Person-centred care: A qualitative study on first line managers’ experiences on its implementation

Abstract

Person-centred care is an up-and-coming care model for reducing fragmentation in healthcare by using the core component partnership between patients and care providers. Therefore, it is important to develop knowledge of the implementation processes. The overall aim of this qualitative study was to describe managers' experiences of the implementation of person-centred care. This paper provides an example of how person-centred care was implemented in the medical department of a hospital in the western part of Sweden. The study comprised eight interviews with firstline managers, and the data were analysed using qualitative content analysis. The results formed three categories, structured approach -to be organized; care planning -to be continued and teamwork -to be together, that describe the implementation of person-centred care from philosophy to practice application. Managerial skills of first-line managers are key components to developing a structured approach that improves and develops person-centred care, i.e. work together towards the mutual care plan. Continuous cooperation within and across organizational boundaries is needed (synergy effect) to decrease high working load when person-centred care is implemented to improve quality of care.

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

“…Establishing psychosocial/existential/personal care plans in addition to clinical care plans was described as an important tool to provide the foundation for residents' care, in order to provide meaningful lives for the resident. A Swedish study of the hospital context (Rosengren, ) showed that leadership was central to the implementation process of person‐centred care through establishing clear routines and care plans, which was similar to the findings in the current study. In previous research (Ekman et al, ), documenting personal preferences, beliefs, and values gives legitimacy to a person's perspective and contributes to transparency between resident and staff and facilitate continuity in care (Ekman et al, ).…”

“…Recent cross‐sectional studies have shown that leadership which is characterised by experimenting with new ideas, controlling work closely, relying on subordinates, coaching and giving direct feedback and handling conflicts in a constructive way is positively associated with staff perceptions of PCC in Swedish nursing homes (Backman, Sjogren, Lindkvist, Lovheim, & Edvardsson, , ). Intervention studies have also suggested that supportive and engaged managers have a central role when implementing PCC in nursing homes (Jeon et al, ; Rosvik, Kirkevold, Engedal, Brooker, & Kirkevold, ; Stein‐Parbury et al, ) and in hospital care (Rosengren, ). It has been shown that leaders are central to developing professional vision, being supportive and acting as role models for implementing PCC, when they actively participate in care (Rokstad, Vatne, Engedal, & Selbaek, ).…”

Development of an Academic Course in Person-Centred Care for Students in Higher Education: Teachers’ Perspectives

“…Furthermore, studies show such efforts decrease patients' fatigue [5] and uncertainty [7], which results in lower costs [8,9] due to shorter hospital stays [3,10,11]. Moreover, staff report higher job satisfaction, a friendlier working environment, and reduced conscience stress when person-centred care is implemented [12][13][14][15]. At present, whether a PCC approach is implemented in clinical practice is linked to the attitudes of staff (interest in PCC), the presence of a strong medical tradition, and time constraints [10,14,[16][17][18].…”

Simplifying the care plan documentation procedure – An interview study with nurses at a medical ward at a university hospital in Sweden

“…Moreover, support of an ethical approach that forms the basis of PCC [1,2,11] can guide and improve teamwork for all involved parties (staff, patient, and relatives) using all available resources, including patients. [35] PCC has been implemented in Sweden [5] and other countries [36,37] as a drive to support nurses worldwide, who are inspired by others to achieve effective, high quality care. In the present study, nurses describe a strong desire to involve the patient and relatives to a greater extent and to improve healthcare by visualizing the patient's voice in the care plan.…”

“…By using evidence-based knowledge, teamwork is improved even within a hierarchical organization. [35] Nurses agree on the need for a well-informed patient and/or family member, because admission to the hospital reduces uncertainties regarding the healthcare content and structure, which facilitates patient safety within the work environment. Inclusion of a mutual care plan in the medical records facilitates the relationship (patient-nurse) as a partnership (expert-expert) i.e., in practice, patients are partners with resources.…”