Skip to main content
Top
Published in: BMC Health Services Research 1/2015

Open Access 01-06-2015 | Research article

Healthcare professionals’ views on patient-centered care in hospitals

Authors: Mathilde Berghout, Job van Exel, Laszlo Leensvaart, Jane M. Cramm

Published in: BMC Health Services Research | Issue 1/2015

Login to get access

Abstract

Background

Patient-centered care (PCC) is a main determinant of care quality. Research has shown that PCC is a multi-dimensional concept, and organizations that provide PCC well report better patient and organizational outcomes. However, little is known about the relative importance of PCC dimensions. The aim of this study was therefore to investigate the relative importance of the eight dimensions of PCC according to hospital-based healthcare professionals, and examine whether their viewpoints are determined by context.

Methods

Thirty-four healthcare professionals (16 from the geriatrics department, 15 from a surgical intensive care unit, 3 quality employees) working at a large teaching hospital in New York City were interviewed using Q methodology. Participants were asked to rank 35 statements representing eight dimensions of PCC extracted from the literature: patient preferences, physical comfort, coordination of care, emotional support, access to care, continuity and transition, information and education and family and friends. By-person factor analysis was used to reveal patterns of communality in statement rankings, which were interpreted and described as distinct viewpoints.

Results

Three main viewpoints on elements important for PCC were identified: “treating patients with dignity and respect,” “an interdisciplinary approach” and “equal access and good outcomes.” In these viewpoints, not all dimensions were equally important for PCC. Furthermore, the relative importance of the dimensions differed between departments. Context thus appeared to affect the relative importance of PCC dimensions.

