PP22 How do emergency staff communicate with patients during resuscitation?

BackgroundClinical communication plays a key role in conveying compassion between individuals. Positive non-verbal communication (NVC) has been shown to encourage connectedness and improve patient outcomes – i.e. reducing pain and anxiety – in a range of conditions, including major trauma. Whilst little is understood about how staff utilise NVC in the resuscitation room, quality of interpersonal interactions has been shown to be the largest overall predictor of patient satisfaction within the Emergency Department (ED). Existing studies within the ED highlight patient experiences of feeling ‘isolated’, with their distress being ‘insensitively disregarded’ by staff, hence further research is required to improve patient experience.MethodsThis study utilised the video auditing system within the ED of Edinburgh’s Royal Infirmary to observe how emergency staff employed NVC with conscious patients across (n=15) resuscitation cases. Results were fed back to clinical staff, with suggestions for developing compassion awareness. Mixed method qualitative and quantitative analyses were employed to assess positive and negative staff NVC behaviours and evaluate how these appeared to influence patient experience. Several existing matrices for measuring staff non-technical performance informed design of a novel system for scoring five key aspects of clinical NVC: touch, eye contact, body language, proximity and patient exposure.ResultsThis study highlights significant variation in how emergency staff convey compassion to patients during resuscitation. Staff members exhibited a range of positive and negative NVC behaviours, which were occasionally at odds with verbal cues given. Patterns of communication appeared related to members’ roles within the emergency team, with medical and nursing staff exhibiting different strengths.ConclusionsOur findings are consistent with the idea that acts of compassion are ‘emotional labour’, underlining the need for staff education surrounding positive NVC, as well as increased workplace support. We suggest environmental level strategies including incorporation of a specifically designed ‘compassionate care’ toolkit into handover/pre-arrival checklists.

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Key drivers of patient experience in ambulatory paediatric cardiology

Cardiology in the Young ◽

10.1017/s1047951117000841 ◽

2017 ◽

Vol 27 (8) ◽

pp. 1585-1590 ◽

Cited By ~ 4

Author(s):

Shalini D. Allam ◽

Mary Mehta ◽

Bertha Ben Khallouq ◽

James F. Burrows ◽

Paul Rosen

Keyword(s):

Patient Satisfaction ◽

Patient Outcomes ◽

Patient Experience ◽

Increase Patient Satisfaction ◽

Central Focus ◽

Patient Satisfaction Survey ◽

Patient’S Experience ◽

Key Drivers ◽

Key Aspects ◽

Improve Patient

AbstractPatient experience is becoming a central focus of healthcare. A broad range of studies on how to increase patient satisfaction ratings exists; however, they lack the specificity to adequately guide physicians and hospitals on how to improve patient experience. The objective of this study was to define the aspects of patient experience within paediatric cardiologist practices that can serve as predictors of excellent patient satisfaction. From 1 January, 2013 to 28 February, 2015 (26 months), outpatients who visited paediatric cardiologists were asked to complete a 39-question patient satisfaction survey regarding their experience. Surveys were collected over a 26-month period by Press Ganey, an independent provider of patient satisfaction surveys. Participants were asked to rate their experience on a 1–5 Likert-scale: a score of 1 demonstrated a “poor” experience, whereas a score of 5 demonstrated a “very good” experience. This retrospective study of 2468 responses determined that cheerfulness of the practice (r=0.85, p<0.001), a cohesive staff (r=0.83, p<0.001), and a care provider explaining problems and conditions (r=0.81, p<0.001) were key aspects of a paediatric cardiologist’s practice that can be used as predictors of overall patient satisfaction. Awareness of how doctors can personalise a patient’s experience is vital to achieve greater patient satisfaction and, ultimately, better patient outcomes.

