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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…

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

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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.

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

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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…

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

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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…

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

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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

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Article
Publication date: 29 April 2021

Kathy Kornas, Meghan O'Neill, Catherine Y. Liang, Lori Diemert, Tsoleen Ayanian, Melissa Chang and Laura Rosella

The purpose of this study is to understand health care providers' experiences with delivering a novel Integrated Care (IC) Program that co-ordinates hospital-based…

Abstract

Purpose

The purpose of this study is to understand health care providers' experiences with delivering a novel Integrated Care (IC) Program that co-ordinates hospital-based clinical services and home care for thoracic surgery patients, including perceptions on the provision of person-centred care and quality of work life.

Design/methodology/approach

The authors conducted a process evaluation using qualitative methods to understand provider experiences in the Integrated Care (IC) Program and to identify areas for programme improvement. Study data were collected using a focus group with thoracic surgeons, open-ended survey with home care providers, and semi-structured interviews with lead thoracic surgeons and IC leads, who are nurses serving as the primary point of contact for one consistent care team. Data were analysed using thematic analysis.

Findings

The IC Program was successful in supporting a partnership between health care providers and patients and caregivers to deliver a comprehensive and person-centred care experience. Informational continuity between providers was facilitated by IC leads and improved over time with greater professional integration and adaptation to the new care delivery processes. Differential impacts were found on quality of work life for providers in the IC Program.

Originality/value

This study describes provider experiences with delivering integrated and person-centred care across the hospital to home continuum, which can inform future integrated care initiatives.

Details

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

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Article
Publication date: 13 May 2021

Madalyn Anne Scerri and Rajka Presbury

This paper offers an exploration of contextual factors that influence carer-to-resident talk in Australian residential aged care.

Abstract

Purpose

This paper offers an exploration of contextual factors that influence carer-to-resident talk in Australian residential aged care.

Design/methodology/approach

A qualitative exploratory multiple case study methodology and a theoretical framework of service language were applied to explore the perspectives of 21 registered nurses, assistants in nursing, leisure and lifestyle officers, general managers and care managers at three residential aged care homes in Australia.

Findings

The findings demonstrate contextual factors related to the care home environment, the carer and the relationship between carers and residents that impede or enable carer-to-resident talk in residential aged care. Multiple factors related to the care home environment were found to impede carer-to-resident talk, including time pressures, staffing levels, team culture and the prioritisation of tasks. Factors related to carers had potential to either impede or enable talk, including carers' awareness of the importance of communication, level of experience and individual characteristics, values and attitudes. A strong relationship between a carer and resident built on knowledge of individuals was a key enabling factor.

Originality/value

The paper advances an understanding of factors that influence talk and interaction in residential aged care in Australia from carers' and care home leaders' perspectives. The findings can be used to support verbal communication management strategies aligned with a person-centred care approach, including training and development of staff, cultural change interventions and a review of care delivery procedures.

Details

Journal of Health Organization and Management, vol. 35 no. 5
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 1 July 2020

Giovanna I. Cruz and Sarah M. McGhee

This case study aims to understand the experience of care from a patient/carer perspective and to describe how the method can be replicated to address gaps in evidence…

Abstract

Purpose

This case study aims to understand the experience of care from a patient/carer perspective and to describe how the method can be replicated to address gaps in evidence relating to integrated person-centred care.

Design/methodology/approach

The case study was constructed using data extracted from personal diaries and medical records kept by a person with a complex condition, correspondence with family from the last 18 months of life and interviews with the carer and long-term conditions coordinator. The number of professionals or teams involved in providing care from statutory services, the third sector, and private providers were counted to understand the ecosystem of care. The number of contacts was plotted by provider and purpose of care. The type of care and hours of respite were estimated. A protocol was developed to assess the feasibility of replicating the data and analyses used.

Findings

There were 35 care providers from the public, private and the third sector, demonstrating that only the patient or carer can identify the ecosystem of care. The majority of care was for respite and on average, the carer provided four hours of care per every respite care hour. The method was replicated successfully.

