Medicine and Health Sciences Commons^™

Interprofessional Collaboration To Improve And Sustain Patient Experience Outcomes In An Ambulatory Setting, Natalie Sanchez, Kimberly Hermis

Patient Experience Journal

Patient experience is an important factor across diverse healthcare delivery settings. Despite enhanced attention to and advances in patient experience, many of the published initiatives focus on in-hospital care and opportunities have been identified to continue to strategically address patient experience in the ambulatory setting. This quality improvement initiative presents the development of an interprofessional approach to patient experience in a freestanding ambulatory oncology center. The objective of this initiative was to improve and sustain patient experience, as reflected in the Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores via Press Ganey. This approach consisted of redesigning a previously …

Twelve Principles To Support Caregiver Engagement In Health Care Systems And Health Research, Kerry Kuluski, Kristina M. Kokorelias, Allie Peckham, Jodeme Goldhar, John Petrie, Carole Anne Alloway

Patient Experience Journal

Family and friend caregivers (i.e., unpaid carers) play a critical role in meeting the needs of people across various ages and illness circumstances. Caregiver experiences and expertise, which are currently overlooked, should be considered in practice (such as designing and evaluating services) and when designing and conducting research. In order to improve the quality of health care we need to understand how best to meaningfully engage caregivers in research, policy and program development to fill this important gap. Our study aimed to determine principles to support caregiver engagement in practice and research. A pan Canadian meeting brought together 48 stakeholders …

The Importance Of Physician To Physician Coaching, Medical Director And Staff Engagement And Doing “One Thing Different”, Ghazala Q. Sharieff

Patient Experience Journal

With the Center for Medicare and Medicaid Services incorporating patient experience into the Value Based Purchasing metrics, there is increasing hospital focus on improving this important aspect of patient care. The Value Based Purchasing program bases 25% of its value on the patient experience domain and is based on patient perspective as gathered via the Healthcare Consumer Assessment of Healthcare Providers and Systems survey (HCAHPS). Our system chose to implement simultaneous pilot activities to train our 6 Hospitalist groups, obtain Hospitalist medical director buy in and deliver timely physician group feedback in a transparent manner. In addition, a single hospital …

Does The Use Of Volunteers And Playbooks In Pediatric Primary Care Clinic Waiting Rooms Influence Patient Experience?, Tara Servati, Kalpana Pethe, Victoria Tiase

Patient Experience Journal

The purpose of this secondary data analysis was (1) to understand the use of a playbook as a positive distraction technique and (2) to explore the use of volunteers in the waiting room of an outpatient pediatric clinic setting. Specifically, the study examined the impact on perceived wait time, overall quality of care, and patient experience in a convenience sample of patients. Data obtained for a pilot program for improving patient experience were aggregated for exploratory analysis. Although significant differences in perceived wait time or patient experience were not found, the cohort exposed to both the playbook and volunteer intervention …

A Case Study Of The Patient Wait Experience In An Emergency Department With Therapy Dogs, Colleen A. Dell, James Stempien, Lindsey Broberg, Alicia Husband, Lacey Jurke, Betty Rohr, Jane Smith, Joseph Rubin, Susan Tupper, Donna Goodridge, Cathie Fornssler, Logan Fele-Slaferek

Patient Experience Journal

The quality of patient healthcare is a growing concern in Canada’s hospital emergency departments (ED) due to increasing wait times and associated adverse outcomes. A developing body of literature indicates that therapy dogs can positively impact the patient experience. In 2016, members of our team partnered with the Royal University Hospital (RUH) in Saskatchewan to become the first ED in Canada to integrate a visiting therapy dog to positively impact the patient wait experience. The aim of this preliminary case study was to examine if and how this unique initiative impacted patients’ feelings during their ED wait. A brief questionnaire …

The Impact Of Response Rate On Hospital Consumer Assessment Of Healthcare Providers And System (Hcahps) Dimension Scores, Erin Godden, Andrea Paseka, Jan Gnida, Joe Inguanzo

Patient Experience Journal

Patient experience measurement is receiving considerable attention from hospital executives, healthcare leaders, purchasers such as the Centers for Medicare and Medicaid Services (CMS), and patients. It is therefore appropriate and necessary to examine the methods of survey administration, and the analysis presented here seeks to understand the impact of one particular aspect of the measurement: response rate. Utilizing publicly reported HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) data from Hospital Compare, a positive correlation between response rate and HCAHPS scores nationwide was identified and replicated. This correlation, which was most recently published by the Hospital Quality Institute (HQI) …

