scholarly journals A qualitative study on measuring patient‐centered care: Perspectives from clinician‐scientists and quality improvement experts

2019 ◽  
Vol 2 (12) ◽  
Author(s):  
Sadia Ahmed ◽  
Andrea Djurkovic ◽  
Kimberly Manalili ◽  
Balreen Sahota ◽  
Maria J. Santana
Keyword(s):  
Quality Improvement ◽  
Qualitative Study ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Centered Care

scholarly journals Facilitating Team-Based Care Coordination and Collaboration in Myelofibrosis: Findings from a Quality Improvement Study in Three US Community Oncology Systems

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 32-33
Author(s):  
Srdan Verstovsek ◽  
Anne Jacobson ◽  
Jeffrey D Carter ◽  
Tamar Sapir
Keyword(s):  
Decision Making ◽  
Quality Improvement ◽  
Patient Education ◽  
Care Coordination ◽  
Research Funding ◽  
Practice Patterns ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Community Oncology ◽  
Centered Care

Background Care coordination can be especially challenging in the setting of rare malignancies such as myelofibrosis (MF), where hematology/oncology teams have limited experience working together to implement rapidly evolving standards of care. In this quality improvement (QI) initiative, we assessed barriers to patient-centered MF care in 3 community oncology systems and conducted team-based audit-feedback (AF) sessions within each system to facilitate improved care coordination. Methods Between 1/2020 and 3/2020, 31 hematology/oncology healthcare professionals (HCPs) completed surveys designed to characterize self-reported practice patterns, challenges, and barriers to collaborative MF care in 3 community oncology systems (Table 1). Building on findings from the team-based surveys, 39 HCPs from these centers participated in AF sessions to reflect on their own practice patterns and to prioritize areas for improved MF care delivery. Participants developed team-based action plans to overcome identified challenges, including barriers to effective risk stratification, care coordination, and shared decision-making (SDM) for patients with MF. Surveys conducted before and after the small-group AF sessions evaluated changes in participants' beliefs and confidence in delivering collaborative, patient-centered MF care. Results Team-Based Surveys: HCPs identified managing MF-associated anemia and other disease symptoms (42%), providing individualized care despite highly variable clinical presentations (29%), and developing institutional expertise despite low patient numbers (16%) as the most pressing challenges in MF care. For patients who are candidates for JAK inhibitor therapy, HCPs reported most commonly relying on current guidelines (71%) and clinical evidence (61%) to guide treatment selection. HCPs also considered drug safety/tolerability profiles (55%), personal or institutional experience (13%), and out-of-pocket costs for patients (13%); no participants (0%) reported incorporating patient preference into their decision-making. Teams were underutilizing SDM and patient-centered care resources; fewer than 50% reported providing tools to support adherence (48%), visual aids for patient education (47%), financial toxicity counseling (40%), resources for managing MF-related fatigue (36%), or counseling to reduce risk factors for CVD, bleeding, and thrombosis (26%). Small-Group AF Sessions: Across the 3 oncology centers, teams participating in the AF sessions (Table 1) shared a self-reported caseload of 97 patients with MF per month. HCPs reported a meaningful shift in beliefs regarding the importance of collaborative care: following the AF sessions, 100% of HCPs agreed or strongly agreed that collaboration across the extended oncology care team is essential for achieving MF treatment goals, an increase from 71% prior to the AF sessions (Figure 1). Participants also reported increased confidence in their ability to perform each of 6 aspects of evidence-based, collaborative, patient-centered care (Figure 2). In selecting which aspects of patient-centered care to address with their clinical teams, HCPs most commonly prioritized individualizing treatment decision-making based on patient- and disease-related factors (57%), followed by providing adequate patient education about treatment options and potential side effects (24%) and engaging patients in SDM (18%). To achieve these goals, 73% of HCPs committed to sharing their action plans with additional clinical team members; others committed to creating a quality task force to oversee action-plan implementation (15%) and securing buy-in from leadership and stakeholders (9%). Conclusions As a result of participating in this community-based QI initiative, hematology/oncology HCPs demonstrated increased confidence in their ability to deliver patient-centered MF care and improved commitment to team-based collaboration. Remaining practice gaps and challenges can inform future QI programs. Study Sponsor Statement The study reported in this abstract was funded by an independent educational grant from Incyte Corporation. The grantors had no role in the study design, execution, analysis, or reporting. Disclosures Verstovsek: ItalPharma: Research Funding; CTI Biopharma Corp: Research Funding; Promedior: Research Funding; Gilead: Research Funding; NS Pharma: Research Funding; Celgene: Consultancy, Research Funding; Novartis: Consultancy, Research Funding; Genentech: Research Funding; Sierra Oncology: Consultancy, Research Funding; PharmaEssentia: Research Funding; AstraZeneca: Research Funding; Incyte Corporation: Consultancy, Research Funding; Blueprint Medicines Corp: Research Funding; Protagonist Therapeutics: Research Funding; Roche: Research Funding.

scholarly journals The evolution of quality improvement in healthcare: Patient-centered care and health information technology applications

2016 ◽  
Vol 5 (2) ◽  
pp. 62 ◽  
Author(s):  
John Cantiello ◽  
Panagiota Kitsantas ◽  
Shirley Moncada ◽  
Sabiheen Abdul
Keyword(s):  
Information Technology ◽  
Quality Improvement ◽  
Health Information Technology ◽  
Health Information ◽  
Patient Centered Care ◽  
Healthcare Industry ◽  
Patient Centered ◽  
Technology Applications ◽  
Centered Care

