Review of developments in person-centred healthcare

Phelan, Amanda; McCormack, Brendan; Dewing, Jan; Brown, Donna; Cardiff, Shaun; Cook, Neal F.; Dickson, Caroline; Kmetec, Sergej; Lorber, Mateja; Magowan, Ruth; McCance, Tanya; Skovdahl, Kirsti; Štiglic, Gregor; Lieshout, Famke van

doi:10.19043/ipdj.10suppl2.003

Cited by 52 publications

(41 citation statements)

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“…Competence is linked to person centred care, as well as inter-disciplinary collaboration, employing evidence-based practice, applying quality improvement mechanisms and integrating health informatics in care delivery [ 55 ]. Various serious case reviews have linked poor competency to sub-standard care outcomes and a disempowered patient population [ 16 56 ]. Consequently, as recognised by the participants, it is necessary to have clear systems of transparency and accountability [ 57 ].…”

Section: Discussionmentioning

confidence: 99%

“…Globally, there has been a greater focus on stakeholder engagement in policy development [ 15 16 ] and in Ireland, public consultation and engagement are seen as important when developing and implementing health policy. Eliciting feedback on the experience of care is considered a fundamental part of service quality improvement with global initiatives such as those by the Picker Institute [ 17 ].…”

Section: Irish Healthcare System and Policy Directionsmentioning

confidence: 99%

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Co-Creating Descriptors and a Definition for Person-Centred Coordinated Health Care: An Action Research Study

Phelan

Rohde

Casey

et al. 2021

International Journal of Integrated Care

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The aim of this study was to co-create a definition and generic descriptors for person-centred coordinated care for Ireland generated from service users’ narratives. An overarching action research approach was used to engage and empower people to tangibly impact health policy and practice. Through focus groups and a qualitative survey, primary data were collected from a national sample of health services users, caregivers and health care service users’ representative groups. Thematic analysis was used to analyse the data. Three major themes were co-produced as essential care elements. These were: ‘My experience of healthcare’, ‘Care that I am confident in’ and ‘My journey through healthcare’. Through an IPPOSI partner project steering group and their membership groups’ contribution, these themes were further refined into a definition of person-centred coordinated care and nineteen related generic descriptors. Key findings demonstrate that within complex, fragmented healthcare systems, the subjective expectations of service users should be integrated into care delivery, with a scaffolding of services to meet service users’ needs between care settings and disciplines and over time.

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Section: Discussionmentioning

confidence: 99%

Section: Irish Healthcare System and Policy Directionsmentioning

confidence: 99%

Co-Creating Descriptors and a Definition for Person-Centred Coordinated Health Care: An Action Research Study

Phelan

Rohde

Casey

et al. 2021

International Journal of Integrated Care

Self Cite

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“…The philosophy of treating people with dementia is "person-centered-care," including support for the well-being, dignity, and autonomy of the whole unique person. 24,30 Because of limited information regarding the patient's wishes, the consensus is usually that a close family member's decision will be similar to what the patient would likely decide if she or he could. 30 However, PSMs hold values and beliefs regarding Family caregivers Briefly: two groups had similarities regarding ANH for their loved one.…”

Section: Discussionmentioning

confidence: 99%

“…23 Good care relies on the concept of patient-centered care, by acknowledging the beliefs and values of service users at the center of decision-making. 24 There is limited information regarding ethical considerations for end-of-life palliative care and hospice care, specifically for home-confined PWESD. 13 Understanding and elaborating the ethical dilemmas may be beneficial both to the care of PWESD and to the communication between family caregivers and professionals.…”

