Patient Experience Journal (PXJ, The Beryl Institute)
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Patient Engagement and Co-creation in Healthcare Services: A Scoping Review
Get PDFObjective: The objective of this review was to find literature related to the concepts of patient engagement and co-creation in healthcare services and identify models and/or frameworks that combined these concepts. Methods: We developed the eligibility criteria using the Population-Concept-Context framework applicable to studies with population of patients exploring the concepts of engagement and co-creation in the context of healthcare services. The search was conducted in PubMed, CINAHL, Cochrane, APA PsycINFO, and Ovid MEDLINE. We searched for articles in English with no search limitations on publication dates. Reviewers screened abstracts and full texts to identify articles for data extraction. We developed, piloted, and implemented a data extraction tool to extract key information needed to answer the research questions. Results: Our search yielded 3632 references. Fifty-five studies were included in this review with 26 studies in patient engagement and 29 studies in co-creation. Many identified studies explored the field of healthcare services research. We identified the common principles of patient engagement and co-creation along with the existing models and frameworks that were either applied to guide these studies or proposed through these studies. Conclusion: Though there were several models describing different components and phases of patient engagement and co-creation concepts, there was a lack of unified, domain-agnostic models that described characteristics of these combined concepts. This review suggested the need for an innovative conceptual model that would bring together the concepts of co-creation and the principles of patient engagement applicable to various activities in healthcare such as research, implementation, and evaluation
Co-designing of Patient Safety Incident Disclosure Process in Primary Healthcare System in Qatar
Get PDFThe importance of disclosing a patient safety incident to the patient involved is recognized. In Qatar, there is no legal requirement for disclosure. The primary health care system in Qatar includes 30 health centers located around the country, managed by the Primary Health Care Corporation (PHCC). Over 63 nationalities of staff deliver care in the health centers, many coming from countries where a disclosure policy is not implemented, and staff would be reluctant to disclose an incident to a patient for fear of reprimand. Many patients who receive care in the health centers come from countries where the health system culture is not open and transparent with patients. PHCC seeks accreditation of the health centers by Accreditation Canada, which has a required organizational practice of disclosure of patient safety incidents. To maintain accreditation, and consistent with PHCC’s strategy to deliver patient and family-centered care, PHCC needed to develop and implement a disclosure policy and process. The policy and process were co-designed by clinical staff working in the health centers and patients, through a focus group and individual interviews. The resulting policy and process focused on communicating disclosure quickly by a multidisciplinary team, providing for quick access to healthcare services by the patient, and fully documenting the disclosure, using a newly developed electronic record. Staff training, coordination with incident reporting and analysis, and ongoing evaluation were key stages of the implementation. The disclosure process has been in place for five years, with only positive feedback from patients and no legal implications
The Evolution of Patient Experience: From Holistic Care to Human Experience
Get PDFPatient experience has evolved as a critical concept and outcome in health systems internationally. Evolving from consumer-led movements, coupled with shifts in the positioning of patients among clinical professions, the global focus on patient experience is now evident in nationally mandated measurement tools, the creation of dedicated institutional leadership roles, and outlets such as the Patient Experience Journal. By critically analysing the pivotal factors and milestones that have shaped its evolution throughout healthcare history, this review provides an in-depth exploration of the evolution of patient experience. In doing so, the review provides a critical analysis of the application of patient experience in health systems and future directions required to drive change for improvement
The Mental Health Journey of Healthcare Workers Returning to Work After COVID-19 in Pakistan: Recovery and Resilience
