Organizational strategies in promoting person-centered primary care: A participatory concept mapping study

Figures & data

Figure 1. Process flow chart indicating steps employed for participatory, multi-staged, group concept-mapping in the study.

Table 1. Participant background.

No.	Job title	Practice location	Participation
			Session 1	Session 2
1	Public Health Physician	State Health Department	✓	✓
2	Public Health Physician	State Health Department	✓	✓
3	Public Health Physician	State Health Department	✓
4	Public Health Physician	State Health Department	✓
5	Public Health Physician	State Health Department		✓
6	Family Medicine Specialist	Primary care clinic	✓	✓
7	Family Medicine Specialist	Primary care clinic	✓
8	Family Medicine Specialist	Primary care clinic		✓
9	Family Medicine Specialist	Primary care clinic		✓
10	Family Medicine Specialist	Primary care clinic		✓
11	Medical Officer	State Health Department		✓
12	Medical Officer	Primary care clinic	✓	✓
13	Medical Officer	Primary care clinic		✓
14	Medical Officer	Primary care clinic		✓
15	Chief Nursing Supervisor	Ministry of Health Malaysia	✓
16	Nursing Supervisor	State Health Department	✓	✓
17	Nursing Supervisor	District Health Department		✓
18	Nursing Supervisor	Primary care clinic	✓	✓
19	Head nurse	Primary care clinic		✓
20	Medical assistant	State Health Department	✓
21	Medical assistant	Primary care clinic	✓	✓
22	Medical assistant	Primary care clinic		✓

Figure 2. Conceptual map of organizational strategies in promoting person-centered care generated through multidimensional scaling and hierarchical analysis. The numbers in the bigger font represent the clusters, while the smaller font numbers are the statements.

Table 2. Summary of the implementation statements, organized by cluster with mean importance and feasibility ratings.

Cluster, Implementation statements		Mean Importance	SD	Mean Feasibility	SD
A. Multidisciplinary team
1	Sharing the plan with the patient, General Practitioner, and other relevant people involved in patient care	4.50	0.51	3.95	0.22
2	Case manager or patient navigator to improve coordination and continuity of care for a patient with complex care needs	4.50	0.51	3.65	0.75
3	Definition of roles, responsibilities, and job descriptions for each professional or staff member	4.50	0.51	3.95	0.22
4	Newly created professional activities (e.g. telemedicine, shared consultation, shared home visit)	4.50	0.51	4.50	0.51
B. Training and education
5	Training on specific communication, cultural competence, and interpersonal skills to increase trust and awareness of the patient’s agenda	4.50	0.51	4.50	0.51
6	Training program for doctors and nurses on patient-centeredness; with visual agenda chart and readiness to change behavior	4.50	0.51	4.50	0.51
7	Cultural immersion and workshops to increase awareness to barriers to care experiences by limited language proficiency patients	4.50	0.51	3.75	0.44
C. Patient empowerment
8	Access to resources (e.g. laboratory test) to promote self-management	3.85	0.67	3.15	1.18
9	Healthcare coach or telephone health mentors to provide psychosocial support intervention to improve self-care	3.70	0.92	4.50	0.51
10	Decision aids and workbook with a list of questions and important issues to share during visits	4.50	0.51	3.20	1.32
11	Involving patients in checking the accuracy of their information and in self-management plans via personal health records	3.85	0.67	3.55	0.51
12	Use of multi-criteria decision analyzes to quantify and capture patient’s voice using various weighting outcomes	4.50	0.51	3.85	0.67
13	Empowerment in group education sessions prior to discussion with the doctor	4.50	0.51	3.70	0.92
D. Quality assurance
14	Consumer assessment of healthcare providers and systems	3.85	0.67	3.70	0.47
15	Audit and feedback; summary of clinical performance of healthcare delivered by clinician or clinic	4.50	0.51	3.65	0.93
16	Evaluation of past successes and failures of care to tailor future health initiatives	4.50	0.51	3.95	0.22

Figure 3. Go-zones for all clusters (i) A: Cluster 1 – Multidisciplinary team; B: Cluster 2 – Training and education; C: Cluster 3 – Service user empowerment; D: Cluster 4 – Quality assurance (ii) Numbers indicating statements.

Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.