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BackgroundPatient care models have been implemented and documented worldwide. Many studies have focused on features that hinder and facilitate the shift to such models, including the implementation process, staff involvement, resistance to new models and cultural dimensions. However, few studies have identified the potential effects of such new care models from a patient perspective. The aim of the present study was to investigate whether patients did in fact perceive the intentions of partnership in the new care model 1 year after its implementation.MethodsSixteen participants were interviewed, selected from two wards in a medical department where a new care model had been implemented 1 year earlier. A directed deductive content analysis was selected. The aim of the directed approach to content analysis was to investigate to what extent the new care model had been implemented, using patients’ perspectives to describe the level of implementation. A coding framework was developed based on a theoretical paper that described the key features of the new care model.ResultsThe implementation of person-centred care had clearly occurred to a large degree, even if some patients appeared not to have been exposed to the model at all. Aspects of the newly implemented care model were obvious; however, it was also clear that implementation was not complete. The analysis showed that patients felt listened to and that their own perception of the situation had been noted. Patients spontaneously expressed that they felt that the staff saw them as persons and did not solely focus on their disease. It was also stated that not every ailment or aspect of a patient’s illness needed to be addressed or resolved for open listening to be perceived as a positive experience.ConclusionsThe findings indicate that even though some patients were not interested in participating and playing an active role in their own care, this might relate to a lack of understanding on how to invite them to do so and to increase their confidence. To change healthcare from a paternalistic system to care where patients are seen as partners may require pedagogical skills.

Objective: In this study the implementation of a care model was examined in a public hospital in Sweden. The aim was to identify, from the management perspective, barriers and facilitators with respect to the implementation. A further aim was to study the explanatory power of a theoretical framework, normalization process theory (NPT). Method: Semi-structured interviews were conducted with all of the members of a hospital departments’ managerial group. Interview transcripts were analysed by means of directed deductive content analysis, applying NPT as theoretical frame work. Results: The respondents identified factors, which were perceived as facilitating or obstructing the implementation process. These factors were; organizational culture, distribution of power, patient characteristics, resistance to change, teamwork, efficiency, time and speed of implementation. The theoretical framework, NPT, was partly supported by the data. There was however an absence of collective action and reflexive monitoring constructs. Conclusion: The implementation process, according to NPT, was incomplete and there was a risk that it could regress to the previous work routines. However, implementation theories, including NPT, do not have a timeframe for the implementation process. Even though theories are able of describing in detail the steps for successfully embedding and sustaining an innovation, they do not describe or identify factors influencing the speed of the implementation. A possible reason might be that time is a subjective factor.

The results from the present study tentatively indicated an association between an organizational culture and patients' health related quality of life 3 months after discharge. Even if the current understanding of organizational culture, which is dominated by flexibility, is considered favourable when implementing a new health care model, our results showed that it could be hindering instead of helping the new health care model in achieving its objectives.

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