Medicine and Health Sciences Commons^™

Tell Me More: Promoting Compassionate Patient Care Through Conversations With Medical Students, Danielle Qing, Anjali Narayan, Kristin Reese, Sarah Hartman, Taranjeet Ahuja, Alice Fornari

Patient Experience Journal

Tell Me More^® (TMM) is a medical student driven project that represents a movement amongst the rising generation of physicians to practice humanistic, patient-centered medicine through a collaborative approach. Students interviewed patients to create individualized posters designed to build rapport and trust between patients and clinicians, remind patients of their special strengths by highlighting their unique interests and qualities, and encourage more personal and compassionate patient-clinician interactions in order to enhance the patient experience. Students asked each patient three questions: 1. “How would your friends describe you?” 2. “What are your strengths?” 3. “What has been most meaningful to …

Effectiveness Of The Communication Model, C.O.N.N.E.C.T., On Patient Experience And Employee Engagement: A Prospective Study, Agnes Barden, Nicole Giammarinaro

Patient Experience Journal

Northwell Health is a large integrated healthcare organization comprised of 66,000+ employees, 23 hospitals and over 650 medical practice locations located geographically across New York State. In an effort to align and structure interactions between patients, families and healthcare professionals, Northwell Health created a communication model, C.O.N.N.E.C.T. This unique, humanistic model is an acronym that stands for: Contact, Opening Greeting, Name/Title, Needs, Explanation, Closing and Thank. This prospective 3-part study explores the impact of the C.O.N.N.E.C.T. model on professional education, engagement and patient experience. A holistic approach was utilized including a pre and post e-learning module assessment, direct observation behavioral …

Perceptions Of Patient-Centered Care Among Veterans With Gastroesophageal Reflux Disease On Proton Pump Inhibitor Therapy, Salva N. Balbale, Andrew Gawron, Sherri L. Lavela Phd, Mph, Mba

Patient Experience Journal

The aim of this study was to explore perceptions of patient-centered care (PCC) among Veterans with gastroesophageal reflux disease (GERD) on proton pump inhibitor (PPI) therapy using patient-reported outcome (PRO) measures. We used three validated surveys to measure PCC concepts in a national sample of Veterans with GERD on PPI therapy. The Combined Outcome Measure for Risk Communication and Treatment Decision Making Effectiveness (COMRADE) measures patient experiences with risk communication and decision-making. The Patient Activation Measure (PAM) evaluates confidence and knowledge needed for self-management. The Patient Assessment of Care for Chronic Conditions (PACIC) assesses views of chronic care received. We …

How Younger Adults With Psychosocial Problems Experienced Person-Centered Health Consultations, Line Soot, Kirsten S. Freund, Jørgen Lous, Mikkel Vass, Lotte Hvas

Patient Experience Journal

Much attention is focused on the social determinants of health. Family medicine is challenged with a growing number of vulnerable persons with psychosocial or lifestyle related problems. The objective of this work was to explore how vulnerable younger adults experience person-centered preventive health consultations with their general practitioner. The design and setting for this work were a secondary qualitative analysis of a randomized controlled trial (RCT) in Danish general practices. Younger adults (20-45) were consecutively invited to answer a screening questionnaire about psychosocial and lifestyle-related problems when visiting general practice (28 general practitioners (GPs)) for ordinary consultations. The 30% most …

Rules Of Engagement: Strategies Used To Enlist And Retain Underserved Mothers In A Mental Health Intervention, Maureen J. Baker Phd, Rn, Cnl, Beth Perry Black Phd, Rn, Faan, Linda S. Beeber Phd, Pmhcns-Bc, Faan

Patient Experience Journal

Patient engagement has been identified as both a goal and strategy to lower health care costs and improve health care outcomes. However, a lack of consensus and clarity exists as to how the process of patient engagement is implemented in clinical practice. Research addressing the underlying and crucial components of effective patient engagement is limited, leaving a significant gap as to how providers engage patients as active collaborators in their health and health care.

