Abstract
Health and social care organizations are under pressure of organizing care around patients’ needs and preferences while complying with regulatory frameworks and constraint resources. To implement patient-centered care in health and social care organizations successfully, particular organizational preconditions need to be considered. Findings on the implementation of patient-centered care and its preconditions are rare and insufficiently account for the organizational context to explain differences. This study examines the implementation status of patient-centered care in diverse health and social care organizations and analyzes the communication climate as a precondition of successful implementation. In a cross-sectional postal key informant survey, decision makers in the highest leading positions from six different types of health and social care organizations in Cologne, Germany, were surveyed using a paper–pencil questionnaire. Patient-centered care implementation was operationalized by three categories (principles, activities, and enablers) including 15 dimensions. Organizational communication climate was operationalized by aspects of open and constructive communication, cooperation, and inclusion. Out of 1790 contacted organizations, 237 participated. In the analyses, 215 complete datasets were included. Descriptive analyses, Kruskal–Wallis test, post hoc pair-wise test, and linear regression modeling were performed. Results show that the implementation status of patient-centered care was perceived as high but differed between the various types of organizations and in terms of patient-centered care categories. Organizational communication climate was significantly associated with the implementation of patient-centered care. Especially in organizations with a higher number of employees, strategies to create a positive communication climate are needed to create a precondition for patient-centered care.
Highlights
Patient-centered care (PCC) has become a guiding principle in health and social care and is defined as ‘providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions’ [1].These developments put health and social care organizations (HSCOs) under pressure to develop strategies to implement PCC while complying with regulatory frameworks and constraint resources.The extent to which PCC is considered and implemented successfully depends on various organizational preconditions [2,3]
The sample of n = 215 includes 70% women, 78% are between 46 and 65 years old, and 96% work in direct care contact with patients. Some of those contacted fed back reasons for non-response. These included a lack of time for participation as well as structural features, such as HSCO with only one or two persons, which made it difficult to answer questions referring to aspects of internal communication
Our study examined the status of PCC implementation within diverse HSCOs in Cologne, Germany and analyzed the communication climate as a precondition of successful implementation
Summary
Patient-centered care (PCC) has become a guiding principle in health and social care and is defined as ‘providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions’ [1].These developments put health and social care organizations (HSCOs) under pressure to develop strategies to implement PCC while complying with regulatory frameworks and constraint resources.The extent to which PCC is considered and implemented successfully depends on various organizational preconditions [2,3]. Patient-centered care (PCC) has become a guiding principle in health and social care and is defined as ‘providing care that is respectful of, and responsive to, individual patient preferences, needs and values, and ensuring that patient values guide all clinical decisions’ [1]. These developments put health and social care organizations (HSCOs) under pressure to develop strategies to implement PCC while complying with regulatory frameworks and constraint resources. Studies show that the implementation varies between HSCOs [4] This raises the question about organizational preconditions of HSCOs that determine PCC implementation [5,6]. The methodological approaches vary, with qualitative approaches dominating [4,7,9,10]
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