Comparing Psychiatric Care Experiences Shared Online With Validated Questionnaires; Do They Include The Same Content?, Rebecca Baines, John Donovan, Samantha Regan De Bere, Julian Archer, Ray Jones

Patient Experience Journal

Patient feedback is considered integral to patient safety and quality of care. However, limited research has compared the content of validated questionnaires with subjective patient experiences shared online. The aim of this study was to therefore identify and compare the content of psychiatric care experiences shared online with validated questionnaires. All research was conducted in co-production with a volunteer mental-health-patient-research-partner. We analysed all reviews published on the United Kingdom’s leading health and social care feedback platform Care Opinion, between 2005-2017 that discussed adult psychiatric care and compared findings with two validated questionnaires (ACP360 and General Medical Council patient feedback questionnaire). …

“Can I Still Get A Tattoo?” Patients’ Experiences Across The Clinical Trajectory For Metastatic Melanoma: A Dynamic Narrative Model Of Patient Journey, Klay Lamprell, Melvin Chin, Jeffrey Braithwaite

Patient Experience Journal

Advanced and metastatic cancer has a complex diagnostic and management profile that places a heavy long-term burden on patients and healthcare systems. Little attention has been given to patients’ experiences across their entire clinical journey. Using a qualitative, longitudinal methodology over a ten-month period, we examined the symptom-to-outcome trajectories of seven people attending a medical oncology clinic at a large, public tertiary referral center in Sydney, Australia. Rather than care being experienced as a largely linear progression through diagnosis, treatment and onto surveillance in which life may return to ‘normal’, participants are embedded in a cyclical clinical pathway. Recurrence or …

Patient Perception Of Telephone Follow-Up After Resection For Colorectal Cancer: Is It Time For An Alternative To The Out-Patient Clinic?, Marcus Gilmartin, Nicholas Leaver, George Hall, Helena Fawdry, Seung Lee, James Nicholson, Ramya Kalaiselvan, Raj Rajaganeshan

Patient Experience Journal

The economic reality of modern healthcare provides a timely reminder to clinicians of their duty to provide outstanding and cost-effective care. Although multiple guidelines outline investigation, management and surveillance of colorectal cancer, none advocate a particular delivery method. Nurse-led telephone follow-up in multiple specialties has demonstrated equivalent clinical outcomes and patient satisfaction when compared to traditional outpatient department follow-up. This paper aims to compare nurse-led telephone and outpatient follow-up, following surgical resection of colorectal cancer (CRC), focusing on patient perceptions. This cross-sectional study distributed adapted patient satisfaction questionnaire (PS-Q 18) to patients undergoing surveillance following CRC resection via either nurse-led …

How Have Patients' Experiences Of Cancer Care Been Linked To Survival? A Systematic Review, Saleh A. Alessy, Margreet Lüchtenborg Dr, Elizabeth A. Davies Dr.

Patient Experience Journal

Patient experience of care remains an important indicator of health care quality. Although studies show care experiences are associated with health outcomes for some conditions, the situation for cancer is unclear. New datasets on cancer patients in the US, Canada, and UK linking information on experiences and survival may enable an exploration of any association. This review aimed to identify studies linking any aspect of cancer patients’ experiences to their survival, to inform future analyses. We performed a systematic review using Medline database from January 1998 until March 2018.

The settings included outpatient oncology clinics, primary care, hospitals, and cancer …

Using Experience-Based Design To Understand The Patient And Caregiver Experience With Delirium, Lauren Russ, Jennifer Phillips, Val Ferris, Amy London, Logan Kendall, Craig Blackmore

Patient Experience Journal

Hospital-acquired delirium negatively affects clinical outcomes and the care experience for patients and family caregivers. Following the qualitative methods of experience-based design, we completed observations of hospital units and interviews of patients, caregivers (including family members and other companions), and hospital nurses and other staff regarding their experiences with delirium. In addition, we administered an experience-based design questionnaire to another 130 subjects from the same groups. Key findings included: there is a need for preparation of the patients and family caregivers for the possibility of delirium (particularly before surgery), and patients and caregivers lack understanding of delirium and its potential …

Exploring Interventions To Increase Primary Care Providers’ Use Of Self-Management Goals, Nanci Reiland, Kathleen Fitzgerald, Mary E. Maragos

