Patient Experience Journal (PXJ, The Beryl Institute)
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Adolescents with Cystic Fibrosis Expressing their Possible Selves through Photovoice: A Longitudinal Interpretative Phenomenological Analysis to Prepare a Peer Support Intervention for Healthcare Transition
Get PDFWhile the transition from pediatric to adult care has become a field of study and practice focused on preparing the adolescent to ``become an adult with a chronic condition\u27\u27, we are conducting participatory research to develop, implement, and evaluate a peer-support intervention aimed at supporting transition from pediatric to adult care for adolescents living with cystic fibrosis within two hospital centers in France. In preparation for this intervention, we would like to better understand how peer support could support identity self-determination of the adolescents. We conducted a longitudinal qualitative research using photovoice technique. For one year, 8 French adolescents (15–18 years old) with cystic fibrosis were interviewed 3 times (every 6 months) and, based on a photo representing what ``becoming an adult\u27\u27 meant to them and that they had taken, they explained their experience of transitioning to adulthood. Data were analyzed using the interpretative phenomenological analysis approach. The evolution of adolescents\u27 capacities to integrate disease into their identity and imagine possible selves that are not determined by the disease varies depending on a range of exploratory processes and self-event connections that we mapped to produce a dynamic framework of ``illness identity\u27\u27 development. Rejecting master narratives of illness identity, adolescents seek to develop a self-determined gaze, mobilizing cultural and social mediation in particular. In this sense, peer support intervention could support the adolescent\u27s agentivity
What Makes a Hospital Gown Functional? A Comparative Case Study of Effective Patient-Centered Design Practices in Four (\u3ci\u3en =\u3c/i\u3e 4) Hospital Gowns
Get PDFA hospital gown is essentially a patient uniform. Yet, the typical ``tie in the back\u27\u27 hospital gown, standard garb for routine medical procedure, can have great influence over key intervention factors like receptiveness to treatment and patient self-esteem. Thus, the goals of this study are two-fold: 1) To understand patient perceptions of the standard hospital gown, and 2) To understand which principles and elements of design underpin effectively functional hospital gown redesign. Aim 1 was assessed via a comprehensive literature review of n = 5 qualitative or mixed-methods studies which surveyed or interviewed patients on their experience with the standard hospital gown. A sense of lacking dignity emerged as the main problem with the standard hospital gown, functionally defined as lack of appropriate coverage, sizing, or color. They suggested that pajama-like hospital gowns or ``casual wear\u27\u27 would improve their experience at the hospital. To answer the question of feasibility of implementation, aim 2 focused on assessing extant hospital gowns for functionality and success in the hospital system. Four successful hospital gown redesigns were identified and formally analyzed following comparative case methods as described by Yin (2018). Results suggest that the preservation of dignity along with clinical functionality was the primary goal of the hospital gown redesign, unanimously accomplished through full coverage of the back and exchanging ties for snaps as functional closure devices. Quality of patient experience improved following the implementation of the functional hospital gown, supporting feasibility through cost-effectiveness and clinical functionality. Implications for treatment and future directions for research are discussed
Why We Need a Patient-Centered Innovation Renaissance: A Horizontal and Vertical Integration of Knowledge to Transform Care Pathways
Get PDFWe are at a pivotal moment. The future of healthcare innovation can no longer be defined solely by technological advancement or institutional efficiency. While digital tools, therapies and platforms continue to evolve, they must be embedded within a broader transformation, one that places the human experience at the centre of how we design, deliver and evaluate care. This patient-centred renaissance calls for the integration of both horizontal and vertical forms of knowledge: connecting services across the care continuum. From the literature and our experience, an unexpected byproduct of co-production with patients in health innovation and care delivery is a reduction in complaints, litigation and a significant increase in treatment compliance. 19 This results in a reduction in misdiagnosis, 20 over investigation and treatment, giving a reduction in costs in the overall healthcare economy. Empowering patients as innovators is not a symbolic gesture. It is a practical imperative if we are to create pathways that are not only clinically effective but also meaningful and responsive. Fragmented systems that overwhelm or disorient must give way to cohesive and compassionate journeys, designed with and for the people they are meant to serve. This is a call to rethink not only what we innovate, but how and with whom. Let us commit to building systems that honour not just the science of healing, but the individuals we treat. In doing so, we move closer to a future where innovation and empathy are no longer treated as separate domains, but as interdependent pillars of truly transformative care
