Multisite Quality Improvement Study of a Patient-Pathologist Consultation Program

Abstract Objectives The aim of this multisite quality improvement study was to evaluate patients’ experiences with the patient-centered pathology (PCP) consultation program and to determine whether PCP enhanced their care experience. Methods Patients were invited to attend PCP consultations to review their pathology report and slides and have their questions answered by the pathologist privately, with the option to attend the appointment with family members or friends for support. A patient experience questionnaire (PEQ) was administered to patients, who participated voluntarily in the PCP, and survey data were collected and stored in REDCap. Statistical analysis was performed using SAS 9.4 (SAS Institute). Results Sixty-seven patients (95.5% female) aged 18 to 84 years across 4 institutions completed the PEQ. Overall, 58% and 15.8% of patients had breast and brain tumors, respectively, and 59.7% of tumors were newly diagnosed. Most patients thought it was important for them to learn as much as they could about their health condition. However, the majority of patients reported some degree of difficulty learning about their health condition based on written information, despite 97% having completed high school and/or further education. The majority of patients rated their pathologist as “excellent” across communication metrics. Ultimately, 100% of respondents were satisfied, found their visits to be useful, and would recommend the PCP to other patients. Conclusions Patients found that personalized clinical encounters with pathologists improved their understanding of their health condition and their satisfaction with their care experience. Patients thought pathologists communicated respectfully, effectively, and empathetically.

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Comparative effectiveness of a patient-centered prostate biopsy report in clinical prostate cancer practice.

Journal of Clinical Oncology ◽

10.1200/jco.2018.36.6_suppl.145 ◽

2018 ◽

Vol 36 (6_suppl) ◽

pp. 145-145 ◽

Cited By ~ 1

Author(s):

Jasmir G. Nayak ◽

Nicholas Scalzo ◽

Alice Chu ◽

Geolani Dy ◽

Liam Connor Macleod ◽

...

Keyword(s):

Prostate Cancer ◽

Decision Making ◽

Gleason Score ◽

Prostate Biopsy ◽

Pathology Report ◽

Provider Communication ◽

Newly Diagnosed ◽

Patient Centered ◽

Biopsy Report ◽

Standard Report

145 Background: The prostate biopsy pathology report is a critical decision-making document for men newly-diagnosed with prostate cancer, yet the content may be beyond the health literacy of most patients. We compare the effectiveness of a patient-centered prostate biopsy report developed through patient-centered outcomes research methods with standard synoptic reports. Methods: Using a modified Delphi approach, a multidisciplinary group of prostate cancer experts provided consensus for the critical components of a prostate biopsy report for treatment decision-making. Patient focus groups provided input for syntax and formatting to inform the design of a patient-centered pathology report. 94 patients with recent prostate biopsies were block randomized to receive the standard report with or without the patient-centered report. We evaluated patient self-efficacy, provider communication and empathy, and prostate cancer knowledge at pathology disclosure. We compared study groups with descriptive statistics. Results: Experts selected primary and secondary Gleason score and number of positive cores as the important elements of a prostate biopsy report. Patients prioritized a narrative word structure, clear language, a tabular format for histologic grade, and information on risk classification. Initial assessments were completed by 84% (79/94) of participants including 40/46 in the standard report group and 39/48 in the patient-centered report group. Patients who received the patient-centered report had significantly improved ability to recall their Gleason score (100% vs. 85%, p = 0.03) and number of positive cores (90% vs. 65%, p = 0.01). Provider communication and patient self-efficacy were uniformly high and did not differ between groups. 88% of patients who received the patient-centered report felt that it helped them better understand their pathology results. Conclusions: A patient-centered prostate biopsy pathology report is associated with significantly higher knowledge about a new prostate cancer diagnosis. These health information documents may help facilitate shared decision-making among patients newly diagnosed with prostate cancer.