Patient Experience Journal

Accreditors, such as the Joint Commission, consider evidence of patient engagement strategies for awarding Primary Care/Patient-Centered Medical Home (PCMH) accreditation. This project explored the use of brief Motivational Interviewing (MI) training at a local county health center and evaluated the impact on the documented use of self-management goals (SMGs) for patients with diabetes and hypertension. Methods included a professional development program, including an online module, presentation, and educational materials. The goal was to increase providers’ MI knowledge and skills to better construct and document SMGs. The program impact was evaluated by chart review to determine the use of SMGs by …

One Patient's Experiences And Expectations In The Healthcare System: Complicated And Critical Illness With Rare Diagnosis Described By His Advocate, Jennifer Cademartori

Patient Experience Journal

The health care business serves as a profession in the art of human illness. But unlike other businesses there is the human side, the patient experience. These patients are the “customers” receiving the care, but they, unlike customers at a retail store, are vulnerable and scared and must trust their lives in the hands of people they don’t know. The paradigm must change to reflect how the health care business is handled from the eyes of the person receiving the care from the first office visit, through the inpatient stay, to follow up visits. Patient focused training on all levels …

Reframing The Conversation On Patient Experience: Three Considerations, Jason A. Wolf Phd, Cpxp

Patient Experience Journal

In experience, every voice matters, and each of those individual voices are contributing to an ocean of ripples that are positively impacting countless lives. In experience, no one organization owns, nor should claim to own all the answers, but many contribute to the possibilities found in elevating the human experience in healthcare. In experience, when we ensure this is a true strategic focus at the heart of healthcare we will find our way to achieving all the outcomes we aspire to achieve and know are possible in healthcare. This issue helps frame that reality through contributions from around the world …

What's Happening: April 22, 2019, Maine Medical Center

What's Happening

No abstract provided.

Health Leadership & Administration And Quality Improvement Process Measurement And Information Leading To Ms Healthcare, Joanna Burkhardt

Library Impact Statements

No abstract provided.

Sustainability In Quality Improvement And Patient Safety Initiatives, Angelo P. Giardino, Eileen R. Giardino

Journal of Nursing & Interprofessional Leadership in Quality & Safety

The question often asked of a quality improvement initiative is whether the improvement process has been sustained within the organization. Rarely is the question answered satisfactorily. The sustainability of an improvement process is important as it justifies the investment of human and financial capital. The term 'evaporation of improvements' addresses the dilemma that between 33% to 70% of all innovations are reportedly not sustained (Fleiszer, Semenic, Ritchie, Richer, & Denis, 2015) . This evaporation of improvement captures the frustrating inability of many institutions to maintain the achieved improvement after the newness of the initial effort wears off (Buchanan, Fitzgerald, & …

What's Happening: April 15, 2019, Maine Medical Center

What's Happening

No abstract provided.

Why Doula Services Should Become An Essential Health Benefit In New York State, Jalisha Hanshaw, Amy White

Publications and Research

Doulas are birth workers who assist expecting mothers through pregnancy, birth and postpartum using holistic techniques. Techniques include: prenatal yoga, birth affirmations and induction acupuncture. Doulas are underrated healthcare providers who deserve the same respect as clinical and non-clinical providers. Doulas are well-rounded alternative care providers who focus on mental, emotional, and physical well being of mothers. Also, they know special alternative medical techniques that prevent mothers from maternal mortality among other negative health outcomes. The amount of time and effort doulas perform with expecting mothers are equal or more than the average medical healthcare provider and should be a …

Med Conformity: Enhance Adherence With Prescription Opioids, Nafees Qamar

Research Days

A person dies in America approximately every 16 minutes from opioid overdose. It is estimated that one in four patients receiving long-term opioid therapy in a primary care setting struggles with opioid addiction. Medication non-adherence causes unfavorable healthcare outcomes and raises healthcare costs through increased service utilization. We need to provide tools and information for healthcare professionals working on overdose prevention and treatment, and increase awareness and share best practices with providers and patients. Developing a digital health application to run on a smartphone is an inexpensive solution for addressing medication non-adherence. Objective data captured on a digital device can …

What's Happening: April 8, 2019, Maine Medical Center

What's Happening

No abstract provided.

Comparison Of Administratively Collected (Icd-10) Vs. Prospectively Collected Adverse Event Data, Joseph G. O'Sullivan

OHSU-PSU School of Public Health Annual Conference

Background: Accurate adverse event reporting is vital for analyzing outcomes and implementing the proper systemic efforts to improve them. Complication reporting and tracking has implications in medical practice, billing, and ultimately patient safety.

