What Matters Most: A Conversation With Brian Wong, MD, MPH

2015 ◽  
Vol 21 (2) ◽  
pp. 92-99
Author(s):  
Brian Wong ◽  
Mary Koloroutis

In this article, Dr. Brian Wong describes a patient-accountable culture as built around the question, What matters most to patients? He asserts that it is up to each health care professional to take responsibility for his or her positive impact on the culture with every single interaction. Each interaction needs to support what matters most to patients and to the well-being of the team. As all health care professionals get better at showing up in a patient-accountable way, everything else gets better: patient safety, patient satisfaction, employee engagement, and even the bottom line. Not because of a series of initiatives but because we ask one question . . . “What matters most to you?”

2020 ◽  
Vol 37 (4) ◽  
pp. 465-472
Author(s):  
Hao Zhang ◽  
Wenhua Wang ◽  
Jeannie Haggerty ◽  
Tibor Schuster

Abstract Background Patient satisfaction is an essential indicator in medical practise and research. To monitor the health and well-being of adult populations and the ageing process, the World Health Organization (WHO) has initiated the Study on Global AGEing and Adult Health (SAGE), compiling longitudinal information in six countries including China as one major data source. Objective The objective of this study was to identify potential predictors for patient satisfaction based on the 2007–10 WHO SAGE China survey. Methods Data were analysed using random forests (RFs) and ordinal logistic regression models based on 5774 responses to predict overall patient satisfaction on their most recent outpatient health services visit over the last 12 months. Potential predictor variables included access to care, costs of care, quality of care, socio-demographic and health care characteristics and health service features. Increase of the mean-squared error (incMSE) due to variable removal was used to assess relative importance of the model variables for accurately predicting patient satisfaction. Results The survey data suggest low frequency of dissatisfaction with outpatient services in China (1.8%). Self-reported treatment outcome of the respective visit of a care facility demonstrated to be the strongest predictor for patient satisfaction (incMSE +15%), followed by patient-rated communication (incMSE +2.0%), and then income, waiting time, residency and patient age. Individual patient satisfaction in the survey population was predicted with 74% accuracy using either logistic regression or RF. Conclusions Patients’ perceived outcomes of health care visits and patient communication with health care professionals are the most important variables associated with patient satisfaction in outpatient health services settings in China.


2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Leticia Suárez-Álvarez ◽  
Ana Suárez-Vázquez ◽  
Ana-Belén del Río-Lanza

Purpose The increase of life expectancy leads to the elderly living with one or more chronic illnesses. Communication between the elderly and the health-care professional is fundamental but can be difficult. For that reason, it is common to find the patient with an accompanying family member in the doctor’s surgery. The purpose of this paper is to analyze one of the possible actions of the companion during the provision of the medical service: the co-creation of value (through its two dimensions: coproduction and value-in-use) and its effects on the satisfaction of both the companion and the elderly patient. Design/methodology/approach A model has been tested through a system of structural equations using the statistical package EQS 6.2. The sample used is made up of 1,814 informants (907 companions and 907 patients). Findings The importance of coproduction between the accompanying person and the health-care professional is shown, to obtain greater levels of satisfaction (of the companion and the patient), whereas a negative role is conferred to the dimension value-in-use. This paper shows a positive impact of the satisfaction of the companion on that of the patient. Practical implications It is necessary to have health-care professionals who play a proactive role when facilitating the participation in the appointment with the doctor so as not to leave the initiative of participation in the hands of the companions. Originality/value Chronic illnesses are an important focal point of medical attention. Good management of the relations between those involved is fundamental for the diagnosis and adherence to treatment.


