scholarly journals Calling on the Patient’s Perspective in Emergency Medicine: Analysis of 1 Year of a Patient Callback Program

2018 ◽  
Vol 6 (4) ◽  
pp. 318-324 ◽  
Author(s):  
Shaw Natsui ◽  
Emily L Aaronson ◽  
Tony A Joseph ◽  
Andrew J Goldsmith ◽  
Jonathan D Sonis ◽  
...  
Keyword(s):  
Patient Experience ◽  
Care Delivery ◽  
Tertiary Care ◽  
Wait Time ◽  
Discharge Process ◽  
Compassionate Care ◽  
Negative Experience ◽  
Patient Reported ◽  
Reported Data ◽  
Ed Crowding

Background: Patient-centered approaches in the evaluation of patient experience are increasingly important priorities for quality improvement in health-care delivery. Our objective was to investigate common themes in patient-reported data to better understand areas for improvement in the emergency department (ED) experience. Methods: A large urban, tertiary-care ED conducted phone interviews with 2607 patients who visited the ED during 2015. Patients were asked to identify one area that would have significantly improved their visit. Transcripts were analyzed using content analysis, and the results were summarized with descriptive statistics. Results: The most commonly cited themes for improvement in the patient experience were wait time (49.4%) and communication (14.6%). Related, but more nuanced, themes emerged around the perception of ED crowding and compassionate care as additional important contributors to the patient experience. Other frequently cited factors contributing to a negative experience were the discharge process and inability to complete follow-up plan (8.0%), environmental factors (7.9%), perceived competency of providers in the evaluation or treatment (7.4%), and pain management (7.4%). Conclusions: Wait times and perceptions of ED crowding, as well as provider communication and compassionate care, are significant factors identified by patients that affect their ED experience.

Demographic, socioeconomic, and clinical factors associated with oncology patient experience in the Ontario cancer system.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 160-160
Author(s):  
Mary Mahler ◽  
Brett Nicholls ◽  
Catherine Chan ◽  
Narges Nazeri-Rad ◽  
Kelvin K. Chan ◽  
...  
Keyword(s):  
Patient Experience ◽  
Cancer Care ◽  
Care Delivery ◽  
Healthcare Providers ◽  
Oncology Patient ◽  
Negative Experience ◽  
Care Experience ◽  
Cancer Services ◽  
Patient Reported ◽  
Disease Site

160 Background: Your Voice Matters (YVM) is an electronic real time Patient Reported Experience Measure (PREM) collected on all adult patients accessing cancer services in Ontario by Cancer Care Ontario/Ontario Health. To our knowledge, this is the largest oncology PREM dataset worldwide. A total of 25 Items are assessed including care coordination, wait times, access to care and satisfaction with healthcare providers. We attempted to identify demographic, socioeconomic and disease factors that predict for a positive patient experience. Methods: Responses were collated from 18 individual cancer centers between Jan 2017 and Dec 2019. Each item was dichotomized into positive/negative experiences. Multivariable logistic regression was constructed for each of the 25 items. Results: Demographics are described in table. Males (OR=1.11, p=0.0032), genitourinary patients (OR=1.30, p=0.0031) and those receiving radiation (OR=1.39, p=<0.0001) were more likely to have a positive experience. Patients aged 18-39 (OR=0.74, p=<0.0001), receiving chemotherapy (OR=0.76, p=0.0002), and with central nervous system or lung cancer (OR= 0.56, p=<0.001; OR=0.79 p=0.0059, respectively) were more likely to have a negative experience. Lowest income patients were more likely to have a negative experience with healthcare providers (OR=0.83, p=0.0119) and patients from the highest immigration areas had a worse quality experience (OR=0.82, p=0.0029). Conclusions: Age, sex, disease site, visit type, income and immigration status significantly influence patients cancer care experience. This information helps promote equity and the use of PREM data to improve cancer care delivery. [Table: see text]

QIM19-136: Developing an Ideal CAR-T Cell Therapy Patient Experience Through Human-Centered Design and Innovation

2019 ◽  
Vol 17 (3.5) ◽  
pp. QIM19-136 ◽  
Author(s):  
Allison Matthews ◽  
Surbhi Sidana ◽  
Lauren Seymour ◽  
Nancy Pick ◽  
James Pringnitz ◽  
...  
Keyword(s):  
Patient Experience ◽  
Care Delivery ◽  
Design Team ◽  
Patient Journey ◽  
Human Centered Design ◽  
T Cell Therapy ◽  
Evaluation Phase ◽  
Patient Reported ◽  
Car T ◽  
The Impact

