IMPROVE: Implementing person-centred care: Process evaluation of strategies, leadership, and health economics

Short Description of main results

• Prominent strategies for implementing person-centred care (PCC) included training staff in PCC and creating collaborations between different staff categories (1).
• The care units worked in different ways to include patients' stories, discuss goals with the patient and create parts of or a complete health plan. The link between concrete activities and the overall ethics varied (2). 
• Many staff felt that PCC was an unclear concept and that people looked at PCC with different eyes, which meant that they were pulling in different directions (3).
• The patient questionnaire that was developed had mainly good measurement properties (4) 
• There was both agreement and differences in how management at different levels perceived person-centered care (5).
• There were clear costs for implementing PCC, which, however, together constituted 0.009% of the region's budget (6).
 

About the results

IMPROVE reflects how a region worked to implement increased person-centeredness in daily healthcare. The project provides a picture of both opportunities and difficulties. The fact that the participating units worked in different ways reflects the natural differences that existed in contextual conditions. 

The research findings indicate that there has probably been too much focus on some strategies to support implementation and that it was very challenging to support staff to develop such a deep understanding of what person-centered care is so that they could apply person-centered care in their daily practice. The results also indicate that the consistency in how different management levels view person-centered care and how it is communicated can be improved. 

These findings are important points of reference for developed implementation work. The patient questionnaire that was developed in the project (and its continued development) can provide a valuable tool for capturing the patient's experience of the degree to which care is person-centered. The financial evaluation emphasizes that there needs to be budgeted space for the implementation work.

Continued research

There is a significant knowledge gap regarding which strategies, in combination with given contextual conditions, work well to support the transition to a more person-centred care. Studies are underway where the training of healthcare professionals as facilitators (persons who support and facilitate the change process) is being tested, where these facilitators continue to function as support in their “home” organizations’ work with person-centred care: FaciLitating Implementation of Person-Centred Care - the FLIP-project.