Patient Experience Journal (PXJ, The Beryl Institute)
Not a member yet
638 research outputs found
Sort by
Patient experiences in intensive care units: a systematic review
Get PDFThe aim of this systematic review is to analyze the data gathered from studies conducted to determine patient experiences in intensive care and levels of the recollection of the intensive care period that were published between December, 1998 – April, 2013. The systematic review was carried out screening of the related publications. The findings of the systematic review were studied under the following two titles: “remembering the intensive care period” and “recalled experiences” of patients. Studying 15 papers which were found suitable to the inclusion criteria of the review indicated that majority of the patients had recollection of the intensive care process. The physical experiences of the patients were pain, sleep disturbances, discomfort, inactivity or over-activity, noise, thirst, headache, discomfort due to the endotracheal tube (ET), technological support, medical activities, and difficulties in aspiration and swallowing. On the other side, psychological experiences were hallucination, nightmares, fear, worry, anxiety, depression, loneliness, and thoughts about death, panic, nervousness, uncertainty, and despair. In addition, it was seen that patients experienced some communication difficulties. As a result of the systematic review, it was seen that patients could remember the intensive care period, and the number of negative experiences in intensive care were more than the positive ones
Patient safety: just ask. Patients as reporters of real-time safety data; a pilot project to improve patient safety in secondary care
Get PDFThe Berwick review into patient safety recommended ‘involving patients in the healthcare organisation and seeking out the patient voice as an essential asset to monitor safety.’ (1) However routine data collection from patients in our institution is retrospective and doesn\u27t focus on safety. Our objective was to create a patient-centred mechanism to monitor patient-perceived safety concerns and provide immediate resolution of highlighted issues. A pragmatic 6-question questionnaire was developed containing 4 scored and 2 free text questions. This questionnaire was piloted and adjusted before being administered to all inpatients meeting the inclusion criteria in our institution on one day. Safety issues raised were triaged and acted upon according to an agreed protocol providing a mechanism for immediate resolution. 225 patients were inpatients in the clinical areas surveyed of which 149 were eligible and 148 participated (99% participation). The majority (\u3e95%) felt nothing about their stay was unsafe and felt they had no concerns about their treatment plan. However multiple themes regarding patient safety were identified including environmental issues, staffing levels, supervision of vulnerable patients and handover of clinical information. None of the issues reported by patients had been reported through existing hospital incident reporting systems. Safety issues triaged as requiring immediate attention were fed back to appropriate teams on the day to allow immediate learning. These results suggest that patients find safety reporting of their care acceptable via a simple questionnaire. Integration of this new process may increase overall safety reporting and allow targeted improvements in safety, quality and patient experience
Patient Experience: A return to purpose
Get PDFAs an opening reflection to Volume 4 of Patient Experience Journal (PXJ), this editorial reviews the progress of the journal and the implications seen both in the evolving healthcare marketplace globally as well as reviews the data on the developing field of patient experience. It reinforces the need for an integrated view of experience as supported by data in the most recent State of Patient Experience research – one encompassing quality, safety, service, cost and population health implications and one driven on an engine of both patient and family engagement and employee/staff engagement. The article offers that healthcare is as dynamic as it has ever been and is now being pushed at speeds it has not been built to handle, suggesting the need for agility and vision, redesign and expanded thinking. The recognition of these intertwined realities reveals what the author suggests is a return to purpose in healthcare. This is framed by the reinforcement that engagement, communication, quality and safe outcomes are unquestionably central issues for healthcare and they are all now coming together as central to the overall experience dialogue. From these insights, the article offers an invitation for contributions to PXJ that will both underline and expand the exploration found on its pages, from types of submissions to topics including national and global perspectives, technology and culture. The author calls on readers to share their voice, stories, thoughts, research and experiences grounded in the essence of generosity that inspires each of us to sustain a commitment to positive experience efforts each day. The article leaves us in suggesting the powerful simplicity of a return to purpose may be one of the strongest foundations we could hope for in building the future of healthcare
Learning and leading in the experience age
