Leadership assumptions on implementation of patient involvement methods

Abstract

Background From 2014 to 17, a large-scale project, ‘The User-involving Hospital’, was implemented at a Danish university hospital. Research highlights leadership as crucial for the outcome of change processes in general and for implementation processes in particular. According to the theory on organizational learning by Agyris and Schön, successful change requires organizational learning. Argyris and Schön consider that the assumptions of involved participants play an important role in organizational learning and processes. The purpose was to explore leaders’ assumptions concerning implementation of patient involvement methods in a hospital setting. Methods Qualitative explorative interview study with the six top leaders in the implementation project. The semi-structured interviews were conducted and analyzed in accordance with Kvale and Brinkmanns’ seven stages of interview research. Result The main leadership assumptions on what is needed in the implementation process are in line with the perceived elements in organizational learning according to the theory of Argyris and Schön. Hence, they argued that implementation of patient involvement requires a culture change among health care professionals. Two aspects on how to obtain success in the implementation process were identified based on leadership assumptions: “The health care professionals’ roles in the implementation process” and “The leaders’ own roles in the implementation process”. Conclusion The top leaders considered implementation of patient involvement a change process that necessitates a change in culture with health care professionals as crucial actors. Furthermore, the top leaders considered themselves important facilitators of this implementation process.

The Perspectives of Healthcare Professionals and Managers on Patient Involvement in Care Pathway Development: A Discourse Analysis

“…Not only the patient needs to learn, but the professional as well. This emphasises the need for organisations to implement various approaches to stimulate the learning process [ 5 , 59 ]. Bombard et al [ 6 ] mention such strategies as training sessions to clarify roles and develop skills.…”

Integrating Patient Involvement Interventions within Clinical Practice: A Mixed-Methods Study of Health Care Professional Reasoning

“…Quantitative data were collected via an online survey. The survey content was informed by the themes that emerged on basis of the interview findings, prior research, 1 , 19 – 21 theory explaining clinical reasoning, 14 and items from a previous questionnaire concerning patient involvement sent out via the Danish nurses’ organization and the Danish medical doctors’ association in 2014. 28 Questionnaire responses were either multiple choice or items rated on a 5-point Likert scale ranging from strongly agree to strongly disagree , with a possible “do not know” option.…”

“…In Denmark, the User-Involving Hospital project at Aarhus University Hospital (AUH) has developed, evaluated, and implemented several PII since 2014. [19][20][21] An initial survey found that health professionals' views toward involving patients in care and treatment significant improved after these implementation initiatives. 21 Barriers for adoption of the PII focus on contextual and patient-related aspects but not directly on the health care professionals.…”