scholarly journals Relationships Between Time-at-Bedside During Hospital Ward Rounds, Clinician–Patient Agreement, and Patient Experience

2021 ◽  
Vol 8 ◽  
pp. 237437352110083
Author(s):  
John T Ratelle ◽  
Michelle Herberts ◽  
Donna Miller ◽  
Ashok Kumbamu ◽  
Donna Lawson ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Patient Experience ◽  
Hospital Medicine ◽  
Main Concern ◽  
Discharge Location ◽  
Ward Rounds ◽  
Research Assistants ◽  
Improve Patient ◽  
Room Time ◽  
Medication Changes

Hospital medicine ward rounds are often conducted away from patients’ bedsides, but it is unknown if more time-at-bedside is associated with improved patient outcomes. Our objective is to measure the association between “time-at-bedside,” patient experience, and patient–clinician care agreement during ward rounds. Research assistants directly observed medicine services to quantify the amount of time spent discussing each patient’s care inside versus outside the patient’s room. “Time-at-bedside” was defined as the proportion of time spent discussing a patient’s care in his or her room. Patient experience and patient–clinician care agreement both were measured immediately after ward rounds. Results demonstrated that the majority of patient and physicians completely agreement on planned tests (66.3%), planned procedures (79.7%), medication changes (50.6%), and discharge location (66.9%), but had no agreement on the patient’s main concern (74.4%) and discharge date (50.6%). Time-at-bedside was not correlated with care agreement or patient experience ( P > .05 for all comparisons). This study demonstrates that spending more time at the bedside during ward rounds, alone, is insufficient to improve patient experience.

Key drivers of patient experience in ambulatory paediatric cardiology

2017 ◽  
Vol 27 (8) ◽  
pp. 1585-1590 ◽  
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.

585 Preventing Occipital Pressure Injuries in Patients Admitted to the Burn ICU

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S134-S135
Author(s):  
Vitina M Kammin ◽  
Kristine Eckert ◽  
Paula Alem ◽  
Margaret A Dimler ◽  
Vitina M Kammin ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Early Identification ◽  
Wound Care ◽  
Tissue Perfusion ◽  
Educational Support ◽  
Skin Breakdown ◽  
Time Out ◽  
Risk Patients ◽  
Improve Patient ◽  
Room Time

Abstract Introduction Occipital pressure injuries (OPI) are categorized as pressure injuries on the occipital bone caused by pressure, shearing, or friction. Patients with significant burns are at a greater risk of developing these types of injuries due to increased fluid volume from resuscitation, decreased tissue perfusion, immobility, edema and length of stay. The rate of OPI in the BICU was 4.3 in 2016; this led to a comprehensive program to reduce/eliminate these injuries. Methods Early identification of at-risk patients and implementation of prevention strategies was conducted. Best practices were reviewed and the following interventions were put into place: on admission, all patients with facial burns, (intubated or not), were given a small size fluidized positioner pillow. The pillow was to be positioned with a defined divot in the center and not flattened (which is the way they were currently being utilized). The fluidized pillow must go into the hydrotherapy room with the patient and the patient’s head turned and repositioned every 2 hours. The use of a moisture-wicking fabric was utilized over the fluidized positioner pillow to prevent maceration. Nursing staff and burn technicians were educated as to practice changes; wound care nurses were available for educational support. In addition, in 2017, the Burn ICU instituted a 2 RN skin check daily for all patients in the hydrotherapy room once all dressings were removed. This tank room “time out” was instituted for early identification of areas of potential skin breakdown. Results Implementation of these protocols has significantly decreased the occurrence of OPI in the BICU. Since implementation, the rate of OPI in 2017, 2018 and Q1 and Q2 of 2019 has been 0%. The application of the fluidized positioner pillow, tank room “time-out” and staff education has greatly decreased the occurrence of OPI in the BICU. Conclusions Patients sustaining large surface area burns and/or full-thickness burns to the head and neck are susceptible to the development of OPI. The utilization of a fluidized positioner pillow in conjunction with improved assessment and identification using a 2 RN “time out” skin assessment daily, has led to a decrease in OPI in our BICU. Applicability of Research to Practice The utilization of the fluidized positioner pillow in conjunction with the described interventions can lead to a decrease in occipital HAPI and improve patient outcomes.

scholarly journals CRITICAL ASPECTS OF MOBILITY FOR IMPROVING PATIENT OUTCOMES AFTER CARDIAC SURGERY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S472-S472
Author(s):  
Tiffany Tsay ◽  
Jennifer A Schrack ◽  
Allyse Depenbrock ◽  
Amal A Wanigatunga ◽  
Jacek Urbanek ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Length Of Stay ◽  
Patient Outcomes ◽  
Functional Change ◽  
Post Surgery ◽  
Primary Mechanism ◽  
Discharge Location ◽  
Improve Patient ◽  
Post Cardiac Surgery ◽  
Critical Aspects

Abstract Physical activity after major cardiac surgery has been associated with length of stay, discharge location, risk of readmission, and functional change. However, in-hospital mobility is not currently assessed in a standardized way with nurse reports being the primary mechanism of tracking patient activity. Furthermore, it is unclear whether it is the total amount, frequency, or type of activity that is most important for improving patient outcomes post-surgery. To better understand the duration, frequency, and intensity of patient activity post-cardiac surgery, we conducted an observational study of 206 patients using a wrist-worn accelerometer and ankle-worn pedometer. Patients with lower levels of average daily pedometer-based ambulation in the first four days post-surgery, when compared to counterparts who ambulated more, had higher odds of a longer length of stay (OR=4.55, p&lt;0.0001) or being discharged to rehab vs. home (OR=7.7 p=0.012), independent of age, race, bypass time, and EuroSCORE (cardiac surgery risk score). Engaging in an average of less than two bouts of accelerometer-derived activity lasting 5 minutes or more each day was associated with higher odds of having a longer length of stay (OR=2.69, p=0.008) or being discharged to rehab vs. home (OR=20.9, p=0.019). A slower speed of recovery during the first four postoperative days, characterized by a smaller increase in pedometer-based ambulation with each successive day, was also associated with higher odds of being discharged to rehab vs. home (OR=6.62, p=0.008). Further research is needed to develop appropriate frequency and activity thresholds for use as intervention tools to improve patient outcomes post-surgery.

