scholarly journals What Do Patients Want? A Qualitative Analysis of Patient, Provider, and Administrative Perceptions and Expectations About Patients’ Hospital Stays

2020 ◽  
Vol 7 (6) ◽  
pp. 1760-1770
Author(s):  
Sansrita Nepal ◽  
Angela Keniston ◽  
Kimberly A Indovina ◽  
Maria G Frank ◽  
Sarah A Stella ◽  
...  
Keyword(s):  
Health Care Quality ◽  
Healthcare Providers ◽  
Safety Net ◽  
Care Quality ◽  
Hospital Environment ◽  
Structured Interviews ◽  
Patient Centered ◽  
Safety Net Hospital ◽  
Hospital Policies ◽  
Hcahps Survey

Patient experience is increasingly recognized as a measure of health care quality and patient-centered care and is currently measured through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). The HCAHPS survey may miss key factors important to patients, and in particular, to underserved patient populations. We performed a qualitative study utilizing semi-structured interviews with 45 hospitalized English- and Spanish-speaking patients and 6 focus groups with physicians, nurses, and administrators at a large, urban safety-net hospital. Four main themes were important to patients: (1) the hospital environment including cleanliness and how hospital policies and procedures impact patients’ perceived autonomy, (2) whole-person care, (3) communication with and between care teams and utilizing words that patients can understand, and (4) responsiveness and attentiveness to needs. We found that several key themes that were important to patients are not fully addressed in the HCAHPS survey and there is a disconnect between what patients and care teams believe patients want and what hospital policies drive in the care environment.

Usability Study of a Novel Collaborative Health IT in a Pediatric Intensive Care Unit

2021 ◽  
Vol 10 (1) ◽  
pp. 83-90
Author(s):  
Avishek Choudhury ◽  
Onur Asan ◽  
Mathew Scanlon
Keyword(s):  
Health Care Quality ◽  
Vital Signs ◽  
Pediatric Intensive Care ◽  
Care Quality ◽  
Team Approach ◽  
X Rays ◽  
Structured Interviews ◽  
Patient Centered ◽  
Technical Problems ◽  
Adoption Research

Non-mandated technologies hold the promise of increasing health care quality by rendering care that is patient-centered, collaborative, and team approach-driven. Large Customizable Interactive Monitor (LCIM), a non-mandated collaborative health information technology (HIT), is a flat panel touch screen monitor that displays validated patient information from the electronic health record (EHR), including vital signs, laboratory results, medications, X-rays, and interventions. The present study conducts semi-structured interviews with 33 parents and 36 providers to address gaps in post-adoption research on collaborative inpatient LCIM in pediatric settings. The study identified 15 usability issues experienced by doctors and patients’ families while using LCIM. The themes were surrounded around data display characteristics, intuition, physical properties, features supporting or opposing the user’s mental model, and technical problems. Filling these gaps produces scientific knowledge about how providers and patients’ family members perceive LCIM technology’s usability.

scholarly journals Predictors of a Top-Box Patient Experience: A Retrospective Observational Study of HCAHPS Data at a Safety Net Institution

2021 ◽  
Vol 8 ◽  
pp. 237437352110343
Author(s):  
Kimberly A. Indovina ◽  
Angela Keniston ◽  
Venkata Manchala ◽  
Marisha Burden
Keyword(s):  
Patient Experience ◽  
Healthcare Providers ◽  
Safety Net ◽  
Related Factors ◽  
Safety Net Hospital ◽  
Urban Safety ◽  
Adjustment Factors ◽  
Highly Correlated ◽  
Consumer Assessment ◽  
Hcahps Survey

Hospitals commonly seek to improve patient experience as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, yet there are limited data to guide improvement efforts. The HCAHPS survey was developed for interhospital comparisons, whereas its use in intrahospital comparisons has not been validated. We sought to better understand the validity of utilizing intrahospital score comparisons and to identify the factors that may predict top-box HCAHPS scores. We performed a retrospective observational cohort study at an academic urban safety-net hospital examining 4898 HCAHPS surveys completed by hospitalized patients. We found that while most Patient-Mix Adjustment factors for which HCAHPS scores are adjusted were associated with top-box scores on intrahospital comparisons, few additional variables were associated with top-box scores. Further, HCAHPS questions pertaining to nurse and doctor communication were highly correlated with overall hospital rating, suggesting that communication-related factors may influence a patient’s hospital experience more strongly than do administrative factors.

