scholarly journals Person-Centered Care From a Relational Ethics Perspective for the Delivery of High Quality and Safe Healthcare: A Scoping Review

2020 ◽  
Vol 8 ◽  
Author(s):  
Gianpaolo Tomaselli ◽  
Sandra C. Buttigieg ◽  
Aldo Rosano ◽  
Maria Cassar ◽  
George Grima
2021 ◽  
pp. 105477382110330
Author(s):  
Joy Davis ◽  
Sue Sinni ◽  
Stephen Maloney ◽  
Lorraine Walker

Patients are central to healthcare clinicians and organizations but often subsidiary to clinical expertise, knowledge, workplace processes, and culture. Shifting societal values, technology, and regulations have remoulded the patient-clinician relationship, augmenting the patient’s voice within the healthcare construct. Scaffolding this restructure is the global imperative to deliver person-centered care (PCC). The aim of the scoping review was to explore and map the intersection between patient feedback and strategies to improve the provision of PCC within acute hospitals in Australia. Database searches yielded 493 articles, with 16 studies meeting inclusion criteria. Integration of patient feedback varied from strategy design, through to multi-staged input throughout the initiative and beyond. Initiatives actioning patient feedback fell broadly into four categories: clinical practice, educational strategies, governance, and measurement. How clinicians can invite feedback and support patients to engage equally remains unclear, requiring further exploration of strategies to propel clinician-patient partnerships, scaffolded by hospital governance structures.


Dementia ◽  
2021 ◽  
pp. 147130122110126
Author(s):  
Alexandra E Harper ◽  
Lauren Terhorst ◽  
Marybeth Moscirella ◽  
Rose L Turner ◽  
Catherine V Piersol ◽  
...  

Background Person-centered care has been shown to increase desired outcomes for people with dementia, yet informal caregivers’ dissatisfaction with care is often reported. For those living in a nursing home, informal caregivers are uniquely situated to provide key insights into the individual’s care. However, little is known of the informal caregivers’ perspective, which hinders efforts to improve their satisfaction with person-centered nursing home care. Thus, we examined the comprehensive experiences, priorities, and perceptions of informal caregivers of nursing home residents with dementia. Methods In collaboration with stakeholders, a scoping review of Medline (Ovid), EMBASE.com , CINAHL (EBSCO), the Cochrane Library (Wiley), and PsycINFO (Ovid) databases from January 2000 to July 2020 was conducted. Data were extracted reflecting the experiences, priorities, and preferences of caregivers of people with dementia residing in nursing homes. Results We identified 114 articles that revealed nine themes: (1) communication, (2) transition to nursing home, (3) quality of care, (4) quality of life, (5) informal caregiver role, (6) knowledge of dementia, (7) end-of-life preferences, (8) medication use to manage neuropsychiatric behaviors, and (9) finances. Conclusion Informal caregivers described aspects of care that led to both positive and negative experiences with and perceptions of nursing home care. The shortcomings in communication were discussed most frequently, indicating a high priority area. While researchers define the identified themes individually, informal caregivers perceive them to be interwoven as they relate to person-centered care delivery. Although we did not assess the quality of included articles, by identifying themes relevant to caregivers’ perspectives of nursing home care, our findings may help to inform efforts to optimize caregivers’ satisfaction with nursing home care for residents with dementia.


2021 ◽  
Vol 8 ◽  
Author(s):  
Jako S. Burgers ◽  
Trudy van der Weijden ◽  
Erik W. M. A. Bischoff

Background: Delivering person-centered care is one of the core values in general practice. Due to the complexity and multifaceted character of person-centered care, the effects of person-centered care cannot be easily underpinned with robust scientific evidence. In this scoping review we provide an overview of research on effects of person-centered care, exploring the concepts and definitions used, the type of interventions studied, the selected outcome measures, and its strengths and limitations.Methods: Systematic reviews on person-centered care compared to usual care were included from Pubmed, Embase, and PsycINFO. The search was conducted in February 2021. Data selection and charting was done by two reviewers.Results: The literature search yielded 481 articles. A total of 21 full-text articles were assessed for eligibility for inclusion. Four systematic reviews, published between 2012 and 2018, were finally included in this review. All reviews used different definitions and models and classified the interventions differently. The explicit distinction between interventions for providers and patients was made in two systematic reviews. The classification of outcomes also showed large differences, except patient satisfaction that was shared. All reviews described the results narratively. One review also pooled the results on some outcome measures. Most studies included in the reviews showed positive effects, in particular on process outcomes. Mixed results were found on patient satisfaction and clinical or health outcomes. All review authors acknowledged limitations due to lack of uniform definitions, and heterogeneity of interventions and outcomes measures.Discussion: Person-centered care is a concept that seems obvious and understandable in real life but is complex to operationalize in research. This scoping review reinforces the need to use mixed qualitative and quantitative methods in general practice research. For spreading and scaling up person-centered care, an implementation or complexity science approach could be used. Research could be personalized by defining therapeutic goals, interventions, and outcome variables based on individual preferences, goals, and values and not only on clinical and biological characteristics. Observational data and patient satisfaction surveys could be used to support quality improvement. Integrating research, education, and practice could strengthen the profession, building on the fundament of shared core values.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 267-267
Author(s):  
Ryann Engle ◽  
A Lynn Snow ◽  
Valerie Clark ◽  
Shibei Zhao ◽  
Christopher Gillespie ◽  
...  

