scholarly journals Recall and Understanding of Discharge Information in Observation Ward Patients: An Explorative Observational Study

2021 ◽  
Vol 6 ◽  
Author(s):  
Kjersti Østen ◽  
Julia Menichetti ◽  
Jenny M. Nordfalk ◽  
Eirik H. Ofstad
Keyword(s):  
Observational Study ◽  
Information Exchange ◽  
Patient Involvement ◽  
Structured Interviews ◽  
Multiple Sources ◽  
Care Level ◽  
Information Recall ◽  
Patient Recall ◽  
Information Item ◽  
Main Message

Effective communication is essential for understanding and recall of hospital discharge information. This study aimed to explore discharge information, patient recall and patient involvement in discharge encounters. We conducted an explorative observational study at a secondary care level, observational ward. Patients discharged to their home were asked to participate. 34 patients were assessed for eligibility, of which 13 were included in the analysis. Multiple sources of data were collected: videotapes of discharge encounters, questionnaires to patients and physicians, and semi-structured interviews with patients 2 weeks after discharge. All patients were satisfied with the information received. Five of the eight patients discharged with more than one change in medication had only partial or no recall of these changes. In seven of the 13 encounters the patients and physicians did not agree on the main message most important information item. The patients were to a small extent involved in decision-making. Our findings highlight the gaps in the information exchange at discharge encounters and the resulting poor information recall among patients. Patients do not seem aware of these gaps. Greater provider awareness of patient involvement in the encounter and inclusion of the patient’s perspective may improve communication, and consequently understanding and recall.

scholarly journals Leadership assumptions on implementation of patient involvement methods

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kathrine Håland Jeppesen ◽  
Kirsten Frederiksen ◽  
Marianne Johansson Joergensen ◽  
Kirsten Beedholm
Keyword(s):  
Health Care ◽  
Organizational Learning ◽  
Health Care Professionals ◽  
Large Scale ◽  
Patient Involvement ◽  
Hospital Setting ◽  
Implementation Process ◽  
University Hospital ◽  
Structured Interviews ◽  
Implementation Processes

Abstract Background From 2014 to 17, a large-scale project, ‘The User-involving Hospital’, was implemented at a Danish university hospital. Research highlights leadership as crucial for the outcome of change processes in general and for implementation processes in particular. According to the theory on organizational learning by Agyris and Schön, successful change requires organizational learning. Argyris and Schön consider that the assumptions of involved participants play an important role in organizational learning and processes. The purpose was to explore leaders’ assumptions concerning implementation of patient involvement methods in a hospital setting. Methods Qualitative explorative interview study with the six top leaders in the implementation project. The semi-structured interviews were conducted and analyzed in accordance with Kvale and Brinkmanns’ seven stages of interview research. Result The main leadership assumptions on what is needed in the implementation process are in line with the perceived elements in organizational learning according to the theory of Argyris and Schön. Hence, they argued that implementation of patient involvement requires a culture change among health care professionals. Two aspects on how to obtain success in the implementation process were identified based on leadership assumptions: “The health care professionals’ roles in the implementation process” and “The leaders’ own roles in the implementation process”. Conclusion The top leaders considered implementation of patient involvement a change process that necessitates a change in culture with health care professionals as crucial actors. Furthermore, the top leaders considered themselves important facilitators of this implementation process.

scholarly journals Findings from 2017 on Health Information Management

2018 ◽  
Vol 27 (01) ◽  
pp. 067-073
Author(s):  
Meryl Bloomrosen ◽  
Eta Berner ◽  
Keyword(s):  
Health Information ◽  
Information Management ◽  
Information Exchange ◽  
Health Informatics ◽  
Health Information Exchange ◽  
Health Information Management ◽  
Bibliographic Databases ◽  
Major Theme ◽  
Multiple Sources ◽  
Exchange Governance