Conclusion

Healthcare organizations wishing to improve PCC should consider the relative importance of PCC dimensions in their specific context of care provision, which may help to improve levels of patient-centeredness in a more efficient and focused manner. However, as the study sample is not representative and consisted only of professionals (not patients), the results cannot be generalized outside the sample. More research is needed to confirm our study findings.
Literature
1.
go back to reference Richardson WC, Berwick D, Bisgard J, Bristow L, Buck C, Cassel C. Crossing the quality chasm: a new health system for the 21st century: Institute of Medicine. Washington: National Academy Press; 2001. Richardson WC, Berwick D, Bisgard J, Bristow L, Buck C, Cassel C. Crossing the quality chasm: a new health system for the 21st century: Institute of Medicine. Washington: National Academy Press; 2001.
2.
go back to reference Rathert C, Wyrwich MD, Boren SA. Patient-centered care and outcomes: a systematic review of the literature. Med Care Res Rev. 2013;70(4):351–79.CrossRefPubMed Rathert C, Wyrwich MD, Boren SA. Patient-centered care and outcomes: a systematic review of the literature. Med Care Res Rev. 2013;70(4):351–79.CrossRefPubMed
3.
go back to reference Coelho T. A patient advocate’s perspective on patient-centered comparative effectiveness research. Health Aff. 2010;29(10):1885–90.CrossRef Coelho T. A patient advocate’s perspective on patient-centered comparative effectiveness research. Health Aff. 2010;29(10):1885–90.CrossRef
4.
go back to reference Griffin SJ, Kinmonth AL, Veltman MW, Gillard S, Grant J, Stewart M. Effect on health-related outcomes of interventions to alter the interaction between patients and practitioners: a systematic review of trials. Ann Fam Med. 2004;2(6):595–608.CrossRefPubMedPubMedCentral Griffin SJ, Kinmonth AL, Veltman MW, Gillard S, Grant J, Stewart M. Effect on health-related outcomes of interventions to alter the interaction between patients and practitioners: a systematic review of trials. Ann Fam Med. 2004;2(6):595–608.CrossRefPubMedPubMedCentral
5.
go back to reference Rao JK, Anderson LA, Inui TS, Frankel RM. Communication interventions make a difference in conversations between physicians and patients: a systematic review of the evidence. Med Care. 2007;45(4):340–9.CrossRefPubMed Rao JK, Anderson LA, Inui TS, Frankel RM. Communication interventions make a difference in conversations between physicians and patients: a systematic review of the evidence. Med Care. 2007;45(4):340–9.CrossRefPubMed
6.
go back to reference Stewart M, Brown JB, Donner A, McWhinney IR, Oates J, Weston WW, et al. The impact of patient-centered care on outcomes. J Fam Pract. 2000;49(9):796–804.PubMed Stewart M, Brown JB, Donner A, McWhinney IR, Oates J, Weston WW, et al. The impact of patient-centered care on outcomes. J Fam Pract. 2000;49(9):796–804.PubMed
7.
go back to reference Gerteis M, Edgman-Levitan S, Walker JD, Stoke DM, Cleary PD, Delbanco TL. What patients really want. Health Manage Q. 1993;15(3):2–6.PubMed Gerteis M, Edgman-Levitan S, Walker JD, Stoke DM, Cleary PD, Delbanco TL. What patients really want. Health Manage Q. 1993;15(3):2–6.PubMed
8.
go back to reference Gerteis M, Edgman-Levitan S, Daley J, Delbanco TL. Through the patient’s eyes: understanding and promoting patient-centered care. San Francisco: Jossey-Bass; 1993. Gerteis M, Edgman-Levitan S, Daley J, Delbanco TL. Through the patient’s eyes: understanding and promoting patient-centered care. San Francisco: Jossey-Bass; 1993.
9.
go back to reference Greene SM, Tuzzio L, Cherkin D. A framework for making patient-centered care front and center. Perm J. 2012;16(3):49–53.PubMedPubMedCentral Greene SM, Tuzzio L, Cherkin D. A framework for making patient-centered care front and center. Perm J. 2012;16(3):49–53.PubMedPubMedCentral
10.
go back to reference Kitson A, Marshall A, Bassett K, Zeitz K. What are the core elements of patient-centred care? A narrative review and synthesis of the literature from health policy, medicine and nursing. J Adv Nurs. 2013;69(1):4–15.CrossRefPubMed Kitson A, Marshall A, Bassett K, Zeitz K. What are the core elements of patient-centred care? A narrative review and synthesis of the literature from health policy, medicine and nursing. J Adv Nurs. 2013;69(1):4–15.CrossRefPubMed
11.
