Embodying person‐centred being and doing: Leading towards person‐centred care in nursing homes as narrated by managers

Abstract

Aims and objectives To explore how managers describe leading towards person‐centred care in Swedish nursing homes. Background Although a growing body of research knowledge exists highlighting the importance of leadership to promote person‐centred care, studies focused on nursing home managers' own descriptions of leading their staff towards providing person‐centred care is lacking. Design Descriptive interview study. COREQ guidelines have been applied. Methods The study consisted of semi‐structured interviews with 12 nursing home managers within 11 highly person‐centred nursing homes purposively selected from a nationwide survey of nursing homes in Sweden. Data collection was performed in April 2017, and the data were analysed using content analysis. Results Leading towards person‐centred care involved a main category; embodying person‐centred being and doing, with four related categories: operationalising person‐centred objectives; promoting a person‐centred atmosphere; maximising person‐centred team potential; and optimising person‐centred support structures. Conclusions The findings revealed that leading towards person‐centred care was described as having a personal understanding of the PCC concept and how to translate it into practice, and maximising the potential of and providing support to care staff, within a trustful and innovative work place. The findings also describe how managers co‐ordinate several aspects of care simultaneously, such as facilitating, evaluating and refining the translation of person‐centred philosophy into synchronised care actions. Relevance to clinical practice The findings can be used to inspire nursing home leaders' practices and may serve as a framework for implementing person‐centred care within facilities. A reasonable implication of these findings is that if organisations are committed to person‐centred care provision, care may need to be organised in a way that enables managers to be present on the units, to enact these strategies and lead person‐centred care.

The significance of nursing home managers' leadership—longitudinal changes, characteristics and qualifications for perceived leadership, person‐centredness and climate

“…Having a manager who gives clear instructions has been reported to be a facilitator when implementing person-centred care because integrating a person-centred philosophy into practice takes time and continuous support in order to challenge and change traditional care practices (Backman et al, 2020;Moore et al, 2016). One additional item reported as characteristic of highly rated leadership in a previous publication on this data (Backman et al, 2017) was borderline significant-My manager experiments with new ideas (p = .052).…”

Appropriate leadership in nursing home care: a narrative review

“…organizational culture ( Ali and Terry, 2017 ; Backman et al , 2020 ; Corazzini et al , 2015 ; Havig and Hollister, 2018 ; Jeon et al , 2010 ; Nielsen et al , 2008 ; Vesterinen et al , 2009 );…”

“…In most of the literature reviewed, however, leadership behavior is not described or explained precisely. Fortunately, more recent literature is moving away from studying solely leadership styles and is focusing more on appropriate leadership behavior for new developments, like the implementation of Dementia Care Mapping and person-centered care ( Backman et al , 2020 ; Lynch et al , 2018 ; Quasdorf and Bartholomeyczik, 2019 ).…”

Developmental Evaluation of the CHOICE+ Champion Training Program

“…Organizational context and culture, specifically turnover of managers and lack of leadership engagement at the outset of implementation, as well as minimum mentorship for staff to take on leadership roles have been cited as negatively influencing efforts to improve care practice (Brodtkorb et al, 2019;Tappen et al, 2017). Turnover among care staff can have equally devastating effects on innovation uptake, where instability and feelings of disempowerment result in lack of ownership of initiatives, further reducing morale and slowing adoption (Backman et al, 2020;Chamberlain et al, 2017). Special consideration should be given to the readiness of a home before undertaking multidimensional, targeted culture change initiative, such as the CHOICE+ Program (von Treuer et al, 2020;Keller et al, 2020;Wu et al, 2018).…”

“…Mealtimes within Canadian residential care homes have been described as hectic and task-focused compared to those observed in Norway and Germany (Lowndes et al, 2017), which can make it challenging for care staff to change mealtime practices without the proper time, space, and support from leadership. There is an urgent need to prepare those in middle and senior leadership positions to achieve organizational goals through their active involvement, effective communication with stakeholders, and participatory decision-making approaches, so that care staff have the opportunity to create and sustain relationship-centred mealtimes (Backman et al, 2020;MacEachern et al, 2020).…”