Author(s):  
Lynda Katz Wilner ◽  
Marjorie Feinstein-Whittaker

Hospital reimbursements are linked to patient satisfaction surveys, which are directly related to interpersonal communication between provider and patient. In today’s health care environment, interactions are challenged by diversity — Limited English proficient (LEP) patients, medical interpreters, International Medical Graduate (IMG) physicians, nurses, and support staff. Accent modification training for health care professionals can improve patient satisfaction and reduce adverse events. Surveys were conducted with medical interpreters and trainers of medical interpreting programs to determine the existence and support for communication skills training, particularly accent modification, for interpreters and non-native English speaking medical professionals. Results of preliminary surveys suggest the need for these comprehensive services. 60.8% believed a heavy accent, poor diction, or a different dialect contributed to medical errors or miscommunication by a moderate to significant degree. Communication programs should also include cultural competency training to optimize patient care outcomes. Examples of strategies for training are included.


2019 ◽  
Author(s):  
Tran Quang Khanh ◽  
Pham Nhu Hao ◽  
Eytan Roitman ◽  
Baruch Marganitt ◽  
Avivit Cahn

BACKGROUND Digital technologies are gaining an important role in the management of patients with diabetes. The GlucoMe solution integrates multiple aspects of diabetes care: 1) Wireless blood glucose monitor - communicates glucose data automatically to any smartphone; 2) Mobile-app - securely transmits real-time blood glucose monitor data for cloud based analyses, and enables 2-way communication between patients and health care professionals; 3) Digital diabetes clinic – analyzes and presents data to the health care professional; and 4) Control tower software provides population management reports and sends individualized alerts. OBJECTIVE Assess clinical outcomes and user satisfaction of incorporating the GlucoMe digital solution in diabetes clinics of a developing country. METHODS Five hospital endocrinology clinics in Vietnam participated in a market acceptance evaluation pilot of the GlucoMe system. The clinics sequentially recruited all patients willing to join, so long as they had a smartphone and access to internet connectivity. Patients were provided with the GlucoMe app and blood glucose monitor and instructed in their use in individual or groups sessions. The digital diabetes clinic and control tower software were installed in the clinic computers. Face-to-face visits were conducted at baseline and at 12 weeks, with monthly digital visits scheduled in the interim and additional digital visits performed as needed. HbA1c levels were measured at baseline and at 12 weeks (±20 days). Treatment modification was at the discretion of the treating physician. Outcome measures included adherence to glucose monitoring, change in glycemic parameters and patient and physician satisfaction as assessed by questionnaires. Only patients completing the pilot were included in data analyses. RESULTS The study recruited 300 patients of whom 279 patients completed the evaluation. Dropout was due to change in internet access availability (18) or death (3). Adherence to glucose measurements gradually declined, yet, at study end 81% of the patients were measuring glucose at least once a week. Digital contact from the health care professional to the patient or vice-versa (excluding automated alerts) occurred in average every 6.2 days. Average glucose levels declined from 170.4±64.6 mg/dl in the first two weeks to 150.8±53.2 mg/dl in the last two weeks (P<0.001) (n=221). HbA1c levels at baseline and 12 weeks were available for only 126 of the patients and declined from 8.3±1.9% to 7.6±1.3 (P<0.001). Over 95% of the physicians and patients stated they would strongly support the broad usage of the GlucoMe platform in diabetes clinics across the country. CONCLUSIONS The GlucoMe digital solution was broadly accepted by both patients and health care professionals and improved glycemic outcomes. The digital platform yielded increased number of patient-health care professional interactions, yet of short duration, enabling judicious allocation of limited time resources. The durability, scalability and cost-effectiveness of this approach merit further study.


Author(s):  
Kelly R. Arora

Interspiritual conversations are becoming more common in health care settings as providers recognize that patients’ diverse spiritual/religious values, beliefs, and practices may influence their health care decision-making and general well-being. This essay explores the practical dimensions of teaching health care professionals how to use an interspiritual dialogue approach grounded in values and particularism through a course entitled “Faith, Spirituality and Culture in Health Care,” which was designed for and taught to doctoral students at a Denver, Colorado, School of Pharmacy. After considering the contemporary context for teaching interspiritual dialogue to healthcare professionals, the essay reflects upon and relates the pedagogical choices made in designing and teaching the course, as well as the course structure, outline, objectives, and schedule.


