scholarly journals Empowering Patients during Hospitalization: Perspectives on Inpatient Portal Use

2019 ◽  
Vol 10 (01) ◽  
pp. 103-112 ◽  
Author(s):  
Ann McAlearney ◽  
Naleef Fareed ◽  
Alice Gaughan ◽  
Sarah MacEwan ◽  
Jaclyn Volney ◽  
...  
Keyword(s):  
Health Information ◽  
Care Team ◽  
Care Providers ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Secure Messaging ◽  
Team Members ◽  
Centered Care ◽  
Adult Inpatient

Background Patients have demonstrated an eagerness to use portals to access their health information and connect with care providers. While outpatient portals have been extensively studied, there is a recognized need for research that examines inpatient portals. Objective We conducted this study to improve our understanding about the role of a portal in the context of inpatient care. Our study focused on a large sample of the general adult inpatient population and obtained perspectives from both patients and care team members about inpatient portal use. Methods We interviewed patients (n = 120) who used an inpatient portal during their hospitalization at 15 days or 6 months after discharge to learn about their portal use. We also interviewed care team members (n = 331) 4 weeks, 6 months, and 12 months after inpatient portal implementation to collect information about their ongoing perspectives about patients' use of the portal. Results The perspectives of patients and care team members generally converged on their views of the inpatient portal. Three features—(1) ordering meals, (2) looking up health information, and (3) viewing the care team—were most commonly used; the secure messaging feature was less commonly used and of some concern to care team members. The inpatient portal benefited patients in four main ways: (1) promoted independence, (2) reduced anxiety, (3) informed families, and (4) increased empowerment. Conclusion Inpatient portals are recognized as a tool that can enhance the delivery of patient-centered care. In addition to empowering patients by increasing their sense of control, inpatient portals can support family members and caregivers throughout the hospital stay. Given the consistency of perspectives about portal use across patients and care team members, our findings suggest that inpatient portals may facilitate shifts in organizational culture that increase the patient centeredness of care and improve patient experience in the hospital context.

Balancing Support for Staff and Patient Centeredness Through the Design of Immediate and Relational Space: A Case Study of Ambulatory Care Center Layouts

2020 ◽  
pp. 193758672096155
Author(s):  
Julie Zook ◽  
Timothy J. Spence ◽  
Teri Joy
Keyword(s):  
Ambulatory Care ◽  
Care Center ◽  
Team Work ◽  
Care Team ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Descriptive Case Study ◽  
Centered Care ◽  
Visual Properties

Purpose: This descriptive case study of ambulatory care center typologies builds a layout-based approach to patient-centered care and care team work using theory and methods from space syntax and a recently developed approach to floorplan analysis focused on visibility. Background: Calibrating support for care team work and patient centeredness is a persistent dilemma in ambulatory care settings. Method: A review of literature and floorplan layout analysis are used. Results: The center-stage layout more strongly integrates staff and patients, while the onstage–offstage layout provides greater privacy to the care team. The integration values for exam rooms in each layout were roughly equivalent. Analysis of variations on each floor plan demonstrates ways relatively small variations can modulate visibility conditions without altering integration patterns. Conclusion: Decoupling design of immediate visual properties and relational layout properties can act as a strategy to address competing demands.

scholarly journals Clinical Practice Informs Secure Messaging Benefits and Best Practices

2017 ◽  
Vol 08 (04) ◽  
pp. 1003-1011 ◽  
Author(s):  
Jolie Haun ◽  
Wendy Hathaway ◽  
Margeaux Chavez ◽  
Nicole Antinori ◽  
Brian Vetter ◽  
...  
Keyword(s):  
Content Analysis ◽  
Best Practices ◽  
Clinical Care ◽  
Care Team ◽  
Successful Implementation ◽  
Clinical Team ◽  
Secure Messaging ◽  
Team Members ◽  
Centered Care ◽  
Clinical Care Team

Background Clinical care team members in Department of Veterans' Affairs (VA) facilities nationwide are working to integrate the use of Secure Messaging (SM) into care delivery and identify innovative uses. Identifying best practices for proactive use of SM is a key factor in its successful implementation and sustained use by VA clinical care team members and veterans. Objectives A collaborative project solicited input from VA clinical care teams about their local practices using SM to provide access to proactive patient-centered care for veterans and enhance workflow. Methods This project implemented a single-item cross-sectional qualitative electronic survey via internal e-mail to local coordinators in all 23 Veterans Integrated Service Networks (VISNs). Content analysis was used to manage descriptive data responses. Descriptive statistics described sample characteristics. Results VA clinical care team members across 15 of 23 VISNs responded to the questionnaire. Content analysis of 171 responses produced two global domains: (1) benefits of SM and (2) SM best practices. Benefits of SM use emphasize enhanced and efficient communication and increased access to care. Care team members incorporate SM into their daily clinical practices, using it to provide services before, during, and after clinical encounters as a best practice. SM users suggest improvements in veteran care, clinical team workflow, and efficient use of health resources. Clinical team members invested in the successful implementation of SM integrate SM into their daily practices to provide meaningful and useful veteran-centered care and improve workflow. Conclusion VA clinical care team members can use SM proactively to create an integrated SM culture. With adequate knowledge and motivation to proactively use this technology, all clinical team members within the VA system can replicate best practices shared by other clinical care teams to generate meaningful and useful interactions with SM to enrich veterans' health care experience.

