Health and Medical Administration Commons^™

Preventing Delirium After Surgery: A Qualitative Study Of Patients, Caregivers, And Providers, Jennifer O'Brien, Maria Cruz, Heather Dyck, Hassan Yassin, Una Goncin, Lei Xia, Huma Aftab, Lilian Thorpe, Peter Hedlin

Patient Experience Journal

Post-operative delirium is the most common complication in older adults following surgery. Symptoms include agitation, difficulty focusing, sluggishness, hallucinations, slurred speech, restlessness, rapid mood swings, and uncooperative or aggressive behaviour. It can result in longer hospital stays, increased mortality, loss of functional independence, increased need for a higher level of care post-surgery, and an increased risk of readmission to hospital. We aimed to understand and describe the experiences of patients, families, and healthcare providers with postoperative delirium, and to identify targeted initiatives to support patient and family centered care for high-risk patients. We conducted a qualitative descriptive study using interviews …

Beliefs Regarding Patient Experience In The Emergency Department Among Individuals With Sickle Cell Disease, Elizabeth A. Ibiloye, Gloria N. Odonkor, Ayobami A. Aiyeolemi, Jamie C. Barner, Carolyn M. Brown, Hyeun Ah Kang, Benita A. Bamgbade

Patient Experience Journal

Individuals with sickle cell disease (SCD) frequently experience intense, unanticipated pain episodes known as vaso-occlusive events (VOEs), which often require emergency department (ED) treatment. However, they often report suboptimal experiences in the ED. Using the Theory of Planned Behavior (TPB), this study aimed to elicit salient beliefs regarding SCD patient experience in the ED. Three virtual focus group sessions were conducted with individuals with SCD recruited through a Texas SCD Association and Rare Patient Voice. Nine open-ended questions were used to elicit participants' behavioral, normative, and control beliefs regarding ED use when experiencing VOEs. Qualitative analysis was performed using a …

The Quiet End Of The Visit, Avinav Biswas

Patient Experience Journal

Reassuring language is a common and often well-intentioned feature of clinical encounters, frequently used to convey clinical confidence and bring visits to a close. This personal narrative reflects on an observed outpatient encounter during a physician shadowing experience in which reassurance appeared to function not only as comfort, but also as an implicit signal of conversational closure. From the perspective of a student observer, the piece describes a moment of patient hesitation that arose after reassurance was offered, then quietly disappeared as the visit concluded. Although the encounter was clinically appropriate and efficient, the unspoken pause highlighted how uncertainty can …

Human Experience, The Boarding Crisis, And Moral Injury-A Call To Action, Thom Mayer, Wendy Dean

Patient Experience Journal

Patient experience has evolved to a broader definition of human experience, including workforce experience, and community experience. Hospital boarding is a common, pervasive problem facing healthcare, which threatens all levels of human experience, from patient experience, to workforce experience (moral injury and burnout in healthcare professionals), and community experience (delayed and denied access to care for patients, Emergency Medical Services, and even interhospital transfers. Effective system leadership across the systems and processes of healthcare, as well as stakeholder and boundary management, will be essential to deliver acceptable human experience, in addition to solutions to smooth surgical flow, improve discharge systems, …

Utilizing Proactive Rounding With Nursing Leadership To Improve Patient Satisfaction Scores In An Adult Medical-Surgical Unit, Lily A. Bogyah

Student Scholarly Projects

Practice Problem: Patient satisfaction is a key quality indicator that reflects patients’ perceptions of care and the healthcare system’s performance. Patient satisfaction scores at the project site were significantly lower than the national benchmark, particularly on the adult medical-surgical unit.

PICOT: The PICOT question that guided this project was: In patients on an adult medical-surgical unit (P), how does the use of proactive patient rounding conducted by nurse leaders (I) versus current practices alone without such rounding (C) affect patient satisfaction scores over an eight-week period (T)?

