Question

What are the barriers to providing patient-centered care?

Answer 1

Ans. Barriers to patient and family centred care were:

i) staffing constraints and reduced levels of staff experience.

ii) high staff workloads and time pressures.

iii) physical resource and environment constraints.

iv) unsupportive staff attitudes.

The key enablers of patient and family centred care were: i) leadership focus on patient and family centred care

ii) staff satisfaction and positive staff relations,

iii) formal structures and processes to support patient and family centred care

iv) staff cultural diversity

v) health professional values and role expectations. This study provides an understanding of the factors that restrict and enhance patient and family centred care. hospitals in similar settings, to improve patient and family centred care. In turn, this may lead to improved outcomes for patients, families, staff and healthcare organisations.

Staffing constraints and reduced levels of staff experience Both clinical and non-clinical service managers consistently reported that staffing constraints limited PFCC. Managers often spoke about being their full-time-equivalent target due to recruitment delays and staff leave.

In addition, a lack of administrative staff to assist clinicians was described as restricting time for PFCC. if I didn’t have to do my own admin, there would be basically a lot more ability and time to do patient-centred work and get the [health professionals] thinking about more patient-centred work.Managers reported that staff leave was often not back-filled and that because of this that they were not able to deliver the same level of PFCC as with full staffing. One manager noted that reduced staffing negatively impacted on PFCC by demotivating managers and staff in the workplace When leave was back-filled by casual staff, this still limited PFCC because often these staff did not have the same level of context-specific experiential knowledge as permanent staff. ‘We do get staff, but what happens is that they're pool staff members, sometimes without [speciality] experience. So sometimes we could get two pool staff members with two of our own and obviously the service delivery is not good.

High staff workloads and time pressures Managers frequently described high workloads and time pressures as barriers to PFCC. This included both clinical and administrative workloads. Some managers outlined that these workloads were increasing because of increasing patient presentations. time pressure in a busy department is a problem there are many times when patient satisfaction would probably be improved by the doctor going in, or the nurse and giving a nice timely considered explanation to the patient. Some managers also commented that performance targets contributed to time pressures.

‘All of the pressures that [department name] has don’t traditionally work well with giving patients time to digest information and make choices about their care.

High administrative workload for clinical staff was also reported as limiting PFCC. with the amount of phone calls and whatnot that the nurses are taking their time to come and answer phones and doing administrative work when they could be in doing patient care.

Physical resource and environment constraints

Physical resource and environment constraints included a lack of space available for private conversations with patients and families and a lack of equipment such as beds, computers and comfortable chairs.