Person-centered workplace culture: insights from an inpatient department for older adults with chronic illnesses

Abstract

Introduction: An aging population and the increasing prevalence of chronic conditions challenge healthcare systems in developed countries. In response, there is a growing emphasis on person-centered care, as advocated by the World Health Organization and integrated into national health strategies in countries such as the UK and Sweden. However, transitioning to person-centered care is a complex, long-term process shaped by organizational culture and care environments. These contextual factors play crucial roles in the development and sustainability of person-centered practice, significantly transforming the experiences of both older adults and staff. Objective: To describe how workplace culture within an inpatient hospital department shapes person-centered care practices for older adults with chronic illnesses. Methods: A qualitative, descriptive, exploratory-observational study was performed. Data were collected through participant observation guided by the Workplace Culture Critical Analysis Tool®. In a deductive thematic content analysis, data patterns of meaning were identified. The themes were generated underpinned by the Person-Centered Practice Framework dimensions of prerequisites, the practice environment, and person-centered processes and their respective constructs. Results: Themes related to all person-centered practice dimensions were identified. Task demands during shifts create tension between routine-oriented work and the holistic, individualized approach required for person-centeredness. The absence of systematic multiprofessional team meetings further exacerbates this issue, limiting collaborative decision-making and personalized care planning. The contrasts in some subthemes may be related to discrepancies in the care provided by different professionals. Conclusion: This study highlights the tension between routine-driven care and individualized approaches. Addressing identified challenges, such as formalizing multiprofessional meetings and enhancing reflective practices, is crucial for advancing person-centered care in this setting.