Health and Medical Administration Commons^™

The Patient's Lived Experience: A Phenomenological Study On Factors Influencing Tuberculosis Treatment Outcomes In Medan, Indonesia, Erida Novriani, Urip Harahap, Khairunnisa Khairunnisa, Wiryanto Wiryanto

Patient Experience Journal

This qualitative phenomenological study was conducted to analyze the factors influencing tuberculosis (TB) treatment outcomes from the patient's perspective in Medan, North Sumatra, Indonesia. The objective was to uncover the nuanced human factors shaping the patient's treatment journey, moving beyond a sole reliance on statistics and quantitative methods. The research was conducted across all 41 Primary Health Centers (PHCs) in Medan. Through a purposive sampling strategy, data was collected from 22 TB patients via in-depth interviews until data saturation was achieved. The collected data was analyzed using thematic, narrative, and phenomenological approaches to interpret the detailed lived experiences of the …

Applying A Patient Journey Mapping Approach To Understand Maternal Care Patient Journeys: A Pilot Study, Nicole Hicks, Kristin Tully, Christopher Goodier, Sreenath Chalil Madathil, Ayaba Logan, Myrtede Alfred

Patient Experience Journal

Introduction: In the United States, giving birth is the most common cause of hospitalization. Maternal care frequently represents birthing people's first experiences of prolonged interactions with the healthcare system. However, the structure of services is often fragmented and misaligned with individuals' needs, particularly for Black birthing people. Documenting birthing people's experiences during pregnancy and postpartum allows for identification of practices working well and opportunities to improve patient-centered maternal care. Methods: The mixed-methods study was conducted in the southeastern United States and used patient journey mapping(PJM) to document experiences of patients receiving maternal care at a large academic hospital …

No One-Size-Fits-All: Patient Perspectives Of Key Factors Influencing Their Inpatient Rehabilitation Experience, Mirline Milien, Megan Bewernitz, Katherine Stallings, Mary Ellen Young

Patient Experience Journal

Although patient experience in healthcare settings has historically been an ambiguous concept, it has received increasing recognition as a measure of healthcare quality. Despite this growing recognition and efforts to define patient experience, few studies have explored patient perspectives on the key factors driving this quality indicator. This study aimed to explore the core elements patients view as influencing their experiences in the inpatient rehabilitation setting. This was a single-visit, cross-sectional qualitative interview study. Thirteen patients with diverse diagnoses who received at least one week of rehabilitation services were recruited from a single inpatient rehabilitation facility. Purposive sampling was employed …

Expanding Family Participation In Inpatient Rounds Through Remote Access: A Feasibility Study Using Automated Messaging, Praveen Meka, Susan Ayers, Jayme Wilder

Patient Experience Journal

Patient representatives (PR) often wish to be part of the care of their loved ones when hospitalized. However patients are frequently alone during morning bedside rounds. A feasibility study was conducted at a large New England Academic Center to evaluate whether short messaging service (SMS) notifications of morning round times with ability to conference-in could improve remote PR participation in inpatient rounds and assess its impact on communication, acceptability, and care experience. After IRB approval, 17 patients were recruited, resulting in 61 bedside encounters. PRs received daily SMS reminders with scheduled round times and joining instructions; care teams received daily …

The Implementation Of Family-Centered Care And Family Satisfaction In Caring For Children With Cancer, Lenny Gannika, Mulyadi Mulyadi, Jeanette Irene Christie Manoppo

Patient Experience Journal

Background: Family-Centered Care (FCC) is an approach that involves families actively in their children's care by emphasizing respect, collaboration, and support. The goal is to increase family satisfaction with the care of children with cancer. FCC covers six subscales: general satisfaction, information, family inclusion, communication, technical skills, and emotional needs. Objective: This study aims to analyze the relationship between implementing FCC and family satisfaction when caring for children with cancer. Methods: A cross-sectional quantitative study was conducted at the Estella Children's Cancer Center in Manado, Indonesia, from June to October 2024. Parents of hospitalized children with cancer were selected for …

