An Email Coaching Option Increases Participant Program Utilization and Coach Productivity

Purpose To assess impact of adding an email option to phone-based coaching on the number of coaching sessions completed. Design Retrospective analysis of a change in program design. Setting A health plan health and wellness coaching service. Subjects Six thousand six hundred twenty four individuals who scheduled at least one coaching session. Intervention Adding an email option to phone coaching May 1 to August 31, 2020. Measures Association of a participant using an email coaching option with completing 3 coaching sessions; overall number of participants completing 3 coaching sessions when email is offered; participant satisfaction rates; and, average number of participants coached per coach by month. Analysis χ2; linear and logistic regression with gender, age, and education as covariates. Results When we offered email coaching, 29.6% of eligible participants used the option, and compared with the same months the prior year, the proportion of participants completing 3 sessions during those months was higher (73% vs 67%). ( P < .0001) 96.5% of participants who used email, vs 92.0% who did not, completed 3 sessions before their employer’s benefit qualifying deadline. ( P < .0001) More than 85% who responded to the email coaching survey expressed satisfaction. On average, each coach served 43% (486 vs 340) more participants per month when we offered email coaching. ( P < .0001). Conclusion Adding email coaching to phone coaching can increase program utilization by individuals who use email, increase overall program utilization, generate high levels of participant satisfaction, and increase the number of participants served per coach.

Primary care clinicians’ opinions before and after implementation of cancer screening and prevention clinical decision support in a clinic cluster-randomized control trial: a survey research study

Background Electronic health record (EHR)-linked clinical decision support (CDS) may impact primary care clinicians’ (PCCs’) clinical care opinions. As part of a clinic cluster-randomized control trial (RCT) testing a cancer prevention and screening CDS system with patient and PCC printouts (with or without shared decision-making tools [SDMT]) for patients due for breast, cervical, colorectal, and lung cancer screening and/or human papillomavirus (HPV) vaccination compared to usual care (UC), we surveyed PCCs at study clinics pre- and post-CDS implementation. Our primary aim was to learn if PCCs' opinions changed over time within study arms. Secondary aims including examining whether PCCs' opinions in study arms differed both pre- and post-implementation, and gauging PCCs’ opinions on the CDS in the two intervention arms. Methods This study was conducted within a healthcare system serving an upper Midwestern population. We administered pre-implementation (11/2/2017–1/24/2018) and post-implementation (2/2/2020–4/9/2020) cross-sectional electronic surveys to PCCs practicing within a RCT arm: UC; CDS; or CDS + SDMT. Bivariate analyses compared responses between study arms at both time periods and longitudinally within study arms. Results Pre-implementation (53%, n = 166) and post-implementation (57%, n = 172) response rates were similar. No significant differences in PCC responses were seen between study arms on cancer prevention and screening questions pre-implementation, with few significant differences found between study arms post-implementation. However, significantly fewer intervention arm clinic PCCs reported being very comfortable with discussing breast cancer screening options with patients compared to UC post-implementation, as well as compared to the same intervention arms pre-implementation. Other significant differences were noted within arms longitudinally. For intervention arms, these differences related to CDS areas like EHR alerts, risk calculators, and ordering screening. Most intervention arm PCCs noted the CDS provided overdue screening alerts to which they were unaware. Few PCCs reported using the CDS, but most would recommend it to colleagues, expressed high CDS satisfaction rates, and thought patients liked the CDS’s information and utility. Conclusions While appreciated by PCCs with high satisfaction rates, the CDS may lower PCCs’ confidence regarding discussing patients’ breast cancer screening options and may be used irregularly. Future research will evaluate the impact of the CDS on cancer prevention and screening rates. Trial registration clinicaltrials.gov, NCT02986230, December 6, 2016.

Changing perceptions of telemedicine in a surgical outpatients clinic

Background/Aims Before the COVID-19 pandemic, telemedicine was not widely used in surgical departments. Despite its increased use during the pandemic, there is a lack of data on the patient perspective. This study investigated patients' views of telemedicine in a surgical outpatients clinic setting. Method A single-centre cross-sectional study was performed, involving patients who were due to attend the surgical outpatients clinic of one surgical team. Independent investigators contacted the patients by telephone after their virtual telephone consultation to administer the questionnaire. Patient satisfaction rates were recorded using the PSQ-18 questionnaire. Patient consultation preferences were recorded and analysed. Results A total of 223 patients participated in this study. The majority of patients' perceptions shifted in favour of virtual consultations after the onset of the pandemic (P<0.05). Sub-group analysis showed no significant differences between the preferences of older and younger patients before or after the onset of the pandemic. Overall, patients reported high satisfaction rates with their virtual consultations. Conclusions Patient perceptions are changing in favour of virtual telemedicine consultations. Training healthcare providers in this method of service delivery is essential to maintain a good quality of care.

