Using patient value statements to develop a culture of patient-centred care: a case study of an Ontario, Canada hospital

Abstract

Patient-centred care (PCC) is not a new concept; however, in recent years it has garnered increasing attention in the research literature and clinical practice. PCC in clinical practice has been found to improve clinical outcomes, resource allocation, and the patient experience. In response to the need for PCC and quality in healthcare, the Ontario, Canada government developed the Excellent Care for All Act (ECFAA) in 2010. The ECFAA imposes six obligations to Ontario hospitals, one of which is developing and publishing a Patient Declaration of Values (PDoV). The purpose of this study was to explore how a leading patient-centred Ontario hospital operationalized their patient value statement in policy and practice. The objectives of this research were to: a) understand what role the patient value statement played in policy and practice within a leading Ontario hospital and b) to examine how a leading Ontario hospital incorporated these values into their overarching organizational structures. This was a qualitative case study, which took place in a leading patient-centred Ontario hospital. The study included 18 interviews with employees and patient/family advisors. The analysis found a five-step process including: 1) setting the stage, 2) inspiring change, 3) organizational capacity, 4) barriers, and 5) reflection and improvement. This study has highlighted the role of a patient value statement within a leading Ontario hospital. The findings provide a five-step process with 12 core strategies for creating change in a healthcare organization; to embed a culture of patient-centred care.

Facilitators and barriers of patient-centered care at the organizational-level: a study of three district hospitals in the central region of Ghana

“…Moreover, the problem of limited funds does not only affect hospital managers’ ability to reward PCC behavior of staff, it also affects the supply of resources required for the delivery of quality healthcare. Financial challenges related to supply of resources and provision of incentives to staff mirrors findings of previous studies [39, 40].…”

“…Even though Shaller’s work did not consider barriers to PCC, literature has detailed resource constraints, resistance to change, low employee value, unsupportive policies, and poor staff commitment and interest as organizational-level factors inimical to PCC [14, 17, 23, 26]. For instance, human, time and financial resource constraints have been mentioned as challenges to the delivery of PCC, particularly, limited staff capacity, insufficient staff, limited time to set the stage for PCC, limited office space and lack of equipment [17, 18].…”

“…For instance, human, time and financial resource constraints have been mentioned as challenges to the delivery of PCC, particularly, limited staff capacity, insufficient staff, limited time to set the stage for PCC, limited office space and lack of equipment [17, 18]. In other studies, difficulties related to cultural change implementation, inexperienced staff, high workload and poor attitude of staff, stickiness to traditional or standard hospital practices and low employee value have been acknowledged to hamper PCC [14, 16, 17, 21, 28]. These factors can be viewed as frictional forces at the organizational-level that inhibit PCC effort.…”

Here for the people: The argument for making clinical ethics more patient-centred

“…Organizations, including clinical ethics service providers, have to balance direct patient-centred care with considering staff needs and points of view. 7 While autonomy is at the forefront of Canadian healthcare, other factors, such as staff safety, burnout, and overall efficiency, must continue to be taken into account. Employees must also have an opportunity to contribute to decision-making processes, while keeping in mind that a healthcare organization’s ultimate purpose is to provide care to others.…”

“…While this concept is not novel, there has been a significant shift in bringing patient-centred care to the forefront of a hospital's ethos. 7 Overall, patient-centred care has demonstrated benefits in improving clinical outcomes, service delivery, use of resources, and provider satisfaction. [8][9][10][11] Furthermore, this approach has been endorsed through the Ontario government's Excellent Care for All Act (ECFAA) requiring healthcare organizations to implement patient-centred care.…”