Moving toward patient‐centered care in the emergency department: Patient‐reported expectations, definitions of success, and importance of improvement in pain‐related outcomes

Author(s):  
Spencer B. Flynn ◽  
Alexander Gordee ◽  
Maragatha Kuchibhatla ◽  
Steven Z. George ◽  
Stephanie A. Eucker
2016 ◽  
Vol 24 ◽  
pp. 22-27 ◽  
Author(s):  
Jayalakshmi Jambunathan ◽  
Sharon Chappy ◽  
Jack (John) Siebers ◽  
Alishia Deda

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19176-e19176
Author(s):  
Sara A. Hurvitz ◽  
Rebecca R Crawford ◽  
Tamar Sapir ◽  
Jeffrey D. Carter

e19176 Background: In TNBC, ensuring patients understand their treatment options and engaging them in shared decision-making (SDM) is vital to patient centered care; however, system-, team-, and individual-level barriers may challenge optimal SDM. As part of a quality improvement, accredited initiative, we identified areas of discordance between oncology healthcare professionals (HCP) perception and actual patient reported experiences. Methods: From 02/2019 – 10/2019, we administered surveys to assess challenges, barriers, attitudes, and experiences of HCP who care for patients with TNBC (N = 77) and their patients with TNBC (N = 65) at 6 community oncology practices. Results: Despite indications of high levels of SDM – 86% of patients indicated that they are always or mostly involved with treatment decisions – survey responses highlight discordances. For example, when asked to identify the most influential factors to patient treatment choice, HCP most commonly indicated side effects (94%), while patients most commonly indicated quality of life (48%). Additionally, when asked to identify the side effect of greatest concern to patients, 61% of patients indicated alopecia, while 45% of HCP indicated gastrointestinal (GI) distress. While both HCP and their patients indicate that the oncology team is the most useful source of patient education, HCP underestimated the extent to which patients rely on their primary care providers (PCPs). Patients and HCP each identified limited time as a barrier to SDM, but patients indicated not knowing what to ask, while HCP indicated that low health literacy was the top barrier to SDM. 31% of patients and their care team identified that improvements in discussions about realistic prognosis were vital to improved care. Conclusions: These survey findings reveal discordances between oncology HCP’s perceptions and patient reported experiences when receiving treatment for TNBC. These findings may highlight areas for improvement in co-productive patient-centered care. [Table: see text]


2021 ◽  
pp. e1-e9
Author(s):  
Raul Angel Garcia ◽  
John A Spertus

Patient-reported outcomes (PROs) are elicited directly from patients so they can describe their overall health status, including their symptoms, function, and quality of life. While commonly used as end points in clinical trials, PROs can play an important role in routine clinical care, population health management, and as a means for quantifying the quality of patient care. In this review, we propose that PROs be used to improve patient-centered care in the treatment of cardiovascular diseases given their importance to patients and society and their ability to improve doctor- provider communication. Furthermore, given the current variability in patients’ health status across different clinics and the fact that PROs can be improved by titrating therapy, we contend that PROs have a key opportunity to serve as measures of healthcare quality.


2011 ◽  
Vol 18 (12) ◽  
pp. 1289-1294 ◽  
Author(s):  
Julius Cuong Pham ◽  
N. Seth Trueger ◽  
Joshua Hilton ◽  
Rahul K. Khare ◽  
Jeffrey P. Smith ◽  
...  

2021 ◽  
pp. 1-6
Author(s):  
Sofia Mclaren ◽  
Manisha Jhamb ◽  
Mark Unruh

Patients with CKD and ESRD are vulnerable to increased mortality rates and other poor outcomes. Among those with ESRD, their health-related quality of life (HRQOL) is shown little to no improvement as they undergo treatments such as dialysis and providers concurrently manage other health issues that complicate their already vulnerable state. This review synthesizes evidence demonstrating that a focus on measuring and monitoring patient-reported outcomes (PRO) such as pain and depression can improve HRQOL. Patient-centered care has the potential to create an efficient way for clinicians to address specific challenges facing patients. While there is an emerging literature assessing the use of PROs in kidney research, by examining relevant research in other disciplines it is possible to generate better ways to use PROs in this high-risk population. Electronic health records as well as various other electronic methods of communication between the clinician and patient may serve to accelerate the trajectory toward patient-centered care using PROs.


2020 ◽  
Author(s):  
Fabio Efficace ◽  
Massimo Breccia ◽  
Paola Fazi ◽  
Francesco Cottone ◽  
Bernhard Holzner ◽  
...  

BACKGROUND The COVID-19 pandemic has raised unprecedented challenges in the management of patients with cancer and has increased the demands for digital health tools that, for example, could facilitate remote monitoring of patients. Based on this, the Gruppo Italiano Malattie Ematologiche dell’Adulto (GIMEMA) has recently developed a digital health tool dedicated to patients with hematologic malignancies: the GIMEMA-ALLIANCE platform. OBJECTIVE The main objectives of this web-based platform are to generate relevant data to better understand quality of life, symptoms, and medication adherence during the COVID-19 pandemic and postpandemic era; to develop a prospective real-life registry on outcomes of patients with hematologic cancer, with or without a diagnosis of COVID-19; and to facilitate patient-centered care in routine practice. METHODS The platform consists of physician- and patient-secure portals and enables electronic patient-reported outcome (ePRO) assessments with real-time graphical presentation to physicians of individual patient symptoms and quality-of-life outcomes. Automated alerts are sent to treating hematologists based on the following predetermined criteria: presence of clinically important problems and symptoms, problems with adherence to therapy, and risk of COVID-19 diagnosis. The platform also allows physicians to set up video consultations. Clinical information regarding disease and treatment as well as clinical and survival outcomes are also prospectively collected. RESULTS Recruitment of participants started in December 2020. As of April 2021, a total of 116 patients have been enrolled in this study. Use of this platform may help to improve patient-physician communication and help hematologists in the early recognition of clinically important problems and symptoms of their patients. More than 20 community and university-based hospitals have currently agreed to participate. In addition to patient-reported outcome data, the prospective collection of disease- and treatment-related information, as well as data on possible COVID-19 diagnosis and COVID-19 vaccination, will allow the development of a large database to also identify subgroups of patients at risk of poor outcomes. CONCLUSIONS Data generated via this platform will help to answer clinically relevant questions for patients with hematologic malignancies during the COVID-19 pandemic and postpandemic era. The use of the GIMEMA-ALLIANCE platform in routine practice may also contribute to enhancing patient-centered care. CLINICALTRIAL ClinicalTrials.gov NCT04581187; https://clinicaltrials.gov/ct2/show/NCT04581187 INTERNATIONAL REGISTERED REPORT PRR1-10.2196/25271


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