Get PDFSince the beginning of the COVID-19 pandemic various studies have reported that healthcare workers (HCWs) are not only at risk of exposure but also experiencing psychological distress. However, less is known about the mental health outcome of HCWs after their clinical recovery from COVID-19 infection. This study addresses a critical gap in our understanding by focusing on the mental health outcomes of HCWs in Pakistan after their clinical recovery from COVID-19 infection and the resumption of their duties. This cross-sectional, study was conducted among 272 HCWs who had recovered COVID-19 infection. The symptoms of depression were assessed by Patient Health Questionnaire-9. Multivariable logistic regression was performed to identify factors associated with depression. The findings revealed a depression prevalence of 33.82% among the HCWs in the study. Factors such as being female, middle-aged, having lower income, and working in COVID-19 wards increased the risk of depression. Moreover, those who perceived less social support from coworkers and supervisors and experienced an increased workload after resuming duties showed higher depression rates. In conclusion, the study emphasizes that clinical recovery from COVID-19 infection does not guarantee functional recovery for HCWs. To support their psychological well-being and resilience, it underscores the importance of enhanced social support in the workplace for who resume their duties after recovering from COVID-19 infection
Patient Experiences with an mHealth App for Complex Chronic Disease Care: Connections Despite Lack of Traditional Clinical Interactions
Get PDFChronic diseases are costly to treat and burdensome for patients. Mobile health (mHealth) technologies might reduce costs of care and increase patient self-efficacy in chronic disease management, but the patient experience of mHealth is poorly understood. Our objective, therefore, was to evaluate patient experiences with using an mHealth app for complex chronic disease management, within a U.S. population of low-income patients. We used nurse/patient text messages from an mHealth complex chronic disease management tool, and exit interviews from patients, to assess qualitatively Medicaid patients\u27 experiences with a remote monitoring mHealth app. Salient themes about the patient experience included: (1) Visibility and Invisibility in the Medical System (patients felt both seen and heard when using the app), (2) Deconstructing the Clinical Encounter (patients were reassured by being able to access care from any place at any time), (3) Familiarity in the Nurse/Patient Relationship (patients felt connected to the nurses running the app), and (4) Technology as a Conduit of Caring (the technology enhanced nursing care, rather than detracting from it). M-Health apps might be a way to improve provision of care for high-utilizing patients, particularly those from historically marginalized groups
Experiences of Psychosocial Support in Group Rehabilitation Interventions from Adults with Chronic Conditions – A Qualitative Systematic Review
Get PDFAims and objectives: Psychosocial support is essential in group rehabilitation interventions aiming at supporting adaptation to chronic illness and disability. Aim was to synthesize qualitative evidence on how adults with chronic conditions experience psychosocial support in group rehabilitation interventions. Materials and Methods: Four databases (CINAHL, Medic, Pubmed, Scopus) were searched for qualitative studies published between 2009-2022. Study selection and critical appraisal were independently performed by two authors using the JBI Critical Appraisal Checklist. Study selection and critical appraisal were independently performed by two authors. Data were synthesized through inductive content analysis. Results: The findings from nine studies were synthesized into 105 sub-categories, 15 categories and to six main categories: 1) Management of life; 2) Reflective communication; 3) Group process; 4) Invaluable peer support; 5) Professional as a competent human trainer; and 6) Process of relief. Conclusion: Psychosocial support in group rehabilitation interventions can provide adequate social support and a basis for self-management. Both healthcare professionals and peers have invaluable roles in helping patients with chronic conditions adapt to their life situation. Interventions should facilitate knowledge sharing and help patients take responsibility for self-management. Furthermore, participants should be able to choose the topics of the program. Healthcare professionals have an important role in initiating conversations about topics which may be taboo. Professionals should recognize participants’ individualized needs for information and support, and foster group dynamics by supporting open communication and reflection
Experiences of using Electronic Medical Records among Patients from Ethnic Minority Backgrounds: A Rapid Review
Get PDFThis study explores the experiences of individuals from ethnic minority backgrounds using electronic medical records (EMRs) and identifies strategies to improve the inclusivity and usability of EMRs, aiming to reduce the digital divide in their access and use. A rapid review of the literature was conducted using Medline, Embase, and CINAHL databases to identify relevant studies published between 2010 and November 2023, with the assistance of a medical librarian.
A total of 44 studies were included in the review, revealing significant disparities in EMR adoption and utilization among ethnic minority groups. Three key themes of inequality were identified: presentation of EMR and patient portal options, the registration and activation process, and the actual use of patient portals. While the review considered all elements of EMR systems, most published research focused specifically on patient portals.
