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Person-centred care: A problem analysis

Author:

Dave Pearson

Ontario Health – Central, Canada, CA
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Abstract

Introduction: Congregate settings in the province of Ontario, Canada supports a vulnerable patient population that requires coordination across health and care systems. These settings are a wide-ranging category of supportive housing facilities where people live, stay overnight, and use shared spaces. The global pandemic has reinforced the need for person-centred care for these vulnerable patients.

The highlighted complexity and multidimensional care needs of this population lie outside of the traditional health system. Researchers have called for a focus on relationships across providers and a system shift from a patient specific illness state to a person-centred approach that coordinates care across multiple providers.

Methods: This paper reflects the first module of the Precede-Procede model. The research aim, what are the system level factors that influence the ability to deliver person-centred care across health and care providers? 

A patient interview and literature review are combined to consider the patient, professional, leadership, and system factors influencing an ideal state. The most relevant facet of the literature review where the terms ‘leadership’ and ‘person centred’ as well as considering executive and management functions, styles and theories. The patient was “BB” a retired career educator who advanced to the highest level of leadership who is also a steadfast and integral leader and advocate for patient co-design and person central care.

Results: Research identified several factors that impact the ability provide person-centred care for patients will complex care needs. The degree of complexity may itself impact the ability for patients to be part of the care design as well as the behaviours and values of the care providers themselves. Patients own level of knowledge and education also influence their capacity to be involved in system level decision making. Predisposing, enabling and reinforcing factors were considered at the micro (patient and provider), meso (leadership), and macro (system) level of impact. The focus on individual professional expertise was found to lead to a lack of person-centred care, and a lack of investment across providers means and absence of shared values and investment in patient-centres care. Reductionism and oversimplification of both the patients care needs as well as the system complexities, coupled with command-and-control hierarchical leadership structures result in a lack of patient-centred care.    

Conclusion: To be able to have trust in the system and a commitment to patient and person-centred care there is a need to address the lack of relationships spanning the boundaries of individual professionals and providers. The lack of relationship means there is also not shared values, which erodes sustainable trust.

Implications: Person-centred care requires the direct commitment and involvement of leaders that are present and part of the local community. In addition, there is need to focus on partnerships across organizations, active trust building, and acknowledgment of the complex adaptive nature of health and care.

 

How to Cite: Pearson D. Person-centred care: A problem analysis. International Journal of Integrated Care. 2022;22(S3):297. DOI: http://doi.org/10.5334/ijic.ICIC22151
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Published on 04 Nov 2022.

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