Patient satisfaction with the ocular surface individualized medical program

2020 ◽  
pp. 112067212094565
Author(s):  
Ran Hao ◽  
Yilin Chou ◽  
Yu Wan ◽  
Xiaodan Jiang ◽  
Xuemin Li
Keyword(s):  
Patient Satisfaction ◽  
Dry Eye ◽  
Ocular Surface ◽  
Linear Regression Analysis ◽  
Wait Time ◽  
Multivariate Linear Regression Analysis ◽  
Patient Reported ◽  
Peking University ◽  
Medical Program ◽  
Positive Assessment

Purpose: To improve the medical management system and the quality of medical treatment, this study aimed to assess patient satisfaction related to an ocular surface individualized medical program for dry eye, and identified patient needs that should be addressed in future. Methods: We enrolled 166 patients from the dry eye clinic at the Peking University Third Hospital from December 2017 to May 2019. An investigator followed up with all patients by telephone 2 months after the first assessment of overall patient satisfaction, expectations, and experiences. We determined patient satisfaction using a questionnaire and analyzed the results. Multivariate linear regression analysis was used to assess the predictors of overall patient satisfaction. Results: The overall patient satisfaction with the ocular surface individualized medical program skewed toward a positive assessment. Ten variables were significantly associated with overall patient satisfaction: two involving fulfilment of expectations, seven involving patient-reported experiences, and one involving socio-demographics. The most important predictor of overall patient satisfaction was patient-reported experiences with the treatment outcome (β = 0.281, p < 0.001), followed by experiences with medical staff services (β = 0.240, p = 0.002), examination services (β = 0.198, p = 0.002), and interpretation and professionalism (β = 0.168, p = 0.04), expectations fulfilment (β = 0.147, p = 0.025), as well as age (β = −0.13, p = 0.014). Free response-style negative patient feedback suggested that examination wait time and environment needed improvement. Conclusion: Overall, the ocular surface individualized medical program is effective and is able to achieve satisfaction for most patients. The examination procedures and environment require improvements, and treatment must be made more patient-centric to improve satisfaction.

scholarly journals Predictors of deterioration of symptoms and quality of life in patients with sarcoidosis

2013 ◽  
Vol 66 (suppl. 1) ◽  
pp. 77-83
Author(s):  
Branislav Gvozdenovic ◽  
Violeta Mihailovic-Vucinic ◽  
Mira Vukovic ◽  
Aleksandar Gvozdenovic ◽  
Aleksandra Dudvarski-Ilic ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Body Mass Index ◽  
Body Mass ◽  
Linear Regression Analysis ◽  
Forced Expiratory Volume ◽  
Measuring Instruments ◽  
Multivariate Linear Regression Analysis ◽  
Everyday Functioning ◽  
Patient Reported

Introduction. The most frequent clinical outcomes in sarcoidosis patients are typically focused on the objective measurements of functions of the involved organs, but, generally, they do not take into account the individual perception of patients? everyday functioning. The aim of this study was to determine the type of association between the subjective disease outcomes and other objective conventional parameters in patients with sarcoidosis. Material and Methods. In the cross-sectional study including 172 sarcoidosis patients (122 females), quality of life was measured by a generic instrument, i.e. fifteen-dimensional measure of health-related quality of life together with a respiratory specific instrument, i.e. St George?s Respiratory Questionnaire; symptoms of fatigue were measured by Fatigue Scale and dyspnea was measured by the Basal Dyspnea Index. Body-mass index and the course of the disease (acute vs. chronic) were also evaluated. Pulmonary function was assessed by spirometry. Results. Acute sarcoidosis was present in 48 (28%) patients. Mean body mass index was 27.01?5.2. Only 20 (12%) patients had lower forced expiratory volume in one second values (<80%) that indicated the existance of obstructive ventilatory impairment. Multivariate linear regression analysis revealed that body mass index, clinical course of disease and spirometric parameter forced expiratory volume in one second were the significant predictors (R2=0.929, p<0.01) of sarcoidosis related fatigue (B=0.061, B=0.406, B=0.452; respectively). Body mass index and forced expiratory volume in one second were the only parameters that significantly predicted both patients? quality of life (R2=0.932; B=0.017, B=0.263) and dyspnea (R2=0.847; B=0.025, B=0.668). Conclusions. It is important to measure both subjective patient-reported outcomes and objective disease parameters in sarcoidosis since they represent different aspects of the disease. All applied measuring instruments for the examined subjective outcomes demonstrated good measuring properties.

