title: The unannounced patient in the corridor: trust, friction and person-centered care.
abstract: In this study, a Swedish cancer clinic was studied where three to four unscheduled patients sought support from the hospital on a daily basis for pain and nutrition problems. The clinic was neither staffed nor had a budget to handle such return visits. In order to offer the patients a better service and decrease the workload of the staff in addition to their everyday activities, a multidisciplinary team was established to address the unscheduled return visits. The team was supposed to involve the patient, build trust, decrease the friction, and contribute to a successful rehabilitation process. Data were collected from the patients and the staff. Patients who encountered the team (intervention) and patients who encountered the regular ad hoc type of organization (control) answered a questionnaire measuring trust and friction. Nurses in the control group spent 35% of their full-time employment, and the intervention group staffed with nurses spent 30% of their full-time employment in addressing the needs of these return patients. The patients perceived that trust between them and the staff was high. In summary, it was measured as being 4.48 [standard deviation (SD) = 0.82] in the intervention group and 4.41 (SD = 0.79) in the control group using the 5-point Likert scale. The data indicate that using a multidisciplinary team is a promising way to handle the problems of unannounced visits from patients. Having a team made it cost effective for the clinic and provided a better service than the traditional ad hoc organization. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: The Sahlgrenska Academy - Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.|Centre for Person-Centred Care (GPCC), Gothenburg University, Gothenburg, Sweden.
authors.forename: Eric D
authors.initials: ED
authors.lastname: Carlström
authors.affiliation: The Sahlgrenska Academy - Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.|Centre for Person-Centred Care (GPCC), Gothenburg University, Gothenburg, Sweden.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Hansson Olofsson
authors.affiliation: The Sahlgrenska Academy - Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.|Centre for Person-Centred Care (GPCC), Gothenburg University, Gothenburg, Sweden.
authors.forename: Lars-Eric
authors.initials: LE
authors.lastname: Olsson
authors.affiliation: Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Nyman
authors.affiliation: The Sahlgrenska Academy - Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden.|Centre for Person-Centred Care (GPCC), Gothenburg University, Gothenburg, Sweden.|Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors.forename: Inga-Lill
authors.initials: IL
authors.lastname: Koinberg
mesh_terms: D001071:Appointments and Schedules; D002173:Cancer Care Facilities; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D018802:Patient-Centered Care; D011369:Professional-Patient Relations; D036301:Qualitative Research; D011795:Surveys and Questionnaires; D013548:Sweden; D035502:Trust; D016526:Workload
keywords: Sweden; person-centered care; team; trust; unscheduled visits