Patient Experience Journal (PXJ, The Beryl Institute)
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Improving workforce experiences at United States Federally Qualified Health Centers: Exploring the perceived impact of generational diversity on employee engagement
Get PDFThis qualitative study aimed to explore a multigenerational workforce’s impact on employee engagement as perceived by Federally Qualified Health Centers’ (FQHCs) C-suite executives. It sought to answer one research question: What is the perceived impact of generational diversity on employee engagement of Federally Qualified Health Centers (FQHCs) in the United States? This cross-sectional study was national. Primary data were collected using a self-developed, two-part survey instrument: (1) eight demographic questions and (2) two open-ended, short-answer questions. Cognitive interviews, reviews by five subject matter experts, and a pilot study were completed to ensure the instrument’s validity and reliability. Demographic data were analyzed using Minitab V19, and qualitative data were analyzed using MAXQDA V2020. The final sample (n=81) represented 6% of the 1,400 U.S. FQHCs and consisted of respondents from all five U.S. geographic regions: Northeast, Southeast, Midwest, Southwest, and West. Of the 81 FQHCs, one-third had a four-generation workforce, and over one-half had a five-generation workforce. A multigenerational workforce was important and necessary because of enhanced work creativity, improved problem solving, and a better representation of FQHCs’ diverse patients. Conversely, a multigenerational workforce also presented challenges, including the need to address generation-specific expectations, family dynamics, rewards and recognition, technology proficiency, and learning and training opportunities. Engaging a multigenerational workforce presented benefits and challenges. The benefits included fostering a sense of learning culture, transferring knowledge and skills, and promoting more representative patient communities which FQHC employees served. The challenges included varied expectations, different communication styles, and inter-generation perceptions in healthcare workplaces.
Experience Framework
This article is associated with the Staff & Provider 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
Caring for the caregiver during COVID-19 suspended visitation
Get PDFDuring the 4th surge of COVID-19, August to November 2021, visitation was suspended in a hospital system in North Georgia. The Compassionate Connections Call Center (CCCC) was created to alleviate staff stress and to manage calls and communication. The goal of the initiative was to reduce interruptions to patient care caused by the increased number of calls to the clinical units by patients, families, loved ones and personal caregivers. The CCCC managed all incoming calls and communicated with the patient’s primary nurse through a coordinated process which limited interruptions. By caring for the caregiver, the aim was to improve the workplace experience of the nurses. Ninety-seven volunteers from over 13 departments across the organization worked in the CCCC and managed 3200 calls. With an average call time of roughly three minutes, the center freed up approximately 160 hours daily for nurses who might otherwise have paused patient care to answer calls. In addition, a family liaison role was created to proactively provide updates to families. This team of forty-six Registered Nurses worked a total of 2925 hours proactively updating families and facilitating virtual visits.
Experience Framework
This article is associated with the Staff & Provider 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
Developing a patient satisfaction measure for imaging-based patient information during clinical consultations
Get PDFDifferent types of medical imaging are increasingly being used to explain specific aspects of injuries to patients during consultations. However, there are no validated questionnaires available yet that specifically measure patients’ satisfaction with the use of such images. The objective of this study was to develop and evaluate a patient-centred measure of satisfaction with the use of medical imaging modalities in clinical treatment. A preliminary 22-item version of the Questionnaire for Patient Satisfaction with Imaging (QPSI) was developed based on extant literature and interviews with trauma patients. Final item selection and psychometric evaluations were conducted amongst a sample of 106 hospital trauma patients who were shown medical images of their injuries. The psychometric analyses resulted in a final 13-item questionnaire comprising two subscales that measure the importance of seeing the images (9 items) and the clearness of the image (4 items). Both subscales showed adequate internal consistency (α = 0.84 and 0.75). The subscales were weakly intercorrelated (ρ = 0.34) and were both significantly and independently associated with patients’ global ratings of satisfaction with the use of imaging. The final two-dimensional QPSI is an innovative, reliable and valid questionnaire for measuring patients’ satisfaction with imaging-based information during clinical consultations.
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
Home health care CAHPS® survey: Predicting patient experience performance
No full textOur home health (HH) division has collected Home Health Care CAHPS® Survey (HHCAHPS) data since 2011. To date, HH providers have not met performance thresholds related to patient experience. This study aimed to explore HHCAHPS composite measures and specific questions to predict 1) overall rating of care provided by the agency (Care Rating) and 2) willingness to recommend home health agency to family and friends (Recommend Agency). We also explored survey comments to identify specific themes related to positive and negative patient experiences. Logistic regression (N = 7 268) revealed being treated with courtesy and respect, and providers being informed and up to date about care were the 2 most impactful factors of Care Rating. The top 2 most impactful factors for Recommend Agency were problem-free care and providers being informed and up to date about care. Thematic analyses revealed negative patient experiences were described as staff being rude, unhelpful services, and disregarding the patients’ time and schedules. Positive patient experiences were described when patients believed HH services improved their health; quality and professional services were provided by knowledgeable HH providers; and HH providers respected them, their time, and their homes. Our findings suggest that HH agencies must improve interpersonal relationships, provider communication, and clinical skills and knowledge to provide the highest quality of service with the utmost courtesy, respect, and trust; specifically, within the context of elderly adults’ desire for independence and to remain in their homes.