Abstract The Department of Veterans Affairs (VA) began its culture transformation journey in 2006, supporting its nursing homes in providing high-quality, person-centered care in person-centered environments. We implemented a quality improvement intervention to support frontline staff from low-performing VA nursing homes in providing high-quality care using a whole-person, whole-team approach. The intervention consisted of a bundle with four components: 1) specialized frontline staff huddles that encouraged high-quality frontline staff communication and collaboration, 2) micro-root cause analyses and targeted interventions to promote resident sleep and reduce resident falls through individualized care, 3) in-depth frontline conversations regarding residents’ distress behaviors and mobility, and 4) targeted, team-based, person-centered performance improvement projects. The intervention was implemented at 8 low-performing VA nursing homes (August 2018 - April 2019) via in-person and virtual sessions and facilitated through CLC-based champions and intervention team-based coaches. We monitored the intervention’s impact using pre-post Centers for Medicare and Medicaid Services quality star ratings. We also conducted 17 post-intervention interviews with key informants at 7 participating nursing homes and conducted a content analysis of the data. Pre intervention, all 8 nursing homes had a history of being 1 or 2 stars in overall quality. Post intervention, 3 homes increased 1 star; 1 home increased 2 stars; 2 homes increased 3 stars; 2 homes increased 4 stars. Post intervention, participants perceived improved delivery of person-centered care (e.g., providing individualized sleep hygiene, de-implementing alarms). Our findings suggest a whole-person, whole-team intervention can effectively and efficiently improve both person-centered care and care quality.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 548-549
Author(s):  
Jane Tavares ◽  
Marc Cohen ◽  
Ann Hwang

Abstract Person-Centered care is integral and necessary to high-quality systems of care, providing a holistic approach and addressing the needs and preferences of individuals. Analyzing the 2014 and 2016 Health and Retirement Survey we measure the extent to which the health care system provides person-centered care, to whom and how its receipt affects satisfaction levels and service utilization. About one-third of individuals’ report that their preferences were only rarely or sometimes takes account. Results vary greatly by race, highlighting great disparities in person-centered care. One in four Hispanics and one in six Blacks report never having their preferences taken into account compared to roughly one in ten Whites. When people report that their preferences are ignored, they are more likely to forgo medical care and report lower satisfaction with the system. Strategies exist to strengthen and assure advancements in person-centered care, something particularly needed for people of color and low-income populations.


2011 ◽  
Vol 23 (8) ◽  
pp. 1205-1212 ◽  
Author(s):  
David Edvardsson ◽  
Deirdre Fetherstonhaugh ◽  
Linda McAuliffe ◽  
Rhonda Nay ◽  
Carol Chenco

ABSTRACTBackground: There are challenges in attracting and sustaining a competent and stable workforce in aged care, and key issues of concern such as low staff job satisfaction and feelings of not being able to provide high quality care have been described. This study aimed to explore the association between person-centered care provision and job satisfaction in aged care staff.Methods: Residential aged care staff (n = 297) in Australia completed the measure of job satisfaction and the person-centered care assessment tool. Univariate analyses examined relationships between variables, and multiple linear regression analysis explored the extent to whichperceived person-centredness could predict job satisfaction of staff.Results: Perceived person-centred care provision was significantly associated with job satisfaction, and person-centred care provision could explain nearly half of the variation in job satisfaction. The regression model with the three person-centered care subscales as predictor variables accounted for 40% of the variance in job satisfaction. Personalizing care had the largest independent influence on job satisfaction, followed by amount of organizational support and degree of environmental accessibility. Personalizing care and amount of organizational support had a statistically significant unique influence.Conclusions: As person-centered care positively correlated with staff job satisfaction, supporting staff in providing person-centered care can enhance job satisfaction and might facilitate attracting and retaining staff in residential aged care. The findings reiterate a need to shift focus from merely completing care tasks and following organizational routines to providing high quality person-centered care that promotes the good life of residents in aged care.


2020 ◽  
Vol 32 (10) ◽  
pp. 671-676
Author(s):  
Katie Giessler ◽  
Avery Seefeld ◽  
Dominic Montagu ◽  
Beth Phillips ◽  
James Mwangi ◽  
...  

Absrtact Objective To understand perspectives and experiences related to participation in a quality improvement collaborative (QIC) to improve person-centered care (PCC) for maternal health and family planning (FP) in Kenya. Design and setting Semi-structured qualitative interviews were conducted with members of the QIC in four public health facilities in Kenya. Participants Clinical and nonclinical public health facility staff who had participated in the QIC were purposively sampled to participate in the semi-structured interviews. Intervention A QIC was implemented across four public health facilities in Nairobi and Kiambu Counties in Kenya to improve PCC experiences for women seeking maternity or FP services. Main outcome measure Semi-structured interviews with participants of the QIC to understand perspectives and experiences associated with sensitization to and implementation of PCC behaviors in maternity and FP services. Results Respondents reported that sensitization to PCC principles resulted in multiple perceived benefits for staff and patients alike, including improved interactions with patients and clients, deeper awareness of patient and client preferences, and improved interpersonal skills and greater job satisfaction. Respondents also highlighted system-level challenges that impeded their ability to consistently provide high-quality PCC to women, namely staff shortages and frequent turnover, high patient volumes and lack of space in their respective health facilities. Conclusion Respondents were easily able to articulate perceived benefits derived from participation in this QIC, although they were equally able to identify challenges that hindered their ability to consistently provide high-quality PCC to women seeking maternity or FP services.


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