Get PDFA focus on experiences of care helps health systems realize the very transformations they look to achieve. This is because patient experience allows patients, families and carers to define value, enabling healthcare organizations to focus on what matters to them and not simply what is the matter with them. This is what we mean by an ‘experience age’, one in which clear connections are made between the things patients value and the clinical outcomes we look to achieve: where links are drawn between experience, clinical effectiveness, safety and cost in order to provide the very best care for all patients. Central to the experience age is ensuring our health systems: (1) are accountable for the whole patient experience and thus able to act sooner to keep people well and out of hospital, (2) work to establish new relationships with patients, families and carers in which patients, carers and staff work together to establish what matters and how care can be delivered and (3) make stronger connections between patient and staff experience. In committing to these efforts, the global dialogue on patient experience will become even more important, as we recognise that despite differences in design and operation, the challenges our health systems face and the focus on what matters most to patients are shared
“Quiet at Night”: Reduced overnight vital sign monitoring linked to both safety and improvements in patients’ perception of hospital sleep quality
Get PDFObtaining middle of the night vital signs is disruptive to sleep and not founded on evidence-based medicine. We sought to investigate the perception of quality of sleep and overall satisfaction during a hospital stay between an intervention group where overnight night vital signs were not obtained and a standard of care group where overnight vital signs were obtained every four hours. We also monitored for adverse events in the intervention and standard group. Low-risk observational stay patients with a planned cardiac procedure were eligible for this study. After consent, patients were randomized to the intervention or standard group. Participants were provided a questionnaire on the day following their overnight stay to assess their perception of quality of sleep and satisfaction with their hospital stay. Charts were reviewed to assess for any adverse outcomes. During the study period, 39 patients were enrolled in the standard group and 41 in the intervention group. All patients were discharged the following day as planned and no adverse events occurred overnight. More patients in the standard group rated good/excellent sleep at home, and more patients in the intervention group rated good/excellent sleep in the hospital. There was a trend toward less disruptive sleep between home and hospital for the intervention group (p = 0.096). There was no difference found in the overall satisfaction of hospital stay response between the intervention and standard groups (p = 0.999). Fewer patients in the intervention group had worse sleep in the hospital as compared to home, significant at p \u3c 0.10. We also found there was no escalation of care despite not obtaining vitals throughout the night in our intervention group. With this proof of concept now safely implemented, it is our intention to implement further studies to broaden our inclusion criteria and population to encourage a restful and healing environment through the entire healthcare stay
A trip to healthcare
Get PDFThis narrative shares how my experience with two colonoscopies and three surgeries in one year taught me that I am not so good at engaging in treatment decisions. I thought I was. This essay sets out where I made my mistakes, why I believe I made those mistakes, and how the hospitals, intentionally or not, made good decision-making harder. I offer two suggestions for enhancing the role of the patient in decision-making including 1) Every doctor in a diagnostic-decision-making interview should use the sentence “You have some choices here.” The doctor will have preferences, of course, but the patient needs to hear that there is more than one way to take the next step and 2) For diagnostic-decision-making moments, all doctors (and hospitals) should provide patients with support personnel to help the patients use decision-aids, prepare for discussions with doctors, and make the decisions. I conclude with why this is critical in healthcare today
Patient Experience: The field and future
Get PDFIn an effort to understand the progress and evolution of the field, a self-examination study has been administered to assess contributions to the core knowledge base in the field and to assess the degree to which articles published in Patient Experience Journal (PXJ) addressed the core elements of patient experience outlined in the definition of patient experience as offered by The Beryl Institute. The purpose of this examination is to understand PXJ’s position as a central voice for patient experience scholarship, practice, and knowledge exchange. The findings suggest that the operating definition of the field continues to be suitable and appropriate to the scope of practice and to the knowledge base in patient experience and reinforce that patient experience scholars and practitioners share a common understanding of the patient experience field. The article offers a call to action for patient experience practitioners, scholars, and educators and acknowledges that for as much as we have explored, we still do not know all that we can about patient experience. While reinforcing its core ideas, the results suggest that new themes germane to the patient experience await beyond the horizon
