Health and Medical Administration Commons^™

When Hope Meets Harm: A Story Of Trust, Pain, And Consent In Intimate Care, Sharon I. Choe, Erin Foster

Patient Experience Journal

Transparent communication is key to building and maintaining strong patient-provider relationships. In this article, I interviewed a patient who shared her experience undergoing treatment for a chronic vulvar condition and the consequences that followed. She described a painful procedure for which she felt unprepared and later realized she had not been educated about the need for ongoing care. Years later, this gap in understanding contributed to irreversible disease progression. After re-establishing care with a dermatologist she felt comfortable confiding in, the patient expressed a desire for her story to be shared. This narrative presents her experience as she shared it …

``We'll Be Right With You'', Improving Patient Experience With Complaint Management Within A Learning Health System Collaborative, James J. Perry, Mackenzie Hahn, Angela Kmiec, Brant J. Oliver

Patient Experience Journal

An improvement team at Cheshire Medical-Dartmouth Health participated in the Care Experience Collaborative aimed at enhancing the patient and workforce experience. Utilizing a hybrid Lean Six Sigma DMAIC approach alongside modified Institute for Healthcare Improvement learning techniques, local teams were coached by quality improvement specialists. The project's focus was on improving the complaint management process to boost hospital ratings and recommendations. Initial assessments revealed significant inefficiencies, such as delays in response times and poor tracking of complaint resolutions. Implementing a new digital monitoring system in conjunction with standardized training resulted in substantial improvements: complaint resolution times decreased by 53%, while …

Inaccessibility And Performative Inclusivity: Higher-Weight Francophone And Newcomer Adults' Experiences In A Canadian Atlantic Province, Andrea E. Bombak, Norma Chinho, Kathleen O'Keefe, Sumaiya Akhter, Lisa Thomson, Courtney Burk, Lee Turner

Patient Experience Journal

Weight stigma research is needed in diverse populations. Two populations that may experience compromised healthcare in New Brunswick, Canada's only officially bilingual province (English/French), are Francophone New Brunswickers and newcomers to Canada. As such, this study explores the experiences of higher-weight (Body Mass Index ≥ 30) adults (≥ 18 years of age) who also identify as primarily Francophone or as having moved to Canada ≤ 5 years ago in and out of healthcare contexts. Participants were interviewed according to a semi-structured interview guide face-to-face, by telephone, or video-call two times, at 2-to-3-month intervals. Interviews included questions about experiences and effects …

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 …

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 …

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 …

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 …

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.

Understanding The Care Experiences And Support Needs Of Uk Adults Treated In Hospital For Meningitis, Harriet Hay, Amy Tallett Dr, Bec Aeddi, Beverley Corbett, Claire Donovan, Jane Blewitt, Juan Abad Madroñero

Patient Experience Journal

Background: Meningitis often results in ongoing and multifaceted after-effects, which can impact many aspects of people's lives, yet relatively little support and follow-up is offered. This study explored post-treatment care experiences of UK adults aged 16 and over following a recent stay in hospital for meningitis. Methods: A survey was designed to ask about hospital discharge, recovery, information provision and aftercare support. The research involved 5 semi-structured, in-depth interviews and a 15-participant online asynchronous focus group. The themes arising from this qualitative stage informed the development of a quantitative 32-item questionnaire which was hosted and promoted online between September 2022 …

The Impact Of Learners On Patient Satisfaction In The Orthopedic Setting, Sydney Boike, Kevin Hodge, Lynsey Malin, Timothy Nyangacha, Rebekah Kleinsmith, Megan Reams, Julia Stumpf, Bradley Nelson

Patient Experience Journal

This investigation evaluates the impact of learners and their post-graduate year (PGY) levels on patient satisfaction in the orthopedic outpatient clinic, an area with limited prior research. A retrospective cohort study was conducted using data from July 2020 to December 2022, involving 2,484 patients, with a 39% response rate. Satisfaction was measured via NRC Health surveys, focusing on the likelihood of recommending the provider or clinic based on the presence of learners, categorized as none, present in the clinic, or involved in patient care. Non-parametric statistical analysis revealed significant reductions in satisfaction when learners were involved in care, with top-box …

Patient Perspectives On Health Care Utilization At Two Free Clinics – A Qualitative Study, Patrick Fagan, Danny Guillen Perez, Roberta D. Baer, John Petrilli

Patient Experience Journal

Millions of uninsured Americans access health care through free clinics, but their experience with the medical system is understudied. This study sought to understand patterns in free clinic patients' experience with healthcare utilization through qualitative and descriptive analyses. Data were collected through face-to-face, open-ended interviews at two free clinics in an urban Florida community. The clinics included one student-run free clinic and one community-based free clinic. Survey questions were developed based on prior literature and validated through expert consensus and pilot interviews. The interviewers conducted 74 interviews between May 7 and June 10, 2022. Responses were coded by the authors, …