This study provides specific, detailed insight and description into the processes through which advanced practice mental health nurses engaged low-income depressed mothers in a mental health …

Racial/Ethnic And Geographic Differences In Access To A Usual Source Of Care That Follows The Patient-Centered Medical Home Model: Analyses From The Medical Expenditure Panel Survey Data, Zo Ramamonjiarivelo, Delawnia Comer-Hagans, Shamly Austin, Karriem Watson, Alicia Kaye Matthews

Patient Experience Journal

This study examined racial and geographic differences in access to a usual source of care (USC) and it further explored these differences among individuals who had a USC that followed the patient-centered medical home (PCMH) model. Using cross-sectional data from the Household Component of the Medical Expenditure Panel Survey (2008-2013), our sample consisted of non-institutionalized US civilians ages 18-85 (n= 146,233; weighted n = 229,487,016). Our analysis included weighted descriptive statistics and weighted logistic regressions. Although 76% of the respondents had a USC, only 11% of them had a USC that followed the PCMH model. Among respondents who had a …

Transforming Care Through Bedside Leader Rounding: Use Of Handheld Technology Leads To Improvement In Perceived Patient Satisfaction, Alison Tothy, Sunitha K. Sastry, Mary K. Springman, Heather M. Limper, John Fahrenbach, Susan M. Murphy

Patient Experience Journal

When consistently executed, leader rounding has the ability to capture actionable information ensuring delivery of safe and effective patient care, identifying excellence among staff, and bringing opportunities for improvement. Our team set out to create an effective, standardized approach to targeted, daily, technology-driven leader rounding with the goal of integrating real-time patient feedback into the care experience. An application on handheld computer tablets was tailored and integrated with the hospital’s admission, discharge, and transfer (ADT) feed, allowing for streamlining of the rounding process by creation of workflow templates. Additionally, capabilities to receive and send alerts across disciplines were integrated in …

Can Specific Feedback Improve Patients’ Satisfaction With Hospitalist Physicians? A Feasibility Study Using A Validated Tool To Assess Inpatient Satisfaction, Sarah E. Richards, Rachel Thompson, Steven Paulmeyer, Ashvita Garg, Sarah Malik, Kristy Carlson, Elizabeth Lyden, Jason Shiffermiller

Patient Experience Journal

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a patient satisfaction survey utilized for hospital reimbursement calculations. It is not, however, considered a valid measure of individual physician performance. The object of this study was to determine if the “Tool to Assess Inpatient Satisfaction with Care from Hospitalists” (TAISCH) instrument could be leveraged to improve patient satisfaction. A pragmatic pre/post study was conducted with adult inpatients admitted to either teaching or non-teaching general internal medicine services at a large mid-western academic medical center. TAISCH surveys were administered to patients (n=192) who were able to identify their hospitalist …

Developing The First Pan-Canadian Acute Care Patient Experiences Survey, Salima Hadibhai, Jeanie Lacroix, Kira Leeb

Patient Experience Journal

The Canadian Institute for Health Information (CIHI) in partnership with stakeholders sought to develop the first pan-Canadian patient experiences survey for inpatient care (CPES-IC). The goal was to provide a national survey standard for comparative patient experience measures to facilitate benchmarking for quality improvement. A cognitive and pilot testing study design was performed using survey data from adult inpatient care settings. Participants included the inter-jurisdictional members (IJ), survey subject matter experts and CIHI (The Group). Cognitive testing of the survey took place in three Canadian jurisdictions in English and French languages. Thirty-nine individuals participated in one-on-one interviews. During pilot testing, …

First, Do No Harm: The Patient's Experience Of Avoidable Suffering As Harm, Ashley Bauer Mha

Patient Experience Journal

Although my entire career has been spent in Patient Experience, nothing I have learned from data, evidence-based practice, or experience-based correlations, has been near as impactful as what I learned from being a patient. This article discusses my own experiences as a patient. I ask readers to consider instances of avoidable suffering as sources of harm that negatively impact patient perceptions, erode trust in care providers and healthcare delivery systems, and create barriers to engaging patients in their care. Recognizing how avoidable suffering creates harm challenges traditional views of Patient Experience as hospitality-based “soft skills” and helps to establish patient …

Call For Submissions - Special Issue July 2019: The Role Of Technology And Innovation In Patient Experience, Patient Experience Journal

Patient Experience Journal

Patient Experience Journal (PXJ) is excited to announce the call for submissions for its July 2019 special issue on the topic of the role of technology in patient & family experience. A focus on technology and innovation will be essential in healthcare experience, requiring new ways of thinking and doing and the technologies and tools to ensure efficiencies, expand capacities and extend boundaries of care.