To address these disparities, a multifaceted approach is necessary, one that acknowledges linguistic diversity, enhances digital health literacy, and actively incorporates feedback from ethnic minority communities to improve EMR engagement
Patient Safety Culture Among Healthcare Settings in Low and Middle-Income Countries: A Systematic Review and Meta-Analysis
Get PDFEnsuring patient safety is a crucial element in providing high-quality healthcare services. Therefore, this study aimed to assess the current state of patient safety culture in healthcare settings within low- and middle-income countries. A thorough search was conducted across multiple databases, including Science Direct, Scopus, Google Scholar, EMBASE, and PubMed. Data extraction was carried out using Microsoft Excel, and statistical analysis was performed using STATA software (version 14). To evaluate publication bias, methods such as Egger\u27s regression tests, rank tests, and forest plots were utilized. The I2 statistic was used to assess heterogeneity, followed by an overall estimated analysis. Additionally, subgroup analyses were performed based on sample size and type of healthcare. After reviewing 1,143 articles, 21 publications involving 17,782 research participants were selected. The results indicated that the prevalence of patient safety culture in healthcare facilities in low- and middle-income countries was 48.25 percent (95 percent CI: 41.26, 55.24), with an I2 value of 78.8 percent. Among the various dimensions of patient safety culture, teamwork within units received the highest score (67.8%), while non-punitive responses to errors received the lowest score (27.6%). Compared to previous studies, it can be concluded that patient safety cultures in low- and middle-income countries are lacking, underscoring the need for targeted interventions to address this issue
“Not Your Father’s Heart”: How Healthcare Discrimination for Neurodivergent Patients Taught Me About the Human Experience
Get PDFIt is easy to assume all patients who come into a hospital for acute crisis care have a clear understanding of how their experience will be facilitated. When a patient is neurodivergent, they cannot always agree to needed intervention. This is exacerbated by the “poor timing” of questions portrayed to impact the critical care received, sometimes irreparably. This is my story of watching my young, active partner suffer two massive heart attacks and refuse intervention because he was ashamed to admit he had not seen a doctor in over thirty years. Due to his neurodivergence, he could not process questions under pressure, held the belief he had no health insurance, and could not afford care. This is also the story of how one talented cardiothoracic surgeon listened to my partner through the ears of a patient and nothing more. My experience with the intersection of patient experience and healthcare volunteerism led me to advocating for a truly terrified human being and I realized this was not the storybook heart attack portrayed in movies or what we typically hear from our parents or grandparents. This was living, in real-time, the thought I would lose my partner because he could not cope. We are on the other side now, but I wonder what other neurodivergent patients do when they do not have someone like me. I hope my story helps providers and PX professional think through the lens of those who cannot follow the traditional expectations of emergent care
Healthcare Team Members’ Views on Social Determinants of Health Screening and Referral Practices in a Pediatric Emergency Department
Get PDFWe aimed to explore the healthcare team members’ (HTMs) views on social determinants of health (SDH) screening and referral processes in a pediatric emergency department (PED). We conducted a cross-sectional, mixed-methods study to explore PED HTMs’ views on social care practices at a quaternary-level children’s hospital. The survey was created using a goal identification framework. The survey gathered quantitative and qualitative data by assessing SDH screening practices, comfort and personal habits in screening, prioritization of SDH domains, workflows to perform screening, and perceived barriers to screening. Quantitative data were analyzed using descriptive statistics. Qualitative data were analyzed using thematic analysis and multiple reviewers to identify themes in free-text responses. There were 63 HTMs (48% response rate, Table 1), all of whom reported SDH screening efforts should continue in the PED (Fig. 1), yet 36% were unaware of the current SDH screening processes. Participants reported a median comfort level rate of 47.5 out of 100 when asking SDH-related questions (Fig. 1), and the highest reported barriers were “lack of knowledge/skill on resources” (77.3%), “lack of time” (68%), and “patient volume” (59%) (Fig. 2). Regarding the screening process, approximately half of the respondents suggested improvements in “integration of screening” and “variability of screening” (Fig. 4). This explorative analysis demonstrated that HTMs support continuing screening and referring patients for SDH-related needs. In addition, HTM survey respondents suggested improvements in screening and referral processes, opportunities for HTM training, and screening support to address social needs and ultimately improve patient health outcomes