Objectives: To determine accuracy of complications reported in administrative data compared to prospectively obtained data.

Methods: A total of 1,213 patients undergoing spine surgery were followed over a two-year period (January 2011 to December 2012) sampled at a single institution. All patients undergoing spine surgery were eligible for inclusion in the study. Prospective data collection of adverse events was accomplished using OrthoSAVES, a standardized …

05-07-2019 Hsc Committee Revised Agenda, Hsc Committee

HSC Committee (A subcommittee of the UNM Board of Regents)

No abstract provided.

Dental Practice Success Vol. 6 No. 1, American Dental Association, Publishing Division

Dental Practice Success

No abstract provided.

What's Happening: April 1, 2019, Maine Medical Center

What's Happening

No abstract provided.

Prevalence And Practice For Rare Diseases In Primary Care: A National Cross-Sectional Study In The Usa, Ara Jo, Samantha Larson, Peter Carek, Michael R. Peabody, Lars E. Peterson, Arch G. Mainous

Family and Community Medicine Faculty Publications

Objectives There are more than 7000 rare diseases in the USA, and they are prevalent in 8% of the population. Due to life-threatening risk and limited therapies, early detection and treatment are critical. The purpose of this study was to explore characteristics of visits for patients with rare diseases seen by primary care physicians (PCPs).

Design The study used a cross sectional study using a national representative dataset, the National Ambulatory Medical Care Survey for the years 2012–2014.

Setting Primary care setting.

Participants Visits to PCPs (n=22 306 representing 354 507 772 office visits to PCPs).

Primary outcome measures Prevalence …

Implementation Of Pharmacogenomics Into Electronic Health Record And Clinical Decision Support, Dharaben Naik

Applied Research Projects

The advent of electronic health records (EHR) and clinical decision support (CDS) has brought numerous changes in the healthcare field and has improved how patients receive care. The field of pharmacogenomics has made many breakthrough discoveries in the last few decades and these new advances have immensely reduced the cost of genetic testing. As advances have been made, researchers have discovered that individuals may respond to a medication differently due to genetic variants. There is a shift in the medical field from a one size fits all model to a personalized medicine model based on genetic information. Institutions have started …

Health Information Exchanges In The Community Pharmacy Setting, Kenneth D. Sykes

Applied Research Projects

The landscape of health care is shifting as new payment models and mandates for health information technology (HIT) rise. There is an unprecedented demand to meet our nation’s health care challenges of access, safety, quality, and cost. To meet these demands, the health care industry has recognized a team-based care model which can introduce the collaborative power through health information exchanges (HIEs). Providers like pharmacists, can detect and resolve medication errors, duplications, and omissions by using HIEs. HIEs give pharmacists the entire view of the patient from the bed-side of the hospital to the community pharmacy. However, the implementation of …

An Assessment Of Utilization Of Prescription Anti-Hypertension Medications Via A Health Records Database, Ryan Payne

Applied Research Projects

Obesity is a growing problem in the United States, though not a new one. It was estimated that over 72 million U.S. adults alone have a diagnosis of obesity. Among all preventable premature deaths, obesity ranks as the second leading cause. Contemporary classifications define obesity as a body mass index (BMI) greater than or equal to 30. Several common comorbidities are widely present in obese populations, particularly hypertension, diabetes, and hyperlipidemia. Among these chronic disease states, hypertension has been identified as the most common and earliest identifiable. The purpose of this study was to make inferences on the prescribing of …

Improving Nursing Staffing Methodology And Nursing Sensitive Outcomes With The Addition Of A Patient Centered Acuity Measure, Douglas C. Howard Rn, Ms, Ne-Bc

Doctor of Nursing Practice Projects

Background: Assigning the correct nursing resources to hospitalized patients positively impacts patient outcomes. The current process for matching nurses to patients is highly variable and involves a combination of simple ratios, historical workload data, and expert opinion but lacks objective measurement of the patient’s condition.

Objectives: This project evaluated change in selected quality indicators and the daily unit-level management of nursing resources after implementing the Troubled Outcome Risk (TOR) into existing nursing staffing methodology in a Department of Veterans Affairs hospital.

Methods: TOR provides objective measurement of individual patient allostatic load. Daily calculation of TOR scores for each patient on …