Objective: To summarize the recent literature and research and present a selection of the best papers published in 2017 in the field of Health Information Management (HIM) and Health Informatics. Methods: A systematic review of the literature was performed by the two HIM section editors of the International Medical Informatics Association (IMIA) Yearbook with the help of a medical librarian. We searched bibliographic databases for HIM-related papers using both MeSH descriptors and keywords in titles and abstracts. A shortlist of 15 candidate best papers was first selected by section editors before being peer-reviewed by independent external reviewers. Results: Health Information Exchange was a major theme within candidate best papers. The four papers ultimately selected as ‘Best Papers’ represent themes that include health information exchange, governance and policy issues, results of health information exchange, and methods of integrating information from multiple sources. Other articles within the candidate best papers include these themes as well as those focusing on authentication and de-identification and usability of information systems. Conclusions: The papers discussed in the HIM section of IMIA Yearbook reflect the overall theme of the 2018 edition of the Yearbook, i.e., the tension between privacy and access to information. While most of the papers focused on health information exchange, which reflects the “access” side of the equation, most of the others addressed privacy issues. This synopsis discusses these key issues at the intersection of HIM and informatics.

scholarly journals Knowing and Not Knowing about Fertility: Childless Women and Age-Related Fertility Decline

2021 ◽  
Vol 42 (1) ◽  
pp. 30-48
Author(s):  
Lauren Jade Martin
Keyword(s):  
Fertility Decline ◽  
Formal Education ◽  
Structured Interviews ◽  
Multiple Sources ◽  
Childless Women ◽  
Age Related ◽  
Reproductive Decision Making ◽  
Biomedical Diagnostics ◽  
Individual Self ◽  
Knowledge Claims

Knowledge claims may play an essential role in reproductive decision-making, as individuals seek out, assess, reject, and use information about health and fertility gathered from numerous sources. This paper focuses specifically on childless women’s self-perceptions of knowledge about infertility and age-related fertility decline. How knowledgeable do childless women perceive themselves to be about fertility and infertility in general, and from where they do they obtain this knowledge? Furthermore, how knowledgeable do childless women perceive themselves to be about their own fertility and ability to conceive, and to what do they attribute this knowledge? Data for this project was gathered through semi-structured interviews with 72 childless American women; the interviews were inductively and thematically coded using qualitative-analysis software. Childless women assessed their general knowledge of fertility as confident, self-doubting, or novices, and they claimed multiple sources as the basis of this knowledge, including formal education and training, media and popular culture, and family members and peers. When assessing knowledge about their own fecundity, the women tended to rely on two additional sources: biomedical diagnostics and embodied knowledge. Childless women’s awareness of average statistics of age-related fertility decline did not necessarily translate to individual self-knowledge about their own bodies and fecundity. Because knowledge claims were based on multiple information sources given unequal weight, this raises questions about authoritative knowledge—that is, the knowledge that “counts” for women as they make decisions regarding their future childbearing.

scholarly journals Disconnection in Information Exchange During Pediatric Trauma Transfers: A Qualitative Study

2021 ◽  
Vol 8 ◽  
pp. 237437352110565
Author(s):  
Hadley S Sauers-Ford ◽  
James B Aboagye ◽  
Stuart Henderson ◽  
James P Marcin ◽  
Jennifer L Rosenthal
Keyword(s):  
Qualitative Study ◽  
Information Exchange ◽  
Pediatric Patients ◽  
Traumatic Injury ◽  
Pediatric Trauma ◽  
Structured Interviews ◽  
Theoretical Concepts ◽  
Qualitative Thematic Analysis ◽  
Clinician Communication ◽  
Flow Of Information

Pediatric patients experiencing an emergency department (ED) visit for a traumatic injury often transfer from the referring ED to a pediatric trauma center. This qualitative study sought to evaluate the experience of information exchange during pediatric trauma visits to referring EDs from the perspectives of parents and referring and accepting clinicians through semi-structured interviews. Twenty-five interviews were conducted (10 parents and 15 clinicians) and analyzed through qualitative thematic analysis. A 4-person team collaboratively identified codes, wrote memos, developed major themes, and discussed theoretical concepts. Three interdependent themes emerged: (1) Parents’ and clinicians’ distinct experiences result in a disconnect of information exchange needs; (2) systems factors inhibit effective information exchange and amplify the disconnect; and (3) situational context disrupts the flow of information contributing to the disconnect. Individual-, situational-, and systems-level factors contribute to disconnects in the information exchanged between parents and clinicians. Understanding how these factors’ influence information disconnect may offer avenues for improving patient–clinician communication in trauma transfers.

Deciding on treatment duration for unprovoked venous thromboembolism: what is important to patients?

