Patient Experience Journal (PXJ, The Beryl Institute)
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My six-word story: Power to reconnect and connect
Get PDFThe COVID-19 global pandemic is a threat to the well-being of our healthcare professionals. Recent studies on the mental health effects of healthcare professionals from China and Italy have revealed higher levels of depression, anxiety and psychological distress. As a Pediatric Emergency Medicine physician working on the frontline and a H3 (Helping Healers Heal) Peer Champion, I sought to support my staff’s well-being and emotional resilience. My Six-Word Story, a simple and meaningful activity was designed to support the psycho-social well-being of those on the frontline providing care. This new project was implemented in the Pediatric Emergency Department at NYC Health + Hospitals/ Harlem. Six-word stories, a form of micro fiction, have increased in popularity in recent years. The staff participating in the project shared their six-word stories on their inspiration in choosing a career in medicine. After receiving all the submissions, illustrations were added to each story creating a poster story. This project was well received by the staff as it allowed them to be creative, focus on positive thoughts and was not time-consuming. My Six-Word Story is shown to have the power to reconnect with our purpose and connect with each other through common interests, shared beliefs and shared values. This innovative initiative can easily be replicated or adapted to help support the well-being and human experience of all us.
Experience Framework
This article is associated with the Staff & Provider Engagement lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this lens
Patients and families strengthen COVID-19 communication across Los Angeles County
Get PDFPFCCpartners supported Los Angeles County Department of Health Services to develop a Person Family Engaged Culture. When COVID-19 hit Los Angeles, system leaders understood the importance of keeping a pulse on what information people were looking for. With the continued support from PFCCpartners, a survey of community members was conducted to understand their questions during this unprecedented time. The survey highlighted barriers to accessing supplies, refilling prescriptions and using technology for virtual appointments. Utilizing the survey questions, a small group discussion was held to deepen understanding of the barriers and challenges faced during the pandemic. These two engagement activities ensured LA County communications were accessible, informational and accurate.
Experience Framework
This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this lens
Patient reported experience of inpatient rehabilitation in Australia
Get PDFWhile the value of patient reported experience is increasingly acknowledged, the measurement of rehabilitation-specific patient reported experiences is an area that is yet to attract a lot of attention. The aim of this study was to examine the patient-reported experience of person-centred inpatient rehabilitation. The study consisted of a multi-site cross sectional survey using the 33-item modified Client Centred Rehabilitation Questionnaire (CCRQ). A total of 408 participants were recruited from 20 inpatient rehabilitation facilities across Australia. Participants were in the final days of their inpatient rehabilitation episode when approached to complete the paper based modified CCRQ. Nineteen of the 33 items had an 80% or greater proportion of positive responses (‘agree’, ‘strongly agree’). The items belonging to the Family Involvement and Support subscale had the lowest proportion of positive responses (range 57.1%-82.4%), the highest proportion of ‘does not apply’ responses (range 10.0%-23.0%) and the largest variability in positive responses across all 33 items. The three negatively worded items (items 2 and 33 in the Client-centred Education subscale and item 7 from the Continuity/Co-ordination subscale) demonstrated the greatest proportions of negative responses (range 44.6%-65.7%). The breadth of the modified CCRQ items enables identification of service gaps as seen from the patient’s perspective. Identification of such gaps allows rehabilitation services to plan actions to improve the quality of services provided.
Experience Framework
This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this lens
Factors associated with patient rating of physician communication effectiveness and satisfaction in musculoskeletal care
Get PDFEffective communication is associated with adherence to healthy habits. This study sought factors associated with communication effectiveness and satisfaction with musculoskeletal specialty care in order to inform efforts to improve communication effectiveness using measurement, feedback, and coaching. After a new or return upper extremity specialist visit, 146 adult patients completed a survey recording demographics, measures of catastrophic thinking in response to nociception, symptoms of depression, and symptoms of anxiety, and they rated communication effectiveness (5 questions answered on a 4-point Likert scale) and satisfaction with the visit (slider with anchors of 0 and 100). Patients also provided text answers to 4 questions addressing strengths and opportunities for improved communication. We assessed the association of experience measures (communication and overall satisfaction) with patient characteristics. Ratings of “clinician listens carefully” were higher in older patients. Higher rating of clinician explains in an understandable way was associated with fewer symptoms of depression. Higher rating of clinician showed respect was associated with fewer symptoms of depression and less catastrophic thinking. Higher rating of clinician used models was associated with older age. Men had higher overall satisfaction scores. In Factor analysis, the scree plot of eigenvalues showed that the 5 communication questions and the single satisfaction question load onto a single factor. The finding that age and psychological factors are associated with patient experience – which seems to reduce statistically to a single underlying construct – emphasizes a potential to attend to mental health in efforts to improve patient experience.
Experience Framework
This article is associated with the Policy & Measurement lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this lens
How do health systems approach patient experience? Development of an innovative elective curriculum for medical students
Get PDFMedical students currently learn about patient-centered care and practice communication skills via a variety of curricula. However, there is little in the published literature describing a standardized approach for training future physicians how health systems approach and work to improve patient experience. The [Anonymous1 and Anonymous2] Schools of Medicine designed a plan to pilot a two-week elective for medical students in their clinical years. The curriculum is designed to help students understand and appreciate the key elements of the patient experience across the continuum of care and prepare students to impact the patient experience either as a practicing physician and/or as a future leader. Teaching methods include experiential activities as well as a variety of flipped-classroom sessions, dedicated time for independent reflection and study, interactive lectures, and a capstone project. This elective is slated for implementation at both medical centers over the next couple of years and the curriculum design stakeholders will continually review and refine the structure of the course based on feedback from participating students and core educators. The goal is to develop a novel and reproducible patient experience curriculum that can be taught to medical students around the country, ideally during both the clinical and pre-clinical years of their training.
