Patient Experience Journal (PXJ, The Beryl Institute)
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The initial psychometric evaluation of a new Emergency Department Patient-Reported Experience Measure (ED PREM)
Get PDFPatient-reported experience measures (PREMs) are critical to evaluating the person-centeredness, safety, and quality of healthcare services internationally. The aim of this study was to describe the initial psychometric evaluation of a new Emergency Department (ED) PREM. Adult patients presenting to the ED of a tertiary hospital in southeast Queensland, Australia during January 2022 were recruited in-person. Participants selected their preferred ED PREM mode of administration from online, telephone, or postal, and had 14 days from recruitment to complete the survey. Item reduction, structural validity, discriminant validity, and internal consistency reliability were assessed. A sample of 349 (68.4%) was achieved. Item reduction analysis indicated ceiling effects for all ED PREM items (ranging between 34.4-79.7%). Exploratory factor analysis revealed a 4-factor solution comprising 26-items that explained 55% of model variance. Cronbach’s α ranged between 0.84-0.97 per factor, demonstrating internal consistency reliability. Known groups analysis demonstrated the ED PREMs’ ability to discriminate experiences based on gender, age, and ED length of stay. The ED PREM is a valid and reliable instrument for capturing patient experiences in the ED. The content of the ED PREM emphasizes person-centeredness and shared decision making, making it suitable for use in clinical practice evaluation and health service performance measurement. The factor structure of the ED PREM should be confirmed in future research, and item redundancy addressed.
Experience Framework
This article is associated with the Policy & Measurement lens of The Beryl Institute Experience Framework (https://theberylinstitute.org/experience-framework/). Access other PXJ articles related to this lens. Access other resources related to this lens
Leveraging patient experience measures as surrogate outcomes to evaluate health care interventions
Get PDFPatient experience quality measure scores are widely accepted as outcomes in health services research. For some patients and in some settings, such as hospice care, they can be the most important outcomes. While these measures are widely used, the potential to use them as surrogate outcomes in a clinical trial sense has gone under-recognized. The purpose of this commentary is to discuss the use of patient experience measures as potential surrogate outcomes in evaluating the effect of a health care intervention.
Experience Framework
This article is associated with the Policy & Measurement lens of The Beryl Institute Experience Framework (https://theberylinstitute.org/experience-framework/). Access other PXJ articles related to this lens. Access other resources related to this lens
The role of patient-centered communication scale in patients’ satisfaction of healthcare providers before and during the COVID-19 pandemic
Get PDFAssess the effect of patient-centered communication (PCC) scale on the patient satisfaction of healthcare providers (HCPs). The 2020 Health Information National Trends Survey (HINTS) was used to analyze the patient’s satisfaction of HCPs. This survey includes 2466 patients’ responses and were analyzed using the multivariable binary Hyperbolastic regression model of type II. The study examines the effects of PCC scale on patients’ satisfaction of HCPs while controlling for pandemic status, employment, education, marital status, race, political views, waiting time status, sex, income, and age. PCC scale was the most significant predictor of patients’ satisfaction of their HCPs (P-value \u3c 0.001) followed by waiting time status (P-value \u3c 0.001), and age (P-value = 0.016). The odds of patient satisfaction with the healthcare provider services were approximately 20% higher prior to the pandemic than during the pandemic (P-value = 0.415). The odds of satisfaction for patients earning 35,000 (P-value = 0.003). PCC scale is a powerful measure that may be used as a metric for patients’ satisfaction of HCPs. Taking steps to improve communication between HCPs and patients is a key factor in patient satisfaction. Concentrating on the seven domains of PCC will result in higher patient satisfaction of HCPs. The improvement in PCC will encourage each patient to disclose vital information about his or her health. This may increase the accuracy of diagnosis, quality of care, and health outcomes.
Experience Framework
This article is associated with the Policy & Measurement lens of The Beryl Institute Experience Framework (https://theberylinstitute.org/experience-framework/). Access other PXJ articles related to this lens. Access other resources related to this lens
Strengthening patient-family engagement amidst a pandemic: Lessons learned and paths forward
Get PDFThe COVID-19 pandemic was highly disruptive to healthcare and negatively affected healthcare worker and patient experience on multiple levels. Patient Family Advisors serve an important role in partnering with health systems to improve patient experience, yet the work of many volunteer programs were interrupted by the onset of the pandemic, at a time when integrating patient voice into care delivery was sorely needed. This case study presents one health system’s experience adapting a system-wide Patient Family Advisory program in the setting of the COVID-19 pandemic, including the transition to a virtual format and increased flexibility in how Patient Family Advisors engage with staff projects. Despite challenges, we were able to maintain meaningful Patient Family Advisory program work throughout the first two years of the pandemic, with at least fifteen Patient Family Advisor project activities each six months. We focused on three primary areas: early patient engagement, increasing visibility of patient engagement, and increasing the effectiveness of our Patient Family Advisors. Adaptation to virtual meetings and adding project-based embedments in addition to traditional council models also allowed the recruitment of new, diverse PFA membership. Commitment to patient engagement and co-design can be challenging but is of particular importance during times of stress for health systems. Flexibility in methods to engage and utilize Patient Family Advisors are needed to maintain success. Increasing agency of Patient Family Advisors will drive meaningful engagement for both volunteers and staff.