Evidence: A literature review of multiple studies found that implementing daily nurse leader …

Improving Prostate Cancer Patients’ Experience And Understanding With A Pre-Ct Simulation Checklist In Genitourinary Radiation Oncology, Christopher Le

Doctor of Nursing Practice Final Project Abstract

Improving Prostate Cancer Patients’ Experience and Understanding With a Pre-CT Simulation Checklist in Genitourinary Radiation Oncology

Purpose

The purpose of this quality improvement (QI) project was to implement a Pre-CT Simulation checklist for Prostate cancer patients in the outpatient Radiation Oncology Genitourinary clinic to improve patients’ experience and comprehension on their Simulation Day.

Background

The CT simulation is a critical step in treatment planning. Lack of clear, concise, consistent instruction and education preparation prior to simulation day can delay planning and treatment. Currently, there is no standardized checklist to ensure patients are educated and prepared for their CT simulation day. …

Virtual Nurse Discharge: Improving Patient And Nurse Experience, Dina Flihan, Christine Odell, Stacey Davis, Carolyn Oates, Fay Wright

Patient Experience Journal

This case study reviews the virtual discharge nurse (VDN) process and its impact on patient experience and nursing workflow as an exemplar of an effective telehealth innovation at a community hospital 23-bed Short Stay Unit (SSU). At the SSU, the daily turnover rate of more than 50% of the unit census challenged the nurses’ ability to provide comprehensive individualized discharge education. SSU patient experience scores measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) reflected opportunities to improve the discharge process. Therefore, the direct care nurses on SSU suggested a trial innovation of a VDN to improve …

Triad: A Novel Team Structure Pilot And Its Impact On Patient Experience In The Pediatric Emergency Department, Walter Palmer Md, Joseph R. Mijares Iii, Md, Sephora Morrison Mbbs, Msci, Mba

Patient Experience Journal

Introduction: Patient experience is inextricably tied to effective communication between the care team and patient. Published trials designed to improve communication and therefore patient experience in the pediatric emergency department setting are lacking. Methods: This is a novel care team reorganization in a single tertiary care pediatric emergency department. A Triad team consisted of a nurse, emergency technician (Tech), and physician or advanced practice practitioner (APP). The team was designed and trained with an emphasis on closed loop communication with the team and patient to test whether improving effective communication can subsequently improve the patient experience. Using a real-time survey, …

Empowering Frontline Staff In Service Recovery, Sarah E. Duncan, Brianna Camera, Iva Ervin-Stanberry, Heather L. Pezzullo

Patient Experience Journal

Objective: This study aimed to develop and implement a standardized service recovery training program within the VA healthcare system to enhance patient experiences and address grievances effectively. The purpose of the training was to equip VA employees with the necessary skills and knowledge to resolve service issues promptly and empathetically, adhering to the principles of the VA’s SALUTE model for service recovery. Method: The training program was designed based on feedback from anonymous pre-surveys to identify knowledge gaps and incorporate industry best practices. The VA’s SALUTE model, which emphasizes six key actions—saying hello, apologizing, listening, understanding, taking action, …

A Systematic Review Of The Literature On The Validity, Reliability, And Utility Of The Nhs Friends And Family Test As A Method For Gathering Feedback On And Improving The Experiences Of Patients, Miss Jenny King, Catherine Davidson, Miss Hannah Wade, Chris Graham

Patient Experience Journal

The NHS Friends and Family Test (FFT) is widely used across the National Health Service to collect patient feedback on care experiences. Given its scale and cost, there is strong public and organisational interest in the validity, reliability, and utility of the FFT. This study aimed to systematically review the literature on the validity, reliability, and utility of the FFT as a method for gathering feedback on and improving patient experiences. PubMed and ProQuest databases were searched in September 2024. Studies were included if they met the inclusion criteria. Information extracted included study information (e.g., title, authors, publication year, research …

Reliability And Validity Of A Modified Version Of The Consumer Assessment Of Healthcare Providers And Systems (Cahps®) Clinician And Group Visit Survey 4.0 (Beta) For Ambulatory Behavioral Health Care, Jessica K. Jeffrey, Ron D. Hays, Randi Hissom, Mark Grossman, Samuel A. Skootsky