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INNV-25. PATIENT CENTERED MULTI-DISCIPLINARY NEURO-ONCOLOGIC CARE AS DIRECTED BY NEW PATIENT STAKEHOLDERS

Neuro-Oncology ◽

10.1093/neuonc/noaa215.508 ◽

2020 ◽

Vol 22 (Supplement_2) ◽

pp. ii122-ii122

Author(s):

Rachel Hunt ◽

Adam Robin ◽

Lisa Scarpace ◽

Nestelynn Gay ◽

Ian Lee ◽

...

Keyword(s):

Brain Tumor ◽

Focus Group ◽

Health System ◽

Advisory Council ◽

Tumor Board ◽

Valuable Insight ◽

Newly Diagnosed ◽

Patient Centered ◽

Care Experience ◽

System Leaders

Abstract Multidisciplinary oncology care requires a team of experts which should include patient stakeholders. The Henry Ford Health System (HFHS) Hermelin Brain Tumor Center (BTC) patient and family advisory council (PFAC) recommended a focus group of patient stakeholders newly diagnosed with glioblastoma(GBM) to better understand this experience. Our PFAC, comprised primarily of long-term survivors and patient advocates, felt the perspective of newly diagnosed patients may not be adequately represented. We reviewed the BTC tumor board records, identified patients within six months from GBM diagnosis, and invited these patients and their advocates to participate in an in-person session held November 2019. The BTC Patient Resource Coordinator who is also a brain tumor survivor led the session. Predefined questions prompted discussion of their neuro-oncologic care experience. Patient perspectives and recommendations were disseminated to the BTC PFAC and health system leaders. Nine patients and ten caregivers participated. Key feedback included the need for improved communication in the peri-operative period (symptom presentation until pathology results consultation). Participants requested more information prior to surgery on what to expect after surgery and with a brain tumor diagnosis. The PFAC-developed BTC experience handbook was declared useful, but patients did not receive this book until 2-weeks after surgery. As a result, we ensured that patients received a copy of the handbook at the time of diagnosis. Additionally, the development of a brain tumor surgery “prehab” course is underway. Use of a focus group to obtain input from patients recently diagnosed with GBM provided valuable insight into their experience that can be used to align care pathways with patient needs. Feedback was used to improve the delivery of neuro-oncologic care and enhance patient communication. In the constantly evolving landscape of GBM diagnosis and treatment, it is important to remain attuned to our patients’ perspectives on the care we deliver.

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Patient-Centered, Integrated Health Care Quality Measures Could Improve Health Literacy, Language Access, and Cultural Competence

NAM Perspectives ◽

10.31478/201902a ◽

2019 ◽

Cited By ~ 3

Author(s):

Ignatius Bau ◽

Robert A. Logan ◽

Christopher Dezii ◽

Bernard Rosof ◽

Alicia Fernandez ◽

...

Keyword(s):

Health Care ◽

Quality Improvement ◽

Health Literacy ◽

Cultural Competence ◽

Health Care Quality ◽

Care Quality ◽

National Committee ◽

Patient Centered ◽

Organizational System ◽

Language Access

The authors of this paper recommend the integration of health care quality improvement measures for health literacy, language access, and cultural competence. The paper also notes the importance of patient-centered and equity-based institutional performance assessments or monitoring systems. The authors support the continued use of specific measures such as assessing organizational system responses to health literacy or the actual availability of needed language access services such as qualified interpreters as part of overall efforts to maintain quality and accountability. Moreover, this paper is informed by previous recommendations from a commissioned paper provided by the National Committee for Quality Assurance (NCQA) to the Roundtable on Health Literacy of the National Academies of Sciences, Engineering, and Medicine. In the commissioned paper, NCQA explained that health literacy, language access, and cultural competence measures are siloed and need to generate results that enhance patient care improvements. The authors suggest that the integration of health literacy, language access, and cultural competence measures will provide for institutional assessment across multiple dimensions of patient vulnerabilities. With such integration, health care organizations and providers will be able to cultivate the tools needed to identify opportunities for quality improvement as well as adapt care to meet diverse patients’ complex needs. Similarly, this paper reinforces the importance of providing more “measures that matter” within clinical settings.