Evaluating The Effectiveness Of Teledermatology For Undeserved Populations During And Post-Covid-19, Jakob Gibbs, Sean Hanshaw

Theses, Dissertations and Capstones

Introduction: Teledermatology, a subset of telemedicine, has gained prominence as a means to increase access to dermatologic care while reducing costs and improving patient satisfaction. The swift expansion of teledermatology during the COVID-19 pandemic was driven by the necessity to limit physical contact and adapt to public health restrictions. This technological shift aimed to address longstanding disparities in dermatology access, especially in rural and underserved populations, and to respond to the rising demand for dermatologic services amid provider shortages.

Purpose of the Study: The purpose of this study was to analyze the effects that teledermatology following the COVID-19 pandemic had …

A Quality Improvement Initiative Using Discharge Education Videos To Improve Communication With Families In A Pediatric Urgent Care, Hannah G. Carron, Gisella Valderrama, Adam A. Vukovic

Patient Experience Journal

Introduction: Effective discharge communication, often given in verbal and written form, during pediatric acute healthcare visits positively impacts caregiver satisfaction and competency in providing at-home care. Institutions are beginning to incorporate evidence-based, and standardized multimedia education to try to further improve these outcomes.

Methods: For this QI initiative, educational videos were created and shown to families prior to discharge from a pediatric urgent care. PDSA cycles focused on development of an electronic medical record (EMR) order to provide video education, a best practice alert regarding this order, and recurrent staff education. The primary outcome measure was the percentage …

Language Barriers And The Quality Of Care, Vanessa Colina

Narrative Medicine: Essays on Health and Care

No abstract provided.

The Impact Of Electronic Health Record Unintended Consequences On Quality Of Care Within A High Complexity Healthcare Organization, Joetta Powell

ATU Theses and Dissertations 2021 - Present

“Unintended consequences are unexpected, and unwanted outcomes that can limit the value of EHR implementation and adversely affect quality of care and patient safety” (Lee & Kang, 2021, p. 898). Few organizations have redesigned the EHR to improve usability to mitigate potential patient safety concerns. This study aims to identify unintended consequences in patient care workflows and determine educational needs related to EHR usability. A mixed method approach was used to investigate unintended consequences in deidentified patient safety reports submitted Jan 1, 2020, through December 31, 2023. The data was analyzed to identify error types and educational deficits. The Acute …

“Not Your Father’S Heart”: How Healthcare Discrimination For Neurodivergent Patients Taught Me About The Human Experience, Cate Murphy

Patient Experience Journal

It is easy to assume all patients who come into a hospital for acute crisis care have a clear understanding of how their experience will be facilitated. When a patient is neurodivergent, they cannot always agree to needed intervention. This is exacerbated by the “poor timing” of questions portrayed to impact the critical care received, sometimes irreparably. This is my story of watching my young, active partner suffer two massive heart attacks and refuse intervention because he was ashamed to admit he had not seen a doctor in over thirty years. Due to his neurodivergence, he could not process questions …

What Does It Look Like For Mental Healthcare Organizations To Be Healthy Places To Work? An Action Research Study, Stephanie L. Fox

Antioch University Dissertations & Theses

Mental healthcare organizations have a reputation for being unhealthy places to work. The irony of this reputation is keenly felt by its workforce who report unsustainable workloads, high levels of stress, and lack of support or engagement from higher-level leadership. As a mental healthcare provider now in a position of leadership, who has worked across all levels of care within the sector, it was of interest to me to explore how a mental health organization can become a healthier and more sustainable place to work. I approached this study with the assumption that if an organization was healthy and intentional …

Global Child And Family-Centered Care Fellowship, Education And Mentorship For Pediatric Healthcare Professionals: A Literature Review, Ashley Zheng, Bobbijo Pansier

Patient Experience Journal

Child- and family-centered care (FCC) is increasingly accepted and implemented to optimize the healthcare experience for patients, their families, and healthcare professionals. Standish Foundation for Children, a 501(c)(3) non-profit, has designed and piloted a fellowship to educate pediatric healthcare professionals in FCC & psychosocial care via an inquiry and mentorship model in Tbilisis, Georgia. This review aimed to evaluate and synthesize existing literature on psychosocial and FCC mentorship for pediatric healthcare professionals in four parts: ongoing need, effects on healthcare professionals, effects on children and their families and/or caregivers, and in cross-country healthcare settings. Reviewers searched open-source databases for articles …