Time stamps used to measure the patient's clinic experience.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 150-150 ◽  
Author(s):  
Terry Jensen ◽  
Roy Brown ◽  
Gay Riegel ◽  
Lalan S. Wilfong ◽  
John Russell Hoverman
Keyword(s):  
Patient Satisfaction ◽  
Wait Time ◽  
Office Visit ◽  
Site Quality ◽  
Satisfaction Survey ◽  
Wait Times ◽  
Time Stamp ◽  
Patient Satisfaction Survey ◽  
Patient Reported ◽  
Time Stamps

150 Background: In 2013, a patient reported satisfaction survey indicated 19% of patients waited 20-40 minutes, 8% 40-60 minutes and 4% over 1 hour. We initiated a project to objectively quantify the components of wait times to investigate opportunities for improvement. Methods: Utilizing existing technology in the practice management system, clinic staff use the Day List feature to capture time stamps as patients move through the clinic. We focused on provider appointments but these visits could also include business office, labs, infusion and diagnostics. It was important to define where the wait(s) occurred. The Time Stamp durations measured are as follows: Arrival to Depart – duration of each appointment; Arrival to site to Exam Start – duration of activity until ready to be seen by the provider, includes rooming, labs and business office activity. Used to compare to the patient satisfaction survey responses; Exam Start to Depart – the provider portion of the office visit, includes patient wait plus exam time. Three reports are generated: Time Stamp Error Report indicating the completeness of data collection; Average Wait Times Report with appointment counts by physician by site and average durations; Provider Wait Times Report with office visit counts, Wait Time Category counts ( < 10 min, 10-20, 20-40, 40-60, and > 1 hour ) and average durations. Results: There was a correlation calculation to the patient satisfaction survey of .779, with long wait times more likely to be underreported by patients. Site and physician data were available for review at site Quality Committees. The data can be used by the site to improve processes, such as lab and infusion room scheduling. Time stamps are used to communicate patient readiness for next steps in the office visit. The time stamps provide objective data to discuss patient complaints with staff. Conclusions: Patient wait times are a valued measure of patient satisfaction and quality. Full utilization of the Day List and supporting technology allows us to objectively monitor and improve this aspect of patient care. Table 1: Sample Provider Report [Table: see text]

scholarly journals A cross-sectional study of ocular surface discomfort and corneal nerve dysfunction after paclitaxel treatment for cancer

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jeremy Chung Bo Chiang ◽  
David Goldstein ◽  
Terry Trinh ◽  
Kimberley Au ◽  
Susanna B. Park ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Dry Eye ◽  
Ocular Surface ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Peripheral Neurotoxicity ◽  
Patient Reported ◽  
Paclitaxel Group ◽  
Corneal Nerve ◽  
Paclitaxel Treatment

AbstractOcular surface dysfunction is common in patients receiving anti-cancer drug treatment. The effects of paclitaxel, a neurotoxic chemotherapeutic drug, on ocular surface discomfort associated with dry eye disease was investigated. Patients with cancer who had completed paclitaxel treatment between 3 and 24 months prior to assessment (n = 29) and age- and sex-matched healthy control subjects (n = 29) were recruited and assessed with the Ocular Surface Disease Index (OSDI) to measure ocular surface discomfort. In-vivo corneal confocal microscopy was used to evaluate corneal nerve parameters in the right eye. Peripheral neurotoxicity was assessed using patient-reported outcomes and clinical grading scales. The paclitaxel group had significantly worse OSDI total scores compared with controls (Median, Md = 19.3 and Md = 0, p = 0.007, respectively). Corneal nerve fiber and inferior whorl lengths were reduced in the paclitaxel group compared with controls (14.2 ± 4.0 and 14.4 ± 4.0 mm/mm2 vs. 16.4 ± 4.0 and 16.9 ± 4.9 mm/mm2, respectively, p = 0.04). When analyzed by presence of peripheral neuropathy, paclitaxel-treated patients with neuropathy showed worse OSDI total scores compared to those without peripheral neuropathy post-treatment (p = 0.001) and healthy controls (p < 0.001). More severe ocular discomfort and worse visual function was associated with greater peripheral neurotoxicity symptoms (r = 0.60, p = 0.001) and neuropathy severity (r = 0.49, p = 0.008), respectively. Patients who have been treated with paclitaxel have a higher risk of ocular surface discomfort associated with dry eye disease, particularly those with peripheral neuropathy. Future longitudinal studies should investigate the clinical impact of corneal nerve reduction in dry eye disease.