Patient Experience Journal

Patient experience is a fundamental indicator of healthcare quality. A patient experience survey that assesses telemedicine and in-person ambulatory behavioral health care is needed. This study aims to adapt the CAHPS Clinician and Group Visit Survey 4.0 (beta) to assess adult patient experience with ambulatory behavioral health services and its reliability and validity. Seven behavioral health subject matter experts (psychiatrists, therapists with master’s degrees, and primary care physicians) at an integrated delivery system aligned with an academic institution provided input to select a subset of items and make minor wording adjustments to the CAHPS survey. The adapted survey was administered …

Using Patient Experience Data With Impact: A Framework For Healthcare Improvement, Corey Adams, Ramesh Walpola, Reema Harrison

Patient Experience Journal

Background: Despite major investment in patient experience measurement, healthcare organizations often struggle to translate patient feedback into lasting improvements. Existing knowledge translation frameworks provide useful concepts, but often lack the practical detail or contextual relevance needed to improve patient experiences. Objective: To develop and present the IMPACT Framework, an evidence-informed approach designed to bridge the gap between patient experience measurement and meaningful improvement in healthcare. Methods: This framework was informed by a systematic review of patient experience measurement and analysis of barriers to feedback use. Findings from contemporary patient experience research were combined with key principles of knowledge translation, change …

Understanding Patient Experience Through Narrative Complaint Analysis: A Mixed Methods Study In A Rural Academic Health System, Htun Ja Mai, Jabeen Ahmad, Brant Oliver

Patient Experience Journal

Patient Experience (PX) is recognized as an independent dimension in assessing healthcare quality and is associated with the quality domain of patient-centeredness. A better understanding of PX can help clinical providers enhance care, guide further research, and inform quality improvement and policies. Our study aims to identify, classify, and prioritize patients’ complaints and grievances at a rural health care system to inform strategic improvement planning. We conducted standard inductive qualitative thematic analysis and quantitative Pareto analyses of narrative comments received from patients and families via phone calls, emails, or standard letters at the four settings under study (one major academic …

Patient Experience Second Opinion: Expanded Telemed Simulation Broadens Inquiry Of Health Care Provider Verbal And Nonverbal Communication Issues, Mike C. Porter, Xiaowen Guan, Paul G. Omodt

Patient Experience Journal

In the quest to improve patient experience and health outcomes, the impact of provider consultation generally earns serious consideration. This study recruited a richly diverse pool of participants to examine how patient demographics and psychographics during a telemedicine consultation simulation impact the perceptions of the provider that contribute to patient satisfaction. Further, this study relies on a between-subject experimental design to investigate how “provider” verbal and nonverbal communication and demographics in addition to patient demographics and psychographics impact patient perceptions and outcomes of the simulated telemedicine experience. Results inform how healthcare provider verbal and nonverbal communication might be improved through …

“Better Than Any Medicine:” Understanding How Therapy Dogs Support Patients Presenting With Mental Health And Substance Use Concerns In An Emergency Department Setting, Alexandria R. Pavelich, Colleen A. Dell, James Stempien, Holly Mckenzie, Aimee Hozack, Jane Smith, Alexis Rowsell, Janet Gunderson, Elizabeth Pease

Patient Experience Journal

In Canada, emergency departments have a large number of patients with mental health and substance use concerns passing through their doors. Our research aim was to assess the impact that therapy dog visits may have for patients presenting with mental health and/or substance use concerns to an emergency department based in Saskatoon, Saskatchewan. Working alongside an active patient advisory group and community-based therapy dog program volunteers, our mixed method approach utilizing ethnography, surveys, and interviews showed that therapy dog visitation had a beneficial impact on both patients and staff, thus improving the overall patient experience. Our study displays how the …