This special issue is open to all authors conducting cutting-edge research, implementing innovative practices or with powerful experiences to share around efforts in either creating or implementing technology focused on positively impacting the patient experience …

Condition Help: 10 Years Of Experience Enhancing Our Culture Of Family Engagement, Andrew Mccormick, Catherine Polak, Michael Fox, Michele Carlson, Charles Guthrie, Michael Decker, Diane Hupp, Gabriella Butler, Andrew Urbach

Patient Experience Journal

“Condition Help” is a family activated rapid response team designed to enhance a partnership between providers and the family. Calling a “Condition Help” results in the rapid arrival of a response team (physician, nurse administrator and patient representative) that assesses the clinical status, listens to families’ concerns and promotes communication to move clinical care forward. “Condition Help” has been an active program for the last 10 years at Children’s Hospital of Pittsburgh of UPMC (University of Pittsburgh Medical Center) and has assisted in the care of 608 patient encounters. This article outlines the experience gained using this vital program, summarizes …

Wait Time Reality Check: The Convergence Of Process, Perception, And Expectation, Marian Hill, Lorianne Classen, Andrea Romay, Erika Diaz

Patient Experience Journal

There are few experiences as ubiquitous to patients as the experience of waiting. It is an occurrence that transcends diagnosis, is common to all demographics, and is shared across the continuum of care. The experience can be frustrating and full of ambiguity for patients and their families. Wait time and delays can lead to patients sensing a loss of control and magnify the feelings of anxiety they may already be suffering. In an effort to improve patient experience, a framework was developed to examine patient satisfaction as a function of expectations, perceptions, and reality. The process domain focused on the …

Family Experience Tracers: Patient Family Advisor Led Interviews Generating Detailed Qualitative Feedback To Influence Performance Improvement, Kathryn Taff, Sheryl Chadwick, Deejo Miller

Patient Experience Journal

Patient Family Advisors (PFAs) are integral partners in quality improvement processes at Children’s Mercy Kansas City. Mimicking Joint Commission patient tracers, the Family Experience Tracer program was created to gather perspectives from end users of care and provide valuable insights regarding the patient experience. The Patient and Family Engagement team collaborates with departmental and organizational leadership to define the scope of the tracer project and determine meaningful topics to elicit feedback from patients and families. Tracers are conducted across the continuum of care and are led by a Patient Family Advisor to establish an immediate peer relationship. Patients and families …

What Constitutes The Patient Experience Of Children? Findings From The Photo Elicitation And The Video Diary Study, Nina Karisalmi, Hanna Stenhammar, Johanna Kaipio

Patient Experience Journal

Patient experience (PX) is getting attention among researchers and healthcare service providers, but little is known about the experiences of child patients and how to explore those. This paper reports findings from a study in which two participatory research methods, photo elicitation and video diary, were applied to investigate the elements of children’s PX in the context of children’s hospital. The aim was to find out what elements constitute the PX of children aged 7–16 years. The research data were gathered in 2016–2017. Twenty-two child patients participated in the study: eight children aged between 7 and 10 in the photo …

The Pediatric Emergency Department Care Experience: A Quality Measure, Terri L. Byczkowski, Kimberly A. Downing, Michael R. Fitzgerald, Stephanie S. Kennebeck, Gordon L. Gillespie, Evaline A. Alessandrini

Patient Experience Journal

To develop and validate a measure of the quality of the pediatric emergency department care experience from the parent perspective. This was a multiphase study conducted at a tertiary-care pediatric health system using qualitative and quantitative methods. A list of candidate questions was developed to measure each of eight dimensions of family-centered pediatric emergency care described in a published framework. This list was evaluated and refined using the Question Appraisal System (QAS-99) followed by cognitive interviewing methods. Remaining questions were field tested using survey methods via telephone interviews with randomly selected parents. Composite scores to measure each of the eight …

Caring Moments Within An Interprofessional Healthcare Team: Children And Adolescent Perspectives, Amélia Didier, David Gachoud, Gabriela Von Niederhäusern, Lazare Benaroyo, Maya Zumstein-Shaha

Patient Experience Journal

Patients are now recognized as key partners to improve healthcare outcomes. Some organisations such as the WHO or the Canadian Interprofessional Health Collaborative (CIHC) encourage considering patients as partners in the interprofessional healthcare team. However, limited knowledge exists on patients’ perspective of interprofessional collaboration (IPC) and of their role in the collaborative process, particularly in pediatric settings. The experiences and perspectives of patients regarding IPC have to be considered in order to fully understand the concept of IPC and integrate it into practice. This qualitative study aimed at gaining a better understanding of the perspective of children of IPC, how …

