Macrosystem
| | |
(1) Demand from changing demographics to adopt a new care model | SingHealth leaders capitalised on the opportune time to introduce EN supported by its good track record | Collective decision to adopt EN in SingHealth |
(2) A process and structure are needed to operationalise person-centred care in population health | The logic of EN, ‘What is Best for Esther?’, resonated with what clinicians intuitively want for their patients | Collective decision to adopt EN in Singapore |
Mesosystem
| | |
(3) Dissatisfaction with the busy-ness and target-oriented healthcare model | Learning trip to Jönköping by key SingHealth leaders reinforced a group and community spirit | Collective alignment |
(4) Organisational tagline ‘Patients at the heart of all we do’ often interpreted differently by staff groups | The simplicity of the brand name Esther was perceived to be easily understood by staff and service users | EN symbolised hope that service users’ participation will shape better care |
Microsystem
| | |
(5) Workforce less engaged; the top-down and formal approach reduced work satisfaction | Leaders recognised that the EN model promoted coproduction between staff and patients | Engaged and activated workforce |