Research limitations/implications

The case study formed the basis of a workshop that brought together health care professionals from the public services and the third sector. The discussion led to the identification of gaps and areas where greater coordination between providers would benefit patients.

Originality/value

The case study method combines contemporaneous patient and carer sources of data and health service activity to create a detailed account of care at the end of life. The approach addresses gaps in person-centred evidence for the development and evaluation of integrated palliative and end-of-life care.

Details

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

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Article
Publication date: 1 February 2012

Patricia Duff OBE and Rosemary Hurtley

This paper aims to highlight the benefits of the 360 SF diagnostic audit for assessing person centeredness of a domiciliary agency and to highlight the challenges they…

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Abstract

Purpose

This paper aims to highlight the benefits of the 360 SF diagnostic audit for assessing person centeredness of a domiciliary agency and to highlight the challenges they face with some suggested actions. These are exemplars of what is raised in policy and recent reports relating to personalisation, dignity and integration of health and social care and have wider implications for all agencies as they strive to resolve issues for the client.

Design/methodology/approach

The approach is a case study describing results of the audit in relation to challenges that include practice development needs, inter agency co‐ordination, collaboration and co‐operation for the achievement of relationship based person centered outcomes in quality improvement work. The pilot study involved data gathered from the clients, relatives and staff, which were analyzed resulting in findings, conclusions and suggestions for ongoing improvement from which action plans were devised and implemented.

Findings

The audit results provide examples of the primary interface relationship and co‐ordination challenges, highlighting leaning needs for staff delivering person centred care in domiciliary settings.

Practical implications

This paper raises important practice development issues both inside and outside the agency's responsibility. Use of the tool would support cultural and interface relationship issues affecting the client experience and highlight ways to assist the achievement of collaborative ways of working needed for the integration of health and social care.

Social implications

The 360 SF (DS) can help organisations provide evidence to CQC and the public for their performance and identify the close interface relationships and their effectiveness in delivering co‐ordinated and integrated health and social care.

Originality/value

The 360 SF DOM has highlighted with evidence the challenges of the systemic culture at the interface, in particular the nature and quality of collaboration, communication and practice development needs across the organisational divide to deliver person centred care and support.

Details

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

Keywords

Content available
Article
Publication date: 28 October 2019

Tinna Elfstrand Corlin and Ali Kazemi

The purpose of this paper is to describe three different approaches to work in elderly care (i.e. professional, market-oriented and person-centred) and examine whether…

Abstract

Purpose

The purpose of this paper is to describe three different approaches to work in elderly care (i.e. professional, market-oriented and person-centred) and examine whether these theoretically derived approaches can be confirmed empirically. Additional aims were to examine the endorsement of these approaches and whether there were differences in the endorsement of these approaches in nursing home vs home care and municipality vs privately run care units.

Design/methodology/approach

Data were collected using a cross-sectional survey study of frontline care staff (n=1,342). Exploratory factor analysis was used to investigate the empirical validity of the proposed approaches to work in elderly care. A series of paired and independent samples t-tests were conducted to analyse mean differences between the proposed approaches to work.

Findings

A principal axis factoring analysis yielded three theoretically meaningful factors as proposed. These results indicated that the respondents were able to differentiate between three distinct but related approaches to work with older persons. The results also showed that the professional care approach was the highest endorsed and the market-oriented the lowest endorsed approach. No notable differences in approaches to work were observed in nursing home vs home care and municipality vs privately run care units.

Originality/value

This is the first study to examine multiple approaches to work in elderly care as previous research studies mainly have investigated the person-centred care approach. Current findings indicate that these approaches to work often coexist in various combinations and that the care staff adopts all these approaches but to varying degrees. The approaches differ in several important respects (e.g. legitimacy and view of the older person) and most likely affect the way care staff treats the older person and how the older person perceives their relationship with the care staff. Knowledge about these differences facilitates management of the care staff’s work situation and helps to improve the quality of care.

Details

Working with Older People, vol. 24 no. 1
Type: Research Article
ISSN: 1366-3666

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