As part of our mission to introduce Person Centered Care, we kindly asked Dr Vivienne BYERS to share some experiences about the CostCares STSM that she attended in the University of Gothenburg, Centre for person-centred care.
Dr. Byers: I am a researcher in health services management and policy for over 20 years and I am committed to understanding the views of policy makers, service providers/managers and patients through their experiences of health policy implementation and healthcare delivery in primary and acute care settings, as well as the wider health services. I am also the Vice Dean of Postgraduate Studies & Research based at the National College of Ireland.
Q: What is your area of research?
Dr. Byers: Specifically, my area of research interest is in the implementation of health policy, and I am particularly interested in the implementation of person-centred care. My research in health policy implementation is informed by my perspective from both a practitioner (first-line) and policy analysis (macro) perspective.
Q: How is your work connected to the CostCares mission?
Dr. Byers: I am involved in a number of research projects and currently I am exploring the experiences of those involved in the implementation of a PCC approach to healthcare delivery in Sweden (GPCC). I hope to be able to tease out the issues across a health system and to inform a whole systems approach to implementation of integration and a re-orientation to delivering services with the person at the centre. I want to bring this learning to the Irish, as well as wider contexts. I also hope to inform the ongoing research in GPCC in Sweden with regard to understanding the policy and wider environmental influences on micro and meso level policy implementation.
Q: What do you think is the biggest problems for healthcare sustainability?
Dr. Byers: Healthcare systems across the world are facing a number of challenges. These include an increase in chronic disease and aging populations, as well as a strong focus on cost cutting or containment sometimes used to the detriment of health service quality through not working in partnership with both patients and citizens for their health and well-being.
Q: Can you summarize your expectations for the CostCares action?
Dr. Byers: I’m fully on-board with aims of CostCares. I’m a member of working group 1 and my expectations are that we can create added interest and buy-in for the implementation of person-centred care. Our ongoing aim is to develop the work required to generate a real and better understanding of the PCC concept in Europe. There is now an opportunity through access to decision-makers, to have impact at this level in re-orienting European healthcare, particularly in adding interest to these concepts espoused by the R & D Roadmap.
Q: Can you present your results and outcomes from the STSM?
Dr. Byers: My STSM focused on exploring the experiences of those involved in the implementation of a PCC approach to healthcare delivery in Sweden (GPCC). I wanted to be able to identify the key levers that are utilised across a health system that inform a whole systems approach to implementation of delivering services with the person at the centre. I also want to bring this learning back to the Irish, as well as wider contexts. Whilst I was in Sweden I carried out interviews with those involved in GPCC projects, exploring macro, meso and micro perspectives. During the STSM the following was undertaken:
- Met with key researchers, practitioners and managers involved in planning and implementation of PCC at the micro and meso organisational levels to:
- clarify and define domains & sub-domains of person-centred care and routes to its implementation through familiarity with GPCC projects.
- Met with key researchers involved in understanding PCC from a policy level, organisational and health systems context, as well in the areas of law and of leadership in health care organisations and also from a wider stakeholder base to:
- distil a number of tangible actions and processes to move from principles to implementation that have application in the Irish and wider context
- Met with those involved in implementing PCC care at the level of municipalities, the new test bed, as well as at hospital and ward level and identified practice based tools, approaches and learning that enabled implementation and change creation.
- Took part in the CA15222- Training school in Gothenburg in October 2018, in order to avail of the learning opportunities
As a result of my visit, I am now completing a number of publications to inform and educate professionals, politicians and other stakeholders about the importance of these innovative measures in healthcare, in order to successfully embed future research findings and innovations and to build the critical mass necessary to perform large scale testing. This contribution includes:
- Development of a research paper addressing how to utilise levers in society to move implementation from a policy vision to street-level or first-line practice, based on a synthesis of the GPCC experience. This paper focuses on a macro view point with a comparative discussion of policy and legislative provisions in both Sweden and Ireland as enablers/barriers to implementation. It is being written in collaboration with researchers from GPCC and will be published in a leading health policy journal.
- Completion of a review to be published in an Irish public administration journal in order to build knowledge & bring innovation and understanding in the area of implementing PCC in Ireland. Thus, addressing WG1 goals of attuning on-going national research to be in line with the EU Roadmap, coordinating on-going research and sharing and integrating research outcomes and findings in order to create added interest in the R&D Roadmap.