Effects of resident-oriented care on quality of care, wellbeing and satisfaction with care

e18254 Background: Coordinated MDC, in which all key specialists concurrently provide early input, develop and execute a consensus plan of care in collaboration with pts and their caregivers, may improve satisfaction with care. We rigorously evaluated this premise. Methods: Prospective clinical cohort study comparing newly-diagnosed LCa pts receiving MDC (n=156) or SC (n=307) in the same healthcare system. Pts were enrolled before treatment onset. At baseline (study entry) and 3 months later, pts and caregivers completed treatment-related measures from the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey, including perceptions of quality of care, satisfaction with care, and extent of involvement in decision making. Satisfaction indices at 3 months will be compared in multiple linear regression models, adjusting for baseline scores and demographic and treatment-related characteristics. Results: Pt characteristics were similar, except for age and stage (Table). At baseline, MDC pts rated their care more positively than SC pts, but satisfaction with provider communication was similar. Three month data are currently being analyzed. Conclusions: MDC provided greater pt satisfaction in the diagnostic phase of LCa care. Further prospective analyses will test the hypothesis that MDC pts experience greater satisfaction with quality of care and provider communication compared to SC pts. Clinical trial information: NCT02123797. [Table: see text]

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Lean maturity and quality in primary care

Journal of Health Organization and Management ◽

10.1108/jhom-04-2018-0118 ◽

2019 ◽

Vol 33 (2) ◽

pp. 141-154 ◽

Cited By ~ 4

Author(s):

Monica Kaltenbrunner ◽

Svend Erik Mathiassen ◽

Lars Bengtsson ◽

Maria Engström

Keyword(s):

Primary Care ◽

Quality Of Care ◽

Satisfaction With Care ◽

National Guidelines ◽

Content Type ◽

Lean Principles ◽

Quality Of Primary Care ◽

Further Development ◽

Practical Implications

Purpose The purpose of this paper is twofold: first, to describe Lean maturity in primary care using a questionnaire based on Liker’s description of Lean, complemented with observations; and second, to determine the extent to which Lean maturity is associated with quality of care measured as staff-rated satisfaction with care and adherence to national guidelines (NG). High Lean maturity indicates adoption of all Lean principles throughout the organization and by all staff. Design/methodology/approach Data were collected using a survey based on Liker’s four principles, divided into 16 items (n=298 staff in 45 units). Complementary observations (n=28 staff) were carried out at four units. Findings Lean maturity varied both between and within units. The highest Lean maturity was found for “adhering to routines” and the lowest for “having a change agent at the unit.” Lean maturity was positively associated with satisfaction with care and with adherence to NG to improve healthcare quality. Practical implications Quality of primary care may benefit from increasing Lean maturity. When implementing Lean, managers could benefit from measuring and adopting Lean maturity repeatedly, addressing all Liker’s principles and using the results as guidance for further development. Originality/value This is one of the first studies to evaluate Lean maturity in primary care, addressing all Liker’s principles from the perspective of quality of care. The results suggest that repeated actions based on evaluations of Lean maturity may help to improve quality of care.

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Is Failure to Meet Spiritual Needs Associated With Cancer Patients' Perceptions of Quality of Care and Their Satisfaction With Care?

Journal of Clinical Oncology ◽

10.1200/jco.2007.12.4362 ◽

2007 ◽

Vol 25 (36) ◽

pp. 5753-5757 ◽

Cited By ~ 179

Author(s):

Alan B. Astrow ◽

Ann Wexler ◽

Kenneth Texeira ◽

M. Kai He ◽

Daniel P. Sulmasy

Keyword(s):

New York ◽

Quality Of Care ◽

Treatment Quality ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Spiritual Needs ◽

Satisfaction With Care ◽

Staff Members ◽

Spiritual But Not Religious

Purpose Few studies regarding patients' views about spirituality and health care have included patients with cancer who reside in the urban, northeastern United States. Even fewer have investigated the relationship between patients' spiritual needs and perceptions of quality and satisfaction with care. Patients and Methods Outpatients (N = 369) completed a questionnaire at the Saint Vincent's Comprehensive Cancer Center in New York, NY. The instrument included the Quality of End-of-Life Care and Satisfaction with Treatment quality-of-care scale and questions about spiritual and religious beliefs and needs. Results The participants' mean age was 58 years; 65% were female; 67% were white; 65% were college educated; and 32% had breast cancer. Forty-seven percent were Catholic; 19% were Jewish; 16% were Protestant; and 6% were atheist or agnostic. Sixty-six percent reported that they were spiritual but not religious. Only 29% attended religious services at least once per week. Seventy-three percent reported at least one spiritual need; 58% thought it appropriate for physicians to inquire about their spiritual needs. Eighteen percent reported that their spiritual needs were not being met. Only 6% reported that any staff members had inquired about their spiritual needs (0.9% of inquiries by physicians). Patients who reported that their spiritual needs were not being met gave lower ratings of the quality of care (P = .009) and reported lower satisfaction with care (P = .006). Conclusion Most patients had spiritual needs. A slight majority thought it appropriate to be asked about these needs, although fewer thought this compared with reports in other settings. Few had their spiritual needs addressed by the staff. Patients whose spiritual needs were not met reported lower ratings of quality and satisfaction with care.

