Improving patient participation in a challenging context: a 2-year evaluation study of an implementation project.
OBJECTIVE
To evaluate an implementation project on patient participation.


BACKGROUND
Patient participation is one of the cornerstones of person-centred care. A previous intervention study resulted in improved patient participation in a surgical department in a large university hospital in Sweden. A subsequent implementation project was guided by the PARiSH framework and included several strategies over 2 years.


METHODS
Patients (n = 198) in five units completed a questionnaire and nurse managers (n = 5) were interviewed.


RESULTS
Although the long-term implementation project did not improve patient participation in the units, the nurse managers described a changing culture in which staff grew to accept patients' involvement in their own care. Several barriers to change and sustainability were acknowledged.


CONCLUSIONS
Improving patient participation in a busy environment is challenging. The framework was useful in the different steps of the project. In the future, the interrelationship of the core elements needs to be analysed in an ongoing and deeper way to allow both prediction and prevention of barriers to improvement.


CONCLUSIONS
A dedicated leadership together with skilled facilitators should encourage and support staff to reflect on their attitudes and ways of working to increase person-centred care.
Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden.|Department of Surgery, Uppsala University Hospital, Uppsala, Sweden.
Eva
E
Jangland
Department of Public Health and Caring Sciences, Uppsala University Hospital, Uppsala, Sweden.|Quality Department, Uppsala University Hospital, Uppsala, Sweden.
Lena
L
Gunningberg
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009723:Nurse-Patient Relations; D009726:Nurses / Q000523:psychology; D010358:Patient Participation / Q000379:methods / Q000523:psychology*; D018802:Patient-Centered Care / Q000379:methods / Q000592:standards; D010465:Perception; D016730:Program Development / Q000379:methods*; D015397:Program Evaluation / Q000379:methods; D036301:Qualitative Research; D012648:Self Care; D011795:Surveys and Questionnaires; D013548:Sweden
facilitators; implementation; nurse managers; patient participation; person-centred care; surgical care