Patient-centred care is a way of doing things: How healthcare employees conceptualize patient-centred care

Gemmae M. Fix*, Carol VanDeusen Lukas, Rendelle E. Bolton, Jennifer N. Hill, Nora Mueller, Sherri L. LaVela, Barbara G. Bokhour

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

36 Scopus citations

Abstract

Background: Patient-centred care is now ubiquitous in health services research, and healthcare systems are moving ahead with patient-centred care implementation. Yet, little is known about how healthcare employees, charged with implementing patient-centred care, conceptualize what they are implementing. Objective: To examine how hospital employees conceptualize patient-centred care. Research Design: We conducted qualitative interviews about patient-centred care during site four visits, from January to April 2013. Subjects: We interviewed 107 employees, including leadership, middle managers, front line providers and staff at four US Veteran Health Administration (VHA) medical centres leading VHA's patient-centred care transformation. Measures: Data were analysed using grounded thematic analysis. Findings were then mapped to established patient-centred care constructs identified in the literature: taking a biopsychosocial perspective; viewing the patient-as-person; sharing power and responsibility; establishing a therapeutic alliance; and viewing the doctor-as-person. Results: We identified three distinct conceptualizations: (i) those that were well aligned with established patient-centred care constructs surrounding the clinical encounter; (ii) others that extended conceptualizations of patient-centred care into the organizational culture, encompassing the entire patient-experience; and (iii) still others that were poorly aligned with patient-centred care constructs, reflecting more traditional patient care practices. Conclusions: Patient-centred care ideals have permeated into healthcare systems. Additionally, patient-centred care has been expanded to encompass a cultural shift in care delivery, beginning with patients' experiences entering a facility. However, some healthcare employees, namely leadership, see patient-centred care so broadly, it encompasses on-going hospital initiatives, while others consider patient-centred care as inherent to specific positions. These latter conceptualizations risk undermining patient-centred care implementation by limiting transformational initiatives to specific providers or simply repackaging existing programmes.

Original languageEnglish (US)
Pages (from-to)300-307
Number of pages8
JournalHealth Expectations
Volume21
Issue number1
DOIs
StatePublished - Feb 1 2018

Keywords

  • healthcare workers
  • organizational change
  • patient-centred care
  • qualitative research

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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