is a critical aspect of the service received, with 68 per cent of the respondents reporting this issue. Additionally, poor customer care, as reported by 14 per cent of the respondents, is also a critical issue. Timely service and appointments are among the main factors that contribute to patient satisfaction. Patients in private clinics, instead, particularly value clear explanations from doctors and nurses – this is corroborated by the fact that 11 per cent of the respondents reported appreciation of this type of service.

This paper draws attention to a patient-centric perspective of healthcare, and highlights the importance of educating patients through clear explanations.

Little evidence exists on the standards of healthcare in Dubai. The authors explore this area and present direct evidence on quality standard implementation, identify implementation shortcomings and make recommendations for future research and practice.

This study aimed to describe facilitators and barriers in terms of regulation and financing of healthcare due to the implementation and use of person-centred care (PCC).

A qualitative design was adopted, using interviews at three different levels: micro = hospital ward, meso = hospital management, and macro = national board/research. Inclusion criteria were staff working in healthcare as first line managers, hospital managers, and officials/researchers on national healthcare systems, such as Bismarck, Beveridge, and mixed/out-of-pocket models, to obtain a European perspective.

Countries, such as Great Britain and Scandinavia (Beveridge tax-based health systems), were inclined to implement and use person-centred care. The relative freedom of a market (Bismarck/mixed models) did not seem to nurture demand for PCC. In countries with an autocratic culture, that is, a high-power distance, such as Mediterranean countries, PCC was regarded as foreign and not applicable. Another reason for difficulties with PCC was the tendency for corruption to hinder equity and promote inertia in the healthcare system.

The sample of two to three participants divided into the micro, meso, and macro level for each included country was problematic to find due to contacts at national level, a bureaucratic way of working. Some information got caught in the system, and why data collection was inefficient and ran out of time. Therefore, a variation in participants at different levels (micro, meso, and macro) in different countries occurred. In addition, only 27 out of the 49 European countries were included, therefore, conclusions regarding healthcare system are limited.

Support at the managerial level, together with patient rights supported by European countries' laws, facilitated the diffusion of PCC.

Fragmented health systems divided by separate policy documents or managerial roadmaps hindered local or regional policies and made it difficult to implement innovation as PCC. Therefore, support at the managerial level, together with patient rights supported by European countries' laws, facilitated the diffusion of PCC.

The application of pervasive systems to healthcare has increased in recent years, but resistance to such systems by patients remains high. In this study, the aim is to examine patient and caregiver perceptions of this technology to further develop an understanding of the benefits and functionalities that prospective patients deem as desirable, undesirable, inadequate or in need of further development. The study was conducted as part of the European Union BraveHealth project which is developing a patient‐centred pervasive healthcare system to support cardiac patients at home in everyday life using innovative monitoring and diagnosis, thereby enabling the patient to be more proactive in health management.

Focus group studies were conducted in Italy and the Midlands area of the UK, along with a 31‐item questionnaire. The findings were categorized under seven main headings: personal profile; benefits; adoption; acceptance; risks; security, privacy and trust; and (use of) cell phone.

In the focus group study, most participants felt that there is a great future for this technology and showed positive response to the potential benefits but there are concerns over reliability, security, privacy and trust.

Even though this study constitutes only a small group of participants, the Italian and UK study does represent similar patients' and caregivers perceptions towards at‐home healthcare systems.

This paper contributes to the understanding of the benefits and functionalities that prospective patients and care‐givers deem as either desirable or undesirable.

The purpose of this paper is two-fold. First, it sets the context for the special issue by considering conceptions of patients and their roles in service delivery and improvement. Second, it introduces the contributions to the special issue, and identifies thematic resonance.

The paper utilises a literature synthesis and thematic analysis of the special issue submissions. These emanated from the Ninth International Organisational Behaviour in Healthcare Conference, hosted by Copenhagen Business School on behalf of the Learned Society for Studies in Organizing Healthcare.

The articles evidence a range of perspectives on patients’ roles in healthcare. These range from their being subject to, a mobilising focus for, and active participants in service delivery and improvement. Building upon the potential patient roles identified, this editorial develops five “ideal type” patient positions in healthcare delivery and improvement. These recognise that patients’ engagement with health care services is influenced both by personal characteristics and circumstances, which affect patients’ openness to engaging with health services, as well as the opportunities afforded to patients to engage, by organisations and their employees.

The paper explores the relationally embedded nature of patient involvement in healthcare, inherent in the interdependence between patient and providers’ roles. The typology aims to prompt discussion regarding the conceptualisation patients’ roles in healthcare organisations, and the individual, employee, organisational and contextual factors that may help and hinder their involvement in service delivery and improvement. The authors close by noting four areas meriting further research attention, and potentially useful theoretical lenses.