go back to reference Cramm JM, Nieboer AP. High-quality chronic care delivery improves experiences of chronically ill patients receiving care. Int J Qual Health Care. 2013;25(6):689–95.CrossRefPubMedPubMedCentral Cramm JM, Nieboer AP. High-quality chronic care delivery improves experiences of chronically ill patients receiving care. Int J Qual Health Care. 2013;25(6):689–95.CrossRefPubMedPubMedCentral
12.
go back to reference Avgar AC, Givan RK, Liu M. Patient-centered but employee delivered: patient care innovation, turnover intentions, and organizational outcomes in hospitals. Indu Lab Rel Rev. 2010;64:423.CrossRef Avgar AC, Givan RK, Liu M. Patient-centered but employee delivered: patient care innovation, turnover intentions, and organizational outcomes in hospitals. Indu Lab Rel Rev. 2010;64:423.CrossRef
13.
go back to reference Bernabeo E, Holmboe ES. Patients, providers, and systems need to acquire a specific set of competencies to achieve truly patient-centered care. Health Aff. 2013;32(2):250–8.CrossRef Bernabeo E, Holmboe ES. Patients, providers, and systems need to acquire a specific set of competencies to achieve truly patient-centered care. Health Aff. 2013;32(2):250–8.CrossRef
14.
15.
go back to reference Smith NW. Current systems in psychology: history, theory, research, and applications. Belmont: Wadsworth; 2001. Smith NW. Current systems in psychology: history, theory, research, and applications. Belmont: Wadsworth; 2001.
16.
go back to reference Watts S, Stenner P. Doing Q methodological research. London: Sage; 2012. Watts S, Stenner P. Doing Q methodological research. London: Sage; 2012.
17.
go back to reference Kline P. An easy guide to factor analysis. New York: Routledge; 1994. Kline P. An easy guide to factor analysis. New York: Routledge; 1994.
19.
go back to reference Bechtel C, Ness DL. If you build it, will they come? Designing truly patient-centered health care. Health Aff. 2010;29(5):914–20.CrossRef Bechtel C, Ness DL. If you build it, will they come? Designing truly patient-centered health care. Health Aff. 2010;29(5):914–20.CrossRef
20.
go back to reference Berwick DM. What ‘patient-centered’ should mean: confessions of an extremist. Health Aff. 2009;28(4):555–65.CrossRef Berwick DM. What ‘patient-centered’ should mean: confessions of an extremist. Health Aff. 2009;28(4):555–65.CrossRef
21.
go back to reference Mead N, Bower P. Patient-centredness: a conceptual framework and review of the empirical literature. Soc Sci Med. 2000;51(7):1087–110.CrossRefPubMed Mead N, Bower P. Patient-centredness: a conceptual framework and review of the empirical literature. Soc Sci Med. 2000;51(7):1087–110.CrossRefPubMed
23.
go back to reference Schmolck P, Atkinson J. Q Method software and manual 2.11. 2002. Schmolck P, Atkinson J. Q Method software and manual 2.11. 2002.
24.
go back to reference Hartgerink JM, Cramm JM, Bakker TJ, van Eijsden RA, Mackenbach JP, Nieboer AP. The importance of relational coordination for integrated care delivery to older patients in the hospital. J Nurs Manag. 2014;22(2):248–56.CrossRefPubMed Hartgerink JM, Cramm JM, Bakker TJ, van Eijsden RA, Mackenbach JP, Nieboer AP. The importance of relational coordination for integrated care delivery to older patients in the hospital. J Nurs Manag. 2014;22(2):248–56.CrossRefPubMed
25.
go back to reference Christensen M, Hewitt-Taylor J. Patient empowerment: does it still occur in the ICU? Intensive Crit Care Nurs. 2007;23(3):156–61.CrossRefPubMed Christensen M, Hewitt-Taylor J. Patient empowerment: does it still occur in the ICU? Intensive Crit Care Nurs. 2007;23(3):156–61.CrossRefPubMed
26.
go back to reference Leach W. Land of desire: merchants, power, and the rise of a new American culture. New York: Pantheon Books; 1993. Leach W. Land of desire: merchants, power, and the rise of a new American culture. New York: Pantheon Books; 1993.
27.
go back to reference King J, Gibbons E, Graham C, Walsh J. Developing measures of people’s self-reported experiences of integrated care. Oxford: Picker Institute Europe; 2013. King J, Gibbons E, Graham C, Walsh J. Developing measures of people’s self-reported experiences of integrated care. Oxford: Picker Institute Europe; 2013.
28.
go back to reference Davis K, Stremikis K, Schoen C, Squires D. Mirror, mirror on the wall, 2014 update: how the U.S. Health Care System Compares Internationally. New York: The Commonwealth Fund; 2014. Davis K, Stremikis K, Schoen C, Squires D. Mirror, mirror on the wall, 2014 update: how the U.S. Health Care System Compares Internationally. New York: The Commonwealth Fund; 2014.
