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Open Access
Article
Publication date: 13 September 2021

Kristina Rosengren, Petra Brannefors and Eric Carlstrom

This study aims to describe how person-centred care, as a concept, has been adopted into discourse in 23 European countries in relation to their healthcare systems (Beveridge…

4449

Abstract

Purpose

This study aims to describe how person-centred care, as a concept, has been adopted into discourse in 23 European countries in relation to their healthcare systems (Beveridge, Bismarck, out of pocket).

Design/methodology/approach

A literature review inspired by the SPICE model, using both scientific studies (CINHAL, Medline, Scopus) and grey literature (Google), was conducted. A total of 1,194 documents from CINHAL (n = 139), Medline (n = 245), Scopus (n = 493) and Google (n = 317) were analysed for content and scope of person-centred care in each country. Countries were grouped based on healthcare systems.

Findings

Results from descriptive statistics (percentage, range) revealed that person-centred care was most common in the United Kingdom (n = 481, 40.3%), Sweden (n = 231, 19.3%), the Netherlands (n = 80, 6.7%), Northern Ireland (n = 79, 6.6%) and Norway (n = 61, 5.1%) compared with Poland (0.6%), Hungary (0.5%), Greece (0.4%), Latvia (0.4%) and Serbia (0%). Based on healthcare systems, seven out of ten countries with the Beveridge model used person-centred care backed by scientific literature (n = 999), as opposed to the Bismarck model, which was mostly supported by grey literature (n = 190).

Practical implications

Adoption of the concept of person-centred care into discourse requires a systematic approach at the national (politicians), regional (guidelines) and local (specific healthcare settings) levels visualised by decision-making to establish a well-integrated phenomenon in Europe.

Social implications

Evidence-based knowledge as well as national regulations regarding person-centred care are important tools to motivate the adoption of person-centred care in clinical practice. This could be expressed by decision-making at the macro (law, mission) level, which guides the meso (policies) and micro (routines) levels to adopt the scope and content of person-centred care in clinical practice. However, healthcare systems (Beveridge, Bismarck and out-of-pocket) have different structures and missions owing to ethical approaches. The quality of healthcare supported by evidence-based knowledge enables the establishment of a well-integrated phenomenon in European healthcare.

Originality/value

Our findings clarify those countries using the Beveridge healthcare model rank higher on accepting/adopting the concept of person-centered care in discourse. To adopt the concept of person-centred care in discourse requires a systematic approach at all levels in the organisation—from the national (politicians) and regional (guideline) to the local (specific healthcare settings) levels of healthcare.

Details

Journal of Health Organization and Management, vol. 35 no. 9
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 managing…

1139

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 June 2021

Teresa Burdett and Joanne Inman

Due to the need for the development of person-centred integrated models of care with a population health approach, this paper explored contemporary literature in this arena.

1157

Abstract

Purpose

Due to the need for the development of person-centred integrated models of care with a population health approach, this paper explored contemporary literature in this arena.

Design/methodology/approach

A systematic literature review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Papers included in this review focused upon person-centred integrated care and a health promotion/public health approach (January 2018–October 2020). Papers were excluded due to not being written in English, not fitting the age criteria and not being peer reviewed.

Findings

Eight studies met the inclusion criteria and three overarching themes were identified with regards to person-centred integrated care as a health promotion/public health approach: Core components; Development, implementation, and evaluation of models of care and relationship to population health and wellbeing outcomes.

Research limitations/implications

The need for person-centred integrated care as a health promotion/public health approach, to enhance population health and well-being outcomes requires further research to continue to develop, implement and evaluate models of care.

Originality/value

The international scope of this contemporary review brought together the three concepts of person-centred integrated care and public health, exploring the translation of policy into practice (WHO, 2016). The juxtaposition of public health approaches in the background/consequential or foreground/active agent demonstrates how promotion, prevention and population health can be re-valued in integrated people-centred health services (WHO, 2016).

Details

Journal of Integrated Care, vol. 29 no. 3
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 17 June 2011

Jonathan Webster

This paper seeks to demonstrate the role of personcentred assessment in improving the standard of care for people with dementia in acute hospitals.

2013

Abstract

Purpose

This paper seeks to demonstrate the role of personcentred assessment in improving the standard of care for people with dementia in acute hospitals.

Design/methodology/approach

The paper offers a review of recent research and literature on person centred care highlighting its role in acute hospital settings. Case studies are also used by way of illustration.

Findings

Acute hospitals are inherently complex environments which pose particular challenges for the care and management of people with dementia. Evidence drawn from the literature and recent research suggests that personcentred assessment has the capacity to enhance the quality of care for people with dementia and improve outcomes. Patients who are understood, listened to, and responded to tend to display lower levels of challenging behaviour, are calmer, more receptive to accepting treatment and have higher levels of well being. Although experienced nurses working in acute wards often have in‐depth knowledge of older peoples' health‐related needs, a reliance on inflexible “assessment frameworks” can distract them from focusing on the individual. The routinised nature of many ward environments, shift patterns, high staff turnover and weak clinical leadership also act as barriers. Personcentred assessment can be employed to identify the needs of people with dementia based upon their life history and patterns of daily living; it can also underpin the design and delivery of personcentred care and treatment throughout their hospital stay.

Originality/value

The capacity of personcentred care to improve care suggests that it needs to be embedded in gerontological nursing practice in acute hospital settings as a clinical and managerial priority.

Details

Quality in Ageing and Older Adults, vol. 12 no. 2
Type: Research Article
ISSN: 1471-7794

Keywords

Book part
Publication date: 3 July 2018

Bruce Gurd, Cheryll Lim and Ellen Schuler

This chapter reports on a hybrid sector of disability provision in Australia and the changes to the sector due to the shift to person-centred care in Australia. It explains the…

Abstract

This chapter reports on a hybrid sector of disability provision in Australia and the changes to the sector due to the shift to person-centred care in Australia. It explains the significant changes to the way the sector will respond to government and to client demands and how the organisations are responding to this by re-structuring and building new performance measurement systems including Social Return on Investment.