Background: The patient/caregiver experience during CAR-T therapy is stressful, overwhelming, terrifying, and often a patient’s last treatment option. The Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery Innovation and Design team has worked with the CAR-T therapy clinical team to develop a patient experience that provides patients with a sense of caring, supportive environment, timely knowledge, and realistic expectations. Using a human-centered design approach, the Innovation and Design team worked with patients and caregivers to understand latent and unspoken needs in order to develop an ideal CAR-T therapy patient journey. Methods: With qualitative interviewing techniques, patient observation, and low fidelity experimentation, 21 patients/caregiver pairs were interviewed throughout their CAR-T therapy experience in 2018. Patients were interviewed at several touch points as well as encouraged to reach out to the Innovation and Design team at any point with reflections on their experiences. Patients were recruited as they began their evaluation phase for CAR-T therapy. The interviews were unscripted to allow for a breadth of discovery by not constraining the conversations to previously developed themes. As themes emerged from patient/caregiver interviews, artifacts and interventions were designed to alleviate pain points and improve the patient/caregiver experience. These artifacts and interventions were integrated into the clinical processes in real time and patient/caregivers were interviewed to understand the impact of these activities. Results: Several themes emerged from qualitative interviews with patients and caregivers. From the themes, interventions were developed. We were able to demonstrate a qualitative improvement in patient/caregiver experience through these interventions (Figure 1). Conclusions: Patients/caregivers undergoing CAR-T therapy have unique issues surrounding the logistics of care, emotional burden, and physical effects of treatment. We implemented processes to address these issues and observed a qualitative improvement via patient interviews/feedback. Ongoing work includes optimizing remote monitoring, digital platforms for patient education, and a quantitative study looking at patient reported outcomes (PROs) in such patients. To our knowledge, this is the first report for care delivery optimization in real-world practice for this new therapy.

scholarly journals Development of an on-job mentorship programme to improve nursing experience for enhanced patient experience of compassionate care

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Alma Arshad Hookmani ◽  
Naureen Lalani ◽  
Noureen Sultan ◽  
Aly Zubairi ◽  
Ayesha Hussain ◽  
...  
Keyword(s):  
Patient Experience ◽  
Tertiary Care ◽  
Intervention Development ◽  
Theory Of Change ◽  
Pediatric Care ◽  
Care Hospital ◽  
Compassionate Care ◽  
Frontline Staff ◽  
Middle Income ◽  
Experience Of Care

Abstract Background Evidence suggests improvement in nursing staff satisfaction, competence, and retention after implementation of evidence-based mentorship programmes. When guided by a framework of compassion, mentoring as a caring action can not only build healthy, transformative relationships but a similar behavior is reciprocated to patients which subsequently can drive patient experience of care. However, examples of on-job mentorship programs for nurses in low- and middle-income countries (LMIC) are limited. Objective The objective of the study was to develop an on-job nursing mentorship programme using a compassionate framework aimed at improving nurses’ experience and thus enhancing patient experience in a tertiary care hospital in Pakistan. Methods Designed as an intervention development study, it was completed between January 2018–December 2019. The programme was developed by a team composed of service and nursing leadership, director patient experience of care and a compassion specialist using a theory of change model. The package followed a series of steps, a) identification of a framework, b) creation of working group c) needs assessment and d) multiple meetings to frame the model followed by implementing the preconditions for roll-out of the programme with the frontline staff. Results The eventual outcome was improving the patient’s experience of compassion while the intermediate outcome was to have nurses demonstrate compassionate care. The pre-conditions were identified as: recruitment of staff with appropriate skills for pediatric care, provision of compassionate experience to the frontline nurses by addressing their specific pain points, development of competent head nurses as supervisors and creation of a compassionate culture. To ensure the pre-conditions, various interventions were planned with some implemented through the course of the study while others are in the process of being rolled out. These involved, inclusion of pediatric compassion specific module during orientation of new hires, creation of space to talk about compassionate skills with staff, provision of trainings and mentorship to create competent head nurses, and creating a culture that promoted and recognized compassionate care values. Conclusion The approach helped to delineate feasible pathways for an on-job compassionate mentorship programme enhancing routine supervisors' role as facilitators of compassionate care.

scholarly journals What does the patient have to say? Valuing the patient experience to improve the patient journey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Raffaella Gualandi ◽  
Cristina Masella ◽  
Michela Piredda ◽  
Matteo Ercoli ◽  
Daniela Tartaglini
Keyword(s):  
Patient Experience ◽  
University Hospital ◽  
Hospital Patient ◽  
Patient Journey ◽  
Patient Reports ◽  
Patient Reported ◽  
Improve Hospital ◽  
Potential Improvement ◽  
Reported Data ◽  
Clinical Conditions