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Quality improvement methodology to improve patient experience and transforming transplant service delivery

10.26226/morressier.5a38ffa4d462b8029238b4e7 ◽

2018 ◽

Author(s):

Roshni Rathore

Keyword(s):

Quality Improvement ◽

Service Delivery ◽

Patient Experience ◽

Improve Patient

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Medical Students and Patients Benefit from Virtual Non-Medical Interactions Due to COVID-19

Journal of Medical Education and Curricular Development ◽

10.1177/23821205211028343 ◽

2021 ◽

Vol 8 ◽

pp. 238212052110283

Author(s):

Taylor M Coe ◽

Trevor J McBroom ◽

Sarah A Brownlee ◽

Karen Regan ◽

Stephen Bartels ◽

...

Keyword(s):

Medical Students ◽

Communication Skills ◽

Patient Experience ◽

Clinical Medicine ◽

Organ Transplant ◽

Medical Patient ◽

Pilot Program ◽

Transplant Recipients ◽

Kidney Transplant Recipients ◽

Clinical Communication

Background: Patient care restrictions created by the COVID-19 pandemic constrained medical students’ ability to interact directly with patients. Additionally, organ transplant recipients faced increasing isolation due to the rise of telemedicine, the importance of social distancing and their immunosuppressed state. We created a pilot program to pair students with transplant patients for structured, virtual encounters and studied its impact on medical students and patients. Methods: In May 2020, medical students conducted virtual visits with patients via telephone or video conferencing. Patients and students were surveyed regarding their experiences and independent focus groups were conducted. The survey responses and focus group discussions were deidentified, transcribed, and analyzed for themes. Results: Ten participating students were in their first, second, or final year of medical school. The 14 patients were liver or kidney transplant recipients or kidney donors. All interactions lasted longer than 30 minutes, with 56% greater than 1 hour. Three themes emerged related to the student experience: improvement of their clinical communication skills, development of knowledge and attitudes related to organ transplantation and donation, and independent management of a patient encounter. Three themes related to the patient experience: appreciation of the opportunity to share their personal patient experience to help educate future physicians, a cathartic and personally illuminating experience and an opportunity to share the message of donation. Conclusions: This pilot program provided a novel opportunity for virtual student-patient interactions that was feasible, well-received, and mutually beneficial. The use of virtual non-medical patient experiences allowed for experiential learning during which students learned about both clinical medicine and enhanced their communication skills directly from patients. Additionally, patients were able to engage with medical students in a new way, as teachers of clinical interactions, and reported a high level of satisfaction in addition to deriving personal benefit.

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A Modified CGM Algorithm Enhances Data Availability While Retaining iCGM Performance

Journal of Diabetes Science and Technology ◽

10.1177/19322968211007521 ◽

2021 ◽

pp. 193229682110075

Author(s):

Rebecca A. Harvey Towers ◽

Xiaohe Zhang ◽

Rasoul Yousefi ◽

Ghazaleh Esmaili ◽

Liang Wang ◽

...

Keyword(s):

Data Integration ◽

Patient Experience ◽

Real World ◽

Data Availability ◽

Post Processing ◽

Sensor Error ◽

The Mean ◽

The Difference ◽

Data Gap ◽

Improve Patient

The algorithm for the Dexcom G6 CGM System was enhanced to retain accuracy while reducing the frequency and duration of sensor error. The new algorithm was evaluated by post-processing raw signals collected from G6 pivotal trials (NCT02880267) and by assessing the difference in data availability after a limited, real-world launch. Accuracy was comparable with the new algorithm—the overall %20/20 was 91.7% before and 91.8% after the algorithm modification; MARD was unchanged. The mean data gap due to sensor error nearly halved and total time spent in sensor error decreased by 59%. A limited field launch showed similar results, with a 43% decrease in total time spent in sensor error. Increased data availability may improve patient experience and CGM data integration into insulin delivery systems.

