Patients’ perceptions with musculoskeletal disorders regarding their experience with healthcare providers and health services: an overview of reviews

Abstract Objectives This overview of reviews aimed to identify (1) aspects of the patient experience when seeking care for musculoskeletal disorders from healthcare providers and the healthcare system, and (2) which mechanisms are used to measure aspects of the patient experience. Data sources Four databases were searched from inception to December 20th, 2019. Review methods Systematic or scoping reviews examining patient experience in seeking care for musculoskeletal from healthcare providers and the healthcare system were included. Independent authors screened and selected studies, extracted data, and assessed the methodological quality of the reviews. Patient experience concepts were compiled into five themes from a perspective of a) relational and b) functional aspects. A list of mechanisms used to capture the patient experience was also collected. Results Thirty reviews were included (18 systematic and 12 scoping reviews). Relational aspects were reported in 29 reviews and functional aspects in 25 reviews. For relational aspects, the most prevalent themes were “information needs” (education and explanation on diseases, symptoms, and self-management strategies) and “understanding patient expectations” (respect and empathy). For functional aspects, the most prevalent themes were patient’s “physical and environmental needs,” (cleanliness, safety, and accessibility of clinics), and “trusted expertise,” (healthcare providers’ competence and clinical skills to provide holistic care). Interviews were the most frequent mechanism identified to collect patient experience. Conclusions Measuring patient experience provides direct insights about the patient’s perspectives and may help to promote better patient-centered health services and increase the quality of care. Areas of improvement identified were interpersonal skills of healthcare providers and logistics of health delivery, which may lead to a more desirable patient-perceived experience and thus better overall healthcare outcomes. Trial registration Systematic review registration: PROSPERO (CRD42019136500).

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Informal caregivers’ views on the quality of healthcare services provided to older patients aged 80 or more in the hospital and 30 days after discharge

10.21203/rs.2.17065/v3 ◽

2020 ◽

Author(s):

Ingvild Lilleheie ◽

Jonas Debesay ◽

Asta Bye ◽

Astrid Bergland

Keyword(s):

Health Services ◽

Social Services ◽

Healthcare System ◽

Older Patients ◽

Informal Caregivers ◽

Healthcare Providers ◽

The European Union ◽

Professional Care ◽

The Impact

Abstract Background: In the European Union (EU), informal caregivers provide 60% of all care. Informal caregiving ranges from assistance with daily activities and provision of direct care to helping care recipients to navigate within complex healthcare and social services systems. While recent caregiver surveys document the impact of informal caregivers, systematic reviews show that they have unmet needs. Because of the political desire to reduce the length of hospital stays, older patients are discharged from the hospital ‘quicker and sicker’ than before. The transition between different levels of the healthcare system and the period after hospital discharge is critical for elderly patients.Caregivers’ perspectives on the quality of older patients’ care journeys between levels of the healthcare system may provide valuable information for healthcare providers and policymakers. This study aims to explore older patient’s informal caregivers’ views on healthcare quality in the hospital and in the first 30 days after hospitalisation. Method: We conducted semi-structured individual interviews with 12 participants to explore and describe informal caregivers’ subjective experiences of providing care to older relatives. The interviews were then transcribed and analysed thematically.Results: The analysis yielded the overarching theme ‘Informal caregivers – a health service alliance – quality contributor’, which was divided into four main themes: ‘Fast in, fast out’, ‘Scant information’, ‘Disclaimer of responsibility’ and ‘A struggle to secure professional care’. The healthcare system seemed to pay little attention to ensuring mutual understandings between those involved in discharge, treatment and coordination. The participants experienced that the healthcare providers’ main focus was on the patients’ diseases, although the health services are supposed to view patients holistically.Conclusion: Based on the information given by informal caregivers, health services must take into account each person’s needs and preferences. To deliver quality healthcare, better coordination between inter-professional care teams and the persons they serve is necessary. Health professionals must strengthen the involvement of caregivers in transitions between care and healthcare. Future work should evaluate targeted strategies for formal caregivers to cooperate, support and empower family members as informal caregivers.

