Processes of patient-centred care in Family Health Teams: a qualitative study

Abstract

Background: Patient-centred care, access to care, and continuity of and coordination of care are core processes in primary health care delivery. Our objective was to evaluate how these processes are enacted by 1 primary care model, Family Health Teams, in Ontario. Methods:Our study used grounded theory methodology to examine these 4 processes of care from the perspective of health care providers. Twenty Family Health Team practice sites in Ontario were selected to represent maximum variation (e.g., location, year of Family Health Team approval). Semi-structured interviews were conducted with each participant. A constant comparative approach was used to analyze the data.Results: Our final sample population involved 110 participants from 20 Family Health Teams. Participants described how their Family Health Team strived to provide patient-centred care, to ensure access, and to pursue continuity and coordination in their delivery of care. Patient-centred care was provided through a variety of means forging the links among the other processes of care. Participants from all teams articulated a commitment to timely access, spontaneously expressing the importance of access to mental health services. Continuity of care was linked to both access and patient-centred care. Coordination of care by the team was perceived to reduce unnecessary walk-in clinic and emergency department visits, and facilitated a smoother transition from hospital to home.Interpretation: These 4 processes of patient care were inextricably linked. Patient-centred care was the focal point, and these processes in turn served to enhance the delivery of patient-centred care. Abstract Research Research CMAJ OPEN E272CMAJ OPEN 4(2)

Association between person-centredness and financially driven postponement of care in European primary care: a cross-sectional multicountry study

“…An increase in the general practitioner's person-centredness with 1 standard deviation was associated with a decreased likelihood of postponing care for financial reasons, with an OR of 0.923. Our findings are in line with qualitative research of Brown and colleagues, 7 who identified a link between person-centred care and accessibility of primary care in Canada. The association between personcentredness and access to primary care can be attributed to the fact that general practitioners with a person-centred attitude design care around patients by considering their context, such as financial difficulties.…”

“…14 Person-centredness may, as such, be a driving force of equity. Furthermore, Brown and colleagues 7 showed that person-centredness is linked to accessibility of health care.…”

“…A person-centred provider explores illness and disease experiences, has a perspective on the whole person and finds common ground, which enhances the patient-physician relationship and extends beyond isolated disease episodes. [6][7][8][9] Person-centredness positively influences several outcomes such as objective and subjective health status, therapy adherence and patient trust, and reduces use of diagnostic testing. 6,[10][11][12][13] Moreover, personcentredness positively affects equity in health care.…”

Perspectives of specialists and family physicians in interprofessional teams in caring for patients with multimorbidity: a qualitative study

“…44 The success of the TIP Program may come from its merger of different methods for teaching and learning through collaboration that have previously been identified in the literature. [5][6][7][8][9][10][11] Ongoing description and evaluation of similar practice-based programs is required to further explore the perceived interprofessional and educational benefits. Further research on the influence of interprofessional collaborative teamwork such as the TIP Program and its impact on patient care and outcomes is required.…”

“…8,9 However, most research in this field has focused on primary health care teams or teams collaborating within hospitals or residential settings. 10,11 People with multimorbidity require care from providers across settings, which often include primary care, secondary care and community care. Because clinical care is often organized according to the care setting, team processes that extend beyond these traditional boundaries are rarely implemented.…”