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Table 1 Mapping of GPCC challenges and strategies against NPT constructs

From: Deliberate and emergent strategies for implementing person-centred care: a qualitative interview study with researchers, professionals and patients

Constructs of NPT Challenges Deliberate strategies Emergent strategies
Coherence (sense-making work)  (1) Differentiation  (2) Communal specification  (3) Individual specification  (4) Internalization Conflicting and/or divergent views and expectations about PCC Translating abstract principles into concrete practices Education and seminars organized by GPCC Design of the training programme allowing for contextual adaptations and developments Lunch seminars, informal meetings, inter-professional discussions in small groups Invited lectures and seminars Individual and/or collective ways of relating to professional experiences
Cognitive participation (relational work)  (1) Initiation  (2) Enrolment  (3) Legitimation  (4) Activation Resistance (to change) Force of habit Different approaches among professionals (mainly nurses and doctors) Fatigue from previous implementations Education and seminars organized by GPCC Use of research-based evidence (e.g. reduced time of hospitalisation) Using leading personalities, initiators (“ambassadors”), engaging previous personal relations at work Convincing and motivating unwilling actors (e.g. doctors with “scientific” evidence) Interpretation and collective development of routines (e.g. documentation)
Collective action (operational work)  (1) Interactional workability  (2) Relational integration  (3) Skill set workability  (4) Contextual integration Time shortage Organizational problems (rotation of the staff and the physical environment) Inter-professional hierarchies (mainly between nurses and doctors) Different patient groups with specific conditions and needs Division of workload (e.g. increased documentation) Funding and extra staff (research nurses) Initiating teamwork Transfer of expertise via researchers and experienced implementers Use of scales and technologies Commitment and support of managers (e.g. initiating and consolidating teamwork) Strengthening teamwork by engaging all expertise in the team (the patient included) and empowering nurses to contribute more to decision making Developing new practices to safeguard continuity (e.g. introduction programmes for new staff
Reflexive monitoring (appraisal work)  (1) Systemization  (2) Communal appraisal  (3) Individual appraisal  (4) Reconfiguration Time shortage Increased number of patients and more workload from documentation Focus on shortening hospitalisation time Small group discussions, “ethical forums” Continuous education, evaluation in practice Evaluation of the workload