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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