Patient Experience Journal (PXJ, The Beryl Institute)
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Surveying pediatric caregivers’ readiness for dyad isolation in the hospital during COVID-19
Get PDFThe onset of any emerging outbreak is stressful for everyone. Singapore was one of many countries affected early by COVID-19. In response, many precautionary measures were quickly initiated, including the isolation of suspected COVID-19 pediatric cases, and their caregivers were isolated together with their hospitalized children as a result. Caregivers play an important role in facilitating their child’s health in the hospital. Rooming in with their children during hospitalization promotes the benefits of parental presence and reduces separation effects. However, sudden admission with strict movement restrictions poses stress to these caregivers too. This study ran a 3-part paper-based survey to understand the stresses and concerns which caregivers faced when suddenly entering dyad isolation. The survey polled caregivers’ general perception of the situation, and also used questions adapted from the SARS Fear Scale and the Hospital Anxiety & Depression Scale (HADS). Caregivers in the COVID-19 isolation units did not expect their child to be isolated and were not prepared for dyad isolation with their children. They were found to be more dejected and were concerned that they themselves might have possibly infected their family and friends. Caregivers of children suspected of COVID-19 should be pre-empted to prepare for the possibility of isolation. This may include bringing in toys and personal entertainment to reduce boredom, as well as other essential needs. Patient mental wellness programs may consider extending their services to these caregivers too.
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
Breaking barriers to equity: A conversation with Dr. Julia Iyasere
Get PDFI was honored to have the opportunity to talk to someone I\u27ve been fortunate to meet in the past few months and who has taught me incredible things about the topic of equity in healthcare and even more so the idea of health justice, Dr. Julia Iyasere, Executive Director of the NewYork-Presbyterian Dalio Center for Health Justice. As a physician, an educator, a researcher, and I suggest an evidence-based social activist, Dr. Iyasere has led the establishment and growth of the Dalio Center in just the over 9 months since its launch. But the ideas she champions in her work come from deep in her personal story, are inspired by the path she has chosen and have been catalyzed by the moment in which we found ourselves over the last year and a half. Dr. Iyasere underlines how the realities of a world faced with COVID unearthed long established and deeply rooted issues not only in healthcare, but in society in general.
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
Rebuilding a foundation of trust: A call to action in creating a safe environment for everyone
Get PDFWell before the COVID-19 pandemic, incivility and physical threats directed toward healthcare employees and often registered nurses was a growing concern by Chief Nurse Executive (CNE) leaders. In 2019, conversations initiated by The Beryl Institute’s Nurse Executive Council (NEC) to consider how best to achieve a much-needed balance between patient/family and staff safety have now become a critical priority to ensure the safety of everyone receiving and providing health care services. The heart of this work was organized around a set of newly developed ethical precepts designed to guide the exploration of key concepts. A call to action grounded in rebuilding a foundation of trust is proposed. In pursuing future steps to deepen this foundation, and to reaffirm the vital role for nurse leaders and of all in healthcare, we must be willing to engage in dialogue, to ask openly, and question respectfully. We believe healthcare systems and nurse leaders both play a vital role in elevating the humanity on which we will find brighter days ahead. Through a sustained commitment to this aim, we seek to strengthen health care delivery environments that shape physically and psychologically safe environments for everyone.
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
Sociodemographic characteristics and patient and family experience survey response biases
Get PDFEnhancing Patient and Family Experience (PFE) is vital to the delivery of quality healthcare services. Sociodemographic differences affect health outcomes and experiences, but research is limited on biases in PFE survey methodology. We sought to assess survey participation rates across sociodemographic characteristics. This retrospective study analyzed a health system’s ambulatory PFE survey data, collected January 1 – July 31, 2019. Outcomes of interest were rates of survey response, completion, and comments. Predictors included respondent-reported race, ethnicity, language, and measure of social deprivation attached to a respondent’s home address. Addresses were geocoded to census tracts. The tract’s degree of socioeconomic deprivation was defined using the Deprivation Index (DPI). Associations between outcomes and predictors were assessed using the Chi square test. 77,627 unique patient encounters were analyzed. Patients were predominantly White (76%); 5% were Hispanic; and 1% were Spanish-speaking. The overall response, completion, and comment rates were 20.1%, 17.6%, and 4.1%, respectively. There were significant differences across assessed sociodemographic characteristics in response, completion, and comment rates. White patients were most likely to respond, complete, and leave a comment. Spanish-speaking respondents and those living in the most deprived areas were more likely to respond and complete the survey, but less likely to comment than English-speaking respondents and those living in less deprived areas, respectively. PFE survey participation differs across a range of sociodemographic characteristics, potentially introducing noteworthy biases. Health systems should minimize differences in how they collect feedback and account for potential biases when responding to experience data.
