Leading person
centred cultures in
practice
Dr Elaine Maxwell
27th November 2013
What is a person centred
culture?
Respectful
of and responsive to
individual needs
Co-ordinated around and
communicated around the person
Supportive and empowering
Easily accessible
Bechtel, C. And Ness, D.L. (2010) If you build it, will they come? Designing truly patient
centred care Health Affairs 29:5 914-920
The role of the person
Each person is an expert in their own
unique environment and the design
needed to achieve good outcomes.
Person centred cultures facilitate the
individual to manage their own health
Delwyn’s story
“We sometimes speak as if caring did not
require knowledge, as if caring for someone,
for example, were simply a matter of good
intentions or warm regard.
But in order to care I must understand
the other's needs and I must be able to
respond properly to them, and clearly
good intentions do not guarantee this
(Mayeroff 1971)
Leaders of Person Centred Cultures
1. Establish direction (vision and strategies for
producing the change)
2. Align people to the direction (communicating
vision in ways that influence people to make it
happen)
3. Motivate and inspire (energizing people to
overcome barriers and obstacles to change)
(Kotter 1996)
Establishing the direction (vision
and strategies for producing the
change)
Creating a vision of person
centred care
Compassion and Dignity
“compassion impels and empowers
people to not only acknowledge, but
also act” (Schantz, 2007).
Kate Granger #HelloMyNameIs
@grangerkate
No decision about me without
me
"The unique function of the nurse is to assist the
individual, sick or well, in the performance of those
activities contributing to health or its recovery (or to
peaceful death) that he would perform
unaided if he had the necessary strength, will
or knowledge” Virginia Henderson 1966 ICN
Hearing the person
71% of complainants wanted to be given the
chance to tell their own story of what happened.
Friele and Sluijs (2006)
Aligning people to the direction
(communicating vision in ways that
influence people to make it happen)
Explicit expectations
Listening to the patient voice
It is the responsibility of staff to initiate the
listening
• Presencing (Ersser 1998) non verbal readiness of
the nurse to listen conveyed to patient
• Ward Sister surgeries Focused appointment times
for relatives
• What could we do better? Permission to raise the
little things
Leading person centred care

Decision grids and option appraisals

Sharing expected pathways

Teach back (to check I’ve done my job properly
can you just tell me….)

Discharge letter with indicators of common
adverse events and actions to take
Motivating and inspiring
(energizing people to overcome
barriers and obstacles to change)
Look after staff
staff satisfaction is best indicator
of patient satisfaction and quality
of care
(Vahey et al 2004; Pinder et al 2013)
Caring for staff

Emotional labour- the induction or
suppression of feeling in order to produce in
others a sense of being cared for in a safe
place (Hochschild 1983)

Schwartz rounds/ clinical supervision

Keeping the door to offices open unless
someone asks to meet privately gives an
overwhelming sense of accessibility,
openness, approachability and ‘we’re in this
together’
Intervention points
In summary
 Leaders
have a vision, and make sure their
staff understand it
 Leaders
are explicit and demonstrate the
behaviours that they want from staff
 Leaders
look after the staff’s emotional
 Leaders
listen to the patient in real time
labour