“Why Should Anyone Want to Make Things Better for me Particularly?” – A Qualitative Exploration of Care Opinion and NHS Care Improvements
Get PDFCare Opinion is an online platform which enables people to share anonymous feedback (known as “stories”) about their experiences of UK healthcare. In Scotland, this platform has official government backing, though healthcare organisations are not obliged to use it. Care Opinion staff review and edit these stories, acting as moderators. Healthcare staff are invited to respond to stories and are encouraged to use it for healthcare improvement. However, the number of changes made and registered on the platform is relatively small. This paper brings together findings from interviews with story authors (those sharing experiences), NHS staff and Care Opinion moderators to explore their experiences of online feedback and its use for improvement. In-depth semi-structured interviews were undertaken with 10 NHS staff, 10 authors and 6 moderators during 2022. The interviews were based on a sample of Care Opinion stories about services from two National Health Service Scotland organisations. Transcripts were analysed thematically. The findings demonstrate the emotional impact for those involved in online patient feedback. Stories add to a growing online repository, which Care Opinion uses to encourage improvement. As our participants highlight, changes and impact from feedback can be indirect. Online feedback can be used in different formats for different purposes. The external platform captures stories which may have been missed. However, change relies on the engagement of healthcare staff
Assessing patient satisfaction with the services provided under the National Health Insurance Scheme at the Outpatient Department of the Levy Mwanawasa University Teaching Hospital in Lusaka, Zambia
No full textThe National Health Insurance Scheme (NHIS), introduced in Zambia in 2019 to enhance healthcare financing and service delivery, still faces challenges impacting patient satisfaction. This study assesses and investigates the factors influencing patient satisfaction with NHIS-provided services at a third-level tertiary public hospital. The study was conducted at the outpatient department (OPD) of Levy Mwanawasa University Teaching Hospital (LMUTH) in Lusaka, Zambia, deliberately chosen as one of the largest publicly financed tertiary referral hospitals and among the first NHIS-accredited facilities. A cross-sectional survey was conducted with 270 respondents using a modified SERVQUAL 5-point Likert scale questionnaire, whose reliability was assessed via Cronbach’s Alpha. Data were analysed using descriptive and inferential statistics, with mean satisfaction percentages calculated. The results showed that 83% of the respondents were satisfied with the NHIS-provided services and 17% were not. Education level, duration of NHIS enrollment, communication from the National Health Insurance Management Authority (NHIMA), drug availability, staff attitude, and waiting time were identified as significant factors. However, the key predictors of NHIS patient satisfaction identified were employment status (OR = 0.237, p = 0.030) and communication and feedback from NHIMA (OR = 2.922, p = 0.001). While these findings show a high NHIS satisfaction level similar to some studies conducted in Nigeria and Ghana, future research should explore the long-term effects and satisfaction levels, including the accessibility and affordability of NHIS services across various demographic groups and regions within Zambia
A Qualitative Study: Patients\u27 Expectation of Private Hospitals
Get PDFObjectives: This study was conducted to explore patients\u27 expectations and perceptions of private healthcare facilities, understand the key factors influencing their choice of such facilities, also identify elements that enhance patient satisfaction and loyalty, enabling the development of actionable recommendations to improve patient-centered care in private healthcare settings. Method: A qualitative study using thematic analysis was conducted with 29 patients from various nationalities and backgrounds who received services in private hospitals in Kuwait, including Dar Al Shifa Hospital. Insights were gathered through semi-structured interviews. Results: The study delved into the significant correlation between patients\u27 experience of their healthcare encounters and their subsequent loyalty to healthcare providers or facilities. It underscores the pivotal role of communication by care providers within private hospitals in shaping these experiences. Additionally, the study explores the impact of physicians\u27 race or nationality on the patient-physician relationship, nursing care, and hospital ambiance in shaping patient experiences and loyalty. This research seems to provide significant insights into the multifaceted nature of patient experiences and their association with the attributes of healthcare providers. Discussion: The study findings align with global literature emphasizing the role of communication, nursing care, and ambiance in patient satisfaction. The findings underscore the importance of cultural compatibility in patient-physician relationships, particularly when shared racial or ethnic backgrounds enhance trust and communication. Conclusion: This study has emphasized the role of patient experience in building trust and loyalty in healthcare organizations
Unveiling Patient Satisfaction: Exploring Demographics, Interactions, and Health-Seeking Behavior