scholarly journals Leptin’s concentration in tears and dry eye: a clinical observational study

2021 ◽  
Vol 14 (1) ◽  
pp. 83-88
Author(s):  
Ran Hao ◽  
◽  
Xue-Min Li ◽  
Keyword(s):  
Dry Eye ◽  
Linear Regression Analysis ◽  
Multivariate Linear Regression Analysis ◽  
Ocular Surface Disease Index ◽  
Fluorescein Staining ◽  
Significant Difference ◽  
Eye Symptoms ◽  
Tear Meniscus Height ◽  
Symptoms And Signs ◽  
Dry Eye Symptoms

AIM: To investigate the concentration of leptin in tears and its correlation with dry eye symptoms and signs. METHODS: The study enrolled individuals (n=39) responding to an advertising or dry eye patients (n=58) from the Ophthalmology Department. Tear samples were collected for leptin concentration measuring. Ocular Surface Disease Index (OSDI), tear meniscus height (TMH), tear break up time (TBUT), cornea fluorescein staining, Schirmer test (ST) and impression cytology (IC) were assessed. Leptin concentration in tears of dry eye patients and healthy controls, and its correlation with clinical features of dry eye disease (DED) were analyzed. RESULTS: Age, body mass index (BMI), OSDI scores and cornea fluorescein staining scores showed a negative correlation with leptin concentration in tears (r=-0.340, P=0.001; r=-0.332, P=0.001; r=-0.258, P=0.011; r=-0.424, P<0.001, respectively). ST showed positive correlation with leptin concentration in tears (r=0.206, P=0.045). No significant difference was observed in leptin concentration between dry eye patients and controls (P=0.682). Multivariate linear regression analysis revealed that dry eye, OSDI, corneal fluorescein staining scores and ST correlated with leptin concentration in tears. CONCLUSION: This is the first study measuring leptin concentration in tears. The correlation between leptin concentration and DED symptoms and signs reveal that leptin level correlated with the dry eye, potentially contributing to repair of ocular damage and dry eye improvement.

scholarly journals A systematic review assessing the quality of patient reported outcomes measures in dry eye diseases

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0253857
Author(s):  
Alberto Recchioni ◽  
Olalekan Lee Aiyegbusi ◽  
Samantha Cruz-Rivera ◽  
Saaeha Rauz ◽  
Anita Slade
Keyword(s):  
Psychometric Properties ◽  
Dry Eye ◽  
Full Text ◽  
Ocular Surface ◽  
Ocular Surface Disease ◽  
Reference List ◽  
Patient Reported ◽  
The Impact ◽  
Citation Searching

Background Patient-reported outcome measures (PROMs) can provide valuable insights on the impact of a disease or treatment on a patient’s health-related quality of life. In ophthalmology, particularly in dry eye disease (DED) and ocular surface disease (OSD), it is unclear whether the available PROMs were developed using comprehensive guidelines. To address this, we evaluated the methodological quality of studies assessing the psychometric properties of PROMs in DED and OSD [PROSPERO registration number CRD42019142328]. Methods Four databases were searched; reference list and citation searching of included studies was also conducted. The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was used to appraise the quality of the studies evaluating the psychometric properties of PROMs used in DED and OSD. Results The search strategy (S3 Table) retrieved 5,761 records, 573 duplicates were removed, 5,188 abstracts were screened and 127 full-text articles were retrieved for further review. Of these, 118 full-text articles did not meet the eligibility criteria and were excluded. Reference list and citation searching, identified an additional 8 articles bringing the total numbers of papers reviewed to 17. In general, psychometric properties such as content validity, measurement error and structural validity were not assessed by the studies included in this review. Studies reviewing The Impact of Dry Eye on Everyday Life (IDEEL) presented with the highest quality scores together with the Ocular Surface Disease Index (OSDI) questionnaire. Conclusions The quality of studies evaluating PROMs in DED and OSD was considered using the COSMIN standards. The majority of the studies evaluating PROMs included in this review did not meet the recommended COSMIN criteria and the quality of the PROMs evaluated is not assured. Further evaluation of their psychometric properties is required if these are going to be used in clinical practice or research.

