Department of Health Administration and Education, Faculty of Science Education, University of Education, Winneba, P.O Box 25, Winneba, Central Region, West African, Ghana.
Department of Public Administration and Health Services Management, University of Ghana Business School, P. O. Box, 75, Accra-Legon, Greater Accra Region, West Africa, Ghana.
BMC Health Serv Res. 2019 Nov 27;19(1):900. doi: 10.1186/s12913-019-4748-z.
Improving patient experience of care has gained enormous attention from policy makers and providers of healthcare services in Ghana. In spite of the supposed support for patient-centered care as the means for improving patient experience of care, scientific evidence point to poor patient experience of care in Ghana. Moreover, there seem to be little evidence on organizational-level factors that facilitate or hamper patient-centered care. In this study we assess organizational-level factors that facilitate or impede patient-centered care in three district hospitals in the Central Region of Ghana.
The study was exploratory research that used qualitative methods to collect data from seven senior managers and 3 junior managers in three district hospitals in the Central Region of Ghana. Data were collected with the aid of an interview guide and a checklist. Data were analyzed using content analysis.
Two main Organizational-level factors were identified, namely, facilitators and barriers of patient-centered care. Facilitators to patient-centered care included: 1) Leadership commitment. 2) Leadership support. 3) Training and education for patient-centered care. Patient-centered care barriers identified in the hospitals were: 1) Leadership conceptualization of patient-centered care. 2) Lack of goals and sufficient activities for patient-centered care. 3) Communication related challenges.4) Ownership type. 5) Degree of centralization. 6) Financial constraints.
Organizational-level factors that promoted patient-centered care were fairly present in the hospitals. Yet, several other factors negatively affected patient-centered care in the hospitals. A suitable patient-focused intervention is recommended for implementation at the health system and institutional-levels to improve patient-centered care. Hospitals managers should develop suitable goals and activities to stimulate patient-centered care with the full participation of hospital employees and patients and families.
改善患者的医疗体验已引起加纳政策制定者和医疗服务提供者的高度关注。尽管以患者为中心的护理被认为是改善患者医疗体验的手段，但科学证据表明，加纳的患者医疗体验较差。此外，似乎几乎没有关于促进或阻碍以患者为中心的护理的组织层面因素的证据。在这项研究中，我们评估了加纳中部地区三家地区医院促进或阻碍以患者为中心的护理的组织层面因素。
该研究是一项探索性研究，采用定性方法从加纳中部地区的三家地区医院的七名高级管理人员和三名初级管理人员收集数据。数据收集借助访谈指南和检查表进行。使用内容分析法对数据进行分析。
确定了两个主要的组织层面因素，即促进和阻碍以患者为中心的护理的因素。促进以患者为中心的护理的因素包括：1）领导层的承诺。2）领导层对以患者为中心的护理的支持。3）以患者为中心的护理培训和教育。医院中发现的以患者为中心的护理障碍包括：1）领导层对以患者为中心的护理的概念化。2）缺乏以患者为中心的护理目标和足够的活动。3）沟通相关挑战。4）所有制类型。5）集中化程度。6）财务限制。
在这些医院中，促进以患者为中心的护理的组织层面因素相当普遍。然而，其他一些因素对医院的以患者为中心的护理产生了负面影响。建议在卫生系统和机构层面实施适当的以患者为中心的干预措施，以改善以患者为中心的护理。医院管理人员应制定适当的目标和活动，以充分调动医院员工、患者和家属的积极性，促进以患者为中心的护理。
