Patient Experience Journal (PXJ, The Beryl Institute)
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Leveraging telehealth supportive oncology services to combat COVID-19 isolation in breast cancer patients: A cancer center’s perspective
Get PDFDuring the COVID-19 pandemic, breast cancer patient in-person visits were converted to telehealth visits. Given our concerns about increased isolation amongst breast cancer patients during the pandemic, and the deleterious effects of such isolation on patient outcomes, we investigated utilization rates of psycho-social services amongst newly diagnosed breast cancer patients at our institution. We explored visit platforms (telehealth versus in-person) and time points prior to and encompassing the early pandemic. Despite decreased new breast cancer visits, there was a greater than 2-fold increase in supportive oncology service encounters in breast cancer patients during COVID-19 suggesting increased need for psycho-oncology resources. While services had not been offered virtually prior to the pandemic, the majority of the supportive oncology visits were conducted via telehealth during the initial months (73%) and year (59%) of the pandemic. 89% of breast cancer patients accessing psycho-social services were in-state patients, and service utilization increased amongst rural and urban residents during the pandemic. Total numbers of rural patients receiving supportive oncology services remained low compared to numbers of urban patients, however, though virtual visits predominated. While the number of out-of-state patients accessing psycho-oncology services during the pandemic was low, there was a 5-fold increase in psycho-social service utilization in this group during the pandemic. The majority of these visits were in-person. Telehealth services can be used to extend psycho-social support to breast cancer patients and combat the experience of isolation exacerbated by the pandemic. Virtual visits can be further utilized to increase outreach to rural and out-of-state patients.
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
A multi-stakeholder perspective on quality of care among residents, family members and nursing staff in nursing homes: A Balanced Centricity approach
Get PDFThe objective of this study was to use a Balanced Centricity (BC) approach to describe how personal values related to experienced quality of care are defined for residents, family and nursing staff in nursing homes. Capturing the values from a multi-stakeholder perspective, a qualitative approach was conducted in which the stakeholders’ (e.g., residents, family members of residents and nursing staff; a triad) experiences, opinions and values were explored. Participants were recruited from ten nursing homes within the Living Lab in Ageing & Long-Term Care Limburg, the Netherlands. The audio recording of every interview was transcribed verbatim. The analysis made use of an inductive and deductive approach. In total, 12 individuals were interviewed in 4 triads. Three main values were identified throughout the triads: greater focus on wellbeing, feelings of autonomy and family matters. All stakeholders mentioned the need for a greater focus on well-being in which more one-on-one time (i.e., between one resident and a staff member) is possible. However, discrepancies in the values between these three stakeholders are also present in topics such as autonomy and the role of family visits. This study underscores that, although several values are aligned between these stakeholders, other values display discordance. Especially in a setting as complex as nursing homes, a BC approach might be considered in which not only the values and needs of residents, but also those of their family members and nursing staff are taken into consideration.
Experience Framework
This article is associated with the Quality & Clinical Excellence 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
Doctor behaviors that impact patient satisfaction
Get PDFPatient satisfaction with their doctor is an essential component of healthcare that impacts both patient health outcomes and fiscal success of healthcare organizations. This study identifies doctor behaviors that act as drivers of patient satisfaction when doctor expertise is set aside and determines the importance of these behaviors between different age groups. Survey data were gathered from two samples, one comprising younger adults at a mid-size Midwestern university (n=100) and one comprising older adults from a national market research survey panel provider (n=187). Subjects were asked to rate their satisfaction with their doctors from 0‑100 and rate the importance of 21 doctor behaviors from 1-5. Results support evaluating patients’ overall views with their doctors separately from their views of their doctors when ignoring doctors’ expertise, as three unique doctor behaviors were identified when ignoring the doctors’ expertise (i.e., not rushed, long-term relationship, and being fun). Results also support the existence of age-related patient satisfaction drivers. Unique satisfaction drivers among younger patients include not rushing the interaction, being fun, conveying a caring demeanor, and protecting patient privacy. Conversely, unique satisfaction drivers among older patients include listening, conveying friendliness, building long-term relationships, and seeking patient input. Findings indicate that expertise-independent doctor behaviors are quantifiable and demonstrate clear patterns of importance in terms of patient satisfaction to different age groups. They also align with prior research findings that behaviors traditionally classified as “soft skills” like smiling and active listening are important attributes when considering patient satisfaction.
