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

Jacqueline Nkrumah,Gordon Abekah-Nkrumah

doi:10.1186/s12913-019-4748-z

Jacqueline Nkrumah, Gordon Abekah-Nkrumah

Open Access

https://doi.org/10.1186/s12913-019-4748-z

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Abstract

BackgroundImproving patient experience of care has gained enormous attention from policy makers and providers of healthcare services in Ghana. In spite of the supposed support for patient-centered care as the means for improving patient experience of care, scientific evidence point to poor patient experience of care in Ghana. Moreover, there seem to be little evidence on organizational-level factors that facilitate or hamper patient-centered care. In this study we assess organizational-level factors that facilitate or impede patient-centered care in three district hospitals in the Central Region of Ghana.MethodsThe study was exploratory research that used qualitative methods to collect data from seven senior managers and 3 junior managers in three district hospitals in the Central Region of Ghana. Data were collected with the aid of an interview guide and a checklist. Data were analyzed using content analysis.ResultsTwo main Organizational-level factors were identified, namely, facilitators and barriers of patient-centered care. Facilitators to patient-centered care included: 1) Leadership commitment. 2) Leadership support. 3) Training and education for patient-centered care. Patient-centered care barriers identified in the hospitals were: 1) Leadership conceptualization of patient-centered care. 2) Lack of goals and sufficient activities for patient-centered care. 3) Communication related challenges.4) Ownership type. 5) Degree of centralization. 6) Financial constraints.ConclusionOrganizational-level factors that promoted patient-centered care were fairly present in the hospitals. Yet, several other factors negatively affected patient-centered care in the hospitals. A suitable patient-focused intervention is recommended for implementation at the health system and institutional-levels to improve patient-centered care. Hospitals managers should develop suitable goals and activities to stimulate patient-centered care with the full participation of hospital employees and patients and families.

Highlights

Improving patient experience of care has gained enormous attention from policy makers and providers of healthcare services in Ghana
Organizational-level factors that promoted patient-centered care were fairly present in the hospitals
Research on institutional-level facilitators and barriers to the achievement of the patient-centered vision of the health system and the patient-centered mission and value statements of healthcare institutions in Ghana appears to be missing. To fill these gaps in the healthcare quality literature on Ghana, this study aims at assessing organizational-level factors that enhance or inhibit Patient-centered care (PCC) in three district hospitals in the Central Region of Ghana

Summary

Introduction

In this study we assess organizational-level factors that facilitate or impede patient-centered care in three district hospitals in the Central Region of Ghana. PCC has moved to the center stage on issues of healthcare delivery and has received enormous attention as an PCC is defined as healthcare that establishes partnership among practitioners, patients, and their families (when appropriate) to ensure that decisions respect patients’ wants, needs, and preferences and that patients have the education and support they need to make decisions and participate in their own care [2]. Baker’s definition [2] brings to the fore the importance of patients’ education and support to the promotion of patient-provider dyadic relationship, which is crucial in ensuring that patients participate in decision making regarding their own care.

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