Impact Of Non-Pharmacological Interventions On Patient Experience, Opioid Use, And Healthcare Utilization In Adult Cardiac Surgery: A Randomized Controlled Mixed Methods Trial, Julie R. Piazza, Alexander A. Brescia, Jessica N. Jenkins, Alexander J. Ivacko, Xiaoting Wu, Sara M. Jafri, Christopher J. Varlamos, James C. Piazza, Lindsay K. Heering, Stefanie L. Peters, Molly Dwyer-White, Bailey H. Brown, Faraz N. Longi, Katelyn P. Monaghan, Frederick W. Bauer, Varun G. Kathawate, Melissa C. Webster, Amanda M. Kasperek, Nickole L. Garvey, Claudia Schwenzer, Kiran H. Lagisetty, Michelle Riba, Donald S. Likosky, Jennifer F. Waljee, Nicholas H. Osborne, Mary E. Byrnes, G. Michael Deeb

Patient Experience Journal

Non-pharmacological techniques designed to reduce anxiety, pain, and healthcare utilization have shown effectiveness in pediatric and non-surgical adult populations; however, their application has not been widely evaluated among adult surgical patients. This study randomized opioid-naive adults undergoing first-time, elective cardiac surgery to receive either targeted interventions from a trained “comfort coach” or usual care. The primary outcome assessed was healthcare utilization, specifically measured as the number of days at home within the first 30 days post-surgery. Secondary outcomes included postoperative opioid use and patient-reported outcomes, collected via validated surveys. Additionally, 50 participants in the intervention group completed semi-structured qualitative interviews …

Perceived Social Support And Its Associated Factors In Patients Undergoing Hemodialysis: A Cross-Sectional Study, Hosna Karami, Parvin Abbasi

Patient Experience Journal

Introduction: Hemodialysis is a vital, lifelong therapy for patients with end-stage kidney disease. Due to various physiological and psychosocial challenges, it is often perceived as traumatic. Social support is recognized as an essential coping strategy for managing chronic illnesses, including advanced kidney failure. This study aimed to assess perceived social support and its related factors among patients undergoing hemodialysis. Methods: This analytical cross-sectional study was conducted from November 2024 to February 2025 at two major hemodialysis centers in Kermanshah, a city in western Iran. A total of 230 patients were selected through convenience sampling based on predefined criteria. Data were …

Correlation Between Resident Physician And Patient Perceptions Of Empathy In The Emergency Department, Austin Porter, James Christian, Meryll E. Bouldin, Erin Willard, Stefan Graw, Sarah House, Sofie Morgan, Kristin Parker, Carly Eastin

Patient Experience Journal

Background: Empathy is essential for emergency medicine physicians, impacting patient outcomes and experiences, especially in the fast-paced emergency department (ED). However, empathy often declines during medical training, negatively affecting care. Little is known about how emergency medicine trainees perceive their empathy compared to their patients. Objective: This study aimed to explore the correlation between patient perceptions of resident physician empathy and residents’ self-perceptions during ED visits. Methods: This was a prospective observational study was conducted at a Level 1 Trauma and Tertiary Care Center in the south-central U.S., using the Consultation and Relational Empathy (CARE) Measure. At patient disposition, ED …

Patients’ Experiences Of Triage And Waiting In Emergency Departments: A Cross-Sectional Survey, Carrie Janerka, Leslie D Gavin, Fenella J Gill, Pcc Ed Triage Group

Patient Experience Journal

Objective: Patient experience is a core aspect of care quality. Patient experiences of emergency departments (EDs) have been examined, but there has been less focus on ED triage and waiting areas, often patients’ initial point of contact with a health service. This study aimed to understand patients’ experiences of ED triage and waiting room. Methods: A cross-sectional survey was conducted across five Australian EDs to understand experiences of patients 14 years and over before, during and after triage. Quantitative data were analysed descriptively and explored for correlations. Qualitative responses for suggested improvements were analysed using a conventional content analysis approach. …

The Hand We Hold: Reflections On Empathetic Practice In Medicine, Aravind Sreeram