scholarly journals More Than Numbers: Discourses of Health Care Quality in Finland

SAGE Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 215824402098001
Author(s):  
Tiina J. Peltola ◽  
Hanna Tiirinki
Keyword(s):  
Health Care ◽  
Health Care Quality ◽  
Patient Centered Care ◽  
Patient Reported Outcome Measures ◽  
Care Quality ◽  
Structured Interviews ◽  
Patient Centeredness ◽  
Patient Centered ◽  
Patient Reported ◽  
Centered Care

Finnish institute for health and welfare is developing national health care quality registers for the ongoing project in 2018–2020, which covers seven disease pilot registers. This article describes professionals’ and patient associations’ cultural health care quality conceptions at developing process, reflecting to Weick’s sensemaking theory and patient-centered care. Research data ( N = 13) were collected by individual thematic semi-structured interviews from pilot registers’ professionals and patient associations. Data were analyzed using the discursive approach. Six main discourses on the shared sociocultural meanings of health care quality were constructed: confidence and reliability, information and understanding, safety and medical effectiveness, support, benchmarking and utility, and requirement and justice. Health care quality is built-in culture and action to achieve patient-centered care and is complex to define. Patient–clinician interaction, understanding, and support are constructive elements to make sense of quality registers’ necessity and data collection. The importance of Patient-Reported Outcome Measures (PROMs) and Patient-Reported Experience Measures (PREMs) measures is recognized to strengthen the patient-centeredness, which reflects to all health care decision-making, processes, and care. The data publication should be designed clearly and visually versatile. The study can offer new aspects for selecting valid quality indicators to produce comprehensive information for health care quality registers.

Patient-Centered, Integrated Health Care Quality Measures Could Improve Health Literacy, Language Access, and Cultural Competence

2019 ◽  
Author(s):  
Ignatius Bau ◽  
Robert A. Logan ◽  
Christopher Dezii ◽  
Bernard Rosof ◽  
Alicia Fernandez ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Health Literacy ◽  
Cultural Competence ◽  
Health Care Quality ◽  
Care Quality ◽  
National Committee ◽  
Patient Centered ◽  
Organizational System ◽  
Language Access

The authors of this paper recommend the integration of health care quality improvement measures for health literacy, language access, and cultural competence. The paper also notes the importance of patient-centered and equity-based institutional performance assessments or monitoring systems. The authors support the continued use of specific measures such as assessing organizational system responses to health literacy or the actual availability of needed language access services such as qualified interpreters as part of overall efforts to maintain quality and accountability. Moreover, this paper is informed by previous recommendations from a commissioned paper provided by the National Committee for Quality Assurance (NCQA) to the Roundtable on Health Literacy of the National Academies of Sciences, Engineering, and Medicine. In the commissioned paper, NCQA explained that health literacy, language access, and cultural competence measures are siloed and need to generate results that enhance patient care improvements. The authors suggest that the integration of health literacy, language access, and cultural competence measures will provide for institutional assessment across multiple dimensions of patient vulnerabilities. With such integration, health care organizations and providers will be able to cultivate the tools needed to identify opportunities for quality improvement as well as adapt care to meet diverse patients’ complex needs. Similarly, this paper reinforces the importance of providing more “measures that matter” within clinical settings.

scholarly journals A scoping review of registry captured indicators for evaluating quality of critical care in ICU

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Issrah Jawad ◽  
Sumayyah Rashan ◽  
Chathurani Sigera ◽  
Jorge Salluh ◽  
Arjen M. Dondorp ◽  
...  
Keyword(s):  
Critical Care ◽  
Scoping Review ◽  
Health Care Quality ◽  
Grey Literature ◽  
Healthcare Providers ◽  
Evidence Base ◽  
Patient Reported Outcome ◽  
Care Quality ◽  
Patient Reported