Protocol for stepped wedge cluster randomized trial to evaluate the effects of SurgeCon: A quality improvement emergency department surge management platform (Preprint)

2021 ◽  
Author(s):  
Hensley Mariathas ◽  
Shabnam Asghari ◽  
Oliver Hurley ◽  
Nahid Anaraki ◽  
Christina Young ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Patient Satisfaction ◽  
Health System ◽  
Wait Time ◽  
Cluster Randomized Trial ◽  
Wait Times ◽  
Hybrid Design ◽  
Stepped Wedge ◽  
Patient Reported ◽  
Cluster Randomized

BACKGROUND Despite many efforts, long wait time and overcrowding at Emergency Departments (EDs) have remained a significant health system issue in Canada. For several years, Canada has had one of the longest wait times among Organisation for Economic Co-operation and Development OECD countries. From the patient’s perspective, the challenge has been described as “patients wait in pain or discomfort for hours before being seen at EDs”. In this study, we propose an innovative quality-improvement intervention called SurgeCon that includes a protocol-driven software platform and several other initiatives to reduce wait times and improve the sustainability of health systems without significant workforce changes. We piloted SurgeCon at an ED in Carbonear, Newfoundland and Labrador (NL) and found there was a 32% reduction in ED wait time. OBJECTIVE Our primary objectives of the trial are to evaluate the effects of SurgeCon on ED performance based on length of stay (LOS), time to physician’s initial assessment (PIA), and the number of patients leaving the ED without being seen by a physician (LWBS), patient satisfaction and patient-reported experience with ED wait times. The ultimate goal of this study is to create better value care by reducing the per-patient cost of delivering ED services. METHODS This study will investigate the effects of SurgeCon on health system key performance outcomes and patient-reported experience and satisfaction. The study uses a comparative effectiveness-implementation hybrid design. This type of hybrid design has been recommended to help achieve rapid translational gains that can hasten the movement of interventions from research to practice to public health impact. In our hybrid design, we will use a pragmatic stepped wedge cluster randomized trial (SW-CRT) design that enrols four 24/7 on-site ED physician support (category A) hospitals into a 30-month trial. All clusters (hospitals) start with a baseline period of “usual care” and are randomized to determine the order and timing of transitioning to “intervention care” until all hospitals are exposed to the intervention condition for the remainder of the study. RESULTS Data collection for this study is ongoing. To date, 15 randomly selected patients have participated in telephone interviews concerning patient-reported experiences and patient satisfaction with ED wait times. CONCLUSIONS By evaluating the mechanisms behind the use of SurgeCon, we hope to be able to improve wait times and create better value ED care in this healthcare context. CLINICALTRIAL This study is registered in ClinicalTrials.gov NCT04789902

The association between patient rating of their spine surgeon and quality of postoperative outcome

2020 ◽  
pp. 1-7
Author(s):  
Nicholas M. Rabah ◽  
Hammad A. Khan ◽  
Jay M. Levin ◽  
Robert D. Winkelman ◽  
Thomas E. Mroz ◽  
...  
Keyword(s):  
Mental Health ◽  
Patient Satisfaction ◽  
Lumbar Spine ◽  
Linear Regression ◽  
Spine Surgery ◽  
Patient Reported Outcomes ◽  
Linear Regression Analysis ◽  
Lumbar Spine Surgery ◽  
Patient Rating ◽  
Patient Reported

OBJECTIVEThe Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) survey was developed by the Centers for Medicare and Medicaid Services as a result of their value-based purchasing initiative. It allows patients to rate their experience with their provider in the outpatient setting. This presents a unique situation in healthcare in which the patient experience drives the marketplace, and since its creation, providers have sought to improve patient satisfaction. Within the spine surgery setting, however, the question remains whether improved patient satisfaction correlates with improved outcomes.METHODSAll patients who had undergone lumbar spine surgery between 2009 and 2017 and who completed a CG-CAHPS survey after their procedure were studied. Demographic and surgical characteristics were then obtained. The primary outcomes of this study include patient-reported health outcomes measures such as the Patient-Reported Outcomes Measurement Information System Global Health (PROMIS-GH) surveys for both mental health (PROMIS-GH-MH) and physical health (PROMIS-GH-PH), and the visual analog scale for back pain (VAS-BP). A multivariable linear regression analysis was used to assess whether patient satisfaction with their provider was associated with changes in each health status measure after adjusting for potential confounders.RESULTSThe study population included 647 patients who had undergone lumbar spine surgery. Of these, 564 (87%) indicated that they were satisfied with the care they received. Demographic and surgical characteristics were largely similar between the two groups. Multivariable linear regression demonstrated that patient satisfaction with their provider was not a significant predictor of change in two of the three patient-reported outcomes (PROMIS-GH-MH and PROMIS-GH-PH) assessed at 1 year. However, top-box patient satisfaction with their provider was a significant predictor of improvement in VAS-BP scores at 1 year.CONCLUSIONSThe authors found that after adjusting for patient-level covariates such as age, diagnosis of disc displacement, self-reported mental health, self-reported overall health, and preoperative patient-reported outcome measure status, a significant association was observed between top-box overall provider rating and 1-year improvement in VAS-BP, but no such association was observed for PROMIS-GH-PH and PROMIS-GH-MH. This suggests that pain-related outcome measures may serve as better predictors of patients’ satisfaction with their spine surgeons. Furthermore, this suggests that the current method by which patient satisfaction is being assessed and publicly reported may not necessarily correlate with validated measures that are used within the spine surgery setting to assess surgical efficacy.