Abstract Background Patient-reported data—satisfaction, preferences, outcomes and experience—are increasingly studied to provide excellent patient-centred care. In particular, healthcare professionals need to understand whether and how patient experience data can more pertinently inform the design of service delivery from a patient-centred perspective when compared with other indicators. This study aims to explore whether timely patient-reported data could capture relevant issues to improve the hospital patient journey. Methods Between January and February 2019, a longitudinal survey was conducted in the orthopaedics department of a 250-bed Italian university hospital with patients admitted for surgery; the aim was to analyse the patient journey from the first outpatient visit to discharge. The same patients completed a paper-and-pencil questionnaire, which was created to collect timely preference, experience and main outcomes data, and the hospital patient satisfaction questionnaire. The first was completed at the time of admission to the hospital and at the end of hospitalisation, and the second questionnaire was completed at the end of hospitalisation. Results A total of 254 patients completed the three questionnaires. The results show the specific value of patient-reported data. Greater or less negative satisfaction may not reveal pathology-related needs, but patient experience data can detect important areas of improvement along the hospital journey. As clinical conditions and the context of care change rapidly within a single hospital stay for surgery, collecting data at two different moments of the patient journey enables researchers to capture areas of potential improvement in the patient journey that are linked to the context, clinical conditions and emotions experienced by the patient. Conclusion By contributing to the literature on how patient-reported data could be collected and used in hospital quality improvement, this study opens the debate about the use of real-time focused data. Further studies should explore how to use patient-reported data effectively (including what the patient reports are working well) and how to improve hospital processes by profiling patients’ needs and defining the appropriate methodologies to capture the experiences of vulnerable patients. These topics may offer new frontiers of research to achieve a patient-centred healthcare system.

scholarly journals Patient experience with healthcare: Feedback for a Post COVID-19 clinic at a tertiary care center in rural area

2021 ◽  
Author(s):  
Alpana Garg ◽  
Maran Subramain ◽  
Patrick B Barlow ◽  
Lauren Garvin ◽  
Karin F Hoth ◽  
...  
Keyword(s):  
Mental Health ◽  
Patient Experience ◽  
Cognitive Abilities ◽  
Barriers To Care ◽  
Care Center ◽  
Tertiary Care ◽  
Symptom Burden ◽  
Wait Time ◽  
Exercise Intolerance ◽  
Physical And Mental Health

Purpose: Post-acute sequelae of SARS-CoV-2 infection(PASC) is a complex condition with multi-system involvement. We assessed patients perspectives and experience with a PASC clinic established at University of Iowa in June 2020. Methods: We conducted a mixed-method survey in June 2021 to ask PASC clinic patients about 1) PASC symptoms and their impact on physical and mental health, and cognition using the PROMIS Global Health and Cognitive Function abilities items, and 2) satisfaction with clinic services and referrals, barriers to care, and recommended support resources. Findings: Ninety-seven patients (97/277, 35% response rate) completed the survey. Most were women(67%, n=65/97), Caucasian(93%, n=90/97) and received outpatient care during acute COVID-19 illness (79%). Fifty percent reported wait time of 1-3 months and 40% traveled >1 hour for the appointment at PASC clinic. The most common symptoms >3 months from initial infection were fatigue (77%), brain fog (73%), exercise intolerance (73%), anxiety (63%), sleep difficulties (56%) and depression (44%). A minority of patients reported significantly reduced functioning (≥1.5 SD below mean) of their physical health (22.5%), mental health (15.9%) and cognitive abilities (17.6%). Qualitative analysis of open-ended answers added valuable context to quantitative results. Satisfaction with clinical services was high though participants identified barriers to care including scheduling delays and financial concerns. Respondents suggested potential strategies for optimizing recovery including continuity of care, a co-located multispecialty clinic and being provided with timely information from emerging research. Conclusion: Our study reports high PASC symptom burden, its impact on health and patient experience with healthcare. It is important that primary healthcare professionals listen to patients with empathy and support them during recovery. Healthcare systems and policymakers should focus on accessible, comprehensive, and patient-centered integrated care.