Experience Framework
This article is associated with the Staff & Provider 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
Identifying sources of patient dissatisfaction when seeking care for a chronic and complex disease
Get PDFPatients’ evaluations of healthcare often rely on patient satisfaction and encounter-specific approaches. Instead, valuable information can be gained by focusing on patient dissatisfaction with healthcare over time. This study examined patients’ sources of care dissatisfaction when seeking healthcare for a long-term chronic and complex disease (CCD). Participants with a CCD called polycystic kidney disease (N=387) completed an online questionnaire with an open-ended question about dissatisfying experiences. Content analysis was used to analyze responses. The coded data resulted in conceptual codes related to dissatisfaction with information, support, and care management. Analysis revealed the type of healthcare provider is often mentioned, and that more than one type of dissatisfaction can occur at the same time. Patients with CCDs are experiencing a variety of types of dissatisfaction when seeking healthcare, which may point to ongoing communication gaps between patients and the healthcare providers they see over time for their disease. Providers who see patients with CCDs should remember these patients may see multiple providers over time and have unique support needs. Providers can potentially improve care experiences by helping patients manage their care across both providers and experiences, as well as encourage patients to ask questions and express their concerns.
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
Digital patient engagement at a perioperative surgical home implemented community hospital
Get PDFPatients in rural areas typically require more perioperative ‘optimization’ for surgery. The rural healthcare systems often overwhelmed with coordinating perioperative services and deliver less than optimal surgical outcomes. This is due to limited supporting microsystems and ability to effectively engage and track patients over the 120-day perioperative period to limit post-surgical complications. The study assessed longitudinal patient engagement within a newly established Perioperative Surgical Home (PSH) at a rural community hospital serving 10+ surrounding counties to identify barriers and best practices for engagement. A digital patient engagement platform was implemented and used to assess longitudinal patient outcomes and engagement from 30 days preoperative to 90 days postoperative. The research team (health systems engineers teamed with clinicians) analyzed 2-years of collected patient data (n= 301) primarily consisting of Total Joint Replacement (TJR) procedures. The digital patient engagement system’s email and text messages allowed patients and PSH staff to track outcomes, experience, and collaborate on post-surgical events. The average patient engagement was low (less than 40%). However, the average survey completion was 90%, i.e., if a patient responded to a survey on a particular day, on average patients finished 90% of the survey. Patient engagement was critically important to improving surgical care in rural areas. Digital longitudinal patient engagement implemented by PSH clinic was successful at rural community hospitals serving patients from 10+ surrounding counties.
Experience Framework
This article is associated with the Innovation & Technology 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 len
What are the sources of patient experience feedback in the UK prison setting, and what do patients and healthcare staff think about giving and receiving feedback in prison? A qualitative study
Get PDFoai:pxjournal.org:journal-1603Background: The collection of patient experience feedback (PEF) has seen a marked global increase in the past decade. Research about PEF has concentrated mainly on hospital settings albeit a recent interest in primary care. There has been minimal research about PEF in the prison healthcare setting. The aim of this study was to explore the role of prison PEF, the different forms it might take and the perceptions of healthcare staff and people in prison. Methods: Qualitative face to face interview study involving 24 participants across two prisons (male and female) in the North of England, involving 12 healthcare staff and 12 patients. Framework analysis was undertaken. Results: PEF sources were variable, from informal and verbal through to formal and written. The willingness of people in prison to give PEF related to whether they felt sufficiently comfortable to raise concerns, with some feeling too frightened and having apprehension about anonymity. It was viewed as disheartening to give PEF but not be informed of any outcome. Healthcare staff opinions about PEF were divergent but they found PEF unhelpful when it was about prison regime issues rather than healthcare. Suggestions for improving the PEF process were put forward and included accessibility, anonymity and digitalisation. Conclusions: This is the first study to report findings about prison PEF. There are broad similarities between our findings and research examining hospital-based PEF. Prison healthcare services seem to be listening to patients but the ways in which PEF is collected, considered and used could be improved.
