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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

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Health services research
Research
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
  1. Kira Isabel Hower1,
  2. Vera Vennedey2,
  3. Hendrik Ansgar Hillen3,
  4. Ludwig Kuntz3,
  5. Stephanie Stock2,
  6. Holger Pfaff1,
  7. Lena Ansmann4
  8. On behalf of Cologne Research and Development Network (CoRe-Net)
  1. 1 Institute of Medical Sociology, Health Services Research, and Rehabilitation Science (IMVR), Faculty of Human Sciences and Faculty of Medicine, University of Cologne, Cologne, Germany
  2. 2 Institute for Health Economics and Clinical Epidemiology, University Hospital Cologne (AöR), Cologne, Germany
  3. 3 Department of Business Administration and Health Care Management, University of Cologne, Cologne, Germany
  4. 4 Department of Health Services Research, Faculty of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
  1. Correspondence to Kira Isabel Hower; kira.hower{at}uk-koeln.de

Abstract

Objectives Health 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.

Design Qualitative study of n=24 participants in n=20 semistructured face-to-face interviews conducted from August 2017 to May 2018.

Setting and participants Decision 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.

Outcomes The 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.

Results Decision 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.

Conclusions The 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.

Trial registration number DRKS00011925.

  • patient-centered care
  • implementation
  • qualitative research
  • decision-maker
  • health and social care organizations
  • quality In health care

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

http://dx.doi.org/10.1136/bmjopen-2018-027591

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    Footnotes

    • Contributors All members designed the study. KIH, HAH and VV designed and conducted data collection, critically reviewed by LA. KIH drafted and revised the paper in close collaboration with VV and HAH. KIH is guarantor. LA, SS, LK and HP critically revised the paper.

    • Funding This work was supported by the German Federal Ministry of Education and Research (grant no. 01GY1606).

    • Competing interests None declared.

    • Ethics approval The Ethics Committee of the Medical Faculty of the University of Cologne approved the study (reference number: 17–210).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data are available.

    • Collaborators Christian Albus, Lena Ansmann, Frank Jessen, Ute Karbach, Ludwig Kuntz, Holger Pfaff, Christian Rietz, Ingrid Schubert, Frank Schulz-Nieswandt, Stephanie Stock, Julia Strupp, Raymond Voltz, Nadine Scholten.

    • Correction notice This article has been corrected since it was published online. The Collaborator group and Trial Registration number have been added.

    • Patient consent for publication Not required.

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