Get PDFObjective: This study examined the social context of the patient visit (demographics, waiting room experience, patient-provider interaction) and their relationship to satisfaction with the quality of care when seeking medical treatment. It also examined satisfaction as a predictor variable for its effect on three patient behavioral outcomes. Methods: The study was implemented using a cross-sectional quantitative design among adults aged 18 and older. One hundred fifty-eight participants responded to the survey, and the final sample size was n = 147. We employed advanced data analysis, hierarchical regression, three-way ANOVA, linear regression, and logistic regression to examine four outcome variables. Results: Our hierarchical regression found that satisfaction with the quality of care was significantly associated with age, perceptions of rude treatment in the waiting room, the perceived helpfulness of the prescribed treatment, and the provider\u27s friendliness. Linear and logistic regression demonstrated that patient satisfaction strongly predicted whether patients would delay healthcare visits, recommend their current provider to family and friends, and look for a new provider. Conclusions: Factors influencing patient satisfaction appear to differ between older patients and younger adult patients, as demonstrated in this study. Addressing modifiable factors in the waiting room and within the patient-provider interaction may positively affect patient satisfaction, increase healthcare utilization, produce better patient health outcomes, and contribute to organizational success
The Art of Diagnosis: How to Actively Participate in Your Healthcare
Get PDFDiagnosing illness is one of the most complex and error-prone aspects of healthcare, yet patients are rarely equipped with the knowledge or tools to engage in the process actively. This article demystifies diagnosis by explaining how doctors formulate differential diagnoses, the limitations of medical testing, and the cognitive and systemic factors that contribute to diagnostic errors. Drawing on real-world examples, the article highlights the crucial role of clear communication and collaborative decision-making between patients and clinicians. It offers practical, evidence-based strategies for patients to prepare for consultations, communicate their symptoms effectively, and ask key questions that promote accurate diagnosis. By empowering patients to participate more actively in their care, this article supports ongoing efforts in public health and medical safety aimed at reducing diagnostic errors and improving health outcomes
Understanding Online Reviews of Geriatricians: Correlations within a Dataset of 53,210 Physician Reviews
Get PDFIntroduction: Online reviews are increasingly influential in how patients find and choose physicians. Patients appreciate the transparency of online reviews, and they offer an avenue for physicians to receive feedback. This cross-sectional study aims to provide insight into correlations between provider level information such as wait times or physician demographics, and the reviews patients submit online for geriatricians.
Methods: ParseHub software was used to extract and pool data from 6,631 provider profiles categorized under “geriatric medicine” on the popular open-source physician review website Healthgrades.com. Physician race or ethnicity was modeled by profile last name based on 2010 US census data. Non-physician providers were excluded from the main analysis. Standard statistical models including Pearson correlations and t-tests were used to determine relationships between physician information and their average online rating.
Results: We found that physicians with longer wait times have significantly lower reviews (P
Conclusions: Our study supports previous studies that have found correlations between longer wait times and lower physician reviews. Cultural barriers and biases may play into lower online reviews of Asian physicians. Further studies will be helpful in addressing causality and improve the patient and physician experience with online reviews
“All Together”: A Case Study Demystifying Patient and Public Involvement (PPI) in Brief Psychological Interventions within a Community Mental Health Service for Adults in the UK
Get PDFThe importance and value of involving patients and the public in the decision-making processes within services designed to support them, and research projects aimed at understanding and improving those services, have long been established. This is often referred to as Patient and Public Involvement (PPI). However, establishing good quality involvement work in practical terms is often less well understood and therefore, the uncertainty surrounding this can lead to hesitation by clinicians in practice. In this paper, we will share our lessons learned and the practical outcomes of PPI when applied in an NHS community mental health service for adults. We used Brief Psychological Interventions (BPIs) as a case study, demonstrating how PPI, in the form of public consultation, shaped the BPI service evaluation and led to intervention improvements. We aim to capture, ‘how PPI worked’ from the perspectives of the parties involved, including those with lived experience and the clinical team. We endeavour to bridge the gap between the rationale for involving patients and the public in decision-making processes and the practical challenges of implementing effective involvement work, contributing to a more comprehensive understanding of this crucial aspect of PPI