scholarly journals Using patient experience data to develop a patient experience toolkit to improve hospital care: a mixed-methods study

2019 ◽  
Vol 7 (36) ◽  
pp. 1-104
Author(s):  
Laura Sheard ◽  
Claire Marsh ◽  
Thomas Mills ◽  
Rosemary Peacock ◽  
Joseph Langley ◽  
...  
Keyword(s):  
Health Care ◽  
Mixed Methods ◽  
Patient Experience ◽  
Health Care Services ◽  
Care Delivery ◽  
Research Programme ◽  
Hospital Staff ◽  
Care Staff ◽  
Health Care Staff ◽  
Patient Representatives

Background Patients are increasingly being asked to provide feedback about their experience of health-care services. Within the NHS, a significant level of resource is now allocated to the collection of this feedback. However, it is not well understood whether or not, or how, health-care staff are able to use these data to make improvements to future care delivery. Objective To understand and enhance how hospital staff learn from and act on patient experience (PE) feedback in order to co-design, test, refine and evaluate a Patient Experience Toolkit (PET). Design A predominantly qualitative study with four interlinking work packages. Setting Three NHS trusts in the north of England, focusing on six ward-based clinical teams (two at each trust). Methods A scoping review and qualitative exploratory study were conducted between November 2015 and August 2016. The findings of this work fed into a participatory co-design process with ward staff and patient representatives, which led to the production of the PET. This was primarily based on activities undertaken in three workshops (over the winter of 2016/17). Then, the facilitated use of the PET took place across the six wards over a 12-month period (February 2017 to February 2018). This involved testing and refinement through an action research (AR) methodology. A large, mixed-methods, independent process evaluation was conducted over the same 12-month period. Findings The testing and refinement of the PET during the AR phase, with the mixed-methods evaluation running alongside it, produced noteworthy findings. The idea that current PE data can be effectively triangulated for the purpose of improvement is largely a fallacy. Rather, additional but more relational feedback had to be collected by patient representatives, an unanticipated element of the study, to provide health-care staff with data that they could work with more easily. Multidisciplinary involvement in PE initiatives is difficult to establish unless teams already work in this way. Regardless, there is merit in involving different levels of the nursing hierarchy. Consideration of patient feedback by health-care staff can be an emotive process that may be difficult initially and that needs dedicated time and sensitive management. The six ward teams engaged variably with the AR process over a 12-month period. Some teams implemented far-reaching plans, whereas other teams focused on time-minimising ‘quick wins’. The evaluation found that facilitation of the toolkit was central to its implementation. The most important factors here were the development of relationships between people and the facilitator’s ability to navigate organisational complexity. Limitations The settings in which the PET was tested were extremely diverse, so the influence of variable context limits hard conclusions about its success. Conclusions The current manner in which PE feedback is collected and used is generally not fit for the purpose of enabling health-care staff to make meaningful local improvements. The PET was co-designed with health-care staff and patient representatives but it requires skilled facilitation to achieve successful outcomes. Funding The National Institute for Health Research Health Services and Delivery Research programme.

scholarly journals Can the Health-Care System Meet the Challenge of Pandemic Flu? Planning, Ethical, and Workforce Considerations

2007 ◽  
Vol 122 (5) ◽  
pp. 573-578 ◽  
Author(s):  
Peter J. Levin ◽  
Eric N. Gebbie ◽  
Kristine Qureshi
Keyword(s):  
Public Health ◽  
Health Care ◽  
Ethical Issues ◽  
Care Delivery ◽  
Care Staff ◽  
Health Care Staff ◽  
Accurate Information ◽  
The Public ◽  
Health Care Delivery Systems ◽  
The Impact

