Byrne, John-Paul and Power, Robert and Kiersey, Rachel and Varley, Jarlath and Doherty, Colin P. and Saris, A. Jamie and Lambert, Veronica and Fitzsimons, Mary
(2019)
The rhetoric and reality of integrated patient-centered care for healthcare
providers: An ethnographic exploration of epilepsy care in Ireland.
Epilepsy & Behavior, 94.
pp. 87-92.
ISSN 1525-5050
Abstract
In line with healthcare reform across the world, the National Clinical Programme for Epilepsy (NCPE) in Ireland
describes a model that aims to achieve holistic integrated person (patient)-centered care (PCC). While generally
welcomed by stakeholders, the steps required to realize the NCPE ambition and the preparedness of those involved to make the journey are not clear. This study explored the perceptions of healthcare providers in the
Irish epilepsy care ecosystem to understand their level of readiness to realize the benefits of an integrated PCC
model. Ethnographic fieldwork including observations of different clinical settings across three regions in
Ireland and one-to-one interviews with consultant epileptologists (n = 3), epilepsy specialist nurses (n = 5),
general practitioners (n = 4), and senior healthcare managers (n = 3) were conducted. While there is a
person-centered ambiance and a disposition toward advancing integrated PCC, there are limits to the readiness
of the epilepsy care environment to fully meet the aspirations of healthcare reform. These are the following:
underdeveloped healthcare partnerships;, poor care coordination;, unintended consequences of innovation;,
and tension between pace and productivity. In the journey from policy to practice, the following multiple tensions collide: policy aims to improve services for all patients while simultaneously individualizing care; demands
for productivity limit the time and space required to engage in incremental and iterative improvement initiatives.
Understanding these tensions is an essential first step on the pathway to integrated PCC implementation.
| Item Type: |
Article
|
| Keywords: |
Ethnographic research;
Beliefs;
Person-centered care;
Health professionals in epilepsy care;
Integrated care;
Chronic disease; |
| Academic Unit: |
Faculty of Social Sciences > Anthropology |
| Item ID: |
14895 |
| Identification Number: |
https://doi.org/10.1016/j.yebeh.2019.02.011 |
| Depositing User: |
Dr. A. Jamie Saris
|
| Date Deposited: |
05 Oct 2021 10:32 |
| Journal or Publication Title: |
Epilepsy & Behavior |
| Publisher: |
Elsevier |
| Refereed: |
Yes |
| URI: |
|
| Use Licence: |
This item is available under a Creative Commons Attribution Non Commercial Share Alike Licence (CC BY-NC-SA). Details of this licence are available
here |
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