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
Improving the accuracy of Interactive Voice Response (IVR) Technology for pediatric experience scores
Get PDFThe increased use of interactive voice response (IVR) in assessing patient and family experience should be paired with evidence-based practices on how to obtain the most accurate information via this survey mode. We added a brief clarification sentence of the survey scale at the start of the IVR call to improve our experience data both qualitatively and quantitatively. Our setting was an urban pediatric hospital. We gathered lived experiences from our patients, families, and providers to understand and design a change to the IVR survey mode that would reduce survey inaccuracies. Outcome measures were assessed by baseline measurement and post-intervention statistical analysis. Outcome measures were the percent of family comments related to survey errors and the discrepancy in scores for the first question of the survey between the two survey modes, IVR and email. One Plan-Do-Study-Act (PDSA) cycle was used to improve the accuracy of the IVR survey mode. The family survey comments expressing errors made on the first question of the IVR survey were reduced by 92% from a 2.5% (N=3,344 comments) error rate to a 0.2% (N=3,373) error rate. The discrepancy between the first question scores for IVR vs. email reduced by an average of 76.8% change (17.4 vs. 3.8) over a 20-month study period. Our initiative exceeded our goal by statistically significantly reducing the percent of comments expressing errors and the gap in survey mode first question scores.
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
Rare and undiagnosed: Daunting challenges for patients, doctors, and researchers alike
Get PDFThis personal narrative identifies several challenges for patients, doctors, and researchers posed by rare illnesses and difficult to diagnose/long-term undiagnosed patients. In it, I describe several observations on my experiences as a long-time undiagnosed patient and now as one with multiple rare conditions. Rare conditions are all too often missed in diagnosis or dismissed, and treatment is often significantly delayed, such as it was in my case for nearly two years. Adding rare symptoms into the mix makes the challenges of diagnosis and treatment even greater, and I had some extremely rare symptoms. The only way I was able to identify my symptoms as being associated with my suspected diagnosis was by researching assiduously until I finally found a one-off case study describing two women with the same symptoms and with a diagnosis akin to the one my doctor was considering for me. I was able to rely on this case study; but when we consider that many medical practitioners, even medical specialists, don’t submit research papers for publication, it is clear there are holes in the reporting system when it comes to rare conditions. My neurologist, for example, does not publish, and so my case study is not in the medical literature. There need to be outlets for posting of such anomalies as I experienced if rare illnesses and rare conditions are to be fully documented in the literature.
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
Patient involvement in the development of PROMs within the MS Field: A systematic review
Get PDFThis review reports on the development of patient-reported outcome measures (PROMs), published within the past ten years, for people with multiple sclerosis (PwMS). Moreover, this review evaluates the extent to which patient participation was integrated in the development of the PROMs. A systematic review was conducted, and four relevant articles were extracted, from which nine PROMs were identified. Patient involvement in the development phase was identified in three PROMs. The results emphasize the need for more patient involvement in the development of new MS-specific PROMs to ensure that the measures reflect the needs and priorities of PwMS.
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
Community: The true driver of excellence in human experience
Get PDFThe idea that we are a community first, a community of people from a breadth of backgrounds and experiences, from all corners of our world, has been the foundation on which our work has been built, our efforts motivated, our research driven and our hope inspired. It is a tapestry of possibility, grounded in evidence and brought to life in practice that has made the journey to our 9th volume so enriching. A community is fostered in realizations of people who want to be part of something together – an idea, a hope, a purpose or possibility – and that in coming together they can create something greater than they could have alone. That is the essence of community of which I speak. That is the community we have built together. It is when we recognize that community is not just an incubator of ideas, but an engine for action, that significant things can happen. I often share the quote from Coretta Scott King who said, “The greatness of a community is most accurately measured by the compassionate actions of its members.” I would add that the pieces that follow and all we learn from one another represent those very compassionate actions; they are the seams that bind our community, a community that through those actions is the true driver of human experience.
Experience Framework
This article is associated with the Culture & Leadership 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
Views on happiness and mental health: A comparison between residents and staff at a senior care facility
Get PDFResidents and staff members at a senior care facility were questioned about their views on topics related to mental health. The two groups scored similarly on a happiness questionnaire. Differences as well as similarities between residents and staff were revealed through a questionnaire addressing views on mental health, counseling, and medications. The results are discussed in terms of the relationship that develops between older adults and their care givers. We argue that the health and well-being of the residents of a senior care facility may be linked to the health and well-being of the staff. The extent to which the two groups have similar views on issues of health and happiness is probably both a result of, and a basis for, strong relationships between the two.
Experience Framework
This article is associated with the Staff & Provider 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
Patients’ perceptions and knowledge of source isolation for multi-resistant organisms in an Australian metropolitan hospital: A bedside interview with questionnaire study
Get PDFThe aim of this study was to explore perceptions and knowledge of source isolation among hospitalised patients colonised or infected with multi-resistant organisms, to identify if information provided and delivery method are helpful and appropriate, and to identify areas for practice improvements. Purposive sampling was conducted. Between November 2019 and January 2020, bedside interviews with structured questionnaires (combining multiple-choice and free-text questions) were conducted with adult in-patients requiring isolation for multi-resistant organisms in a 180-bed metropolitan hospital in Brisbane, Australia. Data analysis included quantifying multiple-choice responses and thematic analysis of free-text responses. Thirty participants completed the interview questionnaire. Lack of awareness and understanding of multi-resistant organisms was evident. Participants reported a preference for face-to-face education (96.7%) and information brochures (86.7%), rather than phone call (33.3%) or informative video (0%). Qualitative responses revealed communication and information deficits exacerbated patients’ negative psychological impacts including embarrassment, loneliness, abandonment, confusion and fear. Participants identified that clinicians need better communication skills and knowledge of multi-resistant organisms to recognise and ameliorate the effect of source isolation on patients. In conclusion, patients in source isolation reported that they do not receive adequate information. Enhancing clinician knowledge of multi-resistant organisms and improving communication skills may help address the psychological needs of these patients.
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