Patient Experience Journal (PXJ, The Beryl Institute)
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We did our Best!: The Experience of Frontline Workers in Long-Term Care during COVID-19 Outbreaks
Get PDFIn Canada, the COVID-19 pandemic had devastating effects for those living in long-term care (LTC) homes, yet little is known about the experiences of the frontline workers who endured in those settings with COVID-19 outbreaks. Specialized knowledge will improve our understanding of the effects of the pandemic on frontline workers (FW), enabling the development of stronger practices. The purpose of this research was to gain a deeper understanding of the experiences of FW caring for residents in LTC homes during a COVID-19 outbreak, using narrative inquiry. The methods used for data collection include interviews, field notes, and photovoice. Participants were asked to capture photographs representing their experience working during the COVID-19 outbreak at their LTC home. Participants\u27 stories were collected through reflection on their photographs in interviews. The setting for this research was LTC homes in Ontario, Canada. Data analysis followed Frank\u27s hermeneutic method of analysis of stories. Psychosocial effects, support, loss of normalcy, increased workload, and altruism and dedication resonated throughout the three participants\u27 stories. The burnout, stress, and mental exhaustion, as detailed by the participants, emphasizes the importance of protecting the mental health of the FW during outbreaks. Equipping FW with relevant knowledge helped them to feel prepared and confident in protecting the residents, themselves, and their families. Support from management personnel influences the experience of FW during infectious outbreaks
Efficacy of a Communication Toolkit to Optimize Palliative Care Communication in the Surgical Intensive Unit
Get PDFData demonstrates patients benefit from the experience of specialty palliative care providers for advance care planning and prioritizing quality of life, regardless of diagnosis or stage of illness. Despite these benefits, many intensive care units (ICUs) show low utilization of palliative care. The purpose of this study was to evaluate the ability of a bedside communication toolkit to improve communication between family members and caregivers of surgical ICU patients and the ICU team, particularly in the context of medical updates and decision-making. A pilot bedside communication tool was completed by fifty family members of trauma and emergency general surgery (EGS) patients. Participants then completed a survey to provide feedback on the toolkit.
The majority of family members felt the toolkit helped them to formulate questions for the team and agreed they were more informed as a result of the toolkit. The majority disagreed the toolkit was emotionally upsetting to read through. The perceived benefit by family members/decision makers of surgical ICU patients offers many opportunities for further investigation and integration of the toolkit into practice in the ICU and beyond. A communication toolkit may improve communication between patient providers and family members, particularly in key medical decision-making discussions
Post-Pandemic Needs of Unpaid Family and Friend Caregivers to Effectively Continue Caregiving Duties in one Northern Ontario Health Authority
Get PDFThe Covid-19 pandemic had a significant impact on the support networks for older adults and caregivers as health and social care systems were forced to dramatically change the ways patients and clients interacted with providers, services, and programs. In Northern Ontario, caregivers are older, caring in more intense situations, more likely to be caring for multiple care recipients simultaneously and less likely to be in contact with health professionals. This research sought to explore the post-pandemic needs of caregivers in a Northern Ontario health catchment to better understand the needed supports. Using a collaborative and co-design approach with caregiver advisors within a qualitative description design, seven focus groups were conducted with 36 participants in total in February 2023. Reflexive thematic analysis was used to generate five themes from the transcripts: caregivers as the invisible but vital backbone of health and social care; amplified distress: navigating overwhelming demands; family fault lines exposed; contextualized care: the need for personalized supports; and empowering caregivers through training and supports. Our findings suggest that the pandemic significantly impacted the already vulnerable support networks for older adults and caregivers, as health and social care systems had to adapt to new restrictions and limitations. Caregivers were forced to take on additional responsibilities and cope with social isolation, leading to detrimental effects on their mental health and overall well-being
Helping Patients Navigate the Emergency Department: Assessing the Utility of a Poster Illustrating the Patient Journey