Objective: Quality improvement in the healthcare industry has evolved over the past few decades. In recent years, an increased focus on coordination of care efforts and the introduction of health information technology has been of high importance in improving the quality of patient care.Methods: In this review, we present a history of quality improvement efforts, discuss quality improvement in the healthcare industry, and examine quality improvement strategies with a focus on patient-centered care and information technology applications via patient registries.Results: Evidence shows that the key to quality improvement efforts in the healthcare industry is the coordination of patient care efforts through better data evaluation processes. By utilizing patient registries that can be linked to electronic health records (EHRs) and the Patient-Centered Medical Home (PCMH) framework, the quality of care provided to patients can be improved.Conclusions: While many healthcare organizations have quality improvement departments or teams in place that may be able to handle these types of efforts, it is important for organizations to be familiar with processes and frameworks that employees at different levels of the organization can be involved in. In order to ensure successful outcomes from quality improvement initiatives, managers and clinicians should work together in identifying problems and developing solutions.

scholarly journals What Do Clinicians Who Deliver Maternity Services Think Patient-Centered Care Is and How Is That Different for Vulnerable Women? A Qualitative Study

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Ted Adams ◽  
Dana Sarnak ◽  
Joy Lewis ◽  
Jeff Convissar ◽  
Scott S. Young
Keyword(s):  
Qualitative Study ◽  
Primary Care Physicians ◽  
Health Management ◽  
Physician Assistants ◽  
Patient Centered Care ◽  
Fee For Service ◽  
Institute Of Medicine ◽  
Patient Centered ◽  
Maternity Services ◽  
Centered Care

Background. Patient-centered care is said to have a myriad of benefits; however, there is a lack of agreement on what exactly it consists of and how clinicians should deliver it for the benefit of their patients. In the context of maternity services and in particular for vulnerable women, we explored how clinicians describe patient-centered care and how the concept is understood in their practice. Methods. We undertook a qualitative study using interviews and a focus group, based on an interview guide developed from various patient surveys focused around the following questions: (i) How do clinicians describe patient-centered care? (ii) How does being patient-centered affect how care is delivered? (iii) Is this different for vulnerable populations? And if so, how? We sampled obstetricians and gynecologists, midwives, primary care physicians, and physician assistants from a health management organization and fee for service clinician providers from two states in the US covering insured and Medicaid populations. Results. Building a relationship between clinician and patient is central to what clinicians believe patient-centered care is. Providing individually appropriate care, engaging family members, transferring information from clinician to patient and from patient to clinician, and actively engaging with patients are also key concepts. However, vulnerable women did not benefit from patient-centered care without first having some of their nonmedical needs met by their clinician. Discussion. Most providers did not cite the core concepts of patient-centered care as defined by the Institute of Medicine and others.

Su1611 PURSUING PATIENT-CENTERED CARE FOR ADVANCED LIVER DISEASE: A QUALITATIVE STUDY OF CLINICIANS' PRACTICES AND PERSPECTIVES

2020 ◽  
Vol 158 (6) ◽  
pp. S-1357
Author(s):  
Jennifer Arney ◽  
Caroline P. Gray ◽  
Jack A. Clark ◽  
Aanand Naik ◽  
Donna L. Smith ◽  
...  
Keyword(s):  
Liver Disease ◽  
Qualitative Study ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Advanced Liver Disease ◽  
Centered Care

Patient-centered care for chronic pain in the emergency department: A qualitative study

2016 ◽  
Vol 24 ◽  
pp. 22-27 ◽  
Author(s):  
Jayalakshmi Jambunathan ◽  
Sharon Chappy ◽  
Jack (John) Siebers ◽  
Alishia Deda
Keyword(s):  
Emergency Department ◽  
Chronic Pain ◽  
Qualitative Study ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Centered Care

Can opioid vigilance and patient-centered care coexist? A qualitative study of communicative tensions encountered by surgical trainees

2020 ◽  
Vol 16 (2) ◽  
pp. 91-101
Author(s):  
Elizabeth Troutman Adams, MA ◽  
Elisia L. Cohen, PhD ◽  
Andrew Bernard, MD ◽  
Whittney H. Darnell, PhD ◽  
Douglas R. Oyler, PharmD
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Medical Profession ◽  
Descriptive Analysis ◽  
Skills Training ◽  
Patient Centered Care ◽  
Patient Centered ◽  
Opioid Prescribing ◽  
Surgical Trainees ◽  
Centered Care

Objective: The American health care system's adoption of the patient-centered care (PCC) model has transformed how medical providers communicate with patients about prescription pain medication. Concomitantly, the nation's opioid epidemic has necessitated a proactive response from the medical profession, requiring providers who frequently dispense opioids for acute pain to exercise vigilance in monitoring and limiting outpatient prescriptions. This qualitative study explores how surgical trainees balance PCC directives, including shared decision making, exchanging information with patients, and relationship maintenance, with opioid prescribing vigilance.Design: Investigators conducted interviews with 17 surgical residents and fellows (trainees) who routinely prescribe opioids at an academic medical center.Results: A qualitative descriptive analysis produced four codes, which were reduced to themes depicting problematic intersections between PCC imperatives and opioid vigilance during post-operative opioid-prescribing communication: (a) sharing the decision-making process contended with exerting medical authority, (b) reciprocating information contended with negotiating opioid prescribing terms with patients, (c) maintaining symbiotic relationships contended with prescribing ethics, and (d) achieving patient satisfaction contended with safeguarding opioid medications.Conclusion: Surgical training programs must supply trainees with post-surgical prescribing guidelines and communication skills training. Training should emphasize how PCC directives may work in tandem with--not in opposition to--opioid vigilance.

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