2021 ◽  
Vol 33 (2) ◽  
Author(s):  
Franziska Maria Keller ◽  
Christina Derksen ◽  
Lukas Kötting ◽  
Martina Schmiedhofer ◽  
Sonia Lippke

Abstract Background Patient-centered care and patient involvement have been increasingly recognized as crucial elements of patient safety. However, patient safety has rarely been evaluated from the patient perspective with a quantitative approach aiming at making patient safety and preventable adverse events measurable. Objectives The objectives of this study were to develop and evaluate the psychometric properties of a questionnaire assessing patient safety by perceived triggers of preventable adverse events among patients in primary health-care settings while considering mental health. Methods Two hundred and ten participants were recruited through various digital and print channels and asked to complete an online survey between November 2019 and April 2020. Exploratory factor analysis was performed to identify domains of triggers of preventable adverse events affecting patient safety. Furthermore, a multi-trait scaling analysis was performed to evaluate internal reliability as well as item-scale convergent–discriminant validity. A multivariate analysis of covariance evaluated whether individuals below and above the symptom threshold for depression and generalized anxiety perceive triggers of preventable adverse events differently. Results The five factors determined were information and communication with patients, time constraints of health-care professionals, diagnosis and treatment, hygiene and communication among health-care professionals, and knowledge and operational procedures. The questionnaire demonstrated a good total and subscale internal consistency (α = 0.90, range = 0.75–0.88), good item-scale convergent validity with significant correlations between 0.57 and 0.78 (P &lt; 0.05; P &lt; 0.01) for all items with their associated subscales, and satisfactory item-scale discriminant validity between 0.14 and 0.55 (P &gt; 0.05) with no significant correlations between the items and their competing subscales. The questionnaire further revealed to be a generic measure irrespective of patients’ mental health status. Patients older than 50 years of age perceived a significantly greater threat to their own safety compared to patients below that age. Conclusion The developed Perceptions of Preventable Adverse Events Assessment Tool (PPAEAT) exhibits good psychometric properties, which supports its use in future research and primary health-care practice. Further validation of the PPAEAT in different settings, languages and larger samples is needed. The results of this study need to be considered when assessing patient safety in the context of health-care research.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ayman Abu-Rumman ◽  
Ata Al Shraah ◽  
Faisal Al-Madi ◽  
Tasneem Alfalah

Purpose This study aims to explore if the application of the customer results criteria contained within the King Abdullah II Award for Excellence (KAIIAE) is correlated with high levels of patient satisfaction within a large hospital based in Jordan. Design/methodology/approach Using a mixed methodology, supported by a pragmatist theoretical approach, a satisfaction survey was conducted with patients accessing the hospital as an in-patient across a range of specialities gathering feedback about different aspects of their care. The results were compared with a self-assessment completed by different speciality teams about the existence and maturity of customer result arrangements implemented as a result of the (KAIIAE). Findings The findings confirmed that quality awards such as the KAIIAE can effectively be applied in a health-care setting and can help provide a framework for improving patient experience and satisfaction. A correlation was found with those specialties that self-assessed themselves more highly in terms of these arrangements and the overall levels of patient satisfaction with that specialty, suggesting that the products of working towards the KAIIAE such as establishing effective patient experience monitoring arrangements and improved learning from complaints, has a positive impact on patient satisfaction. Originality/value There are limited studies which focus specifically on customer results and on the use of the KAIIAE more generally. This study therefore makes a valuable contribution in adding to the debate about the strategic value of working towards formal quality improvement models and awards in health-care settings.


PEDIATRICS ◽  
1994 ◽  
Vol 94 (4) ◽  
pp. 433-439 ◽  
Author(s):  
Alan R. Fleischman ◽  
Kathleen Nolan ◽  
Nancy N. Dubler ◽  
Michael F. Epstein ◽  
Mary Ann Gerben ◽  
...  