The Use Of Patient Experience Data For Quality Improvement In Hospitals: A Scoping Review, Lauren Cadel, Michelle Marcinow, Harprit Singh, Kerry Kuluski

Patient Experience Journal

In this paper we identified what was reported in the literature on qualitative and quantitative approaches used to capture and improve patient experiences in a hospital setting. For inclusion, articles were required to describe an embedded strategy for capturing patient experiences that was used to inform quality improvement in a hospital setting. Articles also had to be published in English between January 2004 and December 2020. Six databases (MEDLINE, EMBASE, PsycINFO, CINAHL, Health and Psychosocial Instruments and Cochrane Library) and grey literature (relevant hospital and government websites) were searched. All articles were screened by two reviewers and any disagreements were …

Using A Multidisciplinary Data Approach To Operationalize An Experience Framework, Kevin Spera, Garrett Holmes, Sunni Barnes

Patient Experience Journal

Like many healthcare organizations, Baylor Scott & White Health (BSWH) is awash with data. Often, this data is used in siloed departments to monitor safety and quality, make local business decisions, and motivate staff to improve processes to achieve sustained excellence and market share. As margins get thinner and competition from various disrupters increases, organizations have tried to improve the patient experience to remain viable as part of a calculated strategy. Nevertheless, these entities have struggled to focus limited resources for sustained improvement in patient experience. This article details how a large Texas-based healthcare system "operationalized" The Beryl Institute's Experience …

How To Address Fear: A Patient’S Perspective Of Seeking Care During Covid-19, Rosie Bartel, Sydney Hoel, Nasia Safdar, Mary Jo Knobloch

Patient Experience Journal

This article is a narrative of one patient’s experience during COVID-19. As a non-COVID patient, she shares her personal fears, the fears of others in her family and the fears of the healthcare professionals. These fears have made navigating the healthcare systems stressful for patients but also caused patients to avoid them completely. In some cases, this avoidance led to delayed diagnosis, missed diagnosis and death. When healthcare providers guide patients through the process of seeking in-person healthcare, the outcomes were more positive for everyone involved but especially for the patients and their care partners. The patient’s voice is needed …

The Influence Of Hospital Site On Emergency Physician Press Ganey Scores, Dietrich Jehle, Brian Doherty, Lexus Dickson, Melville C. O'Brien, Casey Wilson, Scott Gutovitz

HCA Healthcare Journal of Medicine

Background

The use of physician satisfaction scores to evaluate emergency medicine physicians’ performance and compensation is controversial. Prior studies have shown that the clinical environment may influence scores. This study compared satisfaction scores for the same physician at different emergency departments (ED). Differences in their individual score may indicate the ED environment could be as important as the physician’s interaction.

Methods

Press Ganey satisfaction scores were obtained for physicians at three EDs—Grand Strand, South Strand and North Strand—between July 2018 and June 2019. Included physicians worked at all 3 facilities and had at least 6 patient satisfaction surveys at each …

Black And White Health Disparities: Racial Bias In American Healthcare, Yasmeen Almomani

Bridges: An Undergraduate Journal of Contemporary Connections

This paper explores the historical implications of race in American society that have led to implicit racism in the healthcare system. Racial bias in healthcare against Black people is a factor in the health disparities between Black and white people in America, such as the gap in life expectancy, infant death, and maternal mortality. Black people are more likely to report racial discrimination from healthcare providers, which is a reason for the decreased quality of care received. The past justifications of slavery, the Tuskegee syphilis study, and the medical experimentations on Black women are horrifying but were considered acceptable in …

Exploring Communication Processes During Transitions From Acute Care To Skilled Nursing Facilities And Perceived Barriers To Communication, Marrizzia Oxford

Seton Hall University Dissertations and Theses (ETDs)

Background and Purpose of the Study: The need for skilled care and long-term care services often becomes necessary as the older adult transitions into the golden years. In the United States, more than 1.5 million adults live in long-term care facilities, with this number expected to double by 2050 (Johnson, Pope joy & Radina, 2010). Effective communication between the healthcare professionals who refer individuals from an acute care setting to a skilled nursing facility can be challenging and ultimately impact their transfer status and Plan of Care (POC) or plan of action implementation for meeting healthcare goals of the patient …

Testing Of Patients First In A Real-World Setting, As A Patient Experience Accreditation Tool For Hospitals And Clinics, Carlos Bezos, Rosa M. Salazar, María Caballero

