A thematic analysis of middle managers' perceptions of a conceptual framework for person-centred outpatient care

IntroductionPersons with long-term conditions (LTCs) have been identified as a group that could benefit from more person-centred care (PCC). However, the complexity of PCC as a concept, combined with the scarcity of a shared understanding of its definition across different healthcare contexts, has challenged systematic evaluation. To address this gap, a conceptual framework, operationalised in a patient-reported instrument: the Person-Centred Care instrument for outpatient care (PCCoc), was developed to facilitate evaluation and guide targeted efforts to strengthen PCC in outpatient settings for persons with LTCs. Yet, few studies have explored how middle managers, who play a crucial role in implementing and sustaining organisational development, perceive the clinical applicability of such conceptual frameworks. AimTo explore middle managers perceptions of a conceptual framework for person-centred outpatient care and its clinical applicability. MethodsA qualitative design was applied, using thematic analysis to describe middle managers perceptions. Data were collected through semi-structured interviews with middle managers in various outpatient clinics. ResultsThree main themes and seven sub-themes were identified: (1) Factors that may facilitate use, (i.e., aspects that may enhance the adoption and application of the conceptual framework); (2) Challenges for practical application, anticipated challenges in applying the conceptual framework in the outpatient setting; and (3) Practical usefulness in a clinical context, perspectives on the potential use of the conceptual framework in outpatient care for persons with long-term conditions. ConclusionThe findings suggest that the conceptual framework is perceived as clinically relevant and may, through its associated patient-reported instrument, PCCoc, facilitate the evaluation and development of person-centred outpatient care. While middle managers recognised its alignment with existing practices and its potential to advance PCC in outpatient setting, challenges to its adoption were also identified, particularly in relation to organisational factors.