Patient Experience Journal (PXJ, The Beryl Institute)
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Patient satisfaction reported by in-visit and after-visit surveys
Get PDFPatient experience measurement has become a basic requirement for every healthcare provider organization. Yet, when the timing and mode of survey administration are considered, there is skepticism about the usefulness of ‘after- visit’ patient experience surveys to measure satisfaction and identify opportunities to improve service or health care quality. The aim of this observational study was to compare patient satisfaction among those who rated the patient experience at the conclusion of their outpatient appointment while still in the office, to that among those who rated the patient experience up to one month after their outpatient appointment via a mailed survey. Two sampling strategies were used to collect patient experience data from patients of the University of Maryland Family and Community Medicine practice: a postal survey to collect data from patients approximately 30 days after their visit (the After-Visit survey), and a within-visit survey to collect data from patients during their visit (the In-Visit survey). Nineteen survey questions measured comparable constructs between the After-Visit and In-Visit. This study did not find any significant differences between the data sources for any of these questions. The study showed that patient satisfaction could be assessed within a visit or by mail 30 days later without a statistically significant effect on mean responses
The critical role of family in patient experience
Get PDFIn this commentary Brian Boyle raises a simple, yet critical point about the value of family in the care experience. He offers, “When you are focusing on the goals for the patient\u27s recovery, the doctors work with the nurses, specialists, and patient’s family to decide on the appropriate care plan for the patient on both a short- and long-term basis. It is vital that this multi-disciplinary approach occurs during the formation of the care plan and is frequently updated as time goes on. The loved ones of a patient may not have a medical license or healthcare background, but their voice and presence matters in the hospital room.” This reflection is grounded in the author’s personal journey from tragedy to recovery and offers some thoughtful insights not only into the value of family in the patient experience overall, but also how to be intentional in our efforts to engage the family members of those being cared for in healthcare today
Patient leadership: Taking patient experience to the next level?
Get PDFNHS England commissioned the project described in this article to explore how patients and carers can, acting as leaders, make a real difference in improving experience of care. The work was carried out on a collaborative basis, co-designing the scope of the research with patient leaders and commissioners. We gathered case examples across England that had involved patient leaders in using patient and carer feedback to improve experience of care. A Patient Leaders Expert Advisory Group selected four case examples that were visited to undertake a more detailed study and subsequently discussed and agreed the key learning points and conclusions. The Advisory Group chair provided a patient leader view on the project. The main learning points were that in order for patient leadership to have a significant impact on improving experience of care, health organisations should invest in patient leaders, put robust feedback mechanisms in place and develop the culture and systems to act on feedback. Our findings identified ten building blocks that provide a basis for success, including a set of key roles across systems. Our conclusion is that patient and carer leaders can raise the profile of improving experience of care and have a real impact on action being taken in response to patient and carer feedback
Patient and family partner involvement in staff interviews: Designing, implementing, and evaluating a new hiring process
Get PDFHealthcare organizations in Canada and the United States are seeking to enhance their ability to offer patient and family centred care (PFCC). One aspect of PFCC is the participation of Patient and Family Partners (PFPs) in a variety of roles within healthcare organizations. This article describes the creation and evaluation of a hiring process that utilized a PFCC interview tool (PFCCIT) and collaborated with PFPs in interviewing candidates for healthcare positions. An evaluation of the new hiring process was designed, including an on-line survey of candidates and semi-structured interviews with healthcare leaders and PFPs. Survey results indicated candidates felt the new process helped them understand the importance of PFCC at the organization. In interviews with leaders, comments were overwhelmingly positive, with leaders urging the spread of this hiring process throughout the organization. Similarly, the four PFPs who were interviewed felt their participation was valuable, and useful in furthering the organization’s commitment to PFCC. The implementation of a staff hiring process utilizing PFPs and the PFCCIT provides a valuable tool for healthcare organizations working to enhance PFCC to better meet the needs of their patients and families. Further study is required to validate the long-term impact of this initiative and determine whether it improves recruitment and retention of staff sharing the organization’s commitment to PFCC
Improving process and enhancing parent and therapist satisfaction through a coordinated intake approach
Get PDFRecent research indicates that, in Canada, approximately one in five children entering school are not meeting age appropriate milestones in physical, social, language, or cognitive development. Even where support services are available families often face barriers in accessing these. With the goals of improving access to programs, reducing barriers and increasing consistency and efficiency, a new Coordinated Intake Approach (CIA) was developed for families accessing Children’s Rehabilitation Services. It was expected that the CIA would result in 1) parents finding the intake process more satisfactory and easier to complete, 2) therapists feeling more supported and satisfied and 3) a decrease in wait times from the date referrals were received to initial contact with families. Initial data was collected prior to CIA implementation through parent telephone interviews and therapist surveys. This data was then compared with telephone interviews, therapist surveys and chart reviews completed following implementation. Results were consistent with expectations, suggesting that a family centered, CIA contributed to increased parent and therapist satisfaction as well as improved process efficiency. CIA successes and areas for improvement are identified. Possible directions for further process enhancements are also discussed
Patient needs in advanced Renal Cell Carcinoma: What are patients’ priorities and how well are we meeting them?