Health Literacy and Patient -Reported Outcomes

Modern healthcare needs to identify parameters for high-quality care. Quality improvement is the key for advancing in healthcare, and the new assessment tool shifts from a disease-centered outcome to a patient-centered outcome. Clinical outcome such as morbidity and mortality are directly connected and interdependent from patient-reported outcomes: well-informed patients who decide with their healthcare provider what treatment is best for them have better outcomes and higher patient satisfaction rates. These subjective data collected by rigorous, meaningful, and scientific methods and presented in a utilizable format can be used to create care objectives towards which both the surgeon and their patient can travel. Time has come to carry patient-centered outcomes from research into decision making and daily care plans. This chapter outlines a focus beyond life-prolonging therapy, aiming to minimize the negative effects of treatment, optimize quality of life, and align medical decisions with patient expectations.

Reporting Inpatients’ Experiences and Satisfaction in a National Psychiatric Facility: A Study Based on the Random Forest Algorithm

Understanding psychiatric inpatients’ experiences is important to establish a culture of patient-centric care and promote trust in healthcare. This study aimed to evaluate nine dimensions of patients’ experiences and investigate their association with patient satisfaction, revisit intention, and positive word-of-mouth (WoM) recommendation. Cross-sectional questionnaire data from five years of surveying (2016–2020) in the main psychiatric hospital in Bahrain were statistically analyzed, involving 763 psychiatric inpatients with an overall 65.6 ± 17.2 length of stay (days). The findings show that across the five years 2016–2020, the overall reported satisfaction was “very high” (4.75 ± 0.44) with no significant differences between these five years (F [4, 758] = 0.66, p = 0.620). The experience of confidentiality received the highest rating (4.72 ± 0.45). The experiences of ease of access, hospitality quality, and quality of responsiveness to one's needs significantly correlated with revisit intention ( p ˂ 0.05). Patients with high satisfaction had greater potential for revisit intention (r [761] = 0.08, p = 0.027), which was associated with WoM recommendation (r [761] = 0.08, p = 0.033). Overall, men were less likely than women to experience convenient access to psychiatric wards. The findings of the Random Forest algorithm indicate the tendency of female patients with short-term stays to demonstrate lower satisfaction rates, and thus innovative approaches are needed when managing these groups’ psychiatric problems.

To triage or not to triage? The history and evidence for this model of care in psychiatry

SUMMARY Triage wards were introduced as a new model of psychiatric in-patient care in 2004. However, there is limited evidence comparing them with the traditional in-patient models of care. This article reviews the history of triage wards, their principles, the evidence for this model (e.g. length of in-patient stay, readmission rates, staff and patient satisfaction) and the development of assessment wards based on the triage model of care. The evidence shows that the triage model has higher rates of rapid discharge, with a greater proportion of ‘acute care’ performed in the community with the support of home treatment teams. This leads to lower bed occupancy in the triage wards without increased rates of readmission or a worse patient experience of in-patient care. However, overall staff experience was better in the traditional model, given that staff satisfaction rates were lower on locality wards in settings with triage systems in place. Future research should explore the potential impact on home treatment teams, and the rates of serious incidents due to the high number of acutely unwell patients on triage wards.

Evaluation of Gynecologist’s and Patient’s Experience, Anxiety and Pain Perception During Intrauterine Device Insertion Containing Levonorgestrel ELA 52 Study

Objective: To characterize patient’s and obstetricians-gynecologist’s (ob-gyns) experience in insertion of a 52 mg levonorgestrel‐ releasing intrauterine device (LNG-IUD). Materials and Methods: A non-interventional, prospective and multicentric study was conducted in 583 patient of reproductive age who had insertion of Levosert® following routine clinical practice. Questionnaires were used to collect information on obgyns’ and patient’s experiences associated with IUD insertion. Pain and anxiety were rated, and possible predictors such as age, parity were evaluated. Results: Before IUD insertion, 50.8% of the participants felt minimal anxiousness and 44.9% predicted moderate pain. Twohundred and sixteen (37.0%) patient reported mild pain with insertion and 227 (38.9%) reported moderate pain. Ob-gyns were aware of the patient’s insertion pain experience and 84.2% considered LNG-IUD insertion “Easy” or “Very Easy”. The vast majority of patient (88.2%) were also “Satisfied” or “Very Satisfied” with LNG-IUD insertion, considering the procedure less or at least equally painful as they expected. Conclusions: Given the strong link between anxiety and expected pain and the lack pain management strategies effectiveness, the implementation of interventions that may mitigate both anxiety and pain during IUD insertion are crucial. LNG-IUD is associated with high satisfaction rates by patient and considered easy to apply by ob-gyns.