Breaking Bad News And The Importance Of Compassionate Palliative Care Of The Infant, William S. Sessions Ii, Sean Y. Kow, Elizabeth Waldrop, Kayle Stevenson, Ayo Olanrewaju, Thu Tran, Mubariz Naqvi

Patient Experience Journal

Bad news to parents regarding their infant is information that negatively impacts the parent’s feelings and view of the present and/or future. It is implemented in situations with feelings of no hope or those that induce a threat to a parent’s mental and physical well-being. The term is difficult to define as it is based on parent’s subjective feelings. However, it is important to be aware of the impact of bad news as it can cause severe anguish and stress on the parent’s emotional stability. The style of delivering bad news has a significant impact on the physician/parent relationship and …

What Medicine Can Learn From Pediatrics: A Mother's Perspective, Nancy Michaels

Patient Experience Journal

As a mother of a young adult child with Aspergers syndrome, as well as being a long-term patient myself (liver transplant in 2005), I have extensive experience in both camps. Recently my 20-year old son was admitted to a children’s hospital for a twisted colon that had to be surgically reduced. As the parent of a child with special needs and related physical health-related issues connected to him being on the autism spectrum, I was naturally very concerned about him entering a hospital (perhaps PTSD based on my own experience at moments). Surprising to me, the experience was a very …

Lessons For Patient Experience From The Voices Of Pediatrics And Children’S Hospitals, Jason A. Wolf Phd, Cpxp

Patient Experience Journal

This special issue on patient & family experience in children’s hospitals and pediatric care underlines pediatrics’ position as a leader in the experience journey. In pediatrics and children’s hospitals significant efforts are made to the ensure the environment is welcoming and comfortable, there is a commitment to communicating to patients – the children that are cared for – in a way they can understand, and there is a clear intention of engaging family members as an integral part of the care experience. In acknowledging that this is a special issue on pediatrics, we would miss a significant opportunity if we …

Homeless And Marginally Housed Veteran Perspectives On Participating In A Photo-Elicitation Research Study, Keri L. Rodriguez, Daniel O. Hedayati, Lauren M. Broyles, Melissa E. Wieland, Michael A. Mitchell, James W. Conley, Shaddy K. Saba, Adam J. Gordon

Patient Experience Journal

Photo-elicitation interviewing (PEI) seems a valuable tool for engaging marginalized populations in research despite documented challenges. Given limited data on acceptability of PEI among homeless and marginally housed Veterans, this evaluation aimed to characterize their research experience. Veterans took photographs about health, health behaviors, and health care which facilitated semi-structured interviews. Their research study experience was assessed via a modified Reactions to Research Participation Questionnaire-Revised (RRPQ-R), along with additional survey and open-ended questions. Of the 20 participants who consented and participated, 16 (80%) completed the exit surveys. Most participants (>88%) indicated favorable experiences and limited drawbacks. Respondents disagreed that …

What Are The Most Important Dimensions Of Quality For Addiction And Mental Health Services From The Perspective Of Its Users?, Priscilla Liu, Shawn Currie, Jassandre Adamyk-Simpson

Patient Experience Journal

There is a need to better engage service users in improving their experience with the care received in Addiction and Mental Health (A&MH). Dimensions of patient experience that are most salient to A&MH service users still remain to be properly defined from the patient perspective. This research focuses on identifying key domains of service experience important to patients of Addiction and Mental Health using patient focus groups. In addition, through a patient and family advisory committee, patients were also engaged as co-partners of the research team. The patient advisors had a major role in overseeing the research project, assisting with …

Exploring Workforce Confidence And Patient Experiences: A Quantitative Analysis, Katie M. Owens, Stephanie Keller

Patient Experience Journal

Confidence is recognized as one of the most influential factors to affect performance. Individual, leader, and team confidence play essential roles in achieving success and the absence of confidence has been connected with failure. While confidence is not a substitute for competency, it creates trusting relationships, empowerment, and resiliency to persevere when challenges arise. Objective: In this study, we examined workforce confidence in the patient experience and patient perceptions of their experience of care. Methods: We compared responses to the Patient-Centered Excellence Survey (PCES) from 41 United States hospitals, measuring workforce confidence in the patient experience provided, to patient’s ratings …

How Patients View Their Contribution As Partners In The Enhancement Of Patient Safety In Clinical Care, Marie-Pascale Pomey, Nathalie Clavel, Ursulla Aho-Glele, Noemie Ferré, Paloma Fernandez-Mcauley