Using Artificial Intelligence To Enhance Patient Comprehension And Risk Perception Of Pathology Reports: Findings From A Survey Of Patients And Pathologists, Jordyn Franco, Osee Koulong Leussa, Amer K. Abu Alfa, Mark K. Fung

Patient Experience Journal

Context: Electronic health records (EHRs) provide patients with direct access to their pathology reports, often before physician consultation. However, the complexity of medical terminology can lead to misinterpretation and anxiety. Artificial intelligence (AI), particularly large language models such as ChatGPT, may improve patient comprehension by simplifying medical language. Objective: This study evaluates ChatGPT's ability to enhance patient understanding and risk perception of pathology reports by generating patient-friendly explanations and assigning a numerical concern level. Pathologists assessed the accuracy of AI-generated summaries. Design: A publicly available colonoscopy pathology report was analyzed using ChatGPT, which produced a simplified summary and concern score. …

Improving Patients' Experience Through Nurturing Care For Patients Undergoing Kidney Biopsies: A Feedback Survey, Molefe Rapalai, Mahmoud Elshehawy, Johann Nicholas, Patrick Anthony Ball, Hana Morrissey

Patient Experience Journal

Background: Renal biopsies are a key tool in diagnosing kidney diseases, providing histopathological insights for personalised treatment plans. Despite their clinical value, little is explored about how patients experience this invasive procedure. Understanding these experiences is important for improving care quality, safety, and ensuring the process is as patient friendly as possible. There is also a lack of research capturing patient experience feedback on renal biopsies, making studies like this essential for guiding service improvement initiatives. Method: Observational study, May 2022 to June 2024. Eighty-six percutaneous renal biopsies performed. Fifty eligible patients invited to complete the Kidney Biopsy Patient Experience …

Capturing Patient-Centered Quality Of Life: Usability And Initial Validation Of The Pediatric Patient-Generated Index Following Esophageal Atresia Repair, Zanib Nafees, Julia Ferreira, Elena Guadagno, Nikki Ow, Nancy Mayo, Jean-Martin Laberge, Dan Poenaru

Patient Experience Journal

The Patient-Generated Index (PGI) is an individualized measure that allows patients to define the domains most important to their quality of life (QoL). This study evaluates the usability and preliminary validity of the pediatric Patient-Generated Index (pPGI) in children who previously underwent esophageal atresia (EA) repair. We conducted a mixed-methods study including the pPGI, EuroQol-5D-Youth (EQ-5D-Y), and PROMIS Life Satisfaction Short Form-8a. Children aged 7–17 years completed self-reports, while parents served as proxies for younger children. Cognitive interviews explored how children understood and completed the pPGI, and clinician interviews assessed clinical usability. Among 25 participants, the pPGI generated 104 text …

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 Voices I Never Heard: Reflections From A Public Health Advocate On Representation, Silence, And Struggle, Araya Gautam

Patient Experience Journal

Representation of ethnic minorities among trial participants in the UK is poor. It is true that the need for diversity and inclusive language is important in research, but the practicality of making this a reality for patients from under-represented groups has not generally been the case. As a patient advocate, I have been a participant in clinical trial reviews and advisory boards during the past three years and have engaged in a national-level conversation about patient voice and equity. I draw connections between structured frameworks for patient and public involvement (PPI) in the UK and the more informal, community-based caregiving …

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 …

Navigating Medical Ambiguity: A Patient's Perspective On Communication, Timing, And Risk, J. Hansen

Patient Experience Journal

This essay recounts the experience of navigating re-vaccination decisions after an initial diagnosis of vaccine-associated myocarditis. A diagnosis later contested by other specialists. It is not a tale of medical error, but of diagnostic ambiguity and divergent clinical reasoning. My intent is to show how, in the absence of consensus, a patient was compelled to assume a central role in adjudicating between competing medical narratives. Recommendations are offered to make medical advice more available to patients and bridge a growing gap between medicine and the public.