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
A closer look at the association between African American men’s perceptions of healthcare providers’ cultural sensitivity and hypertension
Get PDFAfrican Americans, specifically African American men, continue to have a substantially higher rate of hypertension and lower life expectancy than other racial and ethnic groups. This has been linked to poor interactions with health care providers. The purpose of this study was to examine the association between African American men\u27s perceptions of health care providers\u27 cultural sensitivity and a diagnosis of hypertension. A cross-sectional quantitative study was conducted with a specific focus on the association between the perceptions of provider cultural sensitivity and hypertension controlling for age, socioeconomic status, insurance status, and anxiety. Quantitative data were collected from 330 African American men using a modified NHIS (National Health Interview Survey) questionnaire consisting of an 18-question multiple-choice and Likert-scale survey. A logistic regression analysis was conducted to predict hypertension from age, socioeconomic status, insurance status, anxiety, and perception of provider cultural sensitivity. The overall model was significant and explained 11.7% of the variance in hypertension. Age and anxiety were unique significant predictors of hypertension in African American men. Based on the findings from this study, it is essential healthcare professionals accurately diagnose and treat African American men based on risk factors such as age and anxiety, which may be related to perceived racism and experiences of racism over time.
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
The impact of patient shadowing on service design: Insights from a family medicine clinic
Get PDFA central tenet of patient-centered care is to truly and deeply understand how patients experience health care. One particular qualitative method, patient shadowing, holds the promise of seeing things through the patient’s eyes in real time. The purpose of this research is to utilize patient shadowing to capture the realities of patient experiences in an outpatient family medicine clinic and to report opportunities for improvement to clinic leadership. A total of twenty (20) patients were shadowed at a family medicine outpatient clinic over the course of eight (8) different days, providing a variety of circumstances including staffing levels, shift changes, patient volume, and other factors. Patient shadowing revealed many interesting observations, capturing many best practices in delivering patient experiences as well as a short list of recommendations that could improve patients’ and staff experiences. Areas for improvement include helping patients better understand the entire process, wayfinding from the exam room to check-out, and creating a checklist for patient follow-up items. Patient shadowing presents many benefits to health care organizations and employees, including enhanced communication and teamwork, a greater connection with patient experiences and hardships, and the opportunity to redesign processes to optimize efficiency and service quality.
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
The experiences of rural British Columbians accessing surgical and obstetrical care
Get PDFThe attrition of small volume surgical and maternity services in rural Canada over the past three decades has made access to these services especially challenging for rural citizens. While many of these closures have occurred as consequences of regionalization, a strategy to regionally centralize healthcare services, many studies investigating outcomes of regionalization have focused on costs and medical endpoints rather than the direct experiences of the rural patients affected. In this study, we aimed to understand and document the experiences of rural residents accessing procedural and maternity care both locally and away from home. This study is part of a larger evaluation framework which prioritizes the insight of rural residents regarding healthcare issues. We conducted focus groups and interviews with 54 participants in six communities across British Columbia’s southeastern and northern regions. Thematic analysis showed that rural residents experienced unique challenges when leaving their communities to access care. This included logistics of travel, poor coordination of care between multiple providers, and financial and psychosocial issues. Despite being mostly content with the medical care received, participants expressed needing more attention to their unique needs and preferences as patients leaving their home communities for care. Understanding these challenges facilitates the planning of healthcare services in a more equitable manner. Our findings suggest that we need increased patient-centered healthcare planning that aims to alleviate the financial and psychosocial strain on rural residents.
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
The tensions between healthcare providers and patient and family advisory committees (PFACs): A comparative health system analysis between England and Ontario
Get PDFThere has been a proliferation of patient engagement (PE) in healthcare activities. However, the concept of “engagement” has existed for decades; the first Patient and Family Advisory Committees (PFACs) in North America were formed in the 1970s. These committees are an important mechanism for involving patients and family and have proliferated across the healthcare sector. However, it is unclear how or why PFACs became the predominant mechanism for PE. The objective of this comparative analysis is to review the historical context and legislative imperatives that have contributed to the proliferation of PFACs in Ontario, Canada and England, United Kingdom.
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
No visitors allowed: How health systems can better engage patients’ families during a pandemic
Get PDFThe ravages of COVID -19 and the no visitor policies that accompany it have forged a tectonic shift in the patient and family experience. This hit home for me with a recent family member health event and hospitalization, leading me to think “we HAVE to do better!” Why should hospitals and health systems care about family involvement during COVID-19?
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
Partnering with patients to design a prehabilitation program for optimizing the patient experience through general surgery
Get PDFThe objective of this study was to explore patients’ experiences when preparing for and undergoing general surgery at a large tertiary hospital. Findings aimed to inform the development of a prehabilitation program to empower patients to optimize their recovery and enhance their experience of general surgery. A qualitative exploratory research approach was utilized. Patients (\u3e18 years) attending for elective general surgery between May and July 2018 were invited to participate. Four focus groups (n=18) and an interview were conducted to reach saturation. Deductive content analysis was used to map responses against theoretical determinants of health behavior change. Patients described their overall experience of general surgery as positive but provided key insights about the surgical journey that impacted their capability, opportunity and motivation to optimally engage and address their recovery. Interaction and information from health professionals, understanding expectations, timely access to treatment and support of family members greatly enhanced their experience. Lack of personalized exercise and nutrition prescriptions, access to shared patient experiences of the surgical journey and not being asked about personal goals were key inhibitors. Patients also expressed feelings of frustration and anxiety regarding hospital procedures, including repetitive gathering of information and poor communication across departments. Patients’ experiences of the surgical journey identified gaps that impacted their capability, opportunity and motivation to effectively prepare and rehabilitate, that could be addressed by a multimodal prehabilitation program. Intervention options at patient and policy level were identified for trial to enhance the patient experience of general surgery.
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