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Enacting person‐centredness in integrated care: A qualitative study of practice and perspectives within multidisciplinary groups in the care of older people

BACKGROUND: Person‐centredness is important in delivering care for long‐term conditions. New models of care aim to co‐ordinate care through integration of health and social care which require new ways of working, often remotely from the patient. OBJECTIVE: To describe how person‐centred care is enac...

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Autores principales: Riste, Lisa K., Coventry, Peter A., Reilly, Siobhan T., Bower, Peter, Sanders, Caroline
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6250865/
https://www.ncbi.nlm.nih.gov/pubmed/30004166
http://dx.doi.org/10.1111/hex.12803
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author Riste, Lisa K.
Coventry, Peter A.
Reilly, Siobhan T.
Bower, Peter
Sanders, Caroline
author_facet Riste, Lisa K.
Coventry, Peter A.
Reilly, Siobhan T.
Bower, Peter
Sanders, Caroline
author_sort Riste, Lisa K.
collection PubMed
description BACKGROUND: Person‐centredness is important in delivering care for long‐term conditions. New models of care aim to co‐ordinate care through integration of health and social care which require new ways of working, often remotely from the patient. OBJECTIVE: To describe how person‐centred care is enacted within multidisciplinary groups (MDGs) created as part of a new service, integrating health and social care for older people. METHODS: We followed the implementation of eight neighbourhood MDGs, observing and interviewing staff from three MDGs at different phases of programme implementation using semi‐structured topic guides. RESULTS: Thirty‐four MDG meetings were observed and 32 staff interviewed. Three core themes were identified which impacted on enactment of person‐centred care: the structural context of MDGs enabling person‐centred care; interaction of staff and knowledge sharing during the MDG meetings; and direct staff involvement of the person outside the MDG discussion. CONCLUSIONS: This study provides new insights into attempts to enact person‐centred care within a new model of service delivery. Teams did what they could to enact person‐centred care in the absence of the “real” patient within MDG meetings. They were successful in delivering and co‐ordinating some aspects of care (eg prompting medication reviews, referring to social worker, health improvement and arranging further multidisciplinary team meetings for complex cases). This “absence of patients” and time pressures within the MDGs led to reliance on the “virtual” record, enhanced by additional “soft” knowledge provided by staff, rather than ensuring the patient's voice was included.
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spelling pubmed-62508652018-12-01 Enacting person‐centredness in integrated care: A qualitative study of practice and perspectives within multidisciplinary groups in the care of older people Riste, Lisa K. Coventry, Peter A. Reilly, Siobhan T. Bower, Peter Sanders, Caroline Health Expect Original Research Papers BACKGROUND: Person‐centredness is important in delivering care for long‐term conditions. New models of care aim to co‐ordinate care through integration of health and social care which require new ways of working, often remotely from the patient. OBJECTIVE: To describe how person‐centred care is enacted within multidisciplinary groups (MDGs) created as part of a new service, integrating health and social care for older people. METHODS: We followed the implementation of eight neighbourhood MDGs, observing and interviewing staff from three MDGs at different phases of programme implementation using semi‐structured topic guides. RESULTS: Thirty‐four MDG meetings were observed and 32 staff interviewed. Three core themes were identified which impacted on enactment of person‐centred care: the structural context of MDGs enabling person‐centred care; interaction of staff and knowledge sharing during the MDG meetings; and direct staff involvement of the person outside the MDG discussion. CONCLUSIONS: This study provides new insights into attempts to enact person‐centred care within a new model of service delivery. Teams did what they could to enact person‐centred care in the absence of the “real” patient within MDG meetings. They were successful in delivering and co‐ordinating some aspects of care (eg prompting medication reviews, referring to social worker, health improvement and arranging further multidisciplinary team meetings for complex cases). This “absence of patients” and time pressures within the MDGs led to reliance on the “virtual” record, enhanced by additional “soft” knowledge provided by staff, rather than ensuring the patient's voice was included. John Wiley and Sons Inc. 2018-07-13 2018-12 /pmc/articles/PMC6250865/ /pubmed/30004166 http://dx.doi.org/10.1111/hex.12803 Text en © 2018 The Authors Health Expectations published by John Wiley & Sons Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research Papers
Riste, Lisa K.
Coventry, Peter A.
Reilly, Siobhan T.
Bower, Peter
Sanders, Caroline
Enacting person‐centredness in integrated care: A qualitative study of practice and perspectives within multidisciplinary groups in the care of older people
title Enacting person‐centredness in integrated care: A qualitative study of practice and perspectives within multidisciplinary groups in the care of older people
title_full Enacting person‐centredness in integrated care: A qualitative study of practice and perspectives within multidisciplinary groups in the care of older people
title_fullStr Enacting person‐centredness in integrated care: A qualitative study of practice and perspectives within multidisciplinary groups in the care of older people
title_full_unstemmed Enacting person‐centredness in integrated care: A qualitative study of practice and perspectives within multidisciplinary groups in the care of older people
title_short Enacting person‐centredness in integrated care: A qualitative study of practice and perspectives within multidisciplinary groups in the care of older people
title_sort enacting person‐centredness in integrated care: a qualitative study of practice and perspectives within multidisciplinary groups in the care of older people
topic Original Research Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6250865/
https://www.ncbi.nlm.nih.gov/pubmed/30004166
http://dx.doi.org/10.1111/hex.12803
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