Patient Experience Journal

In this narrative, I reflect on an early clinical encounter that reshaped my understanding of what it means to provide patient-centered care. As a medical student, I entered the exam room with a preset algorithm of what to say and how to act. Yet, when faced with a patient whose suffering could not be measured or addressed by any checklist, I realized the limitations of my scripted approach. I began to understand that some of the most meaningful contributions we offer in healthcare come not from solutions, but from presence. This experience helped me see that patient partnership is not …

Changing Myths Into Truths: Dispelling Physician Misconceptions On Patient Experience, Amit Singh, Syed Ahmed, James Castellone, Michael H Kanter, Mikelle Key-Solle, Sherry Kroll, Paul A Lansdowne, Winnie Lee, Swati Mehta, Sofie Morgan, Sephora Morrison, Susan N Nathan, Sachin Patel, Alexie Puran, Donald Wickline, Liza Dileo Thomas

Patient Experience Journal

Patient experience work can be viewed by some physicians as outside their scope of practice and therefore the responsibility of non-medical providers. Assumptions may also be made by providers about what patient experience work is and is not. These myths can make it difficult to pursue meaningful patient experience related work that is in fact rooted in evidence showing improved outcomes. Moreover, these myths can downplay the importance of patient experience improvement work discouraging physicians who may be interested from pursuing it. In order to combat common myths that can be propagated about patient experience, the authors will cite research …

Beyond The Numbers: Elevating Meaning Through Metrics In Patient Experience, Geoffrey A. Silvera

Patient Experience Journal

This commentary submitted by Patient Experience Journal (PXJ) Associate Editor begins with a simple observation: sometimes, in our effort to measure everything, we miss what’s right in front of us. We look up at the data but fail to notice the larger shape taking form above it, something tall, quiet, and graceful that changes how we see the landscape. Patient experience work demands that we hold both the precision of metrics and the wonder of narrative to truly understand of patients’ experiences of care. Numbers tell us how we are performing and stories remind us why it matters. When we …

We Are Not There Yet! Why The Journey For Experience Excellence Must Persist, Jason A. Wolf

Patient Experience Journal

I am concerned, that many in healthcare think they have gotten to a “THERE” in experience excellence. That the survey scores they received are good enough, that the outcomes they are achieving reflect what they sought to accomplish. And with this in the face of today’s tumultuous healthcare landscape, decisions are being made to sustain efforts at best and in more cases now to reduce investment with the belief that things are ok. Now is NOT the time to cut short our efforts for experience excellence, or to believe there is a “there” to which we have arrived. It must …

Partnership, Collaboration, And Co-Production To Improve Patient Experience Beyond Conducting Surveys – Lessons From The Quebec Model, Canada, Marie-Pascale Pomey, Catherine Wilhelmy, Myriam Fournier-Tombs, Vincent Dumez, Cécile Vialaron, Monica Nelea Iliescu, Karina Prevost, Simon Courtemanche, Louise Normandin, Geneviève David

Patient Experience Journal

Objective: The objectives of this article are to present how, in the province of Quebec (Canada), healthcare and service partnerships have been implemented, to take stock of the current situation and to suggest ways to continue strengthening the model over the coming years, in Quebec and elsewhere in the world. Methods: Three methods were mobilized: (1) a review of the literature and reports published in recent years on implementations of partnerships in Quebec; (2) a survey sent to the persons responsible for partnerships in Quebec’s health and social services establishments; and (3) a working committee comprised of patient experts, partnership …

I Felt More Confident That It Would Work For Me: A Grounded Theory Of Person-Centered Interprofessional Collaboration Based On Patients’ Lived Experiences, Katherine Hope Morgan, Cristina S. Barroso, Kathleen Conroy Brown, Michael R. Bleich, Soghra Jarvandi, Elizabeth B. Strand, Shaun Rowe