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Informal caregivers’ views on the quality of health care services provided to older patients aged 80 or more in the hospital and 30 days after discharge

10.21203/rs.2.17065/v4 ◽

2020 ◽

Author(s):

Ingvild Lilleheie ◽

Jonas Debesay ◽

Asta Bye ◽

Astrid Bergland

Keyword(s):

Health Services ◽

Social Services ◽

Healthcare System ◽

Older Patients ◽

Informal Caregivers ◽

Healthcare Providers ◽

The European Union ◽

Professional Care ◽

The Impact

Abstract Background In the European Union (EU), informal caregivers provide 60% of all care. Informal caregiving ranges from assistance with daily activities and provision of direct care to helping care recipients to navigate within complex healthcare and social services systems. While recent caregiver surveys document the impact of informal caregivers, systematic reviews show that they have unmet needs. Because of the political desire to reduce the length of hospital stays, older patients are discharged from the hospital ‘quicker and sicker’ than before. The transition between different levels of the healthcare system and the period after hospital discharge is critical for elderly patients. Caregivers’ perspectives on the quality of older patients’ care journeys between levels of the healthcare system may provide valuable information for healthcare providers and policymakers. This study aims to explore older patient’s informal caregivers’ views on healthcare quality in the hospital and in the first 30 days after hospitalisation. Method We conducted semi-structured individual interviews with 12 participants to explore and describe informal caregivers’ subjective experiences of providing care to older relatives. The interviews were then transcribed and analysed thematically. Results The analysis yielded the overarching theme ‘Informal caregivers – a health service alliance – quality contributor’, which was divided into four main themes: ‘Fast in, fast out’, ‘Scant information’, ‘Disclaimer of responsibility’ and ‘A struggle to secure professional care’. The healthcare system seemed to pay little attention to ensuring mutual understandings between those involved in discharge, treatment and coordination. The participants experienced that the healthcare providers’ main focus was on the patients’ diseases, although the health services are supposed to view patients holistically. Conclusion Based on the information given by informal caregivers, health services must take into account each person’s needs and preferences. To deliver quality healthcare, better coordination between inter-professional care teams and the persons they serve is necessary. Health professionals must strengthen the involvement of caregivers in transitions between care and healthcare. Future work should evaluate targeted strategies for formal caregivers to cooperate, support and empower family members as informal caregivers.

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Informal caregivers’ views on the quality of health care services provided to older patients aged 80 or more in the hospital and 30 days after discharge

10.21203/rs.2.17065/v2 ◽

2020 ◽

Author(s):

Ingvild Lilleheie ◽

Jonas Debesay ◽

Asta Bye ◽

Astrid Bergland

Keyword(s):

Health Services ◽

Social Services ◽

Healthcare System ◽

Older Patients ◽

Informal Caregivers ◽

Healthcare Providers ◽

The European Union ◽

Professional Care ◽

The Impact

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Informal caregivers’ views on the quality of health care services provided to older patients aged 80 or more in the hospital and 30 days after discharge

10.21203/rs.2.17065/v1 ◽

2019 ◽

Author(s):

Ingvild Lilleheie ◽

Jonas Debesay ◽

Asta Bye ◽

Astrid Bergland

Keyword(s):

Health Services ◽

Social Services ◽

Healthcare System ◽

Older Patients ◽

Informal Caregivers ◽

Healthcare Providers ◽

The European Union ◽

Professional Care ◽

The Impact

Abstract Background In the European Union (EU), informal caregivers provide 60% of all care. Informal caregiving ranges from assistance with daily activities and provision of direct care to helping care recipients to navigate within complex healthcare and social services systems. While recent caregiver surveys document the impact of informal caregivers, systematic reviews show that they have unmet needs. Because of the political desire to reduce the length of hospital stays, older patients are discharged from the hospital ‘quicker and sicker’ than before. The transition between different levels of the healthcare system and the period after hospital discharge is critical for elderly patients. Caregivers’ perspectives on the quality of older patients’ care journeys between levels of the healthcare system may provide valuable information for healthcare providers and policymakers. This study aims to explore older patient’s informal caregivers’ views on healthcare quality in the hospital and in the first 30 days after hospitalisation. Method We used a phenomenological perspective to explore and describe informal caregivers’ subjective experiences of providing care to older relatives. We conducted semi-structured individual interviews with 12 participants. The interviews were then transcribed and analysed thematically. Results The analysis yielded the overarching theme ‘Relatives – a health service alliance – quality creator’, which was divided into four main themes: ‘Fast in, fast out’, ‘Scant information’, ‘Disclaimer of responsibility’ and ‘A struggle to secure professional care’. The healthcare system seemed to pay little attention to ensuring mutual understandings between those involved in discharge, treatment and coordination. The participants experienced that the healthcare providers’ main focus was on the patients’ diseases, although the health services are supposed to view patients holistically. Conclusion Based on the information given by informal caregivers, health services must take into account each person’s needs and preferences. To deliver quality healthcare, better coordination between inter-professional care teams and the persons they serve is necessary. Health professionals must strengthen the involvement of caregivers in transitions between care and healthcare. Future work should evaluate targeted strategies for formal caregivers to cooperate, support and empower family members as informal caregivers.