The federal pandemic influenza plan predicts that 30% of the population could be infected. The impact of this pandemic would quickly overwhelm the public health and health-care delivery systems in the U.S. and throughout the world. Surge capacity for staffing, availability of drugs and supplies, and alternate means to provide care must be included in detailed plans that are tested and drilled ahead of time. Accurate information on the disease must be made available to health-care staff and the public to reduce fear. Spokespersons must provide clear, consistent messages about the disease, including actions to be taken to contain its spread and treat the afflicted. Home care will be especially important, as hospitals will be quickly overwhelmed. Staff must be prepared ahead of time to assure their ability and willingness to report to work, and public health must plan ahead to adequately confront ethical issues that will arise concerning the availability of treatment resources. The entire community must work together to meet the challenges posed by an epidemic. Identification and resolution of these challenges and issues are essential to achieve adequate public health preparedness.

scholarly journals The role of health services in encouraging disclosure of violence against women

2017 ◽  
Vol 56 (4) ◽  
pp. 220-226
Author(s):  
Vesna Leskošek ◽  
Miha Lučovnik ◽  
Lucija Pavše ◽  
Tanja Premru Sršen ◽  
Megie Krajnc ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Services ◽  
Health Workers ◽  
Care Service ◽  
Health Care Service ◽  
Care Staff ◽  
Health Care Staff ◽  
Care Services

Abstract Introduction The aim of the survey was to assess the differences in disclosure by the type of violence to better plan the role of health services in identifying and disclosing violence. Methods A validated, anonymous screening questionnaire (NorAQ) for the identification of female victims of violence was offered to all postpartum women at a single maternity unit over a three-month period in 2014. Response rate was 80% (1018 respondents). Chi square test was used for statistical analysis (p<0.05 significant). Results There are differences in disclosure by type of violence. Nearly half (41.5%) of violence by health care services was not reported, compared to 33.7% physical, 23.4% psychological, and 32.5% sexual that was reported. The percentage of violence in intimate partnership reported to health care staff is low (9.3% to 20.8%), but almost half of the violence experienced by heath care services (44%) is reported. Intimate partnership violence is more often reported to the physician than to the psychologist or social worker. Violence in health care service is reported also to nurses. Conclusions Disclosure enables various institutions to start with the procedures aimed at protecting victims against violence. Health workers should continuously encourage women to speak about violence rather than asking about it only once. It is also important that such inquiries are made on different levels of health care system and by different health care professions, since there are differences to whom women are willing to disclose violence.

scholarly journals Challenges and opportunities of the COVID-19 pandemic for perinatal mental health care: a mixed-methods study of mental health care staff

2021 ◽  
Author(s):  
C. A. Wilson ◽  
C. Dalton-Locke ◽  
S. Johnson ◽  
A. Simpson ◽  
S. Oram ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mixed Methods ◽  
Service Delivery ◽  
Mental Health Care ◽  
Care Staff ◽  
Health Care Staff ◽  
Health And Social Care ◽  
The Impact ◽  
Perinatal Women

AbstractThe aim of this study was to explore staff perceptions of the impact of the COVID-19 pandemic on mental health service delivery and outcomes for women who were pregnant or in the first year after birth (‘perinatal’ women). Secondary analysis was undertaken of an online mixed-methods survey open to all mental health care staff in the UK involving 363 staff working with women in the perinatal period. Staff perceived the mental health of perinatal women to be particularly vulnerable to the impact of stressors associated with the pandemic such as social isolation (rated by 79.3% as relevant or extremely relevant; 288/363) and domestic violence and abuse (53.3%; 192/360). As a result of changes to mental health and other health and social care services, staff reported feeling less able to assess women, particularly their relationship with their baby (43.3%; 90/208), and to mobilise safeguarding procedures (29.4%; 62/211). While 42% of staff reported that some women engaged poorly with virtual appointments, they also found flexible remote consulting to be beneficial for some women and helped time management due to reductions in travel time. Delivery of perinatal care needs to be tailored to women’s needs; virtual appointments are perceived not to be appropriate for assessments but may be helpful for some women in subsequent interactions. Safeguarding and other risk assessment procedures must remain robust in spite of modifications made to service delivery during pandemics.

scholarly journals Improving patient safety through the involvement of patients: development and evaluation of novel interventions to engage patients in preventing patient safety incidents and protecting them against unintended harm