Experience Framework
This article is associated with the Staff & Provider Engagement lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this lens
The essential nature of experience in a time of crisis and beyond
Get PDFAs we have engaged with community members around the world, the last few weeks have provided a unique window into the face of this crisis as we have seen not only the deadliest days on record, but have also had some of the most hopeful conversations at the same time. While we are and still will face challenges in the weeks to come, we too have seen humanity elevated in profound and powerful ways. While it can be offered with little argument that things will never be the same, in moving forward, we too can assert and I believe, that the ideas that have been fundamental to healthcare experience will remain essential for all served by and serving in healthcare. The themes that emerge in this issue, while not planned for this crisis, quite appropriately reinforce what we have seen elevated by this moment in history in which we find ourselves; that all voices matter, that collaboration and partnership matter, that listening and acting matter, that learning and agility matter, and that perseverance matters. To say we are in a time of challenge would not do this moment justice. We are facing tragedy and suffering. We are seeing inequity and systemic weaknesses revealed. We are seeing support elevated and commitment fortified. And we are experiencing a global community drawn together around a shared experience in ways few alive have ever experienced nor deemed possible. That reality, our shared reality, is where we find the essential nature of experience. In the ability to ensure the best in connectedness in a disconnected world; to see deeper into patients’ eyes and into our neighbors’ souls. These are all fundamental building blocks to a shared human experience. One we can all attest is imperfect, but one we too should all agree deserves our greatest attention.
Experience Framework
This article is associated with the Culture & Leadership lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this len
The little things: Exploring perceptions and experiences of client and family-centred care through photovoice
Get PDFHealthcare in Canada is undergoing a paradigm shift, moving away from a prescriptive approach to care delivery to one that prioritizes clients and their families at the center of their care. In the homecare sector, this approach is commonly referred to as client- and family-centred care (CFCC), a philosophy emphasizing the need for point-of-care providers to partner with those receiving care and their families in a way that is respectful and attuned to their individual needs and goals. This philosophy helps homecare agencies like VHA Home HealthCare deliver care to families that embraces what is most important to them. At VHA Home HealthCare, CFCC is well established through education sessions delivered to staff. Despite these efforts, there is limited evidence to confirm whether this education aligns with what is important to clients and families. To address this gap, this study engaged a unique homecare population - parents of children with complex medical needs - to understand how they experience and perceive CFCC using an arts-based approach called photovoice. Through participants’ photographs and in-depth interviews, seven core themes were identified which we refer to as ‘the little things’ of CFCC. Results of our exploration show that in some cases there is alignment between parents’ perceptions of CFCC and the organization’s, but there are also many gaps that could be filled by incorporating the unique voices of participants into the organization’s educational curriculum.
Experience Framework
This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this lens
How University of Chicago Medicine designed virtual rounding to maintain human connections during COVID-19
Get PDFThis story is about how the Patient Experience and Engagement Program (PEEP) team at University of Chicago Medicine adapted our patient rounding program from in-person to virtual during the COVID-19 crisis. With creativity and ingenuity, our team shifted on a dime to ensure that patients received the kind of care and connection that allowed them to start the recovery process from what could otherwise be a traumatizing experience before they even leave the hospital. I will explain the steps we took to quickly transition our rounding program from in-person to virtual. But more than that, I want to convey the power of connection to support healing – especially when circumstances are challenging. During and after the COVID-19 pandemic, people need ways to maintain human connections.
Experience Framework
This article is associated with the Innovation & Technology lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this len
A systems thinking framework to improve care of the terminally ill: An Australian case study
Get PDFThis paper argues the value of systems thinking to patients, family members and medical practitioners in end-of-life care, particularly as a mechanism for considering when palliative care should be introduced as preferred treatment. It applies a well-established set of tenets in systems thinking retrospectively to a case study of patient care in Australia. This highlights how and where different decisions might have been made, based on a holistic consideration of the patient’s best interests. The case is written from the perspective of a family caregiver. It argues that early, deliberate conversation, framed by systems thinking tenets, can support the call for the more timely intervention of palliative care. As a precursor to effective conversation, the case supports recent calls for increased training in systems thinking in graduate and continuing medical education. A change in medical practice would both facilitate and be enabled by a broader cultural change in public attitudes toward dying, end-of-life care and death. Encouraging the documentation of single case studies, written or co-written by medical practitioners and family carers can contribute to the evidence base of both medical and public education.
Experience Framework
This article is associated with the Culture & Leadership lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this len
Getting comfortable with being uncomfortable: A conversation with Marsha Sinanan-Vasishta
Get PDFWe find ourselves managing two critical moments and a powerful confluence of events, one a crisis in health. We are still facing the COVID crisis, and we are trying very hard to rely on evidence and truth that will lead us forward in addressing that in the best way possible. We are also in a crisis of humanity, one that has been simmering beneath the surface for years, the issue of systemic racism and disparities in healthcare, further highlighted by the COVID crisis. This article shares the conversation I had with Marsha Sinanan-Vasishta, MSN, MBA, RN, NEA-BC, CPXP, Deputy Chief Nursing Officer, Patient Care Services Mount Sinai/Morningside as part of The Beryl Institute’s bi-weekly community briefing series on the special topic of addressing systemic racism and health disparities in a time of crisis. Ultimately Marsha called us on to seize this moment to act, to find ways to get comfortable in being uncomfortable with relentlessness and ultimately to take this moment, which could be one of fear and doubt, to truly be brave.
Experience Framework
This article is associated with the Culture & Leadership lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this len