Finding the hidden heart of healthcare: the development of a framework to evidence person-centred practice

摘要

Background: In the present healthcare climate of performance management it has become increasingly challenging to ensure there is a balance between evidence-based practice and person-centred practice. Policy documents lead us to believe that the persons’ understanding of the care process and satisfaction with the care experience is important. However, in many healthcare settings evidence of person-centred practice often remains hidden behind the delivery of target driven, research-based care. Aims: The aim of this development was to develop a shared understanding of person-centred practice. Design: A collaborative enquiry approach was taken as it valued action, reflection and meaning making between participants who work in different healthcare settings. Method: A self-selected group of seven practice development nurses met to share stories and developed insights into evidencing person-centred practice. Dialogue interspersed with critical reflection enabled us to validate our experiences. Ideas shared were grouped into a framework of values, themes and sub-themes. These were validated by practitioners locally, nationally and internationally. Results: The framework is comprised of six values: accepted, listened to, understood, informed, involved and flourishing. For each value there are themes and sub-themes that illustrate the outcomes for individuals, teams and organisations of person-centred practice; the risks if person-centred practice is not achieved and the actions that promote person-centred practice. Conclusion: Implementing this framework for evidencing person-centred practice develops mutual trust and understanding of collective knowledge. It gives a sense of purpose amidst the uncertain, stressful, complexity of the present healthcare context. Interpreting evidence in a participatory learning environment can raise awareness of the values underpinning person-centred practice.