Get PDFPatients often have limited understanding of the emergency department (ED) care process, which can increase anxiety, frustration, and confusion. This study implemented and assessed the usefulness of a poster explaining the ED care process. A large wall-mounted poster illustrating the patient journey was developed; two different data collection techniques were used. First, a QR code/URL was used to passively collect patient reactions to the poster in 15 EDs. Due to limited response, a paper survey was developed and delivered by research assistants in three study sites using a consecutive sampling method. A total of 67 responses were collected from the QR/URL method between October 2017 and July 2021. The in-person survey collected 316 responses, of which approximately half of the respondents were women and the majority identified as white. Half of the respondents presented to the ED alone. Nearly 40% of respondents had noticed and engaged with the poster without prompting. Once prompted, the majority of respondents understood its content and over half found the information to be extremely or very helpful in preparing them for their ED journey. Respondents identified three additional key information needs: 1) real-time waiting times, 2) triaging scoring information, and 3) support on what to do while waiting. Patient journey posters may assist patients in navigating the ED care process. Exploring alternative delivery methods, personalizing materials and addressing wait times may increase usefulness. Reconceptualizing the waiting room as an opportunity for patient education and communication may alleviate patient fears and better prepare them for the ED journey
Acceptability of a New Remote Monitoring Service for Patients with COVID-19 Infection using Wearable BioStickers™: A Mixed Methods Study
Get PDFThe COVID-19 pandemic saw rapid adoption of telehealth, including remote patient monitoring (RPM). There is limited evidence about how patients and staff experience such services in New Zealand. This study aimed to understand the acceptability of the RPM experience, particularly for Maori and Pacific peoples, and identify strengths, gaps, and limitations to inform future delivery of services. A mixed methods study was undertaken between 4 July and 11 September 2022 in Auckland. We conducted telephone surveys with patients and semi-structured interviews with patients and staff. Survey, and clinical and administrative data were analysed descriptively using SPSS. Interviews were analysed using Directed Content Analysis. 121 patients took part in the study, with the majority identifying as Maori and Pacific peoples (40% and 17%, respectively). We conducted 75 telephone surveys (62% response rate), and 30 semi-structured interviews (18 patients and 12 staff). Patients reported feeling safe and reassured while in the RPM service and that they would be willing to use it again. Staff reflected on a range of potential benefits that RPM offers, identified learnings and would like to see a more widespread rollout of RPM. This study demonstrated that remote monitoring of patients infected with Covid-19 can provide an acceptable model for a culturally diverse population. Future research could focus on applying this model to other patient groups, such as people with chronic conditions
Patients’ Perceptions of Interprofessional Collaboration: A Scoping Review
No full textCollaboration has emerged as a pivotal element within an intentional person-centred healthcare framework. However, there is a need for evaluative feedback from patients to enhance interprofessional collaboration and its outcomes. The objective of this review was to describe the state of knowledge on the perspectives of patients living with a chronic condition regarding their experiences of interprofessional collaboration. A scoping review across five online databases (EBSCOhost, Google Scholar, PubMed Central, ScienceDirect, and Taylor & Francis Online; February 2023) identified all peer-reviewed literature published in English between the years 2018 and 2023 that reported on patients’ perspectives of, and experiences with, interprofessional collaboration and/or its effect on patient care and outcomes. Articles selected for final appraisal were descriptively and thematically analysed. The literature search yielded 3454 articles. One hundred and four (104) full-text articles were included for appraisal based on the eligibility criteria. Once study selection and critical appraisal were completed, 25 studies were included in the review. Three themes were reported on the patient’s perspective of interprofessional collaboration: (i) Team functioning, (ii) Patient involvement, and (iii) Coordinated care. Interprofessional relations, role clarification, and team-based communication were the main factors essential to successful team functioning as perceived by patients. Further exploration of these key factors is necessary to guide the development of improvement strategies or interventions focused on strengthening interprofessional collaboration and the patient’s experience. The patient’s perspective of interprofessional collaboration still warrants further investigation to improve patient experience, quality of care, and outcomes in a collaborative environment
Research Imitates Life: Researching Within Your Lived Experience