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Categorizing and Rating Patient Complaints: An Innovative Approach to Improve Patient Experience

Journal of Patient Experience ◽

10.1177/2374373521998624 ◽

2021 ◽

Vol 8 ◽

pp. 237437352199862

Author(s):

Stephanie Bayer ◽

Paul Kuzmickas ◽

Adrienne Boissy ◽

Susannah L. Rose ◽

Mary Beth Mercer

Keyword(s):

Patient Experience ◽

Medical Center ◽

Academic Medical Center ◽

Patient Experiences ◽

Innovative Approach ◽

Satisfaction Survey ◽

Patient Complaints ◽

Academic Medical ◽

Survey Results ◽

Improve Patient

The Ombudsman Office at a large academic medical center created a standardized approach to manage and measure unsolicited patient complaints, including methods to identify longitudinal improvements, accounting for volume variances, as well as incident severity to prioritize response needs. Data on patient complaints and grievances are collected and categorized by type of issue, unit location, severity, and individual employee involved. In addition to granular data, results are collated into meaningful monthly leadership reports to identify opportunities for improvement. An overall benchmark for improvement is also applied based on the number of complaints and grievances received for every 1000 patient encounters. Results are utilized in conjunction with satisfaction survey results to drive patient experience strategies. By applying benchmarks to patient grievances, targets can be created based on historical performance. The utilization of grievance and complaint benchmarking helps prioritize resources to improve patient experiences.

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Broadening the concept of patient safety culture through value-based healthcare

Journal of Health Organization and Management ◽

10.1108/jhom-07-2020-0287 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Viktor Dombrádi ◽

Klára Bíró ◽

Guenther Jonitz ◽

Muir Gray ◽

Anant Jani

Keyword(s):

Patient Safety ◽

Patient Experience ◽

Safety Culture ◽

Improve Patient Safety ◽

Cost Benefit ◽

Population Level ◽

Patient Safety Culture ◽

Content Type ◽

Experience Of Care ◽

Improve Patient

PurposeDecision-makers are looking for innovative approaches to improve patient experience and outcomes with the finite resources available in healthcare. The concept of value-based healthcare has been proposed as one such approach. Since unsafe care hinders patient experience and contributes to waste, the purpose of this paper is to investigate how the value-based approach can help broaden the existing concept of patient safety culture and thus, improve patient safety and healthcare value.Design/methodology/approachIn the arguments, the authors use the triple value model which consists of personal, technical and allocative value. These three aspects together promote healthcare in which the experience of care is improved through the involvement of patients, while also considering the optimal utilisation and allocation of finite healthcare resources.FindingsWhile the idea that patient involvement should be integrated into patient safety culture has already been suggested, there is a lack of emphasis that economic considerations can play an important role as well. Patient safety should be perceived as an investment, thus, relevant questions need to be addressed such as how much resources should be invested into patient safety, how the finite resources should be allocated to maximise health benefits at a population level and how resources should be utilised to get the best cost-benefit ratio.Originality/valueThus far, both the importance of patient safety culture and value-based healthcare have been advocated; this paper emphasizes the need to consider these two approaches together.

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Many small steps to reducing length of stay: A visit to the DH pilot enhanced recovery scheme

Bulletin of The Royal College of Surgeons of England ◽

10.1308/147363510x525143 ◽

2010 ◽

Vol 92 (8) ◽

pp. 266-268

Author(s):

Matthew Worrall

Keyword(s):

Length Of Stay ◽

Health Service ◽

Patient Experience ◽

Enhanced Recovery ◽

Enhanced Recovery Programme ◽

Department Of Health ◽

Recovery Scheme ◽

Hospital Stays ◽

Improve Patient

Enhanced recovery (ER) is one of the current buzz terms in the health service but it seems to mean a different thing depending on to whom you speak. The Department of Health (DH) invited applications from acute trusts across England to become 'innovation sites' for the enhanced recovery programme. These sites are supported by DH as they implement a defined programme that aims to improve patient experience through shorter hospital stays. The Bulletin spent a day at one of them, West Hertfordshire Hospitals NHS Trust, to witness the changes made.

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