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Patient experience surveys for children’s community health services: A scoping review

Journal of Child Health Care ◽

10.1177/13674935211005874 ◽

2021 ◽

pp. 136749352110058

Author(s):

Helen J Nelson ◽

Catherine Pienaar ◽

Anne M Williams ◽

Ailsa Munns ◽

Katie McKenzie ◽

...

Keyword(s):

Health Care ◽

Health Services ◽

Community Health ◽

Patient Experience ◽

Scoping Review ◽

Emotional Support ◽

Community Health Services ◽

Experience Of Care ◽

Healthcare Experience

Patient experience surveys have a user focus and measure the quality of person-centered health care for hospital inpatients and consumers of community health services, providing a governance process to evaluate the quality of care and to action improvement. Experience of care has been described as effective communication, respect and dignity, and emotional support. Measurement criteria for these domains are not standardized, leading to inconsistent reporting of patient experience. The objective of this scoping review was to synthesize evidence for measuring experience of care in children’s community health services using the Joanna Briggs Institute framework for scoping review method. Three parent-reported surveys met the inclusion criteria, and 50 survey items were assessed by expert reviewers for fit to domains of healthcare experience. Conceptual domains of parent experience in children’s community health services included respect and dignity, effective communication, and emotional support. A gap was identified, in that few items in identified surveys measured emotional support. This contribution will promote consistent reporting of healthcare experience, informing policy and practice for person-centered health care.

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National initiatives to promote quality of care and patient safety: achievements to date and challenges ahead

Israel Journal of Health Policy Research ◽

10.1186/s13584-020-00417-x ◽

2020 ◽

Vol 9 (1) ◽

Author(s):

Dalia Dreiher ◽

Olga Blagorazumnaya ◽

Ran Balicer ◽

Jacob Dreiher

Keyword(s):

Patient Safety ◽

Quality Improvement ◽

Patient Satisfaction ◽

Quality Of Care ◽

Healthcare System ◽

Quality Indicators ◽

Patient Experience ◽

Health Care Providers ◽

Care Providers

Abstract Background The quality of healthcare in Israel is considered “high”, and this achievement is due to the structure and organization of the healthcare system. The goal of the present review is to describe the major achievements and challenges of quality improvement in the Israeli healthcare system. Body In recent years, the Ministry of Health has made major strides in increasing the public’s access to comparative data on quality, finances and patient satisfaction. Several mechanisms at multiple levels help promote quality improvement and patient safety. These include legislation, financial incentives, and national programs for quality indicators, patient experience, patient safety, prevention and control of infection and accreditation. Over the years, improvements in quality indicators, infection prevention and patient satisfaction can be demonstrated, but other fields show little change, if at all. Challenges and barriers include reluctance by unions, inconsistent and unreliable flow of information, the fear of overpressure by management and the loss of autonomy by physicians, and doubts regarding “gaming” of data. Accreditation has its own challenges, such as the need to adjust it to local characteristics of the healthcare system, its high cost, and the limited evidence of its impact on quality. Lack of interest by leaders, lack of resources, burnout and compassion fatigue, are listed as challenges for improving patient experience. Conclusion Substantial efforts are being made in Israel to improve quality of care, based on the use of good data to understand what is working and what needs particular attention. Government and health care providers have the tools to continue to improve. However, several mechanisms for improving the quality of care, such as minimizing healthcare disparities, training for quality, and widespread implementation of the “choosing wisely” initiative, should be implemented more intensively and effectively.

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Patient centred care for multimorbidity improves patient experience, but quality of life is unchanged

BMJ ◽

10.1136/bmj.k4439 ◽

2019 ◽

pp. k4439 ◽

Cited By ~ 2

Author(s):

Rob Cook ◽

Tara Lamont ◽

Rachel Taft

Keyword(s):

Quality Of Life ◽

General Practice ◽

Health Services ◽

Patient Experience ◽

Health Research ◽

Patient Centred Care ◽

Link Type

The studyA patient-centred intervention to improve the management of multimorbidity in general practice: the 3D RCT. Salisbury C, Man M-S, Chaplin K, et al.Published in Health Serv Deliv Res 2019;7(5). This study was funded by the National Institute for Health Research Health Services and Delivery Programme (project number 12/130/15).To read the full NIHR Signal, go to: https://discover.dc.nihr.ac.uk/content/signal-000658/patient-centred-care-for-multimorbidity-improves-patient-experience-but-quality-of-life-is-unchanged

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How does performance-based financing affect the availability of essential medicines in Cameroon? A qualitative study

Health Policy and Planning ◽

10.1093/heapol/czz084 ◽

2019 ◽

Vol 34 (Supplement_3) ◽

pp. iii4-iii19 ◽

Cited By ~ 2

Author(s):

Isidore Sieleunou ◽

Anne-Marie Turcotte-Tremblay ◽

Manuela De Allegri ◽

Jean-Claude Taptué Fotso ◽

Habakkuk Azinyui Yumo ◽

...