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, …

Human Experience: A Catalyst For Global Connection, Jason A. Wolf

Patient Experience Journal

As I think about the state of play in our world today, I find we have two choices in how we react. One is with a sense of despair driven by the intentional efforts to disconnect humanity being perpetuated by some. The other, with a sense of hope, that even in the face of these forces, there are those that strive relentlessly to foster connection and opportunity. I find the path forward in holding the tension of pragmatic idealism – that we can dream, with big and noble goals, while recognizing our path forward must be grounded in practical and …

Optimizing Glycemic Control In Type Ii Diabetes: Continuous Glucose Monitoring : A Scoping Review, Sarah Poe, Bsn, Rn, Bailey Li, Bsn, Rn, Tracy Mcclinton, Dnp, Aprn, Ag-Acnp-Bc, Hget-C, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

Individuals with Type II diabetes mellitus (T2DM) experience increased risk of cardiovascular disease and higher mortality rates relative to non-diabetic populations. Continuous glucose monitoring (CGM) enables more precise analysis of glucose patterns and trends compared to conventional self-monitoring of blood glucose (SMBG). CGM provides frequent measurements and generate meaningful metrics, such as time in range (TIR), time above range (TAR), and time below range (TBR), allowing evaluation of glucose stability and variability. Despite these advantages, evidence comparing CGM and SMBG remains inconsistent. This scoping review aims to evaluate how CGM compares with SMBG across reported outcomes, including TIR, TAR, …

Efficiency Rx: Emr Training For Resident Wellness, Calder Dorn, Do, Tom Chau, Md, Mba, Facp, Shelley Schoepflin Sanders, Md, Facp

Books, Presentations, Posters, Etc.

Introduction: Physician burnout affects nearly 60% of physicians during their careers, leading to increased medical errors, reduced care quality, higher turnover, and lower patient satisfaction. ii. The widespread use of Electronic Medical Records (EMRs) has been identified as a key contributor, with poor usability, inbox overload, and documentation burden reducing direct patient interaction among cited factors iii. Institutions like UCHealth, OHSU, CHOP, and Mayo Clinic have implemented strategies that improved EMR confidence and reduced burnout vi. While Providence offers training to all providers, there are no initiatives specifically targeted to internal medicine (IM) residents. Methods: Providence St. Vincent Medical Center …

Evaluating The Screening And Referral Process For The Use Of Phq-9 Screening Tool In Middle-School Aged Students: A Scoping Review, Kaythi Soe, Msn, Pmhnp-Bc, Fnp-Bc, Margaret Harvey Phd, Acnp-Bc, Fhrs, Sharon Little Dnp, Fnp-Bc

Doctor of Nursing Practice Projects

No abstract provided.

Improving Recognition Of Chronic Kidney Disease In A Federally Qualified Health Center Through A Quality Improvement Initiative, Rachel Monroe, Evan Saulino, Kathleen Mckenna

Books, Presentations, Posters, Etc.

Context/background: Chronic kidney disease (CKD) affects approximately 15% of adults in the United States, yet nearly 90% of affected individuals are unaware of their diagnosis. Early identification in primary care enables interventions such as blood pressure optimization, renin –angiotensin system blockade, and kidney -protective medications that can significantly delay disease progression and postpone dialysis. Screening and diagnosis gaps disproportionately affect high -risk populations, including Latinx patients and immigrant agricultural workers commonly served in federally qualified health centers (FQHCs). National CKD screening rates among patients with diabetes or hypertension remain low, leaving many high -risk individuals unscreened for kidney disease. Improving …

Home-Based Vs Clinic-Based Stool Testing For Detecting Early Cancer Markers: A Scoping Review, S. Elizabeth Brock, Jacqueline Giles, Sydney James, Cha'landria Mccall, Bobby Bellflower Dnsc, Nnp-Bc-Faanp, Fnap, Faan