Abstract Background Excess morbidity and mortality following critical illness is increasingly attributed to potentially avoidable complications occurring as a result of complex ICU management (Berenholtz et al., J Crit Care 17:1-2, 2002; De Vos et al., J Crit Care 22:267-74, 2007; Zimmerman J Crit Care 1:12-5, 2002). Routine measurement of quality indicators (QIs) through an Electronic Health Record (EHR) or registries are increasingly used to benchmark care and evaluate improvement interventions. However, existing indicators of quality for intensive care are derived almost exclusively from relatively narrow subsets of ICU patients from high-income healthcare systems. The aim of this scoping review is to systematically review the literature on QIs for evaluating critical care, identify QIs, map their definitions, evidence base, and describe the variances in measurement, and both the reported advantages and challenges of implementation. Method We searched MEDLINE, EMBASE, CINAHL, and the Cochrane libraries from the earliest available date through to January 2019. To increase the sensitivity of the search, grey literature and reference lists were reviewed. Minimum inclusion criteria were a description of one or more QIs designed to evaluate care for patients in ICU captured through a registry platform or EHR adapted for quality of care surveillance. Results The search identified 4780 citations. Review of abstracts led to retrieval of 276 full-text articles, of which 123 articles were accepted. Fifty-one unique QIs in ICU were classified using the three components of health care quality proposed by the High Quality Health Systems (HQSS) framework. Adverse events including hospital acquired infections (13.7%), hospital processes (54.9%), and outcomes (31.4%) were the most common QIs identified. Patient reported outcome QIs accounted for less than 6%. Barriers to the implementation of QIs were described in 35.7% of articles and divided into operational barriers (51%) and acceptability barriers (49%). Conclusions Despite the complexity and risk associated with ICU care, there are only a small number of operational indicators used. Future selection of QIs would benefit from a stakeholder-driven approach, whereby the values of patients and communities and the priorities for actionable improvement as perceived by healthcare providers are prioritized and include greater focus on measuring discriminable processes of care.

scholarly journals Crossing the Patient-Centered Divide: Transforming Health Care Quality Through Enhanced Faculty Development

2011 ◽  
Vol 86 (4) ◽  
pp. 445-452 ◽  
Author(s):  
Richard M. Frankel ◽  
Florence Eddins-Folensbee ◽  
Thomas S. Inui
Keyword(s):  
Health Care ◽  
Faculty Development ◽  
Health Care Quality ◽  
Care Quality ◽  
Patient Centered

Impact of the Cincinnati Aligning Forces for Quality Multi-Payer Patient Centered Medical Home Pilot on Health Care Quality, Utilization, and Costs

2016 ◽  
Vol 73 (5) ◽  
pp. 532-545 ◽  
Author(s):  
Meredith B. Rosenthal ◽  
Shehnaz Alidina ◽  
Mark W. Friedberg ◽  
Sara J. Singer ◽  
Diana Eastman ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Home ◽  
Health Care Quality ◽  
Care Quality ◽  
Patient Centered Medical Home ◽  
Patient Centered

Characterization of the Recommendations in the Choosing Wisely Initiative

2018 ◽  
Vol 34 (4) ◽  
pp. 360-366 ◽  
Author(s):  
Kelsey Corrigan ◽  
Leonid Aksenov ◽  
Alexandra Paul ◽  
Banafsheh Sharif-Askary ◽  
Sarvesh Agarwal ◽  
...  
Keyword(s):  
Disease Prevention ◽  
Health Care Quality ◽  
Medication Management ◽  
Care Quality ◽  
Descriptive Statistics ◽  
Choosing Wisely ◽  
Patient Centered ◽  
Medical Issues ◽  
Artery Disease

Choosing Wisely is a comprehensive set of recommendations that guides clinicians and patients away from low-value services. The recommendations were reviewed to investigate their breadth and limitations. The authors performed an abstraction of all Choosing Wisely recommendations between March 1 and May 27, 2016. Descriptive statistics were used to characterize various topics found in the recommendations. Of the 461 Choosing Wisely recommendations, 48% targeted workup studies, 26% non–medication management, 20% medication management, and 6% disease prevention. The most commonly targeted medical issues were coronary artery disease (9%), antibiotics overuse (8%), back pain (6%), breast cancer (5%), and prostate cancer (4%). A limited focus was found on disease prevention and a lack of alignment with health care quality measures. Characterization of Choosing Wisely revealed a comprehensive set of recommendations that addresses low-value care across many specialties. Ultimately, this study provides guidance for promoting the creation and implementation of more patient-centered, representative recommendations.

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