Embracing the Quadruple Aim: One hospital’s experience

2020 ◽  
Vol 34 (1) ◽  
pp. 26-28
Author(s):  
Mike Lapaine
Keyword(s):  
Health Outcomes ◽  
Employee Engagement ◽  
Patient Outcomes ◽  
Patient Experience ◽  
Triple Aim ◽  
Quadruple Aim ◽  
Patient Health ◽  
Reduced Costs ◽  
Improve Patient

Healthcare institutions have for some time pursued the Triple Aim: improve patient health outcomes, improve patient experience, and reduce costs. More recently, it has been recognized that the “missing piece” of success is to improve the experience of their clinicians in order to improve the three aims. The leadership of Bluewater Health has been using the Quadruple Aim since 2016 and, by working to improve employee engagement, has succeeded in also delivering exemplary care that has improved patient outcomes and experience and reduced costs.

Combined Approaches to the Skull Base for Intracranial Extension of Tumors via Perineural Spread can Improve Patient Outcomes

2016 ◽  
Vol 77 (S 01) ◽  
Author(s):  
Sheri Palejwala ◽  
Jonnae Barry ◽  
Crystal Rodriguez ◽  
Chandni Parikh ◽  
Stephen Goldstein ◽  
...  
Keyword(s):  
Skull Base ◽  
Patient Outcomes ◽  
Intracranial Extension ◽  
Perineural Spread ◽  
Improve Patient

Microporous Polysaccharide Hemosphere Absorbable Hemostat (AristaAH®) in Re-Operative Cardiac Surgical Procedures

2012 ◽  
Vol 9 (2) ◽  
pp. 96-98
Author(s):  
Brian A Bruckner ◽  
Matthias Loebe
Keyword(s):  
Patient Outcomes ◽  
Surgical Procedures ◽  
Systematic Approach ◽  
Surgical Intervention ◽  
Transfusion Requirement ◽  
Cardiac Surgical Procedures ◽  
Platelet Inhibitors ◽  
Hemostatic Agents ◽  
Surgical Field ◽  
Improve Patient

Patients undergoing re-operative cardiac surgical procedures present a great challenge with regard to obtaining hemostasis in the surgical field. Adhesions are ever-present and these patients are often on oral anti-coagulants and platelet inhibitors. As part of a well-planned surgical intervention, a systematic approach to hemostasis should be employed to decrease blood transfusion requirement and improve patient outcomes. Topical hemostatic agents can be a great help to the surgeon in achieving surgical field hemostasis and are increasingly being employed. Our approach, to these difficult patients, includes the systematic and planned use of AristaAH, which is a novel hemostatic agent whose use has proven safe and efficacious in our patient population.

scholarly journals How to improve emergency care to adults discharged within 24 hours? Acute Care planning in Emergency departments (The ACE study): a protocol of a participatory design study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e041743
Author(s):  
Christina Østervang ◽  
Annmarie Touborg Lassen ◽  
Charlotte Myhre Jensen ◽  
Elisabeth Coyne ◽  
Karin Brochstedt Dieperink
Keyword(s):  
Patient Outcomes ◽  
Participatory Design ◽  
Hospital Admissions ◽  
Phase 1 ◽  
Family Needs ◽  
Focus Group Interviews ◽  
Phase 3 ◽  
Ace Study ◽  
Group Interviews ◽  
Improve Patient

IntroductionThe development of acute symptoms or changes in diseases led to feelings of fear and vulnerability and the need for health professional support. Therefore, the care provided in the acute medical and surgical areas of the emergency department (ED) is highly important as it influences the confidence of patients and families in managing everyday life after discharge. There is an increase in short-episode (<24 hours) hospital admissions, related to demographic changes and a focus on outpatient care. Clear discharge information and inclusion in treatment decisions increase the patient’s and family’s ability to understand and manage health needs after discharge, reduces the risk of readmission. This study aims to identify the needs for ED care and develop a solution to improve outcomes of patients discharged within 24 hours of admission.Methods and analysisThe study comprises the three phases of a participatory design (PD). Phase 1 aims to understand and identify patient and family needs when discharged within 24 hours of admission. A qualitative observational study will be conducted in two different EDs, followed by 20 joint interviews with patients and their families. Four focus group interviews with healthcare professionals will provide understanding of the short pathways. Findings from phase 1 will inform phase 2, which aims to develop a solution to improve patient outcomes. Three workshops gathering relevant stakeholders are arranged in the design plus development of a solution with specific outcomes. The solution will be implemented and tested in phase 3. Here we report the study protocol of phase 1 and 2.Ethics and disseminationThe study is registered with the Danish Data Protection Agency (19/22672). Approval of the project has been granted by the Regional Committees on Health Research Ethics for Southern Denmark (S-20192000–111). Findings will be published in suitable international journals and disseminated through conferences.

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