Patient experience in the behavioral health setting: Key best practices throughout an organizational journey
Get PDFNewYork-Presbyterian/Westchester Division, a clinical affiliate of Weill Cornell Medicine, is a 260-bed hospital providing inpatient and outpatient behavioral health care for children, adolescents, adults and older adults. From 2004-2010 the hospital’s patient experience scores on the Press Ganey® Inpatient Psychiatry Survey improved from the 14th to 53rd percentile nationally. We primarily attribute this to joining the Planetree® Affilliate Network. Planetree is a mission based not-for-profit organization that partners with healthcare organizations around the world and across the care continuum to represent the patient voice and advance how professional caregivers engage with patients and families. In 2011, hourly rounding was redesigned and tailored for the behavioral health setting. This initiative, coupled with regular Planetree education and an ongoing commitment by staff and the healthcare system to improving patient experience, contributed to a further improvement, with the hospital moving to the top ten percent of psychiatric hospitals nationally in the Press Ganey survey. In this paper, we describe the organizational journey that led to these improvements and identify learning for other hospitals, particularly in a behavioral healthcare setting
When one is sick and two need help: Caregivers’ perspectives on the negative consequences of caring
Get PDFInformal or family caregivers contribute significantly to individual care, and to the Canadian healthcare system, yet receive limited support from governments, institutions, and healthcare professionals in recognition of their role, or in response to their health and social care needs – often due to the negative consequences of caregiving. Learning about the diversity of others’ experiences can positively influence personal decision-making, reduce feelings of isolation, as well as promote adjustment to a personal situation. For caregivers, however, few resources exist that provide reliable information on others’ experiences. We collected the narratives of caregivers’ experiences of caring for someone with a chronic physical illness and produced an evidence-based web resource. Through purposive variation sampling, 42 caregivers were recruited across Canada for interviews in their homes or alternate location using video/audio recording. Qualitative data analysis followed a constant comparison approach. 29 thematic pages were developed for the web site (www.healthexperiences.ca) featuring the diversity of lived experiences, and presenting topics important to the caregivers with illustrative video/audio clips, along with other sources of information. Key themes related to caregivers’ perspectives on the negative consequences of caregiving included: the impact upon personal health; challenging interactions with professionals; inconsistent information, limited support from family and friends, and unhelpful societal views. These results contribute to existing evidence of caregiver burden, but uniquely in the voices of caregivers themselves – with constructive insights for understanding the causes of ill health related to caregiving burden and for informing policy and practice
Effects of a hospital-wide physician communication skills training workshop on self-efficacy, attitudes and behavior
Get PDFHospital systems interested in improving patient experience and physician engagement may look to physician communication skills training (CST) as a means of improving both. This study examines a 7.5-hour, multi-specialty, hospital-wide physician CST workshop in a large academic hospital system and its effects on participants’ self-efficacy, attitudes, and behaviors related to communicating with patients. Data was gathered from October 2014 through June 2016 through a web-based questionnaire sent to participants 6-weeks post-workshop which focused on skills taught in the course, attitudes toward communication training, and provider behaviors when communicating with patients. Along with demographic questions, a ten question retrospective pre-post format was used with a 5-point scale for the domains measured. Retrospective pre-post methodology may provide a more accurate assessment of a learners’ self-assessment of skills acquisition. A paired t-test was used to examine changes in participants’ self-efficacy, attitudes, and behaviors toward communicating with patients prior to and 6-weeks post-workshop. Linear regression was used to determine if there were any covariates that explained these changes. A total of 161 responses from 490 participants (21 medical specialties) were collected for a response rate of 32.8%. In 9 out of 10 domains measured, a significant change in self-efficacy, attitudes, and behaviors related to communicating with patients occurred (p\u3c. 05). There was no significant change in perceived time management/efficiency during visits. Our conclusion is that a 7.5 hour hospital-wide, multi-specialty physician CST can be effective in improving participants’ self-efficacy, attitudes, and behaviors toward communicating with patients