scholarly journals Strategizing EHR use to achieve patient-centered care in exam rooms: a qualitative study on primary care providers

2015 ◽  
Vol 23 (1) ◽  
pp. 137-143 ◽  
Author(s):  
Jing Zhang ◽  
Yunan Chen ◽  
Shazia Ashfaq ◽  
Kristin Bell ◽  
Alan Calvitti ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Providers ◽  
Patient Centered Care ◽  
Theory Approach ◽  
Care Providers ◽  
Structured Interviews ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Qualitative Interview Study ◽  
Centered Care

Abstract Objective Electronic health records (EHRs) have great potential to improve quality of care. However, their use may diminish “patient-centeredness” in exam rooms by distracting the healthcare provider from focusing on direct patient interaction. The authors conducted a qualitative interview study to understand the magnitude of this issue, and the strategies that primary care providers devised to mitigate the unintended adverse effect associated with EHR use. Methods and Materials Semi-structured interviews were conducted with 21 healthcare providers at 4 Veterans Affairs (VAs) outpatient primary care clinics in San Diego County. Data analysis was performed using the grounded theory approach. Results The results show that providers face demands from both patients and the EHR system. To cope with these demands, and to provide patient-centered care, providers attempt to perform EHR work outside of patient encounters and create templates to streamline documentation work. Providers also attempt to use the EHR to engage patients, establish patient buy-in for EHR use, and multitask between communicating with patients and using the EHR. Discussion and Conclusion This study has uncovered the challenges that primary care providers face in integrating the EHR into their work practice, and the strategies they use to overcome these challenges in order to maintain patient-centered care. These findings illuminate the importance of developing “best” practices to improve patient-centered care in today’s highly “wired” health environment. These findings also show that more user-centered EHR design is needed to improve system usability.

How to Provide Accessible Hearing Health Information to Promote Patient-Centered Care

2020 ◽  
Vol 5 (1) ◽  
pp. 173-180
Author(s):  
Rebecca Kelly-Campbell ◽  
Vinaya Manchaiah
Keyword(s):  
Decision Making ◽  
Health Information ◽  
Shared Decision Making ◽  
Health Care Professionals ◽  
Patient Centered Care ◽  
Shared Decision ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Centered Care ◽  
Hearing Health

Purpose This clinical focus article focuses on accessible hearing health information and is written in twofold. First, it outlines the connection between factors of patient-centered care, shared decision making, and health literacy on health outcomes. Second, it provides some practical strategies for providing and assessing accessible health information to promote patient-centeredness and shared decision making. Conclusion Health information accessibility will positively influence the treatment choices made by patients and the way in which they self-manage their health. Hearing health care professionals need to take proactive measures to ensure that the information provided in different mediums have easily readable language, adequate quality, suitability, understandability, and actionability to ensure accessibility of hearing health information.

scholarly journals Perspectives on team communication challenges in caring for children with medical complexity

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sherri Adams ◽  
Madison Beatty ◽  
Clara Moore ◽  
Arti Desai ◽  
Leah Bartlett ◽  
...  
Keyword(s):  
Real Time ◽  
Health Information ◽  
Universal Access ◽  
Care Team ◽  
Care Providers ◽  
Children With Medical Complexity ◽  
Team Members ◽  
Access To Health ◽  
Medical Complexity ◽  
Communication Challenges

Abstract Background Children with medical complexity (CMC) require the expertise of many care providers spanning different disciplines, institutions, and settings of care. This leads to duplicate health records, breakdowns in communication, and limited opportunities to provide comprehensive, collaborative care. The objectives of this study were to explore communication challenges and solutions/recommendations from multiple perspectives including (i) parents, (ii) HCPs – hospital and community providers, and (iii) teachers of CMC with a goal of informing patient care. Methods This qualitative study utilized an interpretive description methodology. In-depth semi-structured interviews were conducted with parents and care team members of CMC. The interview guides targeted questions surrounding communication, coordination, access to information and roles in the health system. Interviews were conducted until thematic saturation was reached. Interviews were audio-recorded, transcribed verbatim, and coded and analyzed using thematic analysis. Results Thirty-two individual interviews were conducted involving parents (n = 16) and care team members (n = 16). Interviews revealed 2 main themes and several associated subthemes (in parentheses): (1) Communication challenges in the care of CMC (organizational policy and technology systems barriers, inadequate access to health information, and lack of partnership in care) (2) Communication solutions (shared systems that can be accessed in real-time, universal access to health information, and partnered contribution to care). Conclusion Parents, HCPs, and teachers face multiple barriers to communication and information accessibility in their efforts to care for CMC. Parents and care providers in this study suggested potential strategies to improve communication including facilitating communication in real-time, universal access to health information and meaningful partnerships.