Keyword(s):

Qualitative Study ◽

Health Services ◽

Healthcare Providers ◽

Study Data ◽

Essential Medicines ◽

Middle Income ◽

Middle Income Countries ◽

Performance Based Financing ◽

Low And Middle Income

Abstract Performance-based financing (PBF) is being implemented across low- and middle-income countries to improve the availability and quality of health services, including medicines. Although a few studies have examined the effects of PBF on the availability of essential medicines (EMs) in low- and middle-income countries, there is limited knowledge of the mechanisms underlying these effects. Our research aimed to explore how PBF in Cameroon influenced the availability of EMs, and to understand the pathways leading to the experiential dimension related with the observed changes. The design was an exploratory qualitative study. Data were collected through in-depth interviews, using semi-structured questionnaires. Key informants were selected using purposive sampling. The respondents (n = 55) included health services managers, healthcare providers, health authorities, regional drugs store managers and community members. All interviews were recorded, transcribed and analysed using qualitative data analysis software. Thematic analysis was performed. Our findings suggest that the PBF programme improved the perceived availability of EMs in three regions in Cameroon. The change in availability of EMs experienced by stakeholders resulted from several pathways, including the greater autonomy of facilities, the enforced regulation from the district medical team, the greater accountability of the pharmacy attendant and supply system liberalization. However, a sequence of challenges, including delays in PBF payments, limited autonomy, lack of leadership and contextual factors such as remoteness or difficulty in access, was perceived to hinder the capacity to yield optimal changes, resulting in heterogeneity in performance between health facilities. The participants raised concerns regarding the quality control of drugs, the inequalities between facilities and the fragmentation of the drug management system. The study highlights that some specific dimensions of PBF, such as pharmacy autonomy and the liberalization of drugs supply systems, need to be supported by equity interventions, reinforced regulation and measures to ensure the quality of drugs at all levels.

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Monitoring Quality in a Federal State with Shared Powers in Healthcare: The Case of Belgium

European Journal of Health Law ◽

10.1163/157180911x585298 ◽

2011 ◽

Vol 18 (4) ◽

pp. 413-422 ◽

Cited By ~ 1

Author(s):

Diego Fornaciari ◽

Arthur Vleugels ◽

Stefaan Callens ◽

Kristof Eeckloo

Keyword(s):

Healthcare System ◽

Healthcare Providers ◽

Quality Of Healthcare ◽

Healthcare Services ◽

Federal State ◽

Flemish Community ◽

The Government ◽

Regulatory Powers ◽

Monitoring Quality

AbstractThe Belgian healthcare system consists of a complex of more or less autonomous groups of healthcare providers. It is the responsibility of the government to ensure that the fundamental right to qualitative healthcare is secured through the services they provide. In Belgium, the regulatory powers in healthcare are divided between the federal state and the three communities. Both levels, within their area of competence, monitor the quality of healthcare services. Unique to the Belgian healthcare system is that the government that providers are accountable to is not always the same as the government that is competent to set the criteria. The goal of this article is to provide an overview of the main mechanisms that are used by the federal government and the government of the Flemish community to monitor healthcare quality in hospitals. The Flemish community is Belgian’s largest community (6.2 million inhabitants). The overview is followed by a critical analysis of the dual system of quality monitoring.

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Self-care and remote care during pregnancy: a new paradigm?

Health Research Policy and Systems ◽

10.1186/s12961-020-00627-4 ◽

2020 ◽

Vol 18 (1) ◽

Cited By ~ 1

Author(s):

A. Metin Gülmezoglu ◽

Anne Ammerdorffer ◽

Manjulaa Narasimhan ◽

Alyce N. Wilson ◽

Joshua P. Vogel ◽

...

Keyword(s):

Quality Of Care ◽

Reproductive Health ◽

Health Services ◽

Sexual And Reproductive Health ◽

Healthcare Providers ◽

Self Care ◽

Reproductive Health Services ◽

New Paradigm ◽

Remote Care

Abstract Self-care interventions and remote care offer innovative and equitable ways to strengthen access to sexual and reproductive health services. Self-isolation during COVID-19 provided the opportunity for obstetric facilities and healthcare providers to integrate and increase the usage of interventions for self-care and remote care for pregnant women and to improve the quality of care overall.

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