Assessment of single screening questions for dysphagia for routine clinical use in a tertiary care practice.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 102-102
Author(s):  
Catherine Brown ◽  
Ashlee Vennettilli ◽  
Deval Patel ◽  
Katherine Zora Zeman ◽  
Anthea Lau ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Tertiary Care ◽  
Patient Survey ◽  
Care Practice ◽  
Common Symptom ◽  
Multidisciplinary Practice ◽  
Patient Reported ◽  
Screening Question ◽  
Reported Data

102 Background: Dysphagia is a common symptom among esophageal cancer patients. However, there is neither a validated PROMIS tool nor a validated PRO-CTCAE tool for this symptom. Clinically, obtaining patient-reported data on this symptom systematically in specific disease sites is important, but keeping the patient survey burden low means that this may be best done using a screening question first. The goal of this study was to assess the performance of such a screening question when compared to a more standard tool for measuring dysphagia, FACT-E, in a esophageal cancer outpatient clinic setting. Methods: Adult esophageal cancer patients seen at the Princess Margaret Cancer Centre between 2012-2014 were all seen by a multidisciplinary practice. Patients completed the FACT-E and screening symptom surveys at regular timepoints. The time point where the most severe set of symptoms was present for each patient was analyzed and severity of symptoms was compared against two 5-level screeners ("How are you currently eating?" (screener 1) and "I can swallow naturally and easily" (screener 2). Prevalence of symptoms, sensitivity (Se) and specificity (Sp) of the screeners was assessed. Complete data was available and analyzed in 173 (87%) of 199 patients. Results: Mean age (range) was 64 (23-89) and 75% were male. Prevalence of moderate to severe difficulty swallowing solid, soft, liquid foods and choking was 31%, 10%, 7%, 4% respectively. 34% of patients experienced at least one moderate to severe symptom of dysphagia. Screener 1 had a Se of 84% and Sp of 79% when using any moderate or severe swallowing problem as the reference. The Se and Sp of screener 2 was 51% and 87%, respectively. Conclusions: Up to a third of esophageal cancer patients experience moderate to severe symptoms of dysphagia. Screener 1 had the better performance as a screening tool. High completion rates in this practice suggest that routine systematic collection of such data is feasible, and perceived to be important to patients. Practice level projects can improve the quality of measuring symptoms. In the future we will be testing the role of mobile and computer technology for the routine collection of dysphagia and other symptoms in this practice setting.

scholarly journals Why Measure Patient Experience in Physical Therapy?

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jacob Eversole ◽  
Ashton Grimm ◽  
Nikita Patel ◽  
Kelly John ◽  
Alessandra N. Garcia
Keyword(s):  
Physical Therapy ◽  
Patient Experience ◽  
Care Delivery ◽  
Clinical Effectiveness ◽  
Measurement Properties ◽  
Main Body ◽  
Low Back ◽  
Patient Centered ◽  
Patient Reported ◽  
Centered Care

Abstract Background Patient experience is an important component of quality and patient centered health care not fully explored in physical therapy. Main body This article addresses (1) concept of patient experience, (2) importance of capturing the patient experience, (3) measures to capture patient experience and whether these measures exhibit psychometrically sound measurement properties, (4) relationship between patient experience and clinical effectiveness outcomes, and (5) clinical applications of patient experience measures in the outpatient physical therapy setting, including suggestions for future studies. Short conclusion Employing patient experience measures into physical therapy practice may be an important key to improve clinical effectiveness outcomes and provide excellent patient-centered care delivery. An area of continued research should be focused on demonstrating the generalizability and measurement properties of patient reported experience measures for the musculoskeletal outpatient physical therapy population focusing first on the most common musculoskeletal conditions such as cervical, low back, and shoulder pain.

scholarly journals Associations between diagnostic pathways and care experience in colorectal cancer: evidence from patient-reported data

2018 ◽  
Vol 9 (3) ◽  
pp. 241-248 ◽  
Author(s):  
Theodosia Salika ◽  
Gary A Abel ◽  
Silvia C Mendonca ◽  
Christian von Wagner ◽  
Cristina Renzi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Primary Care ◽  
Patient Survey ◽  
Negative Evaluation ◽  
Hospital Treatment ◽  
Negative Experience ◽  
Care Experience ◽  
Emergency Presentation ◽  
Patient Reported ◽  
Reported Data

