How to Achieve a Person-Centred Culture Change in a Residential Aged-Care Facility: A Tailored Implementation Strategy.

Abstract

Title. How to Achieve a Person-Centred Culture Change in a Residential Aged-Care Facility: A Tailored Implementation Strategy.

Background. To overcome quality concerns in elderly care, a worldwide culture change movement towards person-centred care is enfolding. However, achieving a person-centred care culture change is known to be difficult. For successful implementation, tailored implementation strategies, such as can be developed with the Innovation-Contingency model, seem effective.

Objective. The objectives of this study were to refine the Innovation-Contingency model’s method and to develop a tailored strategy aimed at successfully implementing person-centred care in a Dutch residential aged-care facility. To reach this, extensive implementation diagnostics were conducted amongst employees. These were used to develop a tailored implementation strategy using the Innovation-Contingency Model. Then, this strategy was assessed on its perceived feasibility by members of the organization it was tailored to.

Method. This study had a sequential embedded QUAN(qual) mixed-methods design. Implementation diagnostics were examined quantitatively by use of six self-reported questionnaires. The perceived feasibility of the tailored implementation strategy was assessed qualitatively in a focus group. Results of both types of data were combined by use of interpretive integration. For both methods, participants were selected by purposive sampling.

Results. Implementation diagnostics (N=96) indicated that there was lack of shared perceptions of person-centred care and team- and development-orientedness needed further development. Therefore, a consensus strategy followed by a co-evolution strategy was developed. This tailored implementation strategy was deemed feasible by members of the organization (N=8) it was tailored to.

Conclusions. In this study, the Innovation-Contingency model’s method was refined. This method led to the development of a feasible implementation strategy to reach a person-centred culture change.

Recommendations. To improve elderly care in the organization, the developed tailored implementation strategy should be used. Mixed-method design is recommended for future implementation research.