Experience Framework
This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework). Access other PXJ articles related to this lens. Access other resources related to this lens
Patient experiences through head and neck cancer: Information delivery combatting psychological distress
Get PDFAs part of a larger study investigating the utility of electronic decision support tools for patients with head and neck cancer (HNC), this article describes the patient experience of receiving cancer treatment in British Columbia, Canada. It aims to give voice to the patient experience and recommend a model of psychological adjustment for clinicians and clinical service management to consider to refine patient centric care pathways for HNC. Based in phenomenology, semi-structured interviews were conducted with 12 survivors of HNC, audio-video recorded, and thematically analyzed. Three themes were identified: (1) patients have high, though varying information needs; (2) an emotional experience; and (3) coping, strength, and resiliency. These themes arose from six concepts: (1) information needs; (2) fear of the unknown; (3) desire for personalized information; (4) varying degrees of information needs; (5) fear as a motivator versus stressor; and (6) high information needs on life after treatment. Conclusions: The patient experience must be considered through the full care trajectory and into survivorship to provide the right information to the correct patient at the optimal time. Patient journey mapping may be a novel approach to exploring the temporal relationship between information needs and the patient experience along the cancer continuum to uncover opportune moments, from the patient perspective, for knowledge and supportive care intervention. The model of psychological adjustment by Calver et al. (2019) can be considered to inform the delivery of cancer care information in a method recognizing the patient as the ultimate knowledge holder.
Experience Framework
This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework). Access other PXJ articles related to this lens. Access other resources related to this lens
Building on a decade of hope: Why we must champion the human experience
Get PDFThe pages of PXJ have served a primary purpose, to expand the evidence on patient experience and push the boundaries of innovation in this critical work. But through this commitment, PXJ has seen much more happen. The contributions of our thousands of authors, reviewers and editors have also fostered an environment of connection. PXJ has emerged as something more than just a journal. It has become a place for conversation. It has served as a conduit for expanding excellence in practice. It has fostered new thinking. And it has broadened our global community. There is something very special found on these pages. It is a shared sense of purpose and of possibility. And it is even more critical as our focus is ensuring excellence in the human experience in healthcare. For this reason, we thrive on the ability to share and learn, apply and evolve, act and improve. We do so with strategic focus, intentional listening, respect for differences and a commitment to agility. This carrying forth of hope and all that lies ahead is not something that just happens in the natural order of things; it takes intention and commitment, vulnerability and openness, and clarity and focus. It also takes the strength to stand up in the face of what some may say is unimportant, intangible or simply impossible. It takes champions of human experience to build on a decade of hope
Medicine and kindness, a glorious concurrence?
Get PDFThis article unfolds the journey of a 28-year-old junior doctor entangled in the throes of a pernicious anemia diagnosis during her travels abroad, a scenario exacerbated by the grip of a COVID-19 lockdown. Adrift without medical insurance and distant from her family, she found herself under the care of a compassionate on-call resident, emphasizing the crucial role of kindness and compassion in her predicament. Her treatment regimen encompassed a series of CBC tests meticulously tracking cobalamin and ferritin levels, complemented by extensive examinations for iron deficiency and a regimen of vital vitamin B12 injections, all carried out under vigilant scrutiny to ensure the eventual normalization of her lab findings—a process spanning over a week. As the medical landscape continues to grapple with the COVID-19 pandemic, stories like hers underscore the vital need for empathy and understanding within the healthcare sphere. In these challenging times, compassion emerged as a lifeline, bridging the gap between distress and recovery. This narrative serves as a poignant reminder that amidst the complexity of medical science, it is often the simplest acts of kindness that can make all the difference. In the face of an ongoing shift towards policy-centric healthcare, the article advocates a return to a patient-centric approach, one where kindness becomes an integral element of treatment, alleviating anxiety, reducing uncertainty, and promoting overall well-being. It prompts readers to reflect on the profound impact of compassion and empathy in medicine, sparking a dialogue on how fostering a more humane and inclusive healthcare system ultimately benefits us all.