ObjectiveTo examine how different pathways to diagnosis of colorectal cancer may be associated with the experience of subsequent care.DesignPatient survey linked to information on diagnostic route.English patients with colorectal cancer (analysis sample n=6837) who responded to a patient survey soon after their hospital treatment.Main outcome measuresOdds Ratios and adjusted proportions of negative evaluation of key aspects of care for colorectal cancer, including the experience of shared decision-making about treatment, specialist nursing and care coordination, by diagnostic route (ie, screening detection, emergency presentation, urgent and elective general practitioner referral).ResultsFor 14 of 18 questions, there was evidence (p≤0.02) for variation in patient experience by diagnostic route, with 6–31 percentage point differences between routes in adjusted proportions of negative experience. Emergency presenters were more likely to report a negative experience for most questions, including those about adequacy of information about their diagnosis and sufficient explanation before operations. Screen-detected patients were least likely to report negative experiences except for support from primary care. Patients diagnosed through elective primary care referrals were most likely to report worse experience for questions for which overall variation by route was generally small.ConclusionsScreening-detected patients tend to report the best and emergency presenters the worst experience of subsequent care. Improvement efforts can target care integration for screening-detected patients and provision of information about the diagnosis and treatment of emergency presenters.

Patient Tolerability of Bowel Preparation is Associated with Polyp Detection Rate During Colonoscopy

2014 ◽  
Vol 23 (2) ◽  
pp. 135-140 ◽  
Author(s):  
Edward W. Holt ◽  
Kidist K. Yimam ◽  
Hanley Ma ◽  
Richard E. Shaw ◽  
Richard A. Sundberg ◽  
...  
Keyword(s):  
Bowel Preparation ◽  
Primary Outcome ◽  
Secondary Outcome ◽  
Polyp Detection ◽  
Cross Sectional ◽  
Quality Outcomes ◽  
Negative Experience ◽  
Polyp Detection Rate ◽  
Patient Reported ◽  
Bowel Prep

Background & Aims: A number of factors have been identified that influence the yield of screeningcolonoscopy. The perceived tolerability of bowel preparation has not been studied as a predictor of quality outcomes in colonoscopy. We aimed to characterize the association between patient-perceived tolerability of bowel preparation and polyp detection during colonoscopy.Methods: We performed a cross-sectional cohort study of 413 consecutive adult patients presenting foroutpatient colonoscopy at two outpatient endoscopy centers at our institution. We developed a standardized questionnaire to assess the patient's experience with bowel preparation. Bowel preparation quality was measured using the validated Ottawa scale and colonoscopic findings were recorded for each patient. The primary outcome was polyp detection and the secondary outcome was the quality of bowel preparation.Results: Patient-reported clarity of effluent during bowel preparation correlated poorly with Ottawa score during colonoscopy, k=0.15. Female gender was an independent risk factor for a poorly tolerated bowel prep (OR 3.93, 95% CI 2.30 - 6.72, p<0.001). Report of a poorly tolerated bowel prep was independently associated with the primary outcome, polyp detection (OR 0.39, 95% CI 0.18 - 0.84, p=0.02) and also with the secondary outcome, lower quality bowel preparation (OR 2.39, 95% CI 1.17 - 4.9, p=0.02).Conclusions: A patient-perceived negative experience with bowel preparation independently predicted both a lower quality bowel preparation and a lower rate of polyp of detection. Assessment of the tolerability of bowel preparation before colonoscopy may be a clinically useful predictor of quality outcomes during colonoscopy.

Verbal compliance-gaining strategies used by male physicians and patient healthcare experience

2017 ◽  
Vol 13 (2) ◽  
pp. 185-202 ◽  
Author(s):  
Annabel Levesque ◽  
Han Z. Li
Keyword(s):  
Health Status ◽  
Patient Experience ◽  
Lifestyle Changes ◽  
Positive Patient ◽  
Negative Experience ◽  
Healthcare Experience ◽  
Healthcare Experiences ◽  
Compliance Gaining ◽  
Family Practice Clinic ◽  
Motivation Strategies

This study explores male physicians’ use of verbal compliance gaining strategies to encourage patients to adhere to medication regimens, lifestyle changes, or future appointments, and assesses which strategies are associated with patients’ reported healthcare experiences. Five physicians from a family practice clinic in northern British Columbia, Canada, were audio-recorded while interacting with 31 patients during actual consultations. Compliance-gaining utterances were coded into five categories of strategies, while patient experience with care was assessed using a questionnaire. A number of intriguing findings emerged: direct orders were related to a more negative experience with interpersonal aspects of care, but were fairly frequently used, especially with female patients. Persuasion was the only strategy that promoted a positive patient experience, but was rarely used. However, the effect of persuasion on patient experience was no longer significant when adjusting for patients’ health status. Physicians relied mostly on motivation strategies to encourage adherence, but these strategies were not related to patients’ assessment of their healthcare experiences. These results suggest that the most frequently used verbal compliance gaining strategies by physicians are not always appreciated by patients. To be more effective, it is necessary to inform physicians about which compliance-gaining strategies promote a positive patient healthcare experience.

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