Patient Experience Journal (PXJ, The Beryl Institute)
Not a member yet
638 research outputs found
Sort by
Beyond patient-centered care: Enhancing the patient experience in mental health services through patient-perspective care
Get PDFDelivering mental health services as patient-centered care has been an international priority for more than 50 years. Despite its longevity there is still not widespread agreement regarding how it should be defined or how it should guide the delivery of services. Generally, though, prioritizing the patient’s values and preferences seem to be at the core of this particular approach. It is not clear, however, that services attend to patient values and preferences as closely as they should. Terms such as “treatment resistant” and “noncompliant” seem to belie an attitude where the therapist’s opinion is privileged rather than the patients. To improve the effectiveness and efficiency of mental health services a move from patient-centered care to patient-perspective care is recommended. An attitude of patient-perspective care would require service providers recognizing that help can only ever be defined by the helpee rather than the helper. A patient-perspective service that was structured around the preferences and perspectives of patients might finally help to end the long-term suffering of many people who experience mental health problems
Patient and health professions student team perceptions of patient-centeredness in an inter-professional education home-visit program: An exploratory study
Get PDFThe purpose of this study was to compare patient and health professions student team perceptions of patient-centeredness in an inter-professional clinical education home-visit program. Following an inter-professional clinical education home-visit program, patient and health professions student team perceptions of patient-centeredness were compared using a modified version of the Patient Perception of Patient Centeredness Questionnaire. The results showed both patient and student team participants perceived that student teams focused on how much they cared about the patient as a person and the opportunity to discuss any questions. Patients, however, reported significantly higher levels of patient-centered clinical method used during the visits than did health professions and osteopathic medical/dental student participants. The study reveals more practice and focus on patient feedback and the patient’s central role in their healthcare decisions is recommended for this inter-professional clinical education program as well as for any program that includes team-based care. Patient-centeredness also requires instruction to the patient about their role in their own healthcare. Health and medical professions educators need to continue to motivate students through inter-professional education programs and activities to adopt a more patient-centered practice. For future research as a follow-up study, adding independent observations of the home visit interactions may allow for a better understanding of which specific behaviors contribute the most to the experienced patient-centeredness
Impact of hospital diagnosis-specific quality measures on patients’ experience of hospital care: Evidence from 14 states, 2009-2011
Get PDFIn order to assess consistency across quality measures for Untied States hospitals, this paper uses patient responses to the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey for three years (2009-2011) from 1,333 acute-care hospitals in fourteen states to analyze patterns in hospital-reported patient experience-of-care scores by diagnosis-specific process and outcome measures for acute myocardial infarction, heart failure, and pneumonia. We also evaluate how scores have changed over the three-year period. We find significant differences in patient experience-of-care scores for 195 out of 230 relationships between HCAHPS patient experience-of-care scores and 23 diagnosis-specific process and outcomes measures. We find nearly no significant differences in changes in scores from 2009-2011 (8 out of 230) when comparing the same experience-of-care and diagnosis-specific quality measures. For the majority of measures, high scores on the quality metrics were associated with high patient experience-of-care scores
Preference-sensitive decisions of patients with metastatic breast cancer: The need for decision support
Get PDFBecause of disease progression and the increasing number of treatment options, patients with metastatic breast cancer face multiple decisions over time. Our aim was to identify the multiple decisions patients with metastatic breast cancer face in order to decide which decision aids will be developed. First, we analyzed the clinical practice guidelines to identify decisions encountered by patients with metastatic breast cancer and healthcare professionals. Furthermore, an online questionnaire for patients, a focus group interview with patients and interviews with healthcare professionals were performed. In addition, we performed a systematic literature research and internet search to identify relevant decision support tools and we assessed their quality. Finally, all results were discussed with a mixed group of eight experts, consisting of researchers, patients and healthcare professionals and a comprehensive advice was given which decision aid to develop. It turned out that patients with metastatic breast cancer and healthcare professionals are confronted with eight major decision points regarding treatment and examinations during the care process. We identified four decision aids. These tools partially overlap with some of the identified decision points. Experts advised to develop a decision aid for patients with metastatic breast cancer that would address all mentioned decision points. We concluded patients with metastatic breast cancer and healthcare professionals will benefit from a personalized decision aid in which all eight major decision points are addressed. This decision aid would help patients and healthcare professionals to explore patients’ personal values and preferences in order to make a well-informed decision
Improving the patient experience through a commit to sit service excellence initiative
Get PDFEffective communication between nurses and patients positively impacts patient care, outcomes, and the patient experience.While in the hospital, patients receive information from multiple caregivers and are often overwhelmed and confused. Nurses make up the majority of interactions with patients and are in an ideal position to improve the patient experience from the front lines. The purpose of implementing the Commit to Sit service excellence initiative was to positively impact the patient’s perception of nurse communication by nurses sitting with their patients during each shift. Outcomes were measured by the overall nurse communication composite on the Press Ganey survey, as well as the composite components of treating patients with courtesy and respect, listening carefully, and explaining understandably. Patients perceive caregivers as spending more time at the bedside when sitting versus standing.
