Client-centred practices and work in inpatient rehabilitation teams: results from four case studies

Papadimitriou, Christina; Cott, Cheryl

doi:10.3109/09638288.2014.955138

Cited by 23 publications

(20 citation statements)

References 37 publications

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“…Some of them focus mainly on the patient-physician/professional interaction [12, 14, 15], whereas others are broader and also consider organizational and structural aspects [6, 8, 13, 16]. Concerning these organizational and structural aspects, interprofessional teamwork and coordination play an important role [17]. Scholl et al [13] conducted a review in order to postulate an integrated model of patient-centeredness, which includes the dimensions patient as individual, patient participation in the treatment process, patient information, healthcare professional-patient communication and patient empowerment.…”

Section: Introductionmentioning

confidence: 99%

A cluster-randomized controlled study to evaluate a team coaching concept for improving teamwork and patient-centeredness in rehabilitation teams

et al. 2017

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PurposeAlthough the relevance of interprofessional teamwork in the delivery of patient-centered care is well known, there is a lack of interventions for improving team interaction in the context of rehabilitation in Germany. The aim of the present study is to evaluate whether a specially developed team coaching concept (TCC) could improve both teamwork and patient-centeredness.MethodA multicenter, cluster-randomized controlled intervention study was conducted with both staff and patient questionnaires. Data was collected at ten German rehabilitation clinics (five clusters) of different indication fields before (t1) and after (t2) the intervention. Intervention clinics received the TCC, while control clinics did not receive any treatment. Staff questionnaires were used to measure internal participation and other aspects of teamwork, such as team organization, while patient questionnaires assessed patient-centeredness. A multivariate analysis of variance was applied for data analysis.ResultsIn order to analyze the effect of TCC on internal participation and teamwork, 305 questionnaires were included for t1 and 213 for t2 in the staff survey. In the patient survey, 523 questionnaires were included for t1 and 545 for t2. The TCC improved team organization, willingness to accept responsibility and knowledge integration according to staff, with small effect sizes (univariate: η2=.010–.017), whereas other parameters including internal participation, team leadership and cohesion did not improve due to the intervention. The patient survey did not show any improvements on the assessed dimensions.ConclusionThe TCC improved dimensions that were addressed directly by the approach and were linked to the clinics’ needs, such as restructured team meetings and better exchange of information. The TCC can be used to improve team organization, willingness to accept responsibility, and knowledge integration in rehabilitation practice, but some further evaluation is needed to understand contextual factors and processes regarding the implementation of the intervention.

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Section: Introductionmentioning

confidence: 99%

A cluster-randomized controlled study to evaluate a team coaching concept for improving teamwork and patient-centeredness in rehabilitation teams

et al. 2017

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“…The problems of patients in IC are often complex and cannot be resolved by the patient alone (Papadimitriou & Cott, 2015), but need the effort of the institutions as well as the health care professionals and their expertise and responsibility (Durose & Richardson, 2016). The results indicate that the relatives are coproducers, a necessary resource in the rehabilitation process.…”

Section: Discussionmentioning

confidence: 99%

Choice, Voice, and Coproduction in Intermediate Care: Exploring Geriatric Patients’ and Their Relatives’ Perspectives on Patient Participation

et al. 2019

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Geriatric patients in intermediate care (IC) often do not feel involved in their rehabilitation process. We conducted interviews with 15 patients and 12 relatives to explore their experiences and preferences regarding patient participation in IC and identify types of patient participation and their potential empowering or disempowering effect. The analysis disclosed a lack of patient choice in a predetermined IC pathway. Being deserving of help meant being sick enough and was associated with the compliant patient who fits the system. Some main additional features were the need of a rehabilitation perspective and patient engagement to enable coproduction as well as the important contribution of relatives as advocates and allies. Finally, the results show the patients’ vulnerable voice in the meeting with the experts’ views. The study will add important knowledge on how staff can contribute to the tailoring of good interventions in IC and improve the understanding of underlying structures.

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“…Successful patient participation within IC services is associated with satisfaction with health‐care services, a lower number of readmissions, better treatment outcome and has the potential to prevent the need for nursing home placement . Further, patient participation is shaped by organizational structures, the patients’ condition, resources, staff attitudes and support from relatives . Still, there is great variation in how patient participation is managed and experienced by patients and relatives .…”

Section: Introductionmentioning

confidence: 99%

Health‐care professionals’ experiences of patient participation among older patients in intermediate care—At the intersection between profession, market and bureaucracy

Kvæl

Bye

Bergland

2019

Health Expectations

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BackgroundPatient participation is a key concern in health care. Nevertheless, older patients often do not feel involved in their rehabilitation process. Research states that when organizational conditions exert pressure on the work situation, care as a mere technical activity seems to be prioritized by the health‐care staff, at the expense of patient involvement.ObjectiveThe aim of this article is to explore how health‐care professionals experience patient participation in IC services, and explain how they perform their clinical work balancing between the patient's needs, available resources and regulatory constraints.DesignUsing a framework of professional work and institutional logics, underpinned by critical realism, we conducted semi‐structured interviews with 18 health‐care professionals from three IC institutions.ResultsIC appears as an important service in the patient pathway for older people with a great potential for patient participation. However, health care staff may experience constraints that prohibit them from using professional discretion, which is perceived as a threat to patient participation. Further, they may adopt routines that simplify their interactions with patients. Our results call for more emphasis on an individualized rehabilitation process and a recognition that psychological and social aspects are critical for patient participation in IC.ConclusionPatients interact in the face of conflicting institutional priorities or protocols. The study adds important knowledge about the practice of patient participation in IC from a front‐line provider perspective. Underlying mechanisms are identified to understand and recommend how to facilitate patient participation at different levels in narrowing the gap between policy and clinical work in IC.

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Client-centred practices and work in inpatient rehabilitation teams: results from four case studies

Cited by 23 publications

References 37 publications

A cluster-randomized controlled study to evaluate a team coaching concept for improving teamwork and patient-centeredness in rehabilitation teams

A cluster-randomized controlled study to evaluate a team coaching concept for improving teamwork and patient-centeredness in rehabilitation teams

Choice, Voice, and Coproduction in Intermediate Care: Exploring Geriatric Patients’ and Their Relatives’ Perspectives on Patient Participation

Health‐care professionals’ experiences of patient participation among older patients in intermediate care—At the intersection between profession, market and bureaucracy

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