Section: Introductionmentioning

confidence: 99%

Ethical challenges in end-stage dementia: Perspectives of professionals and family care-givers

et al. 2021

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Background: In Israel, caring for people with end-stage dementia confined to home is mainly done by home care units, and in some cases by home hospice units, an alternative palliative-care service. Because life expectancy is relatively unknown, and the patient’s decision-making ability is poor, caring for this unique population raises ethical dilemmas regarding when to define the disease as having reached a terminal stage, as well as choosing between palliative and life-prolonging-oriented care. Objectives: Exploring and describing differences and similarities of professional staff members’ (PSMs’) and family caregivers’ perceptions of caring for people with end-stage dementia in two different settings. Design: Qualitative research, using semi-structured interviews analyzed through a thematic content–analysis approach. Participants: Sixty-four interviews were conducted (24 PSMs and 40 family caregivers) in two care-settings—home hospice unit and home care unit. Ethical considerations: The study was approved by the Ethics Committee (BBL00118-17). Findings: We found dilemmas regarding palliative care to be the main theme, including definition of the disease as terminal, choosing “comfort” over “life-prolonging,” clarifying patients’ wishes and deciding whether or not to use artificial feeding. Discussion: Both PSMs and family caregivers deal with ethical dilemmas and have reached different conclusions, both legitimate. Comprehending dementia as a terminal disease influenced participants’ perceptions of the relevancy of palliative care for people with end-stage dementia. Discrepancies between PSMs and family caregivers in caring for people with end-stage dementia were found in both home hospice unit and home care unit environments, raising potential conflicts regarding decisions for end-of-life care. Conclusions: Communication between PSMs and family caregivers is crucial for the discussion about the discrepancies regarding the unique dilemmas of caring for people with end-stage dementia and bridging the gap between them. Lack of communication and resources can hamper the provision of an acceptable solution for quality and equality of care in the best interest of people with end-stage dementia.

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“…This is further enhanced where patients are involved in or co-design QCP-M for implementation and where there is a shift of focus to more patient-centred care instead of medically dominated and diseasefocused [93]. Furthermore, person-centeredness, underpinned by robust philosophical and theoretical concepts, has an increasingly solid footprint in policy and practice [94]. This concurs with quality improvement literature which identifies that patient-centred organizations are more likely to implement quality improvement and change [95][96][97][98][99].…”

Section: Summary Of Findingsmentioning

confidence: 99%

A Rapid Realist Review of Quality Care Process Metrics Implementation in Nursing and Midwifery Practice

Teeling

Davies

Barnard

et al. 2021

IJERPH

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Quality measurement initiatives promote quality improvement in healthcare but can be challenging to implement effectively. This paper presents a Rapid Realist Review (RRR) of published literature on Quality Care-Process Metrics (QCP-M) implementation in nursing and midwifery practice. An RRR informed by RAMESES II standards was conducted as an efficient means to synthesize evidence using an expert panel. The review involved research question development, quality appraisal, data extraction, and evidence synthesis. Six program theories summarised below identify the key characteristics that promote positive outcomes in QCP-M implementation. Program Theory 1: Focuses on the evidence base and accessibility of the QCP-M and their ease of use by nurses and midwives working in busy and complex care environments. Program Theory 2: Examines the influence of external factors on QCP-M implementation. Program Theory 3: Relates to existing cultures and systems within clinical sites. Program Theory 4: Relates to nurses’ and midwives’ knowledge and beliefs. Program Theory 5: Builds on the staff theme of Programme Theory four, extending the culture of organizational learning, and highlights the meaningful engagement of nurses and midwives in the implementation process as a key characteristic of success. Program Theory 6: Relates to patient needs. The results provide nursing and midwifery policymakers and professionals with evidence-based program theory that can be translated into action-orientated strategies to help guide successful QCP-M implementation.

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Review of developments in person-centred healthcare

Cited by 52 publications

References 0 publications

Co-Creating Descriptors and a Definition for Person-Centred Coordinated Health Care: An Action Research Study

Co-Creating Descriptors and a Definition for Person-Centred Coordinated Health Care: An Action Research Study

Ethical challenges in end-stage dementia: Perspectives of professionals and family care-givers

A Rapid Realist Review of Quality Care Process Metrics Implementation in Nursing and Midwifery Practice

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