Experience Framework
This article is associated with the Policy & Measurement 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
Showcasing patient and public involvement: Using consultation, collaboration and co-design to shape a respiratory programme
Get PDFThe NHS is committed to working with patient groups and the public to co-design health services to ensure that lived experience is used to optimise service design and delivery. This case study describes and considers methodologies used by commissioners to meaningfully engage and collaborate with patient groups to co-design respiratory services in a region of England. Stakeholders agreed a two-stage approach to the patient and public involvement (PPI) for this specific project; an initial consultation with patient groups on existing services, to inform a collaborative co-design process for the new pathway. The full pathway was not commissioned, but elements of it were implemented which resulted in patients appreciating that their views had been sought and acted on and strengthened relationships between commissioners and patient support groups. Commissioners should be pragmatic in engaging with patients and the public and consider the needs of a specific population in undertaking meaningful engagement and co-design processes.
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
How an intake conversation in mental healthcare nearly led to suicide
Get PDFAs a patient of mental health care, I want to share and reflect on an experience I had during an intake conversation. I had been dismissed from a hospital stay and my psychiatrist had arranged for an intake conversation for a program specialized in treating people with anxiety and depression in another hospital. Given the state of my illness, I was prepared to give this new program a try. My expectations were that I would be treated with dignity and respect as I had been treated in the hospital from which I had been dismissed. Yet, my experience turned out to be very negative leading me to consider suicide right after the conversation and when getting home. Below, I first provide my narrative of the intake conversation, after which I will share some reflections and recommendations. I now understand that achieving patient-centered care during intake conversations is not obvious, in part because the intaker has little time to get to know the patient, and in part because the patient may defer from speaking openly with the intaker. My conclusion is that, if the intaker and the patient manage to negotiate and work together from different but complementary points of view, one can achieve a patient-centered partnership in care, already during intake conversations.
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
Living with Multiple Sclerosis as a former marathon runner: Impact of attitude and past behaviour on self-care maintenance and perseverance
Get PDFAs healthcare professionals, we have a duty to promote the wellbeing of individuals living with chronic diseases and this could be accomplished through the establishment of self-care strategies that are both collaborative and self-directed. Insight into the complex behaviours and backgrounds of individuals who show initiative in dealing with chronic disease could help achieve this by revealing drivers of health-seeking and engaging behaviours. Therefore, by deducing the complex interactions between attitude, past experiences and disease outlook, broader patient welfare could be championed through the implementation of targeted interventions which promote self-care in chronic disease. This article aims to explore these ideas by focusing on the story of a former marathon runner and proactive secondary progressive Multiple Sclerosis sufferer, Mr. Evans, who has taken charge in leading an active and healthy lifestyle to manage his condition. His sense of patience and self-worth are rooted in his attitude and upbringing and are factors which have championed his ongoing wellbeing and understanding of his condition.
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
Which patient experiences are you capturing? Investigating differences in patient experience drivers by race/ethnicity and survey mode
Get PDFTo address existing disparities in healthcare for underserved populations, healthcare providers and policymakers need to understand how the experiences of these patients differ to take meaningful action. In this study, we examine whether drivers of patient experiences (PX) for underserved populations vary. Using data from the 2018 and 2019 CAHPS Adult PCMH/Adult Primary Care 6 Month (n = 166,349), we examine differences in the importance of PX drivers - effective communication, helpful and courteous staff, timely appointments, and providers’ use of information - across underserved patients. We further examine whether different survey modes compound the observed differences. The findings show that there is significant variation in PX drivers across underserved patients, such that Asian American patients place less importance on effective communication and timely appointments but more emphasis on helpful and courteous staff than the average patient. In contrast, Black or African American patients place a higher importance on timely appointments. We observe additional differences when survey modes are taken into consideration, implying that for underserved populations the way in which patient feedback is collected matters. Taken together, the results from this study highlight the need to not only examine the overall PX for patients of underserved populations but understand which drivers matter. Moreover, our findings imply the need to make various survey modes available to capture patient feedback in a way that is responsive to the needs of each of these populations so that a representative sample is collected as survey mode significantly moderates the PX captured.
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