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Factors that may promote the learning of person-centred care: an ethnographic study of an implementation programme for healthcare professionals in a medical emergency ward in Sweden

Journal article
Authors Liselott (Lisen) Dellenborg
Ewa Wikström
Annette Erichsen Andersson
Published in Advances in Health Sciences Education
Volume 24
Issue 2
Pages 353–381
ISSN 1382-4996
Publication year 2019
Published at University of Gothenburg Centre for person-centred care (GPCC)
Department of Business Administration, Management & Organisation
Institute of Health and Care Sciences
Centre for Global Human Resource Management
Pages 353–381
Language en
Links doi.org/10.1007%2Fs10459-018-09869-...
Keywords Person-centred/person-centered care, Ethnography, Action learning Implementation, Case study, Inter-professional relations, Ethics, Communication, Documentation, Disciplinary knowledge, Team, Management, Resistance, Context
Subject categories Business Administration

Abstract

While person-centred care has gained increasing prominence in recent decades as a goal for healthcare systems, mainstream implementation remains tentative and there is a lack of knowledge about how to develop person-centred care in practice. This study therefore aimed to explore what may be required in order for person-centred care programmes to be successful. The study used an ethnographic method of data collection. This consisted of closely following an implementation programme on a medical emergency ward in a Swedish hospital. Data consisted of participant observation and informal interviews with healthcare providers and their management leaders while they were in the process of training to use person-centred care. These interlocutors were using action learning methods under the guidance of facilitators. Our findings revealed that although the programme resulted in some of the processes that are central for person-centred care being developed, organisational factors and a lack of attention to ethics in the programme counteracted these positive effects. The study highlights the importance of facilitating mechanisms to produce desired results. These include management leaders’ learning about the dynamic and collective nature of learning processes and change. They also include allowing for inter-professional dialogue to enable managers and professionals to reflect deeply on professional boundaries, disciplinary knowledge and power relations in their teams. Teamwork is essential for the development of person-centred care and documentation, in accordance with this specific implementation programme, is also indispensable. The space for inter-professional dialogue should also accommodate their various perspectives on the aims of care and organizational reality.

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