Doctor of Nursing Practice Projects

Purpose/Background 

Colorectal cancer (CRC) remains a significant public health concern in the United States, with screening rates below national targets due to persistent socioeconomic and structural barriers, particularly among underserved populations. Stool-based screening modalities offer accessible alternatives to colonoscopy, and emerging evidence suggests that home-based delivery models may improve screening uptake; however, implementation strategies vary and comparisons between home-based and clinic-based approaches remain limited. This scoping review examines current evidence on strategies that support CRC screening uptake, with a focus on stool-based modalities, including fecal immunochemical testing (FIT), fecal occult blood testing (FOBT), and multitarget stool DNA testing (mDNA), and …

How Does Cognitive Behavioral Therapy (Cbt) And Antipsychotics Compare To Antipsychotics Alone Impact Inpatient Length Of Stay: A Scoping Review, Morgan E. Johnson, Hailey M. Wade, Y'Esha V. Williams-Click, Rocquell Duncan, Laura Reed Dnp, Aprn, Fnp-Bc, Cne, Fnap

Doctor of Nursing Practice Projects

Background

Psychosis in adults is a serious psychiatric condition that often necessitates inpatient hospitalization for stabilization and the initiation of medication. Untreated psychosis can lead to poor outcomes, including longer hospital stays, loss of occupational functioning, and a decreased quality of life. While antipsychotic medications are typically the first line of treatment, they can have severe side effects, which may lead to patients discontinuing their use. Cognitive Behavioral Therapy (CBT) for psychosis is an evidence-based intervention that targets maladaptive behaviors associated with the condition. CBT may improve treatment responses when used alongside antipsychotic medication. However, there is limited research on …

Moving Toward Standardization Of Breast Cancer Screening: A Scoping Review Comparing Uspstf And Acs Recommendations For Women Aged 40–74, Gerita F. Perry, Krystal D. Hester-Smith, Bobby Bellflower Dnsc, Nnp-Bc, Faan, Faanp, Fnap

Doctor of Nursing Practice Projects

Purpose 

To compare U.S. Preventive Services Task Force (USPSTF) and American Cancer Society (ACS) breast cancer screening guidelines for women aged 40–74, and to recommend adopting one consistent, standardized guideline in practice. Standardization can improve care continuity, patient adherence, reduce anxiety, support early detection, and lower mortality.

Background 

Breast cancer is the second leading cause of cancer-related death amongst women. The USPSTF recommends biennial screening mammography for women aged 40 to 74 years. The ACS recommends an annual mammogram. Differences between the two organizations for screening emphasize the need for a common alignment to reduce breast cancer mortality. As breast …

Recovery Instruction Improvement Project, Jonathan Eyestone, Katy Germundson

Publications 2026-present

No abstract provided.

Improving Identification And Referral Of Xylazine‑Associated Wounds In Homeless Healthcare, Ramon A. Gambino

Doctor of Nursing Practice Scholarly Projects

Background: Xylazine-adulterated fentanyl is linked to distinctive necrotic wounds and complex care needs in unsheltered populations. This quality improvement (QI) project implemented a brief survey and referral log at Albuquerque Health Care for the Homeless (AHCH) to track suspected xylazine-associated wounds and referrals to advanced care. Methods: Final data were exported from Qualtrics, cleaned to retain finished responses, standardized categories, and de-identified. The analytic sample included 18 encounters. Results: Results showed that 55.6% (n = 10) documented suspected xylazine-associated wounds; 5.6% (n = 1) reported no suspicion; 38.9% (n = 7) were uncertain. Referrals were rarely documented overall at AHCH …

Organizational Governance Capacity And Organizational Resilience In Hospitals: A Cross-Sectional Study, Leyla Afşar, Selim Yazıcı

Makara Journal of Health Research

Background: This study aims to examine the relationship between organizational governance capacity (OGC) and organizational resilience (OR) in hospitals, with a focus on cross-institutional differences.