Get PDFTreatment options and duration of therapy for patients with metastatic renal cell carcinoma (mRCC) have increased. Many patients now spend in excess of 2 years on active therapy. These patients’ needs, and the ability of health services to respond to them, are poorly understood. Ten patients living with mRCC for more than 2 years and treated with at least one targeted agent were selected at random from three hospitals in the United Kingdom (UK). One interviewer who was not involved in their care conducted in-depth interviews. Interview transcripts were analysed using Interpretative Phenomenological Analysis (IPA) to identify issues of greatest importance to patients, and to understand how well patients felt their needs were being addressed. Perceived delay in initial diagnosis was a major theme. Being told the truth about treatment side effects upfront was important, but was often at odds with perceived delivery. ‘Dealing with side effects’, understanding dose and its effects and not letting ‘negative thoughts get in’ were highlighted as important, but were highly personal to patients and areas where patients struggled. Concordance was observed with delivery of ‘a clear next step’ for treatment, timely access to drugs and guidance on a drug ‘holiday’. Patient experience of mRCC and its treatment requires a tailored approach. This research suggests there are key opportunities for service improvement and improved communication throughout the pathway to better meet the needs of patients, including non-clinical support to build personal resilience
The patient patient: The importance of knowing your navigator
Get PDFIn Ontario, Diagnostic Assessment Programs (DAPs) have been implemented to improve the quality of care patients receive during the diagnostic phase of the cancer journey. Patient navigators play a critical role in this model by coordinating care and providing information and support to patients and their families. The objectives of this study were 1) to determine whether patient navigation in DAPs is associated with a better patient experience and 2) to examine whether patient navigation in DAPs modifies the effect of wait times and patient volumes on patient experience. Data reflecting patients’ experience within the DAP were collected via survey and an average experience score was calculated for each region. To ascertain the relationship between patient experience, wait times and volumes, correlation coefficients were computed between regional patient experience scores and total regional patient volumes and between regional patient experience score and regional diagnostic wait times. To understand the impact of navigators on the patient experience, the sample was subdivided according to whether or not the respondent reported knowing their navigator. Patients who knew their navigator rated their experience significantly better than those who did not. For those who did not know their navigator, there was an inverse and significant correlation between patient experience scores and wait times; patients in regions with long waits had poorer experience scores overall. Patients who knew their navigator reported consistently good experience regardless of their diagnostic wait. The navigator appears to mitigate the negative impact of longer wait times on experience
So much more than a “pair of brown shoes”: Triumphs of patient and other stakeholder engagement in patient-centered outcomes research
Get PDFThis piece illustrates the “real world” experiences of patients and other stakeholder partners in research to help inform and inspire future patient-centered outcomes research (PCOR) efforts. The Patient-Centered Outcomes Research Institute (PCORI) was created in 2010 to fund research that helps patients, clinicians, and other healthcare stakeholders make informed health decisions. The first 50 funded PCORI Pilot Projects engaged patients, caregivers, parents, patient advocates, clinicians, and other non-traditional research stakeholders to serve in advisory and leadership positions on their research teams, many for the first time. In interviews with seven patients and other stakeholders, several lessons learned emerged, including how to build confidence over the course of a research project; how to offer translation and interpretation insights reflective of practical experience; how to understand the benefits and limitations to stakeholder participation; and how to positively influence the research process and study outcomes. By the completion of their Pilot Projects, the stakeholder partners profiled here considered themselves “empowered” research contributors. The authors are hopeful these stories will encourage more patients and other stakeholders to contribute their time and experiential learnings to improve the process, and results of, PCOR
Patient care experiences and perceptions of the patient-provider relationship: A mixed method study
Get PDFImproving interpersonal continuity of care—the personal relationship forged between a patient and their primary care provider (PCP) over time—is often considered a goal of primary care. Continuity of care is frequently assessed in terms of longitudinal continuity, or the proportion of encounters with one practitioner, overlooking aspects of the patient-provider relationship that are key to interpersonal continuity of care. Further, few studies explore patients’ perspectives regarding which care experiences enhance or detract from the patient-provider relationship. This study, using focus group interviews, a patient experience CAHPS-PCMH survey, and electronic medical records, explored how patients’ experiences at 10 primary care clinics influenced their perceptions of their relationship with their PCPs. Focus group interviews with 63 participants indicated that patients’ experiences in the clinics, such as wait-times, influenced their perceptions of the patient-provider relationship. The relationship between patient experience and interpersonal continuity was empirically assessed using survey responses and medical records (n=645). We used patients’ perceptions that their provider knows them as a person as a measure of interpersonal continuity. Logistic regression results indicated that being seen within 15 minutes, receiving visit reminders, effective provider communication, and satisfaction, positively influenced patient perceptions of the patient-provider relationship. Furthermore, patients’ care experiences shaped their perceptions of the patient-provider relationship independent of their satisfaction with care. The mixed methods design adds depth to our understanding of patients’ care experiences, and illustrates that these experiences are critical for understanding the patient-provider relationship. Future research on interpersonal continuity should take patient experiences into account
Exploring the impact of an interprofessional care protocol on the patient experience and outcomes for seniors with diabetes
Get PDFContemporary healthcare has placed intensified focus on the patient experience. Ultimately the patient experience is influenced by relationships with healthcare providers. In order to make a positive impact on patient outcomes and quality of care, the patient experience must be positive. Interprofessional collaboration is recognized as a key aspect of a culture that fosters patient-centered care and a positive patient experience. This quasi-experimental study explores the impact of interprofessional collaboration to develop a preventive services care protocol for seniors with diabetes. Patients were studied over six months using pre-test and post-test measures. Both quantitative data from clinical outcomes and qualitative data from the Diabetes Quality of Life Questionnaire are used to explore the impact of an interprofessional care protocol on the patient experience for seniors with diabetes. Results of the study, while not conclusive, suggest that significant improvements in blood glucose levels and aspects of quality of life, such as perceptions of being able to manage self care and reported feeling ill less often, were realized after receiving services that followed the interprofessional protocol. The study offers insights into the importance of interprofessional collaboration as a factor that can enhance the patient experience and presents a continuing education model to facilitate interprofessional collaboration within the healthcare workforce setting