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 …

A Photo-Elicitation Study Of Homeless And Marginally Housed Veterans’ Experiences With Patient-Centered Care, Samuel F. Sestito, Keri L. Rodriguez, Kristina L. Hruska, James W. Conley, Michael A. Mitchell, Adam J. Gordon

Patient Experience Journal

As part of a qualitatively-driven mixed-methods study, this analysis aimed to describe Veterans Affairs (VA) Homeless Patient Aligned Care Team patients’ experiences with patient-centered care. Veterans participated in audio-recorded, semi-structured photo-elicitation interviews about their health and VA health care. Transcripts were analyzed by two coders using template analysis. In 31/36 interviews, 19/20 participants discussed patient-centered care. Veterans noted Picker’s Patient-Centered Care Principles; 1) access to care, 2) respect for patient-centered values, preference and expressed needs, 3) information, communication, and education, and 4) coordination and care integration were most commonly discussed, followed by 5) physical comfort, 6) transition and …

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 …

The Perioperative Patient Experience Of Hand And Wrist Surgical Patients: An Exploratory Study Using Patient Journey Mapping, Else F. De Ridder, Tessa Dekkers, Jarry T. Porsius, Gerald Kraan, Marijke Melles

Patient Experience Journal

Patient-centred care is becoming more important in healthcare. The success of patient-centred care can be assessed by exploring the patient experience through a patient journey map. As the number of outpatient surgeries is increasing, it is important to reveal the specific characteristics of this type of surgery. The perioperative patient experience is considered very important for outpatient surgery, because all perioperative activities are condensed in one day. To investigate this experience, we performed a case study of hand and wrist surgery. Six teams of two industrial design engineering students interviewed 40 patients in total in two private and two public …

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 …

Barriers And Enablers Of Patient And Family Centred Care In An Australian Acute Care Hospital: Perspectives Of Health Managers, Bradley Lloyd, Mark Elkins, Lesley Innes

Patient Experience Journal

The aim of this study was to identify and explore organisational barriers to, and enablers of, patient and family centred care within an Australian acute care hospital from the perspective of that hospital’s management staff. A qualitative study, incorporating purposive sampling and semi-structured interviews was undertaken in a 215-bed metropolitan acute care public hospital in Sydney, Australia. Fifteen health managers from a broad range of professional groups, including Medicine, Nursing, Allied Health and non-clinical services were interviewed. Interview data were recorded, transcribed, and analysed for key themes using the Framework Approach. The key barriers to patient and family centred care …

Improving The Patient Experience Through Patient Portals: Insights From Experienced Portal Users, Cynthia J. Sieck, Jennifer L. Hefner, Ann Scheck Mcalearney

Patient Experience Journal

Background: Patient portals have become part of the ecosystem of care as both patients and providers use them for a range of activities both individually and collaboratively. As patients and providers gain greater experience using portals, their use and needs related to portals may evolve. Objective: This study aimed to learn from experienced patient portal users to improve our understanding of their perspectives on portal use for collaboration and engagement as well as explore how using a portal influenced their experiences with primary care providers. Methods: Qualitative study involving 29 semi-structured interviews with family medicine patients from a large Academic …

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, …

Standardising The Collection Of Patient-Reported Experience Measures To Facilitate Benchmarking And Drive Service Improvement, Kathleen L. Withers, Sarah Puntoni, Susan O'Connell, Robert I. Palmer, Grace Carolan-Rees

Patient Experience Journal

Patient experience teams in NHS Wales’ Health Boards and Trusts are working across the country to collect patient experience feedback from members of the public who access health care services. Although this work is advanced in many areas, there is currently no way of benchmarking across organisations, reducing opportunities for shared learning. We aimed to work with patients and colleagues across Wales to agree a set of universal Patient Reported Experience Measures (PREMs) questions. Working with patient experience teams, patient groups and Welsh Government, the NHS Wales Patient Reported Outcome Measures (PROMs), Patient Reported Experience Measures (PREMs) and Effectiveness Programme …

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 …

Elevating The Discourse On Experience In Healthcare’S Uncertain Times, Jason A. Wolf Phd, Cpxp

Patient Experience Journal

Over the last five years, we have been inspired by the breadth of contributions that have helped shape the experience landscape through PXJ as well as the reach that the conversation on patient experience has had. Both the authors and readers of PXJ reinforce that the conversation on patient experience and the human experience in healthcare is not one dominated by national intent or even policy. While for some motivation has come in some part from mandated action, for most tackling this idea in healthcare is it grounded in two core realities. The first, in healthcare at its core we …

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 …

Integrating The Patient And Caregiver Voice In The Context Of Pediatric, Adolescent, And Young Adult Care: A Family-Centered Approach, Sarah K. Featherston, Beatriz N. Rozo, Danielle A. Buzanga, Alexandra M. Garcia, Joanne Greene, Laura K. Salvador, Joan O'Hanlon-Curry

Patient Experience Journal

Family-centered care (FCC) is defined as an approach to care coordination founded in collaborative partnerships between healthcare providers, patients and their family caregivers. Amid the enthusiasm for FCC in the pediatric setting, opportunities have been identified to operationalize the engagement of pediatric, adolescent and young adult patients and their caregivers into decision making that translates not only to their healthcare, but also to the context in which care is provided, as well as the research informing their care. At a National Cancer Institute-designated comprehensive cancer center, the Children’s Cancer Hospital was instrumental in designing and implementing patient and family engagement …

Can An Interactive Application Be Used To Collect Meaningful Feedback From Paediatric Patients And Their Parents In A Hospital Setting?, Janelle O'Neill, Graham R. Reeks, Lauren Kearney

Patient Experience Journal

The objective of this study was to determine the acceptability of using an interactive application (Fabio the Frog) to understand the experiences and perspectives of children and parents/carers regarding their health care encounter for the purpose of quality improvement and consumer feedback. Children’s perspectives of their healthcare were collected via the interactive application through the use of a validated survey, the Children’s Perceptions of Healthcare Survey (CPHS). The acceptability of eliciting views from children and parents via an interactive application platform was collected using an additional survey designed for this purpose. Data were collected in two phases. Overall, healthcare experiences …

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 …

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 …

Life With My Baby In A Neonatal Intensive Care Unit: Embracing The Family Integrated Care Model, Yasmin Lalani

Patient Experience Journal

This paper is a personal narrative that describes the components of the Family Integrated Care Model in a neonatal intensive care unit in Canada. I begin by introducing the reader with a brief story of how my son came to be admitted into a NICU. Next, I discuss three aspects of the Family Integrated Care Model that I found to be most striking: medical rounds, “do-ups” and skin-to-skin contact. I also discuss how my immersion in this healthcare setting for three months was a form of autoethnographic fieldwork, as I experienced the NICU both as a parent and a health …

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 …

Partners For Excellence: Committed To Meaningful Partnerships With Patients And Families In Pediatrics, Rachel Biblow, Msw, Sara Toomey Md, Mphil, Mph, Msc

Patient Experience Journal

Although the landscape in pediatrics continues to shift and change, one of the keys to our continued success remains the same… it’s about partnership. It’s clear the element of partnership is well woven through our organizations as illustrated by many of us having patient and family advisory councils, family consultants, and family partners. While this foundation is strong and essential, we must do more to truly listen, recognize the value of patient and family involvement, act upon the information shared, openly discuss issues, and strive for better together. True partnership with patients and families requires us to shift the paradigm …

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 …