Methods: A cross-sectional study was conducted among 1,143 employees from six hospital types in Istanbul, including university, Ministry of Health (state, training and research, and city), and private hospitals. Validated scales were used to measure OGC and OR. Data were analyzed using descriptive statistics, nonparametric tests, and structural equation modeling (SEM) to assess the relationships between these dimensions.

Results: Private hospitals demonstrated the highest levels of both OGC and OR (70%), followed …

Knowledge Of Parents And Guardians Of Computed Tomography Examinations And Radiation Risks In Children In Malaysia, Nur Maisarah Ali Wahab, Nur Hamizah Mohd Zainudin

Makara Journal of Health Research

Background: Early exposure to computed tomography (CT) imaging during childhood increases cancer risk, emphasizing the critical need to minimize unnecessary imaging in pediatric patients. This study aimed to assess parents and guardians’ knowledge about CT examinations and their associated risk following pediatric CT.

Methods: A cross-sectional survey was conducted among parents and guardians who accompanied their children to a private hospital radiology department for CT examinations. The survey enquired about their socio-demographic, knowledge of CT examinations, and their radiation risks. Data were analyzed using descriptive analysis and the Kruskal-Wallis test.

Results: A total of 144 responses were …

Examination Of Health-Seeking Behavior In Individuals With Chronic Diseases, Dilan Aktepe Coşar, Hatice Demirağ, Aynur Cin

Makara Journal of Health Research

Background: Chronic illnesses are long-term, noncommunicable diseases that significantly affect daily life. In addition to physical symptoms, they can reduce quality of life by causing psychological effects such as anxiety and depression. Patients often seek health information to better manage their condition.

Methods: This study aimed to examine the level of health information-seeking behavior among individuals with chronic diseases and the factors influencing this behavior. The sample group for this descriptive study consisted of 306 individuals with chronic illnesses who visited X Hospital in northeastern Türkiye between April 1, 2024, and February 1, 2025. All individuals completed a …

Optimizing Costs & Efficiency With Heartcode Complete: A Quality Improvement Project, Jessica Bryant

Doctor of Nursing Practice Final Project Abstract

PURPOSE

This quality improvement project aimed to implement HeartCode Complete (HCC), a simulation-based BLS training platform, at a 154-bed community hospital. The goal was to replace instructor-led BLS training, improve training efficiency, reduce costs, increase certification compliance, and enhance staff satisfaction.

BACKGROUND

Maintaining competency in CPR is a regulatory requirement for healthcare providers. Traditional instructor-led BLS training requires scheduled classes, instructor availability, and staff time away from clinical duties, contributing to certification delays and operational inefficiencies. Simulation-based training platforms offer self-directed learning with real-time feedback.

METHODOLOGY

This quality improvement project used Lean Six Sigma principles and Plan-Do-Study-Act cycles to guide …

Improving Pneumococcal Immunization Counseling In Children With Systemic Lupus Erythematous, Sarah Dettmann

Doctoral Dissertations & Projects

Background: Pediatric patients with systemic lupus erythematosus (SLE) face elevated risk for invasive pneumococcal disease, yet fewer than 10% are estimated to be current on pneumococcal vaccine (PCV) recommendations.

Local Problem: This quality improvement (QI) project aimed to develop and implement a standardized pneumococcal immunization screening and counseling process in a pediatric rheumatology clinic.

Method: Three consecutive PDSA cycles guided implemention across a nine-week intervention period using a pre-post quasi-experimental design.

Interventions: A multicomponent strategy was employed, including a PCV decision algorithm, EHR Smart Phrase, PCP referral template, and patient education brochure.

Results: Pre-implementation PCV counseling was documented …

Psychological Safety In Health Care: A Prerequisite For High Reliability, Sonali Thosani

Advances in Cancer Education and Quality Improvement

This paper presents a viewpoint on how psychological safety contributes to patient safety, teamwork, and high reliability.