Background. Much has been written about the care of the hopelessly ill adult, but there is little guidance for pediatric health care professionals in the management of children who are critically or terminally ill. Methods. Through a 3-day meeting in Tarrytown, NY, attended by a group of pediatricians and others directly involved in these issues, a principled approach was developed for the treatment of, and health care decision-making for, children who are gravely ill. Results. The group agreed that the needs and interests of the child must be the central focus of any treatment plan and that the child should be involved to as great extent possible, consistent with developmental maturity, in the decision-making process. Quality of future life should be viewed as being relevant in all decisions. Parents are believed to be the natural guardians of children and ought to have great latitude in making decisions for them. However, parental discretion is not absolute and professionals must maintain an independent obligation to protect the child's interests. Conclusions. Decision-making should be collaborative among patient, parents, and professionals. When conflict arises, consultation and ethics committees may assist in resolution. When cure or restoration of function is no longer possible, or reasonable, promotion of comfort becomes the primary goal of management. Optimal use of pain medication and compassionate concern for the physical, psychological, and spiritual well-being of the child and family should be the primary focus of the professionals caring for the dying child.


2008 ◽  
Vol 17 (01) ◽  
pp. 114-127 ◽  
Author(s):  
Rodolphe Meyer ◽  
Patrice Degoulet

Summary Objectives To examine the different methods that can be used in the quantification of the added value of information technologies (IT) in the health care sector. This quantification represents a major issue for decision-makers and health care professionals when they have to plan an IT investment. MethodsArticles were chosen via Medline, internet and the University of Geneva bibliographic portal. Some of the papers were obtained directly from their authors. We examine the most current methods used to evaluate IT return on investment (ROI) in the general business and in the health care sector, drawing attention on methods traditionally used in macro economic studies that could reveal themselves disruptive for IT ROI impact evaluation in hospitals. Results Financial and accounting methods can provide interesting data on a specific IT project but are usually incomplete for revealing the global IT investment influence. Econometric methods tend to demonstrate the positive impact of health care IT (HIT) on hospital production and productivity. Hospitals having higher levels of IT investment tend to deliver a higher level of clinical quality and show improved hospital cost performances. Conclusions Information technologies are so intermingled with people and processes that the identification of specific IT benefit remains questionable. Using macro economic tools could be the best way to analyze and compute IT ROI in health care. Econometric tools take into account all types investments (inputs) and all the returns (outputs) enabling the precise measurement of IT investments impact, breakeven points, and possible threshold levels, thus providing helpful intelligence to reach the higher levels of IT governance in hospitals.


2020 ◽  
Vol 23 (2) ◽  
pp. 160-171
Author(s):  
Rachel Fisher ◽  
Jasneet Parmar ◽  
Wendy Duggleby ◽  
Peter George J. Tian ◽  
Wonita Janzen ◽  
...  

Introduction Family caregivers (FCGs) play an integral, yet often invisible, role in the Canadian health-care system. As the population ages, their presence will become even more essential as they help balance demands on the system and enable community dwelling seniors to remain so for as long as possible. To preserve their own well-being and capacity to provide ongoing care, FCGs require support to the meet the challenges of their daily caregiving responsibilities. Supporting FCGs results in better care provision to community-dwelling seniors receiving health-care services, as well as enhancing the quality of life for FCGs. Although FCGs rely upon health-care professionals (HCPs) to provide them with support and services, there is a paucity of research pertaining to the type of health workforce training (HWFT) that HCPs should receive to address FCG needs. Programs that train HCPs to engage with, empower, and support FCGs are required. Objective To describe and discuss key findings of a caregiver symposium focused on determining components of HWFT that might better enable HCPs to support FCGs. Methods A one-day symposium was held on February 22, 2018 in Edmonton, Alberta, to gather the perspectives of FCGs, HCPs, and stakeholders. Attendees participated in a series of working groups to discuss barriers, facilitators, and recommendations related to HWFT. Proceedings and working group discussions were transcribed, and a qualitative thematic analysis was conducted to identify key themes. Results Participants identified the following topic areas as being essential to training HCPs in the provision of support for FCGs: understanding the FCG role, communicating with FCGs, partnering with FCGs, fostering FCG resilience, navigating healthcare systems and accessing resources, and enhancing the culture and context of care. Conclusions FCGs require more support than is currently being provided by HCPs. Training programs need to specifically address topics identified by participants. These findings will be used to develop HWFT for HCPs.


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