2016 ◽  
Vol 4 (15) ◽  
pp. 1-296 ◽  
Author(s):  
John Wright ◽  
Rebecca Lawton ◽  
Jane O’Hara ◽  
Gerry Armitage ◽  
Laura Sheard ◽  
...  
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Systems Of Care ◽  
Research Programme ◽  
Safety Training ◽  
Care Staff ◽  
Health Care Staff ◽  
Junior Doctors ◽  
Patient Safety Incidents ◽  
Unintended Harm

BackgroundEstimates suggest that, in NHS hospitals, incidents causing harm to patients occur in 10% of admissions, with costs to the NHS of > £2B. About one-third of harmful events are believed to be preventable. Strategies to reduce patient safety incidents (PSIs) have mostly focused on changing systems of care and professional behaviour, with the role that patients can play in enhancing the safety of care being relatively unexplored. However, although the role and effectiveness of patient involvement in safety initiatives is unclear, previous work has identified a general willingness among patients to contribute to initiatives to improve health-care safety.AimOur aim in this programme was to design, develop and evaluate four innovative approaches to engage patients in preventing PSIs: assessing risk, reporting incidents, direct engagement in preventing harm and education and training.Methods and resultsWe developed tools to report PSIs [patient incident reporting tool (PIRT)] and provide feedback on factors that might contribute to PSIs in the future [Patient Measure of Safety (PMOS)]. These were combined into a single instrument and evaluated in the Patient Reporting and Action for a Safe Environment (PRASE) intervention using a randomised design. Although take-up of the intervention by, and retention of, participating hospital wards was 100% and patient participation was high at 86%, compliance with the intervention, particularly the implementation of action plans, was poor. We found no significant effect of the intervention on outcomes at 6 or 12 months. The ThinkSAFE project involved the development and evaluation of an intervention to support patients to directly engage with health-care staff to enhance their safety through strategies such as checking their care and speaking up to staff if they had any concerns. The piloting of ThinkSAFE showed that the approach is feasible and acceptable to users and may have the potential to improve patient safety. We also developed a patient safety training programme for junior doctors based on patients who had experienced PSIs recounting their own stories. This approach was compared with traditional methods of patient safety teaching in a randomised controlled trial. The study showed that delivering patient safety training based on patient narratives is feasible and had an effect on emotional engagement and learning about communication. However, there was no effect on changing general attitudes to safety compared with the control.ConclusionThis research programme has developed a number of novel interventions to engage patients in preventing PSIs and protecting them against unintended harm. In our evaluations of these interventions we have been unable to demonstrate any improvement in patient safety although this conclusion comes with a number of caveats, mainly about the difficulty of measuring patient safety outcomes. Reflecting this difficulty, one of our recommendations for future research is to develop reliable and valid measures to help efficiently evaluate safety improvement interventions. The programme found patients to be willing to codesign, coproduce and participate in initiatives to prevent PSIs and the approaches used were feasible and acceptable. These factors together with recent calls to strengthen the patient voice in health care could suggest that the tools and interventions from this programme would benefit from further development and evaluation.Trial registrationCurrent Controlled Trials ISRCTN07689702.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

scholarly journals Challenges and opportunities of the COVID-19 pandemic for perinatal mental health care: a mixed methods study of mental health care staff

2020 ◽  
Author(s):  
Claire A Wilson ◽  
Christian A Dalton-Locke ◽  
Sonia Johnson ◽  
Alan Simpson ◽  
Sian Oram ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mixed Methods ◽  
Service Delivery ◽  
Mental Health Care ◽  
Care Staff ◽  
Health Care Staff ◽  
Health And Social Care ◽  
The Impact ◽  
Perinatal Women

