Healthcare professionals’ views on patient-centered care in hospitals

Mathilde Berghout, Job van Exel, Laszlo Leensvaart, Jane M. Cramm

Patient-centered care (PCC) is a main determinant of care quality. Research has shown that PCC is a multi-dimensional concept, and organizations that provide PCC well report better patient and organizational outcomes. However, little is known about the relative importance of PCC dimensions. The aim of this study was therefore to investigate the relative importance of the eight dimensions of PCC according to hospital-based healthcare professionals, and examine whether their viewpoints are determined by context. Thirty-four healthcare professionals (16 from the geriatrics department, 15 from a surgical intensive care unit, 3 quality employees) working at a large teaching hospital in New York City were interviewed using Q methodology. Participants were asked to rank 35 statements representing eight dimensions of PCC extracted from the literature: patient preferences, physical comfort, coordination of care, emotional support, access to care, continuity and transition, information and education and family and friends. By-person factor analysis was used to reveal patterns of communality in statement rankings, which were interpreted and described as distinct viewpoints. Three main viewpoints on elements important for PCC were identified: "treating patients with dignity and respect," "an interdisciplinary approach" and "equal access and good outcomes." In these viewpoints, not all dimensions were equally important for PCC. Furthermore, the relative importance of the dimensions differed between departments. Context thus appeared to affect the relative importance of PCC dimensions. Healthcare organizations wishing to improve PCC should consider the relative importance of PCC dimensions in their specific context of care provision, which may help to improve levels of patient-centeredness in a more efficient and focused manner. However, as the study sample is not representative and consisted only of professionals (not patients), the results cannot be generalized outside the sample. More research is needed to confirm our study findings.