Date of Degree

12-2019

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Program

Education

Advisor

Sharon Herbers

Advisor

Arthur E. Hernandez

Advisor

Danielle Gunter

Advisor

Charles W. Mathias

Abstract

Research Focus. The healthcare landscape is transitioning from a provider-centered care model toward greater emphasis on patient-centered care (PCC). The shift to PCC reflects efforts to increase the quality of healthcare and the care experience. The current state of research within healthcare remains focused on how to provide high-quality and sound research that will bring new equipment, procedures, and verify strategies that may benefit healthcare globally. However, changes in the healthcare atmosphere bring a new perspective to research. How is the paradigm shift to patient-centered care implemented in an academic research environment? Does this holistic mindset fully cross into the spectrum of research and fit its existing criteria? The aim of this study is to describe the implementation of PCC within an academic research environment.

Research Methods. A focused ethnographic case study (qualitative) design was selected for this study based on the researcher’s background and experience. The purpose of the study was to discover how implementation of PCC, as defined by the Institute of Medicine and the Agency for Healthcare Research and Quality, integrates within the current healthcare research settings, and to uncover implementation successes and failures. This study utilized interview questions, observations, and a survey to collect and analyze data. Data were collected in two phases, interview questions and survey, and observations were documented throughout the process. These data described the implementation of PCC in an academic research setting through the eyes of six participants, and the success and challenges in meeting the standards expected by the Agency for Healthcare Research and the Institute of Medicine, who developed the survey utilized in this project.

Research Results/Findings. Emergent themes indicate that the structure of PCC falls well short of full realization within this clinic with alignment of PCC being by “essence” not structure. Due to the misalignment of PCC within the research realm the effect is then only measured as an emotional overlay that is normally seen at the end of the clinic assessments.

Conclusions from Research. One implication from the study includes the realization that there has been little to nothing done on the complete implementation package of PCC in an academic research setting. Current attempts to promote the conversation of implementing PCC are currently on the agenda for some researchers within the setting; however, there is confusion about how to begin. Synthesis of the findings suggest that although the clinical group is willing to delve deep into the paradigm to ensure that the care and effects are in tune with PCC, delivery limitations restrict improvement in customer service and appreciation. The current reality is that the implementation of PCC is used as a quality improvement experiment that calls for the clinics to blindly paw at the concept with little guidance on how to properly incorporate the paradigm. There are three recommendations that may help build a strong foundation for setting PCC within the academic research setting: 1. development of measurement tools, 2. experiments to demonstrate what works for implementing PCC in the academic research setting, and 3. implementation guidance for other academic research systems to utilize what is learned from recommendation 2. Projects similar to this would allow for the collective voices of the academic research setting to be heard and would validate the creation of a self-assessment tool that would be system specific. This tool can then be provided on a grand scale to the university setting, initiating the researchers’ vision of complete saturation of PCC into the environment.

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