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OP0321-HPR HIGHER QUALITY OF CARE AND LESS SURGERY AFTER IMPLEMENTING OSTEOARTHRITIS GUIDELINES IN PRIMARY CARE– LONG-TERM RESULTS FROM A CLUSTER RANDOMIZED CONTROLLED TRIAL

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.3575 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 198.2-198

Author(s):

N. Osteras ◽

T. Moseng ◽

L. Van Bodegom-Vos ◽

K. Dziedzic ◽

Ø. Andreassen ◽

...

Keyword(s):

Physical Activity ◽

Primary Care ◽

Quality Of Care ◽

Intervention Group ◽

Satisfaction With Care ◽

Control Group ◽

Structured Model ◽

Knee Oa

Background:To improve quality of care for patients with hip and knee osteoarthritis (OA), a structured model for integrated OA care was developed and implemented among general practitioners (GPs) and physiotherapists (PTs) in primary care. The model was developed based on international treatment recommendations. After 6 months, patient-reported quality of care and satisfaction with care were greater, more patients were referred to physiotherapy and fewer to orthopaedic surgeon, and more patients fulfilled physical activity criteria among OA patients receiving the new model of care compared to the usual care control group1.Objectives:To assess the long-term effects 12 months after implementing the model in primary care.Methods:A cluster-randomised controlled trial with a stepped-wedge design was conducted in six Norwegian municipalities (clusters). The intervention included implementation of the model, facilitated by interactive workshops for GPs and PTs. The main components of the model were a PT led, 3 hour patient education programme followed by 8-12 weeks of individually tailored, supervised exercise. Patient participants were ≥45 years with symptomatic hip or knee OA. Primary outcome was patient-reported quality of care (OsteoArthritis Quality Indicator questionnaire; 0–100, 100 = optimal quality). Secondary outcomes included satisfaction with care, referrals to physiotherapy, orthopaedic surgeon and magnetic resonance imaging (MRI), joint replacement surgery, fulfilment of physical activity recommendations, and proportion with overweight (body mass index ≥25 kg/m2). Data was analysed using multilevel mixed models adjusted for age, sex and secular time.Results:In all, 40 of 80 GPs and 37 of 64 PTs attended the workshops. A total of 393 patients with hip and knee OA were included, with 284 in the intervention and 109 in the usual care control group. In the intervention group, 92% attended the OA education programme and 64% completed ≥8 weeks of exercise. At 12 months the intervention group reported significantly higher quality of care (score 58 vs. 41, mean difference: 17.6; 95% CI 11.1, 24.0) compared to the control group. The intervention group reported significantly higher satisfaction with care (Odds ratio (OR) 7.8; 95% CI 3.55, 17.27) and a significantly larger proportion (OR: 4.0; 95% CI 1.27, 12.63) met the recommendations for physical activity compared to the control group. A smaller proportion was referred to orthopaedic surgeon (OR 0.5; 95% CI 0.29, 1.00) and a smaller proportion received joint replacement surgery in the intervention (4%) compared to the control group (11%) (OR 0.3; 95% CI 0.14, 0.74). The proportion of patients referred to physiotherapy or MRI and the proportion with overweight were similar between the groups.Conclusion:Implementation of a structured model for OA care led to improved quality of care, higher satisfaction with care and higher physical activity levels after 12 months. These results are comparable to the 6 months results, which indicate a long-term persistence in the beneficial effects of the intervention. The lower surgical rate in the intervention compared to the control group suggests that higher uptake of OA recommendations in primary care may reduce or postpone the need for surgery in people with hip or knee OA.References:[1]Østerås N, Moseng T, Bodegom-Vos LV, et al. Implementing a structured model for osteoarthritis care in primary healthcare: A stepped-wedge cluster-randomised trial.PLOS Medicine.2019;16(10):e1002949.Disclosure of Interests:None declared

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Spiritual Needs and Perception of Quality of Care and Satisfaction With Care in Hematology/Medical Oncology Patients: A Multicultural Assessment

Journal of Pain and Symptom Management ◽

10.1016/j.jpainsymman.2017.08.009 ◽

2018 ◽

Vol 55 (1) ◽

pp. 56-64.e1 ◽

Cited By ~ 17

Author(s):

Alan B. Astrow ◽

Gary Kwok ◽

Rashmi K. Sharma ◽

Nelli Fromer ◽

Daniel P. Sulmasy

Keyword(s):

Quality Of Care ◽

Medical Oncology ◽

Spiritual Needs ◽

Satisfaction With Care ◽

Oncology Patients ◽

Perception Of Quality ◽

Multicultural Assessment

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Perceived satisfaction with HIV care and its association with adherence to antiretroviral therapy and viral suppression in the African Cohort Study

AIDS Research and Therapy ◽

10.1186/s12981-021-00414-3 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Nancy Somi ◽

Nicole Dear ◽

Domonique Reed ◽

Ajay Parikh ◽

Anange Lwilla ◽

...