29.
go back to reference Shaw KL, Southwood TR, McDonagh JE, British Society of Paediatric and Adolescent Rheumatology. Development and preliminary validation of the ‘Mind the Gap’ scale to assess satisfaction with transitional health care among adolescents with juvenile idiopathic arthritis. Child Care Health Dev. 2007;33:380–8.CrossRefPubMed Shaw KL, Southwood TR, McDonagh JE, British Society of Paediatric and Adolescent Rheumatology. Development and preliminary validation of the ‘Mind the Gap’ scale to assess satisfaction with transitional health care among adolescents with juvenile idiopathic arthritis. Child Care Health Dev. 2007;33:380–8.CrossRefPubMed
30.
go back to reference Sonneveld HM, Strating MMH, Staa AL, Nieboer AP. Gaps in transitional care: what are the perceptions of adolescents, parents and providers? Child Care Health Dev. doi:10.1111/j.1365-2214.2011.01354.x. Sonneveld HM, Strating MMH, Staa AL, Nieboer AP. Gaps in transitional care: what are the perceptions of adolescents, parents and providers? Child Care Health Dev. doi:10.1111/j.1365-2214.2011.01354.x.
31.
go back to reference Sepucha KR, Levin CA, Uzogara EE, Barry MJ, O’Connor AM, Mulley AG. Developing instruments to measure the quality of decisions: early results for a set of symptom-driven decisions. Patient Educ Couns. 2008;73:504–10.CrossRefPubMed Sepucha KR, Levin CA, Uzogara EE, Barry MJ, O’Connor AM, Mulley AG. Developing instruments to measure the quality of decisions: early results for a set of symptom-driven decisions. Patient Educ Couns. 2008;73:504–10.CrossRefPubMed
32.
go back to reference Counsell SR, Holder CM, Liebenauer LL, Palmer RM, Fortinsky RH, Kresevic DM, et al. Effects of a multicomponent intervention on functional outcomes and process of care in hospitalized older patients: a randomized controlled trial of Acute Care for Elders (ACE) in a community hospital. JAGS. 2000;48(12):1572–81.CrossRef Counsell SR, Holder CM, Liebenauer LL, Palmer RM, Fortinsky RH, Kresevic DM, et al. Effects of a multicomponent intervention on functional outcomes and process of care in hospitalized older patients: a randomized controlled trial of Acute Care for Elders (ACE) in a community hospital. JAGS. 2000;48(12):1572–81.CrossRef
33.
go back to reference Joosten EA, DeFuentes-Merillas L, de Weert GH, Sensky T, van der Staak CP, de Jong CA. Systematic review of the effects of shared decision-making on patient satisfaction, treatment adherence and health status. Psychother Psychosom. 2008;77(4):219–26.CrossRefPubMed Joosten EA, DeFuentes-Merillas L, de Weert GH, Sensky T, van der Staak CP, de Jong CA. Systematic review of the effects of shared decision-making on patient satisfaction, treatment adherence and health status. Psychother Psychosom. 2008;77(4):219–26.CrossRefPubMed
34.
go back to reference Krupat E, Fancey M, Cleary PD. Information and its impact on satisfaction among surgical patients. Soc Sci Med. 2000;51(12):1817–25.CrossRefPubMed Krupat E, Fancey M, Cleary PD. Information and its impact on satisfaction among surgical patients. Soc Sci Med. 2000;51(12):1817–25.CrossRefPubMed
35.
go back to reference Mallinger JB, Griggs JJ, Shields CG. Patient-centered care and breast cancer survivors’ satisfaction with information. Patient Educ Couns. 2005;57(3):342–9.CrossRefPubMed Mallinger JB, Griggs JJ, Shields CG. Patient-centered care and breast cancer survivors’ satisfaction with information. Patient Educ Couns. 2005;57(3):342–9.CrossRefPubMed
36.
go back to reference Venetis MK, Robinson JD, Turkiewicz KL, Allen M. An evidence base for patient-centered cancer care: a meta-analysis of studies of observed communication between cancer specialists and their patients. Patient Educ Couns. 2009;77(3):379–83.CrossRefPubMed Venetis MK, Robinson JD, Turkiewicz KL, Allen M. An evidence base for patient-centered cancer care: a meta-analysis of studies of observed communication between cancer specialists and their patients. Patient Educ Couns. 2009;77(3):379–83.CrossRefPubMed
Metadata
Title
Healthcare professionals’ views on patient-centered care in hospitals
Authors
Mathilde Berghout
Job van Exel
Laszlo Leensvaart
Jane M. Cramm
Publication date
01-06-2015
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2015
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-015-1049-z

Other articles of this Issue 1/2015

BMC Health Services Research 1/2015 Go to the issue