Get PDFThis personal narrative article seeks to bring awareness to and provide an overview of the various aspects that come with being a lived experience researcher including the host of benefits and challenges that come with conducting research within one\u27s own area of lived experience. Throughout this narrative, we (Bethany Donaghy, an autistic person, and Delane Linkiewich a person living with chronic pain) share our perspectives on what it is like to be lived experience researchers. Our narratives discuss how the many identities we hold both improve the impact and relevance of our research while also posing challenges for us like the additional responsibilities we hold and the reflections we have to make. Most importantly, we present several recommendations to all researchers on how to promote inclusive spaces and increase respect and appreciation for the expertise that people with lived experience hold. This piece outlines critical considerations of what may be considered as best practice for future inclusive research and we encourage researchers to actively consider embedding these recommendations within their own working practice
Driving Healthy Behaviors through Social Support: The Role of Co-Responsibility in Weight Loss and Maintenance
Get PDFObjective: The effectiveness of out of hospital lifestyle interventions in healthcare is likely co-dependent on social support from involved one\u27s. We sought to investigate the interrelationships between patient-partner Co-responsibility, Spousal Support, and Self-efficacy and the mechanisms through which they contribute to health behaviors and outcomes relevant to weight loss and maintenance. Methods: Co-responsibility, Spousal Support, self-efficacy, health outcomes and health behaviors like total weight loss, physical activity, OBESI-Q, and health satisfaction were assessed through a questionnaire among 868 individuals attempting to lose weight. Full and semi-partial correlations were used to understand the association between Co-responsibility, Spousal Support, Self-efficacy and health outcomes and behaviors. Results: Results showed that increased Co-responsibility was associated with improved health outcomes and that it extended the construct of Spousal Support. The underlying pathway of associations between Co-responsibility and health outcomes was found to be through Self-efficacy. Finally, it was revealed that increased Co-responsibility caused an improvement in Self-efficacy. Conclusion: Understanding Co-responsibility among patients and their involved one\u27s could provide valuable information to health care professionals to tailor care trajectories and achieve better patient health outcomes
Quality of Outpatient Care in Lebanon: A Cross-Sectional Survey
Get PDFPatient experience is an important driver of healthcare improvement. Yet, in Lebanon, there is a lack of studies focusing on the satisfaction of outpatients with healthcare quality. This study aims to assess the quality of outpatient care in Lebanon from the patient’s perspective and identify its determinants. A cross-sectional survey was administered, between December 2023 and January 2024, to 265 participants over 18 years old who consulted a healthcare provider, excluding dentists. We used linear regression to determine factors affecting consultation quality as perceived by the participants. Waiting time before consultations typically ranged from 5 to 15 minutes, the average consultation duration was 20.8 minutes, and the average quality rating of consultations was 8.3/10. Overall, patients expressed satisfaction with the waiting time, physician and staff behavior, outcomes, and instructions received. Up to 40% of the variance in perceived quality could be attributed to physician-modifiable factors, such as friendliness (β = 0.5, p = 0.53), listening skills (β = 0.7, p = 0.14), attentiveness and effort (β = 0.9, p = 0.04), patient comfort (β = 2.3, p \u3c 0.01) and privacy (β = -0.1, p = 0.82), acceptable consultation duration (β = 0.6, p = 0.12), fewer interruptions (β = 0.7, p = 0.03), better appointment scheduling (β = -0.1, p = 0.8), and less patient waiting time (β = 0.7, p \u3c 0.01). In conclusion, Lebanon has a high standard of outpatient care that is mainly influenced by the doctor-patient relationship rather than financial incentives
Patient Experience Diagnosis: Using Telemed Simulation to Assess Health Care Provider Verbal and Nonverbal Communication Issues to Prescribe Potential Interventions
Get PDFPatient experience contributes to health outcomes, and a host of healthcare organization success factors, including profitability. Often applied and academic analysis of patient experience applies macro-level approaches to defining issues and suggesting improvements. Guided by the theoretical framework of provider-patient communication during telemedicine, this study used a simulation to measure impacts of provider behaviors that might be improved through communication training to positively impact outcomes on both sides of patient care. The study employed between-subject experimental design to investigate impacts of provider verbal and nonverbal communication on patient satisfaction during telemedicine consultations. Participants, randomly assigned to one of eight experimental conditions, watched a recorded telemedicine “consultation” with either a male or female provider that displayed either high- or low-immediacy nonverbal cues. Participants imagined being the patient and completed a survey regarding perceptions of provider communication and evaluation of the experience. Results suggest a healthcare provider’s verbal and nonverbal communication represents a significant predictor of patient satisfaction, even during telemedicine. The findings provide empirical evidence for Miller’s model and point to the importance and potential of improving providers’ verbal and nonverbal communication skills through communication training on specific interpersonal skills