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RECOGNIZING AND ADDRESSING NEWLY DIAGNOSED DIABETES AMONG ADMITTED PATIENTS WITH HYPERGLYCEMIA- A QUALITY IMPROVEMENT PROJECT

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(21)02902-8 ◽

2021 ◽

Vol 77 (18) ◽

pp. 1544

Author(s):

Isaac Mizrahi ◽

Eliza Sharma ◽

Jevon Samaroo-Campbell ◽

Sarah Rosanel ◽

Maria Suarez ◽

...

Keyword(s):

Quality Improvement ◽

Quality Improvement Project ◽

Newly Diagnosed ◽

Improvement Project ◽

Diagnosed Diabetes ◽

Newly Diagnosed Diabetes

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Use of CAHPS® patient experience survey data as part of a patient-centered medical home quality improvement initiative

Journal of Healthcare Leadership ◽

10.2147/jhl.s69963 ◽

2015 ◽

pp. 41

Author(s):

Ron Hays ◽

Denise Quigley ◽

Peter Mendel ◽

Zachary Predmore ◽

Alex Y. Chen

Keyword(s):

Quality Improvement ◽

Survey Data ◽

Patient Experience ◽

Medical Home ◽

Quality Improvement Initiative ◽

Patient Centered Medical Home ◽

Patient Centered ◽

Experience Survey

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Striving for Evidence-Based, Patient-Centered Guidance: The Impetus Behind the Society for Perioperative Assessment and Quality Improvement (SPAQI) Medication Management Consensus Statements

Mayo Clinic Proceedings ◽

10.1016/j.mayocp.2020.06.022 ◽

2021 ◽

Author(s):

Avital Y. O’Glasser ◽

Kurt J. Pfeifer ◽

Angela F. Edwards ◽

Jeanna D. Blitz ◽

Richard D. Urman

Keyword(s):

Quality Improvement ◽

Medication Management ◽

Evidence Based ◽

Patient Centered ◽

Consensus Statements ◽

Perioperative Assessment

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Concordance and Patient-Centered Care in Medicaid Enrollees’ Care Experience With Providers

Journal of Patient Experience ◽

10.1177/23743735211034028 ◽

2021 ◽

Vol 8 ◽

pp. 237437352110340

Author(s):

Iwimbong Kum Ghabowen ◽

Neeraj Bhandari

Keyword(s):

Health Care ◽

Health Care Access ◽

Patient Centered Care ◽

Care Utilization ◽

Federal State ◽

Patient Centered ◽

Care Experience ◽

Centered Care ◽

State And Local ◽

Privately Insured

Patient-centered care is at the nexus of several overlapping institutional reforms to improve health care system performance. However, we know little regarding Medicaid patients’ experience with their doctors along several key dimensions of patient-centered care, and how their experience compares with Medicare and privately insured patients. We studied 4 outcomes using the 2017 National Health Interview Survey: patient–provider concordance on racial/sexual/cultural identity, respectful provider attitude, solicitation of patient opinion/beliefs during the care encounter, and patient-centered communication (PCC). The primary independent variable was Medicaid enrollee status. We dichotomized responses and ran multivariate logistic regressions for each type of care experience outcome, controlling for sociodemographic factors, health care access, and health care utilization of respondents. Compared to Medicare and privately insured enrollees, Medicaid enrollees reported much lower odds of seeing providers who treated them with respect (OR = 1.91, P < .001; OR = 1.62, P < .01) and who offered PCC (OR = 1.35, P < .05; OR = 1.35, P < .01), but similar odds of seeing concordant providers (OR = 0.78, P = .96; OR = 0.96, P = .72). Importantly, Medicaid enrollees reported higher odds of seeing providers who solicited their opinion/beliefs/preferences than their Medicare or privately insured counterparts (OR = 0.82, P < .05; OR = 0.87 P < .10). Medicaid enrollees report less patient-centered experiences in some important facets of their provider interaction than their Medicare or privately insured counterparts. Federal, state, and local policies and practices directed at improving these facets of patient–provider interaction are needed and should be aimed squarely at Medicaid providers, especially those working in geographic areas and settings with a disproportionate number of racial, gender, cultural, and linguistic minorities.

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