Purpose: the aim of this study was to explore staff perceptions of the impact of the COVID-19 pandemic on mental health service delivery and outcomes for women who were pregnant or in the first year after birth (perinatal women). Methods: secondary analysis of an online mixed-methods survey open to all mental health care staff in the UK involving 363 staff working with women in the perinatal period. Results: staff perceived the mental health of perinatal women to be particularly vulnerable to the impact of stressors associated with the pandemic such as social isolation (rated by 79.3% as relevant or extremely relevant; 288/363) and domestic violence and abuse (53.3%; 192/360). As a result of changes to mental health and other health and social care services, staff reported feeling less able to assess women, particularly their relationship with their baby (43.3%; 90/208), and to mobilise safeguarding procedures (29.4%; 62/211). While 42% of staff reported that some women engaged poorly with virtual appointments, they also found flexible remote consulting to be beneficial for some women and helped time management due to reductions in travel time. Conclusions: delivery of perinatal care needs to be tailored to the needs of women; virtual appointments are perceived not to be appropriate for assessments but may be helpful for some women in subsequent interactions. Safeguarding and other risk assessment procedures must remain robust in spite of modifications made to service delivery during pandemics.

Providing Health Care in the Shadow of Violence: Does Emotion Regulation Vary Among Hospital Workers From Different Professions?

2017 ◽  
Vol 35 (9-10) ◽  
pp. 1908-1933 ◽  
Author(s):  
Hadass Goldblatt ◽  
Anat Freund ◽  
Anat Drach-Zahavy ◽  
Guy Enosh ◽  
Ilana Peterfreund ◽  
...  
Keyword(s):  
Health Care ◽  
Emotion Regulation ◽  
Organizational Support ◽  
Health Care Services ◽  
Research Question ◽  
Physical Symptoms ◽  
Emotional Reactions ◽  
Care Staff ◽  
Health Care Staff ◽  
Hospital Workers

Research into violence against health care staff by patients and their families within the health care services shows a rising frequency of incidents. The potentially damaging effects on health care staff are extensive, including diverse negative psychological and physical symptoms. The aim of this qualitative study was to examine how hospital workers from different professions reacted to patients’ and visitors’ violence against them or their colleagues, and how they regulated their emotional reactions during those incidents. The research question was as follows: How do different types of hospital workers regulate the range of their emotional reactions during and after violent events? Participants were 34 hospital workers, representing several professional sectors. Data were collected through in-depth semistructured interviews, which were later transcribed and thematically content analyzed. Five themes were revealed, demonstrating several tactics that hospital workers used to regulate their emotions during incidents of violent outbursts by patients or visitors: (1) Inability to Manage Emotion Regulation, (2) Emotion Regulation by Distancing and Disengagement Tactics, (3) Emotion Regulation Using Rationalization and Splitting Tactics, (4) Emotion Regulation via the Use of Organizational Resources, and (5) Controlling Emotions by Suppression. Hospital workers who experienced dissonance between their professional expectations and their emotional reactions to patients’ violence reported using various emotion regulation tactics, consequently managing to fulfill their duty competently. Workers who did not experience such dissonance felt in full control of their emotions and did not manifest responses of emotion regulation. Others, however, experienced intense emotional flooding and failed to regulate their emotions. We recommend developing health care staff’s awareness of possible emotional implications of violent incidents, for themselves as people and for their intact functioning at work. In addition, we recommend further development of health care staff training programs for coping with violent patients and enhancement of formal and informal organizational support.

Predictors of Caring in the Context of Relationship-Based Care

2018 ◽  
Vol 24 (2) ◽  
pp. 74-87 ◽  
Author(s):  
John W. Nelson ◽  
Mary Ann Hozak
Keyword(s):  
Health Care ◽  
Care Delivery ◽  
Secondary Analysis ◽  
Direct Care ◽  
Care Staff ◽  
Health Care Staff ◽  
Staff Members ◽  
Primary Nursing ◽  
Care Delivery Model ◽  
Relationship Based Care

The caring connection between patients and health-care staff members is important to both patients and staff. This connection is amplified in organizations implementing Relationship-Based Care (RBC), a patient care delivery model that has relationships with self and others as its central concept. A secondary analysis of data from 542 health-care workers in a health-care system in the northeastern United States was performed to identify a profile of staff factors that predict a caring connection as perceived by staff. Specifically, staff self-care, clarity (of self, role, and system), dimensions of job satisfaction, and demographics were examined in relationship to caring for patients. The study demonstrated that constructs within RBC do relate to the creation of a caring connection between health-care staff members and patients, including caring for self, having a direct relationship with the patient using concepts of Primary Nursing, clarity of role, and being a direct care provider.