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
Female and male patients’ perceptions of primary care doctors’ communication skills in Hong Kong
Get PDFThis study examined how female and male patients perceive primary doctors’ communication skills in the Chinese context. To do so, this study specifically investigates female and male patients’ general perceptions toward primary care doctors’ communication skills in medical consultations. Specifically, this study focused on (a) female and male patients’ satisfaction level toward primary care doctors’ communication skills in medical consultations (b) female and male patients’ perception of the types of verbal and nonverbal communication skills applied by primary care doctors in medical consultations (c) as well as which gender of doctors with whom patients prefer to communicate during primary care medical consultations in Hong Kong. A purposive sampling survey of Hong Kong residents aged 18 or older was conducted in April 2014. A total of 450 completed questionnaires were received. All respondents have visited a public hospital for outpatient service in the past 2 years. Results showed that there were no patient gender differences in patients’ perceptions of doctors’ communication skills, both female and male patient respondents showed a preference for same-gender doctors. Interestingly, in contrast with prior research, male patient respondents in this study revealed a stronger preference for doctors of the same gender than female patient respondents did. Other differences, such as cultural norms, values and practices, rather than just gender differences, may account for patients’ perceptions of doctors’ communication skills
Please tick the appropriate box: Perspectives on patient reported experience
Get PDFPatient experience surveys are increasingly used as a method for evaluating important aspects of quality of care and the results are used politically to support general decision-making. However, there have been limited attempts to summarize the newest and most essential knowledge on how to measure and interpret patient experience data. This paper aims to summarize knowledge on the association between delivered care and patient reported experience and the factors influencing this association, and to outline a conceptual model illustrating the association. The method employed is integrative literature review. Quantitative and qualitative studies as well as theoretical and discussion papers that specifically related to the concept of patient evaluations were included. Identified literature was scoped. Thematic analysis was conducted and the results were used to synthesize a model by integrating identified factors. Expectations, patient characteristics, survey timing, loyalty to health professionals, backing up own choices and questionnaire and item design where identified as factors influencing the association between delivered care and patient reported experience. The developed model suggests that there should be a clear differentiation between patient’s experience and patient reported experience. The model derived from the literature underlines that the association between received care and patient reported experience is complex. Patient reported experience data should be interpreted with caution, as reported positive experiences might neither reflect high quality care nor satisfied patients
Applying experience-based co-design with vulnerable populations: Lessons from a systematic review of methods to involve patients, families and service providers in child and youth mental health service improvement
Get PDFThe objective was to identify methods used to involve patients, family and service providers in child and youth mental health service improvement research. We analyzed the alignment of methods used with Experience-Based Co-Design (EBCD) methodology, and how power imbalances among participants were addressed. A systematic review of the English-language peer review literature since 2004 was carried out. The EMBASE, Scholar’s Portal, PubMed, Web of Science databases and the Ontario College of Art and Design University libraries were searched electronically for variations of ‘child’, ‘mental health’, ‘experience-based co-design’, ‘participatory research’ and ‘health care services’. Textual data was systematically extracted and analyzed. The electronic search identified 1468 articles; 13 remained following full text review and reference checking. Many participatory research studies in child and youth mental health were consistent with core elements of the EBCD methodology, but few focused on experiences and incorporated the perspectives of all participants throughout the research process. Story telling and visual media, employing youth as researcher partners, establishing equal status among participants, offering counseling support, paying particular attention to confidentiality, scheduling frequent breaks, and having skilled interviewers and facilitators were suggested methods to address power imbalances for this vulnerable population. Conclusion-The existing child and youth mental health participatory research literature aligns considerably with many elements of EBCD methodology and suggests diverse approaches to address power imbalances. More systematic application of the full range of elements will help to achieve patient centeredness and recovery in mental health and for other vulnerable populations
Patient organizations and primary care development: reflections by patients with chronic diseases
Get PDFTo explore how patients with chronic diseases, as well as members of patient organizations, perceive primary care and how they think about how to participate in primary care development. Focus group interviews with 28 patients in three regions in Sweden were conducted. We identified four themes: Availability of care, How to be met by professionals, Information needs and Continuity and prevention in care. Important was to meet the same doctor at every visit and to be met with empathy and knowledge about your disease. Suggestions about better use of technical information services, introduction of a coordinator in the waiting room and longer and varied open hours came up. The information needs for newly diagnosed and those with a long disease trajectory differed and care treatment plans were asked for by many participants. Discussions between patient organizations about how to participate in education of health care professionals were recommended. Patients’ with chronic diseases want to take more active part in their own care. By promoting more contacts between patient organizations, influence on the politic agendas may be achieved. To achieve effects, the patient organizations should be proposed to be included and to activate themselves about these results. If so, a stronger patient voice may be heard in the society. A change in the paternalistic philosophy in primary health care is also needed so the patients’ rights and contribution will be acknowledged and joint education with health professionals could be one way
Why do they do that?: Looking beyond typical reasons for non-urgent ED use among Medicaid patients
Get PDFBarriers to accessing primary care, including lack of transportation and inadequate appointment times, are common reasons for non-urgent emergency department (ED) use yet even when these barriers are addressed, the problem persists. This study explored non-urgent ED use by Medicaid enrollees through interviews with patients and providers and sought to identify themes beyond the commonly mentioned logistical and access issues. Qualitative interviews with 23 Medicaid enrollees and 31 PCP and ED providers utilizing a semi-structured interview guide focused on reasons for seeking care in the ED and issues associated with PCP appointments. We identified overlap as well as surprising differences in themes identified by providers and by patients. Providers identified cultural and educational issues including that many Medicaid patients had grown up using the ED as their main source of care and lacked awareness of other sources healthcare. Patients did not mention educational and cultural factors directly, but discussed a concern that their condition was too serious for the PCP, or that the ED provided more comprehensive services. Both patients and providers raised neglected concepts, particularly those related to understanding primary care compared to emergency care. These results highlight the importance of addressing multiple paths toward more appropriate ED use, including barriers beyond logistical and access-related concerns. Considering the patient’s perception of the situation, as well as identifying opportunities to improve patients’ understanding of where to seek care may help to create interventions with broader impact than those that address access and logistical barriers alone