Correction:Implementation of patient-centred care: which organisational determinants matter from decision maker’s perspective? Results from a qualitative interview study across various health and social care organisations

ObjectivesThere is considerable variation in non-conveyance rates between ambulance services in England. The aim was to explore variation in how each ambulance service addressed non-conveyance for calls ending in telephone advice and discharge at scene.DesignA qualitative interview study.SettingTen large regional ambulance services covering 99% of the population in England.ParticipantsBetween four and seven interviewees from each ambulance service including managers, paramedics and healthcare commissioners, totalling 49 interviews.MethodsTelephone semistructured interviews.ResultsThe way interviewees in each ambulance service discussed non-conveyance within their organisation varied for three broad themes. First, ambulance service senior management appeared to set the culture around non-conveyance within an organisation, viewing it either as an opportunity or as a risky endeavour. Although motivation levels to undertake non-conveyance did not appear to be directly affected by the stability of an ambulance service in terms of continuity of leadership and externally assessed quality, this stability could affect the ability of the organisation to innovate to increase non-conveyance rates. Second, descriptions of workforce configuration differed between ambulance services, as well as how this workforce was used, trained and valued. Third, interviewees in each ambulance service described health and social care in the wider emergency and urgent care system differently in terms of availability of services that could facilitate non-conveyance, the amount of collaborative working between health and social care services and the ambulance service and complexity related to the numbers of services and healthcare commissioners with whom they had to work.ConclusionsThis study suggests that factors within and outside the control of ambulance services may contribute to variation in non-conveyance rates. These findings can be tested in a quantitative analysis of factors affecting variation in non-conveyance rates between ambulance services in England.

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The importance of relationships in treatment for chronic leg ulceration

Journal of Health Psychology ◽

10.1177/1359105317705984 ◽

2017 ◽

Vol 24 (13) ◽

pp. 1839-1849 ◽

Cited By ~ 1

Author(s):

Philippa Tollow ◽

Jane Ogden

Keyword(s):

Surgical Treatment ◽

Patient Experience ◽

Thematic Analysis ◽

Qualitative Interview ◽

Interview Study ◽

Leg Ulcers ◽

Profound Impact ◽

Patient Centred Care ◽

Qualitative Interview Study ◽

Non Surgical Treatment

Leg ulcers are a hard-to-heal wound that can have a profound impact on the lives of those that they affect. While a significant body of evidence has explored the efficacy of various treatments for leg ulcers, little research has addressed the patient experience of such treatment. A total of 21 participants were recruited for this qualitative interview study, exploring patient’s experiences of non-surgical treatment for leg ulcers. Thematic analysis identified two major themes, ‘Failure’ and ‘Powerlessness’, as well as the overarching theme of ‘Relationships’. These findings are discussed in relation to concepts of acceptance and in the broader context of patient-centred care.

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Implementation of patient-centred care: which organisational determinants matter from decision maker’s perspective? Results from a qualitative interview study across various health and social care organisations

BMJ Open ◽

10.1136/bmjopen-2018-027591 ◽

2019 ◽

Vol 9 (4) ◽

pp. e027591 ◽

Cited By ~ 5

Author(s):

Kira Isabel Hower ◽

Vera Vennedey ◽

Hendrik Ansgar Hillen ◽

Ludwig Kuntz ◽

Stephanie Stock ◽

...

Keyword(s):

Qualitative Study ◽

Social Care ◽

Qualitative Content Analysis ◽

Qualitative Interviews ◽

Sampling Strategy ◽

Well Being ◽

Decision Makers ◽

Patient Centred Care ◽

Qualitative Interview Study ◽

Health And Social Care

ObjectivesHealth and social care systems, organisations and providers are under pressure to organise care around patients’ needs with constrained resources. To implement patient-centred care (PCC) successfully, barriers must be addressed. Up to now, there has been a lack of comprehensive investigations on possible determinants of PCC across various health and social care organisations (HSCOs). Our qualitative study examines determinants of PCC implementation from decision makers’ perspectives across diverse HSCOs.DesignQualitative study of n=24 participants in n=20 semistructured face-to-face interviews conducted from August 2017 to May 2018.Setting and participantsDecision makers were recruited from multiple HSCOs in the region of the city of Cologne, Germany, based on a maximum variation sampling strategy varying by HSCOs types.OutcomesThe qualitative interviews were analysed using an inductive and deductive approach according to qualitative content analysis. The Consolidated Framework for Implementation Research was used to conceptualise determinants of PCC.ResultsDecision makers identified similar determinants facilitating or obstructing the implementation of PCC in their organisational contexts. Several determinants at the HSCO’s inner setting and the individual level (eg, communication among staff and well-being of employees) were identified as crucial to overcome constrained financial, human and material resources in order to deliver PCC.ConclusionsThe results can help to foster the implementation of PCC in various HSCOs contexts. We identified possible starting points for initiating the tailoring of interventions and implementation strategies and the redesign of HSCOs towards more patient-centredness.

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Implementation of patient-centred care: which system-level determinants matter from a decision maker’s perspective? Results from a qualitative interview study across various health and social care organisations

BMJ Open ◽

10.1136/bmjopen-2021-050054 ◽

2021 ◽

Vol 11 (9) ◽

pp. e050054

Author(s):

Carmen Leidner ◽

Vera Vennedey ◽

Hendrik Hillen ◽

Lena Ansmann ◽

Stephanie Stock ◽

...

Keyword(s):

Qualitative Study ◽

Healthcare System ◽

Information Exchange ◽

Social Care ◽

Qualitative Content Analysis ◽

Decision Makers ◽

System Level ◽

Patient Centred Care ◽

Qualitative Interview Study ◽

Health And Social Care

ObjectivesThe healthcare system is characterised by a high degree of complexity and involves various actors at different institutional levels and in different care contexts. To implement patient-centred care (PCC) successfully, a multidimensional consideration of influencing factors is required. Our qualitative study aims to identify system-level determinants of PCC implementation from the perspective of different health and social care organisations (HSCOs).DesignA qualitative study using n=20 semistructured face-to-face interviews with n=24 participants was carried out between August 2017 and May 2018. Interview data were analysed based on concepts of qualitative content analysis using an inductive and deductive approach.Setting and participantsInterviews were conducted with clinical and managerial decision makers from multiple HSCOs in the model region of Cologne, Germany. Participants were recruited via networks of practice partners and cold calling.ResultsThis study identified various determinants on the system level that are associated with PCC implementation. Decision makers described external regulations as generating an economically controlled alignment of the healthcare system. The availability and qualification of staff resources and patient-related incentives of financial resources were identified as an eminent requirement for providers to deliver PCC. Participants considered the strict separation of financing and delivery of healthcare into inpatient and outpatient sectors to be a barrier to PCC. Interorganisational collaboration and information exchange were identified as facilitators of PCC, as they enable continuous patient care cycles.ConclusionThe results showed the necessity of enforcing paradigm changes at the system level from disease-centredness to patient-centredness while aligning policy and reimbursement decisions directly with patient needs and values. A systematic, long-term planned strategy that extends across all organisations is lacking, rather each organisation seeks its own possibilities to implement PCC activities under external restrictions.Trial registration numberDRKS00011925

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