Quality Improvement Commons^™

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 …

Patients’ Perceptions Of Interprofessional Collaboration: A Scoping Review, Robynne Gilchrist Miss, Aayesha Kholvadia Dr, William (Bill) Burdick Prof

Patient Experience Journal

Collaboration has emerged as a pivotal element within an intentional person-centred healthcare framework. However, there is a need for evaluative feedback from patients to enhance interprofessional collaboration and its outcomes. The objective of this review was to describe the state of knowledge on the perspectives of patients living with a chronic condition regarding their experiences of interprofessional collaboration. A scoping review across five online databases (EBSCOhost, Google Scholar, PubMed Central, ScienceDirect, and Taylor & Francis Online; February 2023) identified all peer-reviewed literature published in English between the years 2018 and 2023 that reported on patients’ perspectives of, and experiences with, …

Informed Consent In Surgical Practice With Patients’ Experiences: A Cross-Sectional Study, Seda Kumru, Pakize Yiğit, Meryem Demirtaş, Hüseyin Fındık

Patient Experience Journal

This study aims to evaluate patients' experiences and perspectives regarding informed consent in surgical practice. Data for this cross-sectional study were collected from 276 patients using a questionnaire developed by Falagas et al. Descriptive statistics were employed for all questions. Statistical tests such as the Mann-Whitney U test, Kruskal-Wallis test, and Spearman's rank correlation analysis were performed, and Cohen's effect sizes were reported. IBM SPSS 23.0 was used for all analyses, and p<0.05 was considered statistically significant. A high score on both The Delivered Information Index and The Patient-Physician Index represents a positive informed consent process. Among the participants, 65.2% indicated that they understood all parts of the consent form. Of all patients, 92.8% reported that information about the specific surgical procedure was provided by physicians. However, 47.5% of the patients reported that they did not feel comfortable with their surgeons. The mean score of the Delivered Information Index was 5.63 (2.38). The mean patient-physician relationship score was 14.38 (3.31). There was a moderate positive correlation between the delivered information index and the patient-physician relationship (r=0.50; p<0.001). In addition, there was a moderate positive correlation between the delivered information index and the time spent on the informed consent process, as well as between the patient-physician relationship and the time spent on the informed consent process (r=0.52; r=0.40, respectively). The study emphasized the lack of communication between patients and physicians, the limitation of information on treatment risks, adverse effects, and alternative treatment options.

Experience Framework

This article is associated with the Policy & Measurement lens of The Beryl Institute Experience Framework (https://theberylinstitute.org/experience-framework/).

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Storytelling At Board Meetings: A Case Study Of Co-Developing Recommendations, Dawn Richards, Kimberly Strain, Lisa Hawthornthwaite, Isabel Jordan, Carol Fancott

Patient Experience Journal

In healthcare, stories shared by patients often provide details and insights into experiences of illness and care. Stories are a way to educate healthcare providers and others to improve care and systems to become more patient and family centred and to better meet patients’ needs and priorities. Telling stories may bring benefits to both storytellers and audience members but also presents risks of harm. A reflective storytelling practice aims to honor stories and storytellers by ensuring there is time to prepare, reflect, learn, ask questions, and engage in dialogue with the storyteller to explore what went well and where there …

Patients’ And Family Caregivers’ Experiences With A Newly Implemented Hospital At Home Program In British Columbia, Canada: Preliminary Results, Sean P. Spina Bsc(Pharm), Acpr, Pharmd, Fcshp, Rounak Haddadi Bsc, Bhsