Reduction in resource utilization and increase in patient satisfaction two years after implementation of Perioperative Surgical Home

Introduction: Perioperative Surgical Home (PSH) provides coordinated, team-based care that is patient-centered, designed to guide patients efficiently through the surgical experience. We applied several changes to our anesthesia practice during 2014 and evaluated outcomes for all orthopedic major joint replacement surgeries completed in 2015. Since this was a quality improvement/utilization study, we were granted approval from our institutional review board to retrospectively review these data.Methods: We conducted a utilization review of all 1,356 patients who received total knee, hip, or shoulder joint replacement from 4 major surgical providers in 2015. Preoperative evaluation was limited and focused to each patient’s unique medical conditions. Additionally, we reduced intraoperative fluid use, reduced continuous femoro-sciatic nerve or brachial plexus blocks by increasing the administration of single-shot regional blocks, limited transfusion, and minimized urinary catheter use. We improved pain consult response time and provided timely discharges.Results: We noted 9% reduction in preoperative imaging per case, 22% decrease in average number of tests per case, 87% fewer average units of red blood cell used per case, and a 0.4 day reduction in average length of stay (LOS). Patient satisfaction data showed constant improvement in pain management, and doctor communication.Conclusions: Numerous small modifications to patient care collectively contributed to these progressive observed changes in patient outcomes from quarter to quarter.

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Patientoriented Algorithm for the X-ray Therapy Cabinet of Oncology Dispensary

Medical Radiology and radiation safety ◽

10.12737/1024-6177-2021-66-5-45-49 ◽

2021 ◽

Vol 66 (5) ◽

pp. 45-49

Author(s):

J Zuenkova ◽

D. Kicha ◽

A. Abramov ◽

Y. Buynova ◽

L. Klisova

Keyword(s):

Patient Satisfaction ◽

Skin Cancer ◽

Patient Experience ◽

Adherence To Treatment ◽

Patient Centered ◽

X Ray ◽

Non Melanoma Skin Cancer ◽

Study Results ◽

Therapy Room ◽

Melanoma Skin

Results: IIntroduction: Superficial X-ray therapy is a common treatment of non-melanoma skin cancer with a high incidence worldwide. Interrupting the course of radiation therapy can negatively affect patient survival and treatment results. Low treatment adherence may be associated with a lack of a patient-centered approach and ineffective communications. The original study shows that patients undergoing X-ray therapy for cancer may have different needs. Based on the study results an algorithm for a patient-oriented approach has been developed for the X-ray cabinets. Purpose: To develop a patient-oriented algorithm of the X-ray therapy room to address the issues of increasing patient satisfaction and forming their adherence to treatment. The objectives of the study included studying and detailing the needs of the patients who passed the X-ray therapy and to develop the patient-oriented algorithm for the X-ray therapy room. Material and methods: The study of the patient's values was carried out from 2019 to 2020 by interviewing using open-ended questions to find out the deep motives and beliefs of patients. The study was based on Milton Rokich’s (2005) model of value orientations, which was adapted to the objectives of the study. Results: The study included 116 patients undergoing treatment with the X-ray therapy at the City Clinical Oncology Dispensary. As a result of the study, the following patient needs were identified: clinical outcome of the procedure 111 (96 %), safety of treatment and adverse reactions 106 (91 %), cosmetic outcome 53 (46 %), convenience of the treatment schedule 42 (36 %), painlessness of the procedure 39 (34 %), the ability to lead a normal lifestyle 27 (23 %), comfortable conditions for the procedure 16 (14 %), financial costs associated with treatment 10 (9 %), preservation of organ function 4 (3 %). On the basis of the data obtained, a patient-oriented algorithm for the X-ray therapy was developed, including a communication plan with the patient. The study results clearly demonstrate that even with the same disease and condition, patients may have different priorities hat need to be considered to improve patient experience and adherence to treatment. Conclusion: Radiation treatment decision-making based on the patients values is important for the development of the patient-centered management in oncology since this directly affects patients’ adherence to treatment. Exploring the values and needs of patients is an opportunity to influence and improve the metrics of the patient experience. Due to the mass incidence of non-melanoma skin cancer, the introduction of patient-centered approaches is an important part of patient satisfaction and increase of patients adherence to the treatment.

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PD22-09 LONG-TERM OUTCOMES AND PATIENT SATISFACTION AFTER YACHIA CORPOROPLASTY FOR PEYRONIE'S DISEASE: A SINGLE INSTITUTIONAL REVIEW

The Journal of Urology ◽

10.1016/j.juro.2014.02.1860 ◽

2014 ◽

Vol 191 (4S) ◽

Author(s):

John M. Kelley ◽

Zachary Klaassen ◽

Cormac E. O'Neill ◽

Qiang Li ◽

Patrick J. Fox ◽

...

Keyword(s):

Patient Satisfaction ◽

Peyronie’S Disease ◽

Long Term Outcomes ◽

Institutional Review ◽

Peyronie's Disease

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Implemented Interventionsat the Naef K. Basile Cancer Institute to Protect Patients and Medical Personnel From COVID Infections: Effectiveness and Patient Satisfaction

Frontiers in Oncology ◽

10.3389/fonc.2021.685107 ◽

2021 ◽

Vol 11 ◽

Author(s):

Jean El Cheikh ◽

Samantha El Warrak ◽

Nohra Ghaoui ◽

Farouk Al Chami ◽

Maya Shahbaz ◽

...

Keyword(s):

Patient Satisfaction ◽

Medical Care ◽

Medical Center ◽

Treatment Protocol ◽

Patient Centered ◽

Oncology Patients ◽

Oncology Patient ◽

Safety Measures ◽

Viral Spread ◽

First Case

BackgroundThe Coronavirus Disease 2019 (COVID-19) was declared a pandemic by WHO in March 2020. The first case of COVID-19 was identified in Lebanon on the 21st of February 2020, amid a national economic crisis. As the numbers of cases increased, ICU admissions and mortality rose, which led hospitals across Lebanon to take certain safety measures to contain the virus. The Naef K. Basile Cancer Institute (NKBCI) at the American University of Beirut Medical Center handles oncology outpatient visits and outpatient treatment protocol infusions. The aim of this study is to evaluate the efficacy of the safety measures put forth by the NKBCI early in the pandemic.MethodsOncology patients are amongst the immunosuppressed population, who are at greatest risk of contracting COVID-19 and consequently suffering its complications. In this manuscript, we evaluated the precautionary measures implemented at the NKBCI of AUBMC from March 1st to May 31st of 2020, by surveying oncology patients on the telephone who had live and virtual appointments in both the oncology outpatient clinics and infusion unit. We conducted a prospective study of 670 oncology patients who had appointments at the NKBCI during this period and used their answers to draw responses about patient satisfaction towards those safety measures.ResultsOur results involved 387 responses of oncology patients who visited the NKBCI during the period of March 1st to May 31st of 2020. 99% of our respondents gave a rating of good to excellent with these new measures. The option of online consultation was given to 35% in the hematology group compared to 19% in those with solid tumors (p=0.001). From the total, 15% of patients opted for the telemedicine experience as a new implemented strategy to provide patient-centered medical care. Of this group of patients, 22% faced problems with connectivity and 19% faced problems with online payment.ConclusionNKBCI was competent in following the WHO guidelines in protecting the oncology patient population. Feedback collected from the surveys will be taken into account by the committee of the NKBCI to develop new safety measures that can better control viral spread while providing patient-centered medical care.

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Patient-Centered Redesign of Total Joint Replacement Care: Achieving the Quadruple Aim

The Permanente Journal ◽

10.7812/tpp/19-039-18 ◽

2019 ◽

Author(s):

Violeta Rabrenovich

Keyword(s):

Joint Replacement ◽

Total Joint Replacement ◽

Patient Centered ◽

Quadruple Aim

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Patients’ Satisfaction with Physiotherapy Services for Musculoskeletal Disorder

Pakistan Journal of Public Health ◽

10.32413/pjph.v10i3.499 ◽

2021 ◽

Vol 10 (3) ◽

pp. 174-178

Author(s):

Keramat Ullah Keramat ◽

Abdul Haseeb Bhutta ◽

Misbah Binte Ilyas

Keyword(s):

Patient Satisfaction ◽

Care Facility ◽

Health Care Facility ◽

Simple Random Sampling ◽

P Value ◽

Patient Centered ◽

Retrospective Survey ◽

Physiotherapy Practice ◽

Rehabilitation Sciences

Background: Patient centered approach is the cornerstone in health care facility. Therefore, patient satisfaction is of utmost importance. Factors related to satisfaction of patient in connection with physiotherapy practice are not evaluated. The purpose of this retrospective survey was to evaluate satisfaction of patient receiving physiotherapy for their musculoskeletal disorders at Helping Hand institute of Rehabilitation sciences Khyber Pakhtoon Khawa Mansehra, Pakistan Methods: A retrospective survey of 200 male and female patients in the range of 18 to 80 years old was conducted in 2019 for the patient who had availed the services between 2017 and 2018. These patients were recruited through simple random sampling only to refrain from biasness. Keeping in mind the requirement of this survey the Med Risk Instrument Patient Satisfaction questionnaire was modified and was translated in Urdu. Results: The retrospective survey of 200 patients of a median age 46 with musculoskeletal conditions 46. According to the survey among the abovementioned recipients 67% were with the opinion of highly satisfied with the way they have been facilitated and 32% of recipient fall under the term moderate satisfaction. With P-value <0.001 Conclusion: Our study reveals that there is higher customer satisfaction from the skill of physiotherapist but the follow up exercise plan at home is considered worthless by the recipient. Physiotherapy provides more relish to middle aged and younger adults as compare to the older ones. Similarly, the results derived manifest female recipient satisfaction at higher level than male. The panorama of research exhibits that general contentment of patients is at higher level.

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An Analysis of Methodologies That Can Be Used to Validate if a Perioperative Surgical Home Improves the Patient-centeredness, Evidence-based Practice, Quality, Safety, and Value of Patient Care

Anesthesiology ◽

10.1097/aln.0b013e3182a8e9e6 ◽

2013 ◽

Vol 119 (6) ◽

pp. 1261-1274 ◽

Cited By ~ 39

Author(s):

Thomas R. Vetter ◽

Nataliya V. Ivankova ◽

Lee A. Goeddel ◽

Gerald McGwin ◽

Jean-Francois Pittet

Keyword(s):

Perioperative Care ◽

Healthcare Delivery ◽

Standard Of Care ◽

The United States ◽

Surgical Patients ◽

Patient Centeredness ◽

Patient Centered ◽

Perioperative Surgical Home ◽

Future Demands ◽

Evidenced Based

Abstract Approximately 80 million inpatient and outpatient surgeries are performed annually in the United States. Widely variable and fragmented perioperative care exposes these surgical patients to lapses in expected standard of care, increases the chance for operational mistakes and accidents, results in unnecessary and potentially detrimental care, needlessly drives up costs, and adversely affects the patient healthcare experience. The American Society of Anesthesiologists and other stakeholders have proposed a more comprehensive model of perioperative care, the Perioperative Surgical Home (PSH), to improve current care of surgical patients and to meet the future demands of increased volume, quality standards, and patient-centered care. To justify implementation of this new healthcare delivery model to surgical colleagues, administrators, and patients and maintain the integrity of evidenced-based practice, the nascent PSH model must be rigorously evaluated. This special article proposes comparative effectiveness research aims or objectives and an optimal study design for the novel PSH model.

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Criteria and all that

PEDIATRICS ◽

10.1542/peds.57.4.439 ◽

1976 ◽

Vol 57 (4) ◽

pp. 439-441

Author(s):

Jonathan E. Fielding

Keyword(s):

Average Length ◽

Diagnostic Category ◽

Utilization Review ◽

Title V ◽

General Hospitals ◽

Average Length Of Stay ◽

Statistical Measures ◽

Appropriateness Of Care ◽

Major Criticism

A major criticism of traditional institutional utilization review activities has been the lack of objectivity in assessing the necessity and appropriateness of care. The review systems for Professional Standards Review Organizations (PSROs) and for utilization review require the use of objective measures in assessing care provided to Medicare, Medicaid, and Title V patients admitted to short stay general hospitals. The PSRO Manual defines these measures as follows: Norms—Numerical or statistical measures of usual observed performance, e.g., the average length of stay for a particular diagnostic category in a hospital is 4.6 days. Criteria—Predetermined elements against which aspects of the quality of a health service may be compared.

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Communication Among Team Members Within the Patient-centered Medical Home and Patient Satisfaction With Providers

Medical Care ◽

10.1097/mlr.0000000000000914 ◽

2018 ◽

Vol 56 (6) ◽

pp. 491-496 ◽

Cited By ~ 8

Author(s):

Susan E. Stockdale ◽

Danielle Rose ◽

Jill E. Darling ◽

Lisa S. Meredith ◽

Christian D. Helfrich ◽

...

Keyword(s):

Patient Satisfaction ◽

Medical Home ◽

Patient Centered Medical Home ◽

Patient Centered ◽

Team Members

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Levels of Patient Satisfaction on Integrative Medicine Before and After Implementation of Diagnosis-related Groups

Global Advances in Health and Medicine ◽

10.1177/2164956118759256 ◽

2018 ◽

Vol 7 ◽

pp. 216495611875925 ◽

Cited By ~ 3

Author(s):

Tobias Romeyke ◽

Elisabeth Noehammer ◽

Hans Christoph Scheuer ◽

Harald Stummer

Keyword(s):

Patient Satisfaction ◽

Medical Treatment ◽

Diagnosis Related Groups ◽

Hospital Setting ◽

Nutrition Therapy ◽

Study Patient ◽

Patient Centered ◽

General Evaluation ◽

Conventional Medical Treatment ◽

Before And After

Objectives The aim of this article is to study patient satisfaction with complementary and alternative medicine (CAM) in an in-hospital setting before and after the introduction of diagnosis-related groups (DRGs). Methods Patients were interviewed regarding a general evaluation of their hospital stay, the psychological talking therapy, the nutrition therapy, and the overall success of the treatment. Results The medical treatment was evaluated by 1158 patients. A very good success was reported by 347, a good by 609, a moderate by 181, and none by 21 patients. DRG implementation showed no significant effects. Psychological talking therapy was evaluated as “very good” ( P ≤ .05). With regard to the success of the medical talking and nutrition therapy, there were no significant differences ( P ≥ .05) between the time before and after DRG implementation. Conclusion Broadening conventional medical treatment with CAM practices can lead to a parallel treatment of DRGs in hospitals working with complementary medicine. This results in very patient-centered therapies, which may impact patient satisfaction.

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Bridging the Gap: A Priorities Assessment Tool to Support Shared Decision Making, Maximize Appointment Time, and Increase Patient Satisfaction in Women With Ovarian Cancer

JCO Oncology Practice ◽

10.1200/jop.19.00455 ◽

2020 ◽

Vol 16 (2) ◽

pp. e148-e154 ◽

Cited By ~ 2

Author(s):

Melissa K. Frey ◽

Annie Ellis ◽

Savannah Shyne ◽

Ryan Kahn ◽

Eloise Chapman-Davis ◽

...

Keyword(s):

Ovarian Cancer ◽

Decision Making ◽

Patient Satisfaction ◽

Shared Decision Making ◽

Assessment Tool ◽

Shared Decision ◽

Feedback Form ◽

Patient Centered ◽

Symptom Index ◽

Increase Patient Satisfaction

PURPOSE: Women with ovarian cancer identify patient-physician communication as an essential element in determining treatment course and believe a discussion about goals and values should precede treatment decisions. We sought to develop a patient-centered priorities assessment tool for women with ovarian cancer that could streamline communication, enhance treatment discussions, and increase patient satisfaction. MATERIALS AND METHODS: We designed a priorities assessment tool using a validated ovarian cancer symptom index (National Comprehensive Cancer Center–Functional Assessment of Cancer Therapy Ovarian Symptom Index-18) combined with an index to assess daily quality-of-life priorities. The tool was distributed to women with ovarian cancer in small focus group settings and online, followed by a postactivity feedback form. RESULTS: In this pilot study, 36 women completed the priorities assessment tool and 35 completed the postactivity feedback form between September 2015 and May 2016. All participants reported that the tool was easy to understand and comprehensive in scope. Twenty-nine participants (82.9%) completed the tool in 10 minutes or less. Most participants (n = 31, 86.1%) were able to stratify their priorities and identify 5 top treatment-related priorities. Participants who indicated that their goals and priorities had changed since diagnosis (n = 25, 69.4%) reported that the tool helped to identify current goals and priorities (22 [88%] of 25 participants) and would help them feel more comfortable participating in shared decision making with their medical team (21 [84%] of 25 participants). CONCLUSION: A patient-centered priorities assessment tool was easy to complete and viewed as comprehensive and useful in a pilot cohort of women with ovarian cancer. Use of a priorities assessment tool has the potential to enhance communication, promote shared decision making, and improve patient satisfaction.

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