The first part of the chapter is descriptive of the change to person-centred care in the Australian disability sector using public reports. The second part of the chapter looks at the change at a micro level using an analysis of the literature.

Findings illustrate how the National Disability Insurance Scheme has brought about significant change between sectors of government and between providers, both government and non-government. Organisations have had to make significant changes to adapt to the government’s policy and especially funding change. This includes setting new governance and leadership models, changed human resource management practices and performance measurement systems.

The paper is a report relatively early in the transition phases, and therefore, more evidence is needed as the system change progresses. Still, the Australian disability sector provides a powerful example of significant hybridisation changes as a result of a shift to person-centred care.

This is a dramatic change from the Australian government to impose person-centred care. The adaptations of Australian organisations provide an interesting insight for the international community.

Details

Hybridity in the Governance and Delivery of Public Services
Type: Book
ISBN: 978-1-78743-769-2

Keywords

Article
Publication date: 7 April 2021

Louise Kermode

Person-centred care is a fundamental component of any service. This case study aims to explore the delivery of person-centred care in the voluntary sector, discussing how…

Abstract

Purpose

Person-centred care is a fundamental component of any service. This case study aims to explore the delivery of person-centred care in the voluntary sector, discussing how integrating support can be achieved to benefit individuals. It identifies challenges, best practice and learning that can be applied across sectors and promotes further enquiry.

Design/methodology/approach

This case study is the result of a service audit at a mental health charity. The findings are a blend of reflections, observations and examples from service delivery, synthesised with national policy to provide evidence of best practice and processes that enable person-centred care.

Findings

A focus on need not diagnosis, creating accessible and inclusive services, employing dual trained practitioners, having a varied skill mix along with holistic self-assessment tools are all enablers for integrated person-centred support. Multi-agency assessment frameworks, collaboration across services, cross-agency supervision and a shared vision for integration and person-centred care support services to coordinate more effectively. Barriers to integrated person-centred support include complex physical and mental health needs and harmful risk and safeguarding. The diversity of the voluntary sector, a lack of resources along with complex and competitive funding also hinder integration.

Originality/value

This case study provides a valuable insight into the voluntary sector and shares its findings to enhance best practice. It aims to promote interest and invites further research into health and social care delivery by the voluntary sector. As this delivery continues to increase, it is vital to examine the interface between the voluntary and statutory sector. Through better understanding and further research across all sectors, the author can identify how they can achieve person-centred outcomes and deliver the national policies.

Details

Journal of Integrated Care, vol. 29 no. 3
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 29 April 2021

Daniel Lombard

Interpersonal skills are increasingly important tools in long-term care with older people, especially against the backdrop of loneliness affecting older people and expectations…

1308

Abstract

Purpose

Interpersonal skills are increasingly important tools in long-term care with older people, especially against the backdrop of loneliness affecting older people and expectations for a person-centred, joined-up approach. However, the term is used as a composite and its definition lacks shape and focus. In existing literature, participants appear to be selected on the basis of specific illnesses rather than age. Better understanding of the features of everyday communication processes associated with person-centred care can lead to improvements in policy and practice.

Design/methodology/approach

A scoping review examined communication features associated with person-centred care for older adults. This identified the extent and nature of literature. Several databases were searched; after screening and hand-searching, 31 were included. Findings were analysed for patterns and contradictions, against the objectives of person-centred and integrated care.

Findings

Emotional intelligence and the ability to employ various communication styles are crucial skills of person-centred communication. Such approaches can have positive effects on the well-being of older people.

Research limitations/implications

Some studies' validity was weakened by methodological designs being founded on value judgements.

Practical implications

Using personalised greetings alongside verbal and non-verbal prompts to keep residents emotionally connected during personal care is considered good practice. Stimulating feedback from people using services and their relatives is important.

Originality/value

The role of communication is highlighted in many professional guidance documents on person-centred and integrated care, but the process of implementation is decentralised to individual employers and workers. This paper draws on the findings of contemporary literature, grounded in naturalistic data, with implications for practice and policy.

Details

Journal of Integrated Care, vol. 29 no. 3
Type: Research Article
ISSN: 1476-9018

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 organisational…

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: 1 February 2012

Elaine Argyle

Dementia care is an issue of increasing policy focus, with person centred approaches becoming synonymous with quality provision in this area. However, the implementation and…

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Abstract

Purpose

Dementia care is an issue of increasing policy focus, with person centred approaches becoming synonymous with quality provision in this area. However, the implementation and efficacy of this approach is difficult to measure and there are still huge variations in working practices, with task centred approaches traditionally predominating over more holistic forms of care. In order to address these issues the procedure of dementia care mapping has been developed, which aims to assess the wellbeing of people with dementia and other vulnerable groups through the observation of communal activities. This article aims to critically assess the implementation of a person centred approach.

Design/methodology/approach

With the use of dementia care mapping, this article assesses the implementation of a person centred approach with a group of care home residents. All were female, their ages ranged from 77 to 92.

Findings

It is shown that while participants potentially experienced many benefits from person centred approaches and the social engagement and integration that derived from this, its efficacy and impact was undermined by contextual factors such as staff shortages.

Originality/value

In order that contextual factors are recognised and addressed, practice should transcend its focus on the promotion of individual wellbeing and address the wider group and social contexts which can facilitate or prevent its fulfilment.

Details

Working with Older People, vol. 16 no. 2
Type: Research Article
ISSN: 1366-3666

Keywords

Abstract

Details

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

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