The impact of external academic accreditation of undergraduate medical program on students’ satisfaction

Background The external academic accreditation is a quality assurance and auditing process that focuses on the structure, process, and outcome of the education. It is an interrupting and highly demanding process in terms of effort, time, financial, and human resources. However, it is unclear in the literature how much of these external quality assurance practices impeded in the accreditation processes would reflect on the other end of the learning pathway, including student satisfaction. Methods A retrospective quantitative secondary data analysis, with a before-after comparison research design, was performed to evaluate external accreditation’s impact on students’ mean satisfaction score within two accreditation cycles at King Saud University (KSU)-Bachelor of Medicine, Bachelor of Surgery (MBBS) program. Results The overall average students’ satisfaction scores pre-and-post the first accreditation cycle were 3.46/5 (±0.35), 3.71 (±0.39), respectively, with a P-value of < 0.001. The effect of post first accreditation cycle was sustainable for a couple of years, then maintained above the baseline of the pre-first accreditation cycle until the pre-second accreditation cycle. Similarly, the overall average students’ satisfaction scores pre-and-post the second accreditation cycles were 3.57/5 (±0.30) and 3.70 (±0.34), respectively, with a P-value of 0.04. Compared to the first accreditation cycle, the improvement of the mean score of students’ satisfaction rates was not sustained beyond the year corresponding to the post-second accreditation cycle. Conclusion Both accreditation cycles were associated with an increased score in students’ satisfaction. The preparatory phase activities and navigation through the self-study assessment while challenging the program’s competencies are essential triggers for quality improvement practices associated with accreditation.

CUSTOMERS PERCEPTION ON FOOD SERVICE AND WATER MICROBIOLOGY LABORATORY FROM THE NATIONAL INSTITUTE OF HYGIENICS OF LOME FROM 2012 TO 2020

The general purpose of this article is to help monitor the performance of thewater and food microbiology laboratory at National Institute of Hygienics (NIH)of Lome. To achieve it, thework focused on analyzing trends in customers satisfaction from the laboratory in theperiod from 2012 to 2020. This study mainly took into account the analysis ofcustomers satisfaction levels with satisfaction metrics such as qualityreception facilities, the waiting time, the reliability of the results and the deadline for renderingresults customers complaints analysis as well as analysis of customers suggestions.From the results obtained, it emerged that the majority of the laboratorys customers are satisfiedof its services. Satisfaction rates were over 86% with respect to the quality ofreception facilities, more than 89% concerning waiting time, more than 93% compared tothe reliability of the results and more than 73% for the deadline for rendering results. Claimingcustomers are over 75% cleared and all cleared claims were made within the timeframeresolution expected. Customers suggestions are taken into account through the implementation ofappropriate action plans. However, the analysis of these results has made it possible to identifyinadequacies such as the non-representativeness of the samples from the various satisfaction surveysand the unavailability of certain data which should allow a morethorough. In addition, the available data have shown that the perception of the benefits of thelaboratory by customers, is not growing. However, these data made it possible to achieveto the conclusive results which deserve to be taken into account. In short, it appears clearlythat customers perceptions in the services of the water andfood microbiology laboratory of the NIH of Lome, is satisfactory, even if it is not growing.

Job Satisfaction Scores of Lebanese and Jordanian Nephrologists and Their Association with Age, Gender, Workload and Income

BACKGROUND: The main challenges that nephrologists are facing worldwide are lower income, dissatisfactory payment models, long work hours and burnout. This study aimed to identify factors associated with nephrologists' satisfaction in Lebanon and Jordan. METHODS: A survey was sent to Lebanese and Jordanian nephrologists about demographics, job satisfaction (5-Likert scale), workload and reimbursement. RESULTS: Sixty-seven nephrologists responded, 59 were complete. Mean age was 46.9 ±12.5 years, 39% women. Mean total job satisfaction score was 3.39±0.45. Respondents reported low rates of satisfaction towards job opportunities (20%), income (25%) and administrative support (32%) and high satisfaction rates in relationship with patients (78%) and colleagues (73%). 62.7% of respondents were paid fee for service and income was significantly higher among males (p<0.001). Lebanese nephrologists had payment delays of 12 months and it was significantly associated with lower work-life balance (p=0.038). 61% of respondents worked > 30 hours weekly and 22% followed > 40 dialysis patients. Using regression analysis, older age, working > 10 hours per week and monthly income > 5000 US$ were significantly associated with higher total job satisfaction score (p= 0.002, 0.004 and 0.028 respectively). Satisfaction towards income was significantly lower among females (p < 0.024). Finally, gender discrimination was significantly perceived by women (p<0.001). CONCLUSIONS: Younger age, less workload, lower income and payment delays are associated with dissatisfaction among the surveyed nephrologists. Gender differences are significant with lower satisfaction among women. Decision makers need to address payment delays, support women and regulate students' entry to nephrology programs to avoid unemployment.