Keyword(s):

Health Care ◽

Quality Of Care ◽

Health Care Worker ◽

Viral Suppression ◽

Hiv Care ◽

Satisfaction With Care ◽

Art Adherence ◽

Worker Attitudes ◽

Care Worker

Abstract Background Increased availability of HIV care over the past decade has dramatically reduced morbidity and mortality among people living with HIV (PLWH) in sub-Saharan Africa. However, perceived and experienced barriers to care, including dissatisfaction with services, may impact adherence and viral suppression. We examined the associations between satisfaction with HIV care and antiretroviral therapy (ART) adherence and viral load suppression. Methods The African Cohort Study (AFRICOS) is a prospective observational study conducted at PEPFAR-supported clinics in four African countries. At enrollment and twice-yearly study visits, participants received a clinical assessment and a socio-behavioral questionnaire was administered. Participants were classified as dissatisfied with care if they reported dissatisfaction with any of the following: waiting time, health care worker skills, health care worker attitudes, quality of clinic building, or overall quality of care received. Robust Poisson regression was used to estimate prevalence ratios and 95% confidence intervals (CIs) for associations between satisfaction with care and ART adherence and between satisfaction with care and viral suppression (viral load < 1000 copies/mL). Results As of 1 March 2020, 2928 PLWH were enrolled and 2311 had a year of follow-up visits. At the first annual follow-up visit, 2309 participants responded to questions regarding satisfaction with quality of care, and 2069 (89.6%) reported satisfaction with care. Dissatisfaction with waiting time was reported by 177 (7.6%), building quality by 59 (2.6%), overall quality of care by 18 (0.8%), health care worker attitudes by 16 (0.7%), and health care worker skills by 15 (0.7%). After adjusting for age and site, there was no significant difference in viral suppression between those who were satisfied with care and those who were dissatisfied (aPR: 1.03, 95% CI 0.97–1.09). Satisfaction with HIV care was moderately associated with ART adherence among AFRICOS participants (aPR: 1.09; 95% CI 1.00–1.16). Conclusions While patient satisfaction in AFRICOS was high and the association between perceived quality of care and adherence to ART was marginal, we did identify potential target areas for HIV care improvement, including reducing clinic waiting times.

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Patient satisfaction with chronic HIV care provided through an innovative pharmacist/nurse-managed clinic and a multidisciplinary clinic

Canadian Pharmacists Journal / Revue des Pharmaciens du Canada ◽

10.1177/1715163517734236 ◽

2017 ◽

Vol 150 (6) ◽

pp. 397-406 ◽

Cited By ~ 3

Author(s):

Jason Kielly ◽

Deborah V. Kelly ◽

Shabnam Asghari ◽

Kim Burt ◽

Jessica Biggin

Keyword(s):

Patient Satisfaction ◽

Quality Of Care ◽

Access To Care ◽

Treatment Plan ◽

Patient Characteristics ◽

Hiv Care ◽

Satisfaction With Care ◽

Care Clinic ◽

Multidisciplinary Clinic

Background: Pharmacist/nurse-led clinics are an established model for many chronic diseases but not yet for HIV. At our centre, patients with HIV are seen by a multidisciplinary team (physician, nurse, pharmacist, social worker) at least yearly. Some attend an HIV-specialist pharmacist/nurse clinic (or “nonphysician clinic,” NPC) for alternate biannual visits. Our objective was to assess patient satisfaction with care received through both clinics. Methods: The Patient Satisfaction Survey for HIV Ambulatory Care (assesses satisfaction with access to care, clinic visits and quality of care) was administered by telephone to adults who attended either clinic between January and July 2014. Descriptive statistics described patient characteristics and satisfaction scores. Fisher’s exact test compared satisfaction scores between the NPC and multidisciplinary clinic (MDC). Multivariate logistic regression examined associations between overall satisfaction with care and clinic type and patient characteristics (e.g., age, disease duration). Results: Respondents were very satisfied with the overall quality of HIV care in both the NPC and MDC (89% vs 93%, respectively, p = 0.6). Patients from both clinics expressed satisfaction with access to care, treatment plan input, their provider’s knowledge of the newest developments in HIV care and explanation of medication side effects, with no significant differences noted. Significantly more MDC patients reported being asked about housing/finances, alcohol/drug use and whether they needed help disclosing their status. Patient characteristics were not significantly associated with satisfaction with overall quality of care. Conclusion: Patients are satisfied with both clinics, supporting NPC as an innovative model for chronic HIV care. Comparison of outcomes between clinics is needed to ensure high-quality care.

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