Patient Experience Journal

Interprofessional collaboration (IPC) is considered the highest standard of practice for delivering care to patients with multiple, complex, and chronic conditions. Despite reported benefits of IPC, the voice of the care receiver and how or whether they experience IPC is underexplored. Our objective was to examine patients’ experiences with IPC in two rural primary care settings in the U.S., where the burden of multiple chronic conditions (MCCs) is coupled with lower life expectancies and reduced access to care. We used a semi-structured interview to assess patients’ experiences within 72 hours after an IPC healthcare visit. This study, conducted in two …

“Why Should Anyone Want To Make Things Better For Me Particularly?” – A Qualitative Exploration Of Care Opinion And Nhs Care Improvements, Emma Berry, Zoe Skea, Marion K. Campbell, Louise Locock

Patient Experience Journal

Care Opinion is an online platform which enables people to share anonymous feedback (known as “stories”) about their experiences of UK healthcare. In Scotland, this platform has official government backing, though healthcare organisations are not obliged to use it. Care Opinion staff review and edit these stories, acting as moderators. Healthcare staff are invited to respond to stories and are encouraged to use it for healthcare improvement. However, the number of changes made and registered on the platform is relatively small. This paper brings together findings from interviews with story authors (those sharing experiences), NHS staff and Care Opinion moderators …

Holding Space: An Effective Intervention For When Hope Wanes, Annette Lane, Marlette Reed, Rose Schroeder

Patient Experience Journal

Holding space is a person-centered, non-judgmental approach to working with clients. This approach goes beyond listening to client concerns; it entails deep listening and being present, developing trust with clients, and helping them connect goals with values. Within this brief account, the concept of holding space is described. What it is and is not is explained. Examples of holding space are woven throughout in order illustrate this concept. Finally, implications for professionals are provided.

From Fear To Hope: How Communication Transformed Our Pregnancy Journey A Personal Narrative On The Critical Role Of Healthcare Communication In Patient Experience, Valan. P, Pulidindi Venugopal

Patient Experience Journal

This article emphasises the transformative potential of compassionate healthcare communication, particularly in the context of pregnancy loss. This personal narrative illustrates how varying communication approaches can significantly alter patient experiences, transforming anxiety-laden medical encounters into empowering partnerships with healthcare providers. A ten-month journey through pregnancy after a devastating miscarriage revealed the profound impact of communication quality on both clinical outcomes and emotional healing. The narrative contrasts three distinct communication environments: dismissive administrative systems that induce unnecessary stress, insensitive support staff during vulnerable moments, and a physician whose empathetic approach fundamentally transforms the entire pregnancy experience. Through a detailed examination of …

Development Of Recommendations For The Future Of Telehealth Use Among Sexual And Gender Minorities (Sgm), Jeffrey A. Wilhite

Dissertations and Theses

It is now well-documented that sexual and gender minoritized individuals (SGMs) face consistent stigmatization from not just the health care system, but also from overarching community, federal, and societal entities. Subsections of the SGM community, like gay men for example, face higher rates of eating disorders, certain cancers, alcoholism, mental illness and even obesity, when compared to heterosexual counterparts. Many of these challenges could be exacerbated by current political administration efforts to silence the community. Ensuring access to clinical care is one way of preserving the health and livelihood of the community. Telehealth, or synchronous, remote based clinical care, can …

Hope Experience Essentials: The Next Generation Of Service Standards At Mayo Clinic, Jennifer Packard, Richard M. Elias, Thomas J. (Tripp) Welch, Karee A. Munson, Jonathan A. Leighton

Patient Experience Journal

Engaging employees in providing exemplary patient experience has been challenging for healthcare leaders in recent years given the pressures of the regulatory environment, increases in staff burnout and rising patient expectations. Amid these challenges, addressing patient experience remains a top priority for healthcare organizations. A novel intervention has been applied at Mayo Clinic with the goal of improving both employee engagement and patient experience. Previous efforts to teach service excellence involved customer service trainings, sometimes purchased through outside vendors. This new initiative is based on our organizational culture and values, input from our employees and patients, and considers the changing …