The Role of Shared Decision-Making in Audiologic Rehabilitation

2014 ◽  
Vol 21 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Helen Pryce ◽  
Amanda Hall
Keyword(s):  
Decision Making ◽  
Shared Decision Making ◽  
Behavior Changes ◽  
Shared Decision ◽  
Patient Centered ◽  
Treatment Information ◽  
Centered Care ◽  
Potential Risks ◽  
Audiologic Rehabilitation

Shared decision-making (SDM), a component of patient-centered care, is the process in which the clinician and patient both participate in decision-making about treatment; information is shared between the parties and both agree with the decision. Shared decision-making is appropriate for health care conditions in which there is more than one evidence-based treatment or management option that have different benefits and risks. The patient's involvement ensures that the decisions regarding treatment are sensitive to the patient's values and preferences. Audiologic rehabilitation requires substantial behavior changes on the part of patients and includes benefits to their communication as well as compromises and potential risks. This article identifies the importance of shared decision-making in audiologic rehabilitation and the changes required to implement it effectively.

Patient-Centered Care and Autonomy: Shared Decision-Making in Practice and a Suggestion for Practical Application in the Critically Ill

2019 ◽  
Vol 35 (11) ◽  
pp. 1352-1355
Author(s):  
Marianna V. Mapes ◽  
Peter A. DePergola ◽  
William T. McGee
Keyword(s):  
Decision Making ◽  
Palliative Care ◽  
Critically Ill ◽  
Care Service ◽  
Clinical Care ◽  
Patient Centered Care ◽  
Practical Application ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Centered Care

Decision-making for the hospitalized dying and critically ill is often characterized by an understanding of autonomy that leads to clinical care and outcomes that are antithetical to patients’ preferences around suffering and quality of life. A better understanding of autonomy will facilitate the ultimate goal of a patient-centered approach and ensure compassionate, high-quality care that respects our patients’ values. We reviewed the medical literature and our experiences through the ethics service, palliative care service, and critical care service of a large community teaching hospital. The cumulative experience of a senior intensivist was filtered through the lens of a medical ethicist and the palliative care team. The practical application of patient-centered care was discerned from these interactions. We determined that a clearer understanding of patient-centeredness would improve the experience and outcomes of care for our patients as well as our adherence to ethical practice. The practical applications of autonomy and patient-centered care were evaluated by the authors through clinical interactions on the wards to ascertain problems in understanding their meaning. Clarification of autonomy and patient-centeredness is provided using specific examples to enhance understanding and application of these principles in patient-centered care.

Improving Access to Integrated Behavioral Health in a Nurse-Led Federally Qualified Health Center

2021 ◽  
pp. 107839032199416
Author(s):  
Sarah Stalder ◽  
Aimee Techau ◽  
Jenny Hamilton ◽  
Carlo Caballero ◽  
Mary Weber ◽  
...  
Keyword(s):  
Primary Care ◽  
Quality Improvement ◽  
Behavioral Health ◽  
Behavioral Health Care ◽  
Primary Care Providers ◽  
Care Team ◽  
Psychiatric Nurse ◽  
Care Providers ◽  
Team Members ◽  
Task Forces

BACKGROUND: The specific aims of this project were to create a fully integrated, nurse-led model of a psychiatric nurse practitioner and behavioral health care team within primary care to facilitate (1) patients receiving an appropriate level of care and (2) care team members performing at the top of their scope of practice. METHOD: The guiding model for process implementation was Rapid Cycle Quality Improvement. Three task forces were established to develop interventions in the areas of Roles and Responsibilities, Training and Implementation, and the electronic health record. INTERVENTION: The four interventions that emerged from these task forces were (1) the establishment of patient tiers based on diagnosis, medications, and risk assessment; (2) the creation of process maps to engage care team members; (3) just-in-time education regarding psychiatric medication management for primary care providers; and (4) use of a registry to track patients. RESULTS: The process measures of referrals to the psychiatric care team and psychiatric assessment intakes performed as expected. Both measures were higher at the onset of the project and lower 1 year later. The outcome indicator, number of case reviews, increased dramatically over time. CONCLUSIONS: For psychiatric nurse practitioners, this quality improvement effort provides evidence that a consultative role can be effective in supporting primary care providers. Through providing education, establishing patient tiers, and establishing an effective workflow, more patients may have access to psychiatric services.

The role of digital tools in the delivery of genomic medicine: enhancing patient-centered care

2021 ◽  
Author(s):  
Salma Shickh ◽  
◽  
Sara A. Rafferty ◽  
Marc Clausen ◽  
Rita Kodida ◽  
...  
Keyword(s):  
Genomic Medicine ◽  
Patient Centered Care ◽  
Digital Tools ◽  
Patient Centered ◽  
Centered Care
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