Patient Experience Journal (PXJ, The Beryl Institute)
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Lack of patient involvement in care decisions and not receiving written discharge instructions are associated with unplanned readmissions up to one year
Get PDFThis retrospective, cross-sectional study examined the relationship between aspects of inpatient communication and discharge instructions and unplanned, all-cause readmissions using individual-level data up to one-year post-discharge. Patients completed the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) telephone survey within 6 weeks of hospital discharge in Alberta, Canada. Survey data were linked to corresponding inpatient records. Independent variables included selected demographic characteristics, clinical variables, and five survey questions: a) patient involvement in care decisions, b) receiving written information at discharge, c) understanding the purpose of taking medications, d) understanding responsibility for one’s health, and e) discussing help needed when returning home. From April 2011 to March 2014, 24,869 patients with a mean age of 52.8±19.8 years (range=18-100) were included. 18.6% of patients (n=4,821) experienced an unplanned hospital readmission within 43 to 365 days post-discharge. In adjusted, logistic regression models, patients who felt they were not involved in care decisions were more likely to be readmitted (OR=1.34; 95%CI: 1.17-1.53), as were patients who reported not receiving written information about signs and symptoms to watch out for post-discharge (OR=1.24; 95%CI: 1.15-1.35). Odds of readmission did not differ according to understanding of medications, understanding responsibility for one’s health, or discussion of help needed when returning home. This study provides objective data, showing that specific hospital actions are associated with unplanned readmissions. It is an example of how patient-reported measures may be linked to administrative data to drive quality improvement initiatives
Accelerating patient experience performance: Collaboration and engagement as drivers for success
Get PDFThe efforts at Albert Einstein Jewish Hospital in São Paulo, Brazil have been focused on principles of excellence for many years as realized in engagement in and commitment to some of the leading global healthcare practices over the last decade. In reinforcing a commitment to excellence and continuous improvement, the patient experience efforts at Einstein have evolved from an operating structure for patient experience efforts to a truly integrated program for action in address all elements in the organization impacting and ultimately driving patient experience outcomes. By grounded efforts in core evidence-based practice, while engaging the hearts and minds of staff members from all corners of the organization, Einstein has developed a Patient Experience Accelerating Program that not only reinforces the power of collective and collaborative improvement efforts, but also acknowledges the importance of engaging staff, Einstein has been able to drive clear and tangible outcomes
Turning a blind eye: How lack of communication with ER nurses nearly cost a patient permanent vision loss
Get PDFThis narrative presents a case in which a patient was treated for conjunctivitis, but a breakdown in several layers of communication (between the hospital and the patient, and between hospital personnel) resulted in multiple medical errors that nearly costs the patient permanent vision loss. This real-life case underscores how simple communication errors may lead to life-altering consequences. Recommendations for improving communication to ensure similar errors do not happen to others are provided
Patient experience of taking adjuvant endocrine therapy for breast cancer: a tough pill to swallow
Get PDFAdjuvant endocrine therapy (AET) has substantially improved the mortality rate among breast cancer survivors. Despite the proven efficacy, the non-adherence rate to therapy is still high. This study is aimed to examine women’s challenges related to AET adherence and management. Semi-structured interviews were conducted with six Caucasian and six African American breast cancer survivors who were prescribed for AET. The transcripts of audio-taped interviews were qualitatively analyzed. Key themes were: 1) positive beliefs in AET, 2) uncertainty about long-term adherence, 3) experiences with side effects, 4) forgetting and remembering, 5) other concerns and information needs, 6) potential intervention format, and 7) culturally-coping among African American women. The findings provided insight into women’s experiences and beliefs and how these behaviors might influence AET adherence. Although most women in this study took AET as prescribed, many experienced a range of side effects and emotional distress, often without seeking support or help. New models of programs to promote adherence, support symptom management, and ultimately improve survival are critically needed. Developing culturally sensitive interventions for African American women is desirable
Using appreciative inquiry as a framework to enhance the patient experience
Get PDFThe following case depicts the journey of a non-profit hospital in an under-served community and its attempts to turn around suffering patient experience. The Hospital turned to the theories of Appreciative Inquiry and the power of a strengths-based approach to create a framework to support the patient experience initiatives. Hospital leadership led the formation of a Patient Experience Team to implement ten initiatives in order increase the top box score in the domain of willingness to recommend the hospital, as that was selected as a global measure of success for the overall improvement project
Patient perspectives on quality family planning services in underserved areas