scholarly journals Preoperative Performance of the PROMIS in Patients Undergoing Hip Arthroscopic Surgery for Femoroacetabular Impingement Syndrome

2019 ◽  
Vol 7 (7) ◽  
pp. 232596711986007 ◽  
Author(s):  
Benedict U. Nwachukwu ◽  
Edward C. Beck ◽  
Reagan Chapman ◽  
Jorge Chahla ◽  
Kelechi Okoroha ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
Linear Regression Analysis ◽  
Arthroscopic Surgery ◽  
Impingement Syndrome ◽  
Harris Hip Score ◽  
Poor Correlation ◽  
Multivariate Linear Regression Analysis ◽  
Femoroacetabular Impingement Syndrome ◽  
Patient Reported ◽  
Floor Effects

Background: The Patient-Reported Outcomes Measurement Information System (PROMIS) is being increasingly evaluated for use in orthopaedic surgery. The performance of the PROMIS in patients undergoing hip preservation surgery is unknown. Purpose: To investigate the psychometric performance of the PROMIS compared with legacy patient-reported outcome measures (PROMs) in patients indicated for hip arthroscopic surgery for femoroacetabular impingement syndrome (FAIS). Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Data from consecutive patients who underwent primary hip arthroscopic surgery between January and October 2018 for the treatment of FAIS were collected and analyzed. Baseline data, including preoperative PROM scores and demographics, were recorded. PROMs included the PROMIS Physical Function (PF), the Hip Outcome Score (HOS), the modified Harris Hip Score (mHHS), the International Hip Outcome Tool–12 (iHOT-12), and the Veterans RAND 12-item health survey (VR-12). Pearson and Spearman coefficient analyses were used to identify correlations between continuous and noncontinuous variables, respectively. Correlation was defined as excellent (>0.80), very good (0.71-0.80), good (0.61-0.70), fair (0.41-0.60), or poor (0.21-0.40). A multivariate linear regression analysis was used to identify preoperative predictors of having higher preoperative PROMIS scores. Results: A total of 197 patients with a mean age and body mass index (BMI) of 32.8 ± 12.6 years and 25.7 ± 5.6 kg/m2, respectively, were included in the final analysis. There were no ceiling or floor effects for the PROMIS PF score observed in the study group. With regard to hip-specific measures, PROMIS PF scores demonstrated excellent correlation with HOS–Activities of Daily Living ( r = 0.801; P < .001) scores, very good correlation with mHHS ( r = 0.721; P < .001) and iHOT-12 ( r = 0.722; P < .001) scores, and good correlation with HOS–Sports Specific ( r = 0.675; P < .001) scores. With regard to general health–related quality of life (HRQoL) measures, PROMIS PF scores demonstrated very good correlation with VR-12 mental ( r = 0.721; P < .001) scores, good correlation with VR-12 physical ( r = 0.618; P < .001) scores, and poor correlation with visual analog scale for pain ( r = –0.365; P < .001) scores. Patients who reported being physically active were more likely to have a higher preoperative PROMIS score (β = 3.216; P = .004). Lower PROMIS scores were found in patients with a higher BMI (β = –0.236; P = .005) and in female patients (β = –2.608; P = .014). Conclusion: In patients with FAIS, the preoperative PROMIS PF scores demonstrated excellent to good correlation with legacy hip-specific instruments as well as with HRQoL measures. No ceiling or floor effects were identified. Notably, of the hip-specific PROMs administered, the PROMIS PF demonstrated the weakest correlation with the HOS–Sports Specific subscale. Physical activity, BMI, and sex were predictors of preoperative PROMIS scores in our patient population.

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