October 2020


Featured Finding
Research Identifies Opportunities to Improve
Person-Centered Care for Substance Use Disorder
The Question:
How can specialty substance use disorder treatment facilities                                       Key Findings
operationalize person-centered care across eight dimensions?                                       • The eight dimensions of person-
Person-centered care (PCC) is an ethical and health service imperative, but it has                    centered care are inter-related, such that
been inconsistently conceptualized and poorly operationalized. To date most PCC                       operationalizing one dimension may help
operationalization research has occurred outside of substance use disorder (SUD)                      operationalize another.
treatment. Studies examining PCC in SUD treatment have overwhelmingly focused
on one dimension: respect for client treatment preferences, such as through a shared               • All staff, clinical and non-clinical, are critical
decision-making process. This dimension is very important, but treatment facilities need              for operationalizing person-centered care.
to know that other dimensions of PCC exist and how to operationalize these dimensions
in daily practice. Therefore, researchers from the University of Central Florida, Indiana          • Operationalization of each dimension is
University-Indianapolis, and Georgia State University sought to identify how SUD                      important; merely operationalizing respect
treatment facilities can operationalize each of eight PCC dimensions (based on those
defined by the Picker Institute) using the experiences and perspectives of treatment                  for patient preferences in treatment (the
providers, administrators, and clients.                                                               dimension with the most attention in
                                                                                                      scholarly work to date) is insufficient.
With input from an advisory board of stakeholders, Barbara ("Basia") Andraka-
Christou, J.D., Ph.D., and colleagues developed an interview instrument to examine
research participants' perceptions of how SUD facilities could implement PCC across
eight dimensions: 1) respect for client preferences, values, and culture; 2) information provision; 3) coordination and integration of care,
4) emotional support; 5) physical comfort; 6) family integration into treatment; 7) continuity and transition into the community; and 8)
access to evidence-based practices. We recruited 37 participants from SUD treatment facilities in South Florida, including outpatient and
residential settings, for in-depth, semi-structured telephone interviews. Recruitment and data analysis occurred iteratively until thematic
saturation was reached. Using qualitative thematic data analysis, we identified patterns of operationalization practices for each dimension
and across dimensions. We also created a list of specific practices for each dimension.

This research was funded by Health Foundation of South Florida and was conducted in collaboration with Thriving Mind South Florida.
The research team included Danielle N. Atkins, Ph.D., M.P.A., Associate Professor, University of Central Florida, Department of Health
Management & Informatics; Olena Mazurenko, M.D., Ph.D., M.S., Associate Professor, Indiana University-Indianapolis, Fairbanks
School of Public Health, Department of Health Policy & Management; Kendall Cortelyou-Ward, Ph.D., Associate Professor, University
of Central Florida, Department of Health Management & Informatics; Olivia Randall-Kosich, M.H.A., Ph.D. Student, Georgia State
University, School of Public Health; Rachel Totaram, M.H.A., Ph.D. Candidate, University of Central Florida, Department of Health
Management & Informatics.


The Implications:
The researchers had three broad findings: participants believe all dimensions are critical; the dimensions are
synergistic; and operationalization requires a range of staff.
1. Participants believed each PCC dimension must be operationalized, not just a subset. For example, participants would not consider a
    residential facility that operationalizes one dimension (e.g. by allowing choice in goals) but not another dimension (e.g. by forbidding phone
    calls to family) as person-centered.
2. The dimensions interact in synergistic ways, such that operationalizing one dimension may contribute to operationalization of another.
    For example, operationalizing physical comfort through recreational spaces or gardens may contribute to family integration by
    providing a comfortable location for family to visit and relax.
3. Successful PCC operationalization depends on a range of staff roles. For example, receptionists can operationalize emotional comfort by
    nonjudgmentally directing clients to appropriate clinical staff in times of crisis; food workers can operationalize physical comfort and
    respect for patient culture by modifying food options for individual dietary needs.
The team also created a list of dozens of specific practices that SUD treatment facilities can adopt to implement each PCC dimension.
Examples of these recommendations include:
• provide a menu of treatment modalities instead of a preset program, with choices in medication, group therapy topics, and peer
   support group types (dimension 1);
• repeat information about the purpose of treatments throughout the treatment process instead of only at the beginning (dimension 2);
• include staff with lived experience, like behavioral health technicians and peer support staff; in client case conferences (dimension 3);
• provide routine access to peer support specialists (dimension 4);
• let clients decide whether they want a roommate in residential facilities (dimension 5);
• permit young children to room with parents in residential facilities (dimension 6);
• have peer support specialists do regular aftercare checks with clients after leaving residential facilities (dimension 7); and
• offer or refer for all forms of medications for opioid use disorder (dimension 8).


Learn More
To learn more about price variation and other health policy topics in Minnesota, please visit the Minnesota All Payer Claims Database
publications webpage. There, you will find links to this report, our first report on a different set of four hospital procedures, a supplemental
FAQ, and information for employers.

You can also find research from the Health Economics Program on other health policy topics in Minnesota.