2021 ◽  
Author(s):  
Anouk van de Brug ◽  
Maria De Winter ◽  
Marije ten Wolde ◽  
Karin Kaasjager ◽  
Mathilde Nijkeuter
Keyword(s):  
Venous Thromboembolism ◽  
Treatment Duration ◽  
Patient Involvement ◽  
University Hospital ◽  
Sufficient Information ◽  
Structured Interviews ◽  
Risks And Benefits ◽  
Conventional Content Analysis ◽  
The Impact ◽  
Treatment Education

Background After 3 months of anticoagulation for unprovoked venous thromboembolism (VTE), a decision must be made to stop or continue indefinitely by weighing risks of recurrence and bleeding through shared decision-making (SDM). Despite the importance of patient involvement, patients’ perspectives on treatment duration are understudied. Aim To describe knowledge of VTE and anticoagulation, need for education, perception of risks and benefits of extended treatment and factors influencing patient’s preference to stop or continue treatment after unprovoked VTE. Methods: Semi-structured interviews were conducted between May 2019 and August 2020 with adults with unprovoked VTE in one university hospital and one general hospital. Interviews were audio-recorded and transcribed verbatim. Data were analyzed using conventional content analysis. Results 18 patients were interviewed (median age 64, range 32-83 years). Three major themes were identified: diagnosis and initial treatment, SDM and perception of treatment. Education, knowledge, coping and attitude towards healthcare suffused the major themes. The impact of VTE on daily life varied between individuals, as did the preferred extent of SDM. Overall, patients who felt involved and informed were more satisfied with received care, more aware of risks and benefits of treatment and more likely to be treatment adherent. Generally, patients were more concerned with risk of recurrent VTE than risk of bleeding during anticoagulation. We identified a multitude of aspects important to patients when deciding to stop or continue anticoagulation. Conclusion Sufficient information and an individualized extent of SDM are of crucial importance for patients when deciding on treatment duration after unprovoked VTE.

Patient Involvement in Anesthesia Decision-making: A Qualitative Study of Knee Arthroplasty

2021 ◽  
Author(s):  
Veena Graff ◽  
Justin T. Clapp ◽  
Sarah J. Heins ◽  
Jamison J. Chung ◽  
Madhavi Muralidharan ◽  
...  
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Shared Decision Making ◽  
Knee Arthroplasty ◽  
Patient Involvement ◽  
Medical Center ◽  
Academic Medical Center ◽  
Shared Decision ◽  
Structured Interviews ◽  
Primary Knee Arthroplasty

Background Calls to better involve patients in decisions about anesthesia—e.g., through shared decision-making—are intensifying. However, several features of anesthesia consultation make it unclear how patients should participate in decisions. Evaluating the feasibility and desirability of carrying out shared decision-making in anesthesia requires better understanding of preoperative conversations. The objective of this qualitative study was to characterize how preoperative consultations for primary knee arthroplasty arrived at decisions about primary anesthesia. Methods This focused ethnography was performed at a U.S. academic medical center. The authors audio-recorded consultations of 36 primary knee arthroplasty patients with eight anesthesiologists. Patients and anesthesiologists also participated in semi-structured interviews. Consultation and interview transcripts were coded in an iterative process to develop an explanation of how anesthesiologists and patients made decisions about primary anesthesia. Results The authors found variation across accounts of anesthesiologists and patients as to whether the consultation was a collaborative decision-making scenario or simply meant to inform patients. Consultations displayed a number of decision-making patterns, from the anesthesiologist not disclosing options to the anesthesiologist strictly adhering to a position of equipoise; however, most consultations fell between these poles, with the anesthesiologist presenting options, recommending one, and persuading hesitant patients to accept it. Anesthesiologists made patients feel more comfortable with their proposed approach through extensive comparisons to more familiar experiences. Conclusions Anesthesia consultations are multifaceted encounters that serve several functions. In some cases, the involvement of patients in determining the anesthetic approach might not be the most important of these functions. Broad consideration should be given to both the applicability and feasibility of shared decision-making in anesthesia consultation. The potential benefits of interventions designed to enhance patient involvement in decision-making should be weighed against their potential to pull anesthesiologists’ attention away from important humanistic aspects of communication such as decreasing patients’ anxiety. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

“Can I go to Glasgow?” Learnings from patient involvement at the 17th Congress of the International Society for Peritoneal Dialysis (ISPD)

2020 ◽  
Vol 40 (1) ◽  
pp. 12-25 ◽  
Author(s):  
Talia Gutman ◽  
Karine E Manera ◽  
Amanda Baumgart ◽  
David W Johnson ◽  
Martin Wilkie ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
International Society ◽  
Health Professionals ◽  
Best Practice ◽  
Patient Involvement ◽  
Learning Experience ◽  
Research Priorities ◽  
Self Management ◽  
Structured Interviews ◽  
Research Activities