Use of Thin Dressings Under N95 Respirators: Exploring Their Effect on Quantitative Fit Testing Results to Guide Hospital Practice During the COVID-19 Pandemic

2020 ◽  
Vol 66 (11) ◽  
pp. 13-17
Author(s):  
Susan Guschel ◽  
Karen Chmiel ◽  
Jennifer Rosenstein
Keyword(s):  
Health Care ◽  
Nurse Practitioners ◽  
Skin Barrier ◽  
Hospital Staff ◽  
Health Care Facilities ◽  
Care Staff ◽  
Health Care Staff ◽  
Hydrocolloid Dressing ◽  
Effective Seal ◽  
N95 Respirators

At the beginning of the coronavirus disease-19 pandemic, health care staff at a level 1 trauma center in the state of New York experienced facial irritation and skin breakdown under their N95 respirators due to increased and prolonged use. PURPOSE: Members of the Certified Wound and Ostomy Nurse, Nurse Practitioners staff were charged with developing recommendations within 48 hours to help prevent and manage facial skin issues using available products that would not compromise the seal of the respirators. METHOD: With the assistance of a health care safety specialist from the Environmental Health and Safety Department of the hospital, an ambient particle counting device was used to measure the N95 fit factor following application of a liquid skin barrier, transparent film dressing, light silicone-based adhesive dressing, or an extra-thin hydrocolloid dressing on the bridge of the nose and the cheekbones underneath an N95 respirator of 2 hospital staff members who volunteered to test the dressings. RESULTS: All thin dressings tested showed a fit factor over 100, reflecting an effective seal. The highest fit factors were seen with the liquid skin barrier in the 2 volunteers (200 and 198, respectively). Thin dressing usage information was included in the hospital guidelines for N95 respirators and shared with staff. Subsequent feedback suggests that the light silicone-based adhesive dressing and the extra-thin hydrocolloid dressing were preferred. CONCLUSION: Thin dressing use may help reduce skin complications among hospital staff during periods of extended N95 respirator wear time. Because use of the dressings did not result in failure of the quantitative fit test, they were permitted for use by health care staff under their N95 respirators. Studies are needed to help health care facilities optimize N95 respirator use to protect staff from coronavirus disease-19 and respirator-related skin complications while supply shortages remain.

scholarly journals An assessment of knowledge of basic research methods among primary health care workers in Riyadh region

2021 ◽  
Vol 8 (12) ◽  
pp. 5777
Author(s):  
Amirah Al-Rossais ◽  
Shibli Sayeed ◽  
Mohammad Shibly Khan ◽  
Malak Ayedh Al-Qahtani ◽  
Aedh Bin Fardan
Keyword(s):  
Health Care ◽  
Medical Research ◽  
Research Methods ◽  
Health Care Professionals ◽  
Health Care Services ◽  
Great Majority ◽  
Basic Research ◽  
Care Staff ◽  
Health Care Staff ◽  
Cross Sectional

Background: The knowledge of and attitude towards medical research among health care staff is an important factor in delivering health care services. We aimed to assess the knowledge of basic research methods and the attitude towards medical research among health care professionals.Methods: A cross-sectional study was conducted among the health care professionals working in primary care (including physicians, nursing staff, public health professionals and other paramedical staff). A pre designed, structured, closed ended, self-administered questionnaire was used to collect the data.Results: A great majority (80%) showed interest in participating in a research if offered opportunity. Most of the attitude items had the highest proportion (>80%) of positive response whereas the knowledge items ranged from as low as 14% (awareness of reference management) to as high as 56% (correct knowledge of consent). Although the proportion of correct responses among the physicians was higher in almost all the knowledge items, as compared to nursing and other heath staff but this difference was not observed to be statistically significant (p>0.05).Conclusions: While majority of the participants had good attitude towards medical research, their knowledge was found to be low in basic research methodology.

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