Patient Experience Journal

Many healthcare providers are developing patient experience strategies and investing in this area. Yet, patients have no means to know if a hospital is following proper patient experience standards. For this reason, it is important to certify that hospitals and clinics follow own a patient experience policy and apply patient experience standards. This is the reason why the accreditation Patients First was developed. The goal of this study is to test the accreditations’ feasibility in a real-life environment. The accreditation was tested at the Guadarrama Hospital, nearby Madrid in Spain. A mixed team between Guadarrama staff and the Institute for …

The Paradoxical Injunctions Of Partnership In Care: Patient Engagement And Partnership Between Issues And Challenges, Khayreddine Bouabida, Marie-Pascale Pomey, Genevieve Cyr, Ursulla Aho-Glele, Breitner Gomes Chaves

Patient Experience Journal

Partnership in care and patient engagement is an expanding approach and tremendously promising for improving the quality of healthcare services. However, the approach could be subject to many issues and challenges of various kinds. In this paper, we develop a reflection of the challenges and issues that the approach of patient engagement and partnership in care is facing. After a brief presentation of certain key concepts of partnership in care and patient engagement, we discuss in this paper the most worthy of consideration issues that we identified and classified as follows: Political, Financial, Organizational, Clinical, and Ethical Issues. We then …

Macra And Accountable Care Organizations: Is It Working?, Bukola Abodunde, Chelsea Slater, Alberto Coustasse

Management Faculty Research

The purpose of this study was to examine how the Medicare Access and CHIP Reauthorization Act (MACRA) has improved health care delivery and to determine its impact on Accountable Care Organization (ACO) goals. ACOs have provided quality care through the reduction in readmission rates, coordinated care, and cost savings. With the passage of the MACRA, it has been estimated that it would further decrease Medicare spending on physician and hospital services. Also, ACOs have had a positive impact on improving health care delivery and have played a significant role in providing exceptional quality of care while also managing to increase …

Measurement Matters: Changing Penalty Calculations Under The Hospital Acquired Condition Reduction Program (Hacrp) Cost Hospitals Millions, Olga A. Vsevolozhskaya, Karina C. Manz, Pierre M. Zephyr, Teresa M. Waters

Biostatistics Faculty Publications

BACKGROUND: Since October 2014, the Centers for Medicare and Medicaid Services has penalized 25% of U.S. hospitals with the highest rates of hospital-acquired conditions under the Hospital Acquired Conditions Reduction Program (HACRP). While early evaluations of the HACRP program reported cumulative reductions in hospital-acquired conditions, more recent studies have not found a clear association between receipt of the HACRP penalty and hospital quality of care. We posit that some of this disconnect may be driven by frequent scoring updates. The sensitivity of the HACRP penalties to updates in the program's scoring methodology has not been independently evaluated.

METHODS: We used …

Testing Cost Containment Of Future Healthcare With Maintained Or Improved Quality—The Costcares Project, Karl Swedberg, Desmond Cawley, Inger Ekman, Heather L. Rogers, Darijana Antonic, Daiga Behmane, Ida Björkman Ida Björkman, Nicky Britten, Sandra C. Buttigieg, Vivienne Byers, Mats Börjesson, Kirsten Corazzini, Andreas Fors, Bradi Granger, Boban Joksimoski, Boban Joksimoski, Roman Lewandowski, Virgilijus Sakalauskas, Einav Srulovici, Jan Törnell, Sara Wallström, Axel Wolf, Helen M. Lloyd

Other resources

Increasing healthcare costs need to be contained in order to maintain equality of access to care for all EU citizens. A cross-disciplinary consortium of experts was supported by the EU FP7 research programme, to produce a roadmap on cost containment, while maintaining or improving the quality of healthcare. The roadmap comprises two drivers: person-centred care and health promotion; five critical enablers also need to be addressed: information technology, quality measures, infrastructure, incentive systems, and contracting strategies.

Evaluating The Effect Of Care Around Labor And Delivery Practices On Early Neonatal Mortality In The Global Network's Maternal And Newborn Health Registry, Archana B. Patel, Elizabeth M. Simmon, Sowmya R. Rao, Janet Moore, Tracy L. Nolen, Robert L. Goldenberg, Shivaprasad S. Goudar, Manjunath S. Somannavar, Sarah Saleem, Farnaz Naqvi

Community Health Sciences

Background: Neonatal deaths in first 28-days of life represent 47% of all deaths under the age of five years globally and are a focus of the United Nation's (UN's) Sustainable Development Goals. Pregnant women are delivering in facilities but that does not indicate quality of care during delivery and the postpartum period. The World Health Organization's Essential Newborn Care (ENC) package reduces neonatal mortality, but lacks a simple and valid composite index that measures its effectiveness.
Methods: Data on 5 intra-partum and 3 post-partum practices (indicators) recommended as part of ENC, routinely collected in NICHD's Global Network's (GN) Maternal Newborn …