Background: Recognition of the discrepancy between the research priorities of patients and health professionals has prompted efforts to involve patients as active contributors in research activities, including scientific conferences. However, there is limited evidence about the experience, challenges, and impacts of patient involvement to inform best practice. This study aims to describe patient and health professional perspectives on patient involvement at the Congress of the International Society for Peritoneal Dialysis (ISPD). Methods: Semi-structured interviews were conducted with 14 patients/caregivers and 15 health professionals from six countries who attended ISPD. Interviews were recorded and transcribed verbatim, and transcripts were analyzed thematically. Results: We identified four themes: protecting and enhancing scientific learning (grounding science in stories, sharing and inspiring new perspectives, distilling the key messages of research presentations, striking a balance between accommodating patients and presenting the science); democratizing access to research (redistributing power, challenging the traditional ownership of knowledge, cultivating self-management through demystifying research); inadequate support for patient/caregiver delegates (lacking purposeful inclusion, challenges in interpreting research findings, soliciting medical advice, difficulty negotiating venue and program, limited financial assistance in attending); and amplifying impact beyond the room (sparking innovation in practice, giving patients and families hope for the future). Conclusions: Patient involvement at the ISPD Congress clarified the applicability of research to patient care and self-management, democratized science, and strengthened the potential impact of research. More structured support for patients to help them purposefully articulate their experience in relation to session objectives may enhance their contribution and their own learning experience.

The interplay of avatar identities, self-efficacy, and language practices

2020 ◽  
Author(s):  
Julian Chen
Keyword(s):  
Language Learning ◽  
Second Life ◽  
Self Efficacy ◽  
Sense Of Self ◽  
Language Practices ◽  
Structured Interviews ◽  
Multiple Sources ◽  
Efl Learners ◽  
Learning And Teaching ◽  
The Impact

Abstract This study intends to examine English as a foreign language (EFL) learners’ attitudes toward practicing English in Second Life (SL) and to unpack the effects of avatar identities on EFL learners’ sense of self-efficacy and language practices. Nine EFL learners worldwide participated in a task-based course in SL, using avatars to carry out SL-related tasks while interacting with peers and the teacher via voice chat. Qualitative data were triangulated from multiple sources: learner reflective journals, a post-course survey, and semi-structured interviews. Three major themes emerged: (1) the effects of masked identity on learning, (2) the impact of telepresence and copresence on learning, and (3) the perceived attitudes toward avatar affinity. Findings implicate that the avatar form renders masked identities to safeguard learners’ self-efficacy and empower their language practices. It also opens up a research avenue on the impact of avatar identities on language learning and teaching in 3D virtual environments.

Agency as the achievement of reform ownership

2019 ◽  
Vol 18 (2) ◽  
pp. 249-262
Author(s):  
Lauren Godfrey ◽  
Carol Booth Olson
Keyword(s):  
Student Learning ◽  
Teacher Expertise ◽  
Teacher Professionalism ◽  
Structured Interviews ◽  
Multiple Sources ◽  
Content Type ◽  
Study Approach ◽  
Advance Student ◽  
Current Reform

Purpose The purpose of this study is to explore how, through the cultivation of reform ownership in the professional development (PD) program, the Pathway Project, agency was achieved for the development of teacher professionalism and teacher expertise in the cases of Mrs. Cruz and Mrs. Keyes. This, in turn, provided opportunities to advance student learning. Design/methodology/approach Multiple sources of data (focused classroom observations, semi-structured interviews and collected artifacts) were analyzed through a case study approach to understand the processes by which an agentic context materialized for these two teachers. Findings The authors identified the following three stages in the cultivation of reform ownership in the cases of Mrs. Cruz and Mrs. Keyes: emerging; developing; and deepening. Each of these stages proved critical to the achievement of agency for the development of teacher professionalism, teacher expertise and student learning. Originality/value The cases of Mrs. Cruz and Mrs. Keyes offer a renewed vision of the ways in which teachers can achieve agency in the current reform environment. Given the proliferation of reform efforts within today’s educational landscape, their cases suggest that PD developers take seriously the responsibility of cultivating reform ownership for the achievement of agency and deep and lasting change.

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