Patient Experience Journal

Despite the call from the World Health Organization for more active involvement from patients in the prevention of health care-related risks, there is still insufficient evidence about how patients can be more proactive in the safety of their own care. This study helps understand the perspective of patients as partners regarding their roles, as well as their relatively untapped potential in detecting and limiting adverse events (AEs) for patient safety. 17 patients-as-partners were interviewed on five themes: 1) Behavior of patients/relatives for avoiding AEs; 2) Competencies sought in patients/relatives to play an active role in patient safety; 3) Factors limiting …

The Patient Experience With Shared Decision-Making In Lung Cancer: A Survey Of Patients, Significant Others Or Care Givers, Laurie E. Gaspar, Howard J. West, Bonnie J. Addario, D Ross Camidge

Patient Experience Journal

A survey (via SurveyMonkey) was sent to lung cancer patients, their caregivers or significant others asking about their experience in making difficult treatment decisions. Of the 198 respondents, 118 (69%) indicated that they had faced a difficult decision with respect to their lung cancer treatment. Of those, 73% indicated that they would have desired that the decision be made with their physician using a shared decision-making process, and 58% perceived that such a process had occurred. In addition, only 23% of respondents indicated that they had had the right amount of information when making the decision. Fortunately, only 9% of …

A Framework For Conceptualizing How Narratives From Health-Care Consumers Might Improve Or Impede The Use Of Information About Provider Quality, Melissa L. Finucane, Steven C. Martino, Andrew M. Parker, Mark Schlesinger, Rachel Grob, Jennifer L. Cerully, Lise Rybowski, Dale Shaller

Patient Experience Journal

Consumers choosing a health-care provider have access to diverse information including narratives by patients about their prior experiences. However, little research has examined how narratives might improve or impede the use of information about the quality of providers’ performance. This paper describes a conceptual framework for examining mechanisms by which narrative information might influence consumer judgments and decisions about providers. We conducted a conceptual review of risk communication and behavioral decision research. We synthesized the literature to form the foundation of a conceptual framework for assessing how narrative information about provider quality impacts consumer decisions about providers. We identified four …

Patients’ Stories Of Encounters With Doctors: Expectations And Anxieties, Daniella Arieli, Batya Tamir

Patient Experience Journal

The study contributes to the understanding of how patients experience encounters with doctors. The study is based on the gathering and analysis of subjective stories of 'healthy' patients who live in Israel about their encounters with doctors. On the one hand, medical encounters were described as functional ritualistic events, and the doctor was described as an indifferent clerk. On the other hand, and often at the same time, medical encounters were perceived as incredibly meaningful and potentially fateful events, and the doctor as a supreme authority. Four main inter-connected expressions of this were: 1. The encounter as a ritual: A …

The Gift Of Pain With Transformative Possibilities, Richard B. Hovey

Patient Experience Journal

This personal narrative explores the experiences of pain metaphorically as a gift. The intention of this article is to offer alternative ways to reflect on pain, life and taking risks to move from health literacy toward health agency with help. I describe my approach to decision making using the hermeneutic wager which provides a means to imagine possibilities while mindfully assessing risk. Learning to manage pain and learning to live well with pain is a gift that we are not always aware is within our grasp.

Original Parts: Aging And Reckoning With Cystic Fibrosis Related Kidney Disease, Alexandra Ch Nowakowski

Patient Experience Journal

Kidney disease increasingly impacts people with cystic fibrosis (CF) as adult patients continue to survive longer. Yet the literature on CF related kidney disease focuses little on amplifying the voices of people aging with the condition. This article presents perspectives on CF related kidney disease from a medical sociologist who is themselves managing these issues. It (1) gives an overview of relevant literature and trends in epidemiological data on kidney disease and CF, (2) details the author’s own process of adjusting to progressive changes in renal function, and (3) outlines opportunities for clinicians to make a positive impact for patients …

The Consumer Has Spoken: Patient Experience Is Now Healthcare’S Core Differentiator, Jason A. Wolf Phd

Patient Experience Journal

In just a few days we will celebrate Patient Experience Journal’s (PXJ) 4^th anniversary since our inaugural publication. In these 4 short and quick years we have seen 163 articles published in our first four volumes that have stirred a significant focus on building the evidence base in patient experience. Not only has PXJ served as the central clearing house for thoughtful research, measurable cases, and insightful narratives, but it also has reinforced the breadth and depth of what patient experience truly encompasses. This integrated view was reinforced by the very voices of healthcare’s consumers in The Beryl Institute’s …