Get PDFOngoing challenges impede efforts to improve the quality of family planning services in underserved communities, which by definition lack sufficient numbers of physicians and other health professionals. Challenges to improving the quality of family planning services include financing difficulties, lack of standards, training deficiencies, as well as little understanding and attention to patient preferences. The objectives of this study were to explore female patients’ preferences for family planning services in underserved areas and to develop a framework to help providers improve patient-centered care. The methodology for this paper included mixed methods research including a survey of women between the ages of 18 and 44 in 19 underserved communities (n=1868) across the United States and qualitative research involving 16 focus groups (n=103) to explore patient preferences and experiences with family planning services. Descriptive statistics of survey items and thematic analysis of transcripts were utilized to analyze study data. Triangulation of data sources and methods resulted in an overall framework for patient-centered family planning care. The results show women in underserved areas identified important aspects of family planning care as: relationship with provider, communication, confidentiality in receiving care, provider competence, service access and convenience. The conclusion suggests improving patient-centered care for family planning services could improve outcomes by increasing patient return for follow up care, patient pursuit of other primary and preventive care services, continuation rates of contraceptive method, and higher contraceptive use. Achieving patient-centered family planning care will require investments in human capital and technology, modifications in clinic operations, and an organizational culture focused on patient preferences and experience
An experience of practitioners navigating the role of patient/caregiver
Get PDFThis journey involved one of us having (repeat) intraspinal surgery in a country far from home but of a similar culture and with the same first language. The carer travelled across the world to be present during the hospital stay. We kept a journal during our admission, and following discharge realised there were significant differences between how we had documented our experience and the record presented in the clinical notes. The particular examples we present illustrate the relationships, rules and issues that we navigated. We share our experience in the form of moments from our journal, some of them alongside information recorded in the clinical notes for the corresponding timeframe. This provides insights into differing narratives between the experiences of the patient/caregiver and practitioners. We recommend that individual practitioners and organisations consider the lived experience of patients and how they consciously engage with patients/carers to address the risk of ‘othering’
Understanding the role of patient and public involvement in renal dietetic research
Get PDFThe objective was to consult patients on a proposed recruitment strategy to a patient and public involvement exercise. We wanted to explore the reasoning and willingness of patients to become co-researchers within a grant application. Eighteen people using the renal health service informed the consultation by action research so that their experiences could be used to guide the overall methodology. Twelve people took part in semi-structured interviews. NVIVO 10 and Framework Analysis were used to interpret emerging themes from the data. The recruitment strategy, informed by research expertise, became an experience-based expert design. The design took into account the limitations of attendance, the informational and physical needs of these service users. Service users wanted to share their experiences with people who would listen and were in a position to help make the changes. This gave them a sense of purpose and autonomy in their treatment and helped them cope with living with renal disease in society. However, feelings of doubt as to whether they could personally ‘make a difference’ as a co-researcher, were common. Consulting service users enabled the research team to recruit more people to interviews to explore motivation considering the unique personal and social needs of this service user group. Service users may need additional and continued support if they are to successfully take part in a clinical study research advisory group
“We were learning together and it felt good that way.” A case study of a participatory group music program for cancer patients
Get PDFThough there are similarities to music therapy, the field of community music in healthcare, while in its infancy, is steadily growing. This case study explored how semi-formal, active music-making can play a role in illness and recovery and provide patients with a sense of voice, connection, and community, and the efficacy of community music programming in a hospital. Six participants began and three participants completed a 6-week music class learning the ukulele. Interpretative Phenomenological Analysis (IPA) was used as a method for data analysis from semi-structured pre-questionnaires, transcribed classes, transcribed post-interviews, and weekly questionnaires from both the participants and the facilitator. Emergent and recurrent themes central to the participants’ experiences were discovered: (1) Music as a connector, (2) Music within us external to cancer, (3) Musical experiences interrupted by cancer, (4) Music creates empowerment. Subthemes and individual experiences are also explored. Implications for future research and music’s role in improving the Patient Experience in hospital settings are discussed
Engaging rural residents in patient-centered health care research
Get PDFPatient engagement is increasingly recognized as a critical component in improving health care. Yet, there remains a gap in our understanding of the intricacies of rural patient engagement in health-related research. This article describes the process of engaging rural patients, caregivers and broader stakeholders to actively participate in an exploratory effort to understand rural perspectives around the patient-centered medical home model. Highlights of the project’s engagement activities demonstrate how giving voice to rural residents can have a significant impact. Lessons learned point to the importance of six factors for successful engagement of rural residents as partners in health care research: building relationships, defining expectations, establishing communication guidelines, developing shared understanding, facilitating dialogue, and valuing contributions