Experience Framework
This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework (https://theberylinstitute.org/experience-framework/). Access other PXJ articles related to this lens. Access other resources related to this lens
Patient perspectives of health-related social needs screening in an urban academic adult primary care practice
Get PDFHealth-related social needs (HRSNs) affect health outcomes and healthcare utilization. Patients’ perspectives on the incorporation of HRSN screening in primary care settings is limited. We sought to explore adult primary care patient perspectives of HRSN screening from optional patient-provided free-text comments as part of a pilot self-administered HRSN screening survey on seven domains of HRSNs from the Accountable Health Communities HRSNs Screening Tool. The survey was available in English, Chinese or Spanish with a section titled “Comments” that invited patient respondents to provide anonymous free-text responses. We performed a thematic analysis of the written patient comments. Of the 679 participants surveyed, 93 participants (13.7%) provided written comments. Participants expressed concern for others and gratitude for their health or socio-economic situation, commented on how HRSN screening could improve patient care, and shared stories of overcoming unmet HRSNs in the past. No written comments from participants conveyed dissatisfaction regarding HRSN screening. Identified themes of participant comments show participants’ strong recognition of how health is impacted by unmet HRSNs. Our study adds to the literature of patient perspectives that support a role for HRSN screening in primary care that could help give voice to patient needs and facilitate the delivery of patient-centered care.
Experience Framework
This article is associated with the Policy & Measurement lens of The Beryl Institute Experience Framework (https://theberylinstitute.org/experience-framework/). Access other PXJ articles related to this lens. Access other resources related to this lens
“You Are the Key”: A co-design project to reduce disparities in Black veterans’ communication with healthcare providers
Get PDFInterventions are needed to overcome a key barrier to patient-provider communication, namely that patients hesitate to participate in clinical conversations because they believe their expected role is to be passive. This expectation is reinforced for veterans, who replicate their experience of military hierarchy in the patient-provider relationship. Black veterans, moreover, encounter structural racism that compounds this power imbalance. This paper describes a co-designed intervention to empower Black veterans to talk with providers, using shared decision-making (SDM) for lung cancer screening (LCS) as an exemplar. We worked with a diverse group of 5 veterans to develop materials that normalize participating in clinical conversations. We then interviewed 10 Black veterans selected from a national sample to assess the booklet’s impact and contextual factors. The co-design team produced a 30-page booklet that includes veteran narratives describing positive clinical interactions, as well as didactic information about SDM and LCS. We identified four themes related to Black veteran participants’ healthcare experience: (1) they want truthful and complete information exchange with providers they know; (2) they often feel their concerns are disregarded; (3) poor communication worsens medical treatment; and (4) they are confused and angry about treatment in clinical encounters that they feel are racist. The booklet was described as interesting and informative. The veteran narratives in the booklet particularly resonated with readers. Assessment of the booklet’s overall impact on planned engagement with providers varied. Co-designed materials that normalize participation in clinical encounters can play a role in reducing disparities in patient-provider communication.
Experience Framework
This article is associated with the Innovation & Technology lens of The Beryl Institute Experience Framework (https://theberylinstitute.org/experience-framework/). Access other PXJ articles related to this lens. Access other resources related to this lens
Patient experience in an interprofessional collaborative practice for underserved patients with heart failure
Get PDFHeart failure is a complex chronic condition that results in multiple patient visits throughout the care continuum. Patient experience has associations with clinical outcomes. The purpose of this study was to examine patient experience among the underserved in a specialized interprofessional collaborative practice heart failure clinic. This prospective study utilized both qualitative and quantitative data to describe the patient experience within an interprofessional collaborative practice. Data were collected from patient experience surveys in 1128 patients seen in the Heart Failure Transitional Care Services for Adults (HRTSA) clinic between January 1, 2018, and December 31, 2021. Interprofessional collaborative practice surveys were completed by clinic staff members. When examining relationships associated with patient experience, we found three significant associations. Being single was negatively associated with patient experience. When examining IPCP and patient experience, overall interprofessional collaborative practice alignment [t(237)=2.00, p=.046 ] and the team’s alignment of mission, vision and purpose [t(254)=1.99, p=.047] were positively related to patients’ care satisfaction. Interprofessional collaborative practice team alignment can positively impact patient experience in underserved patients with heart failure.
Experience Framework
This article is associated with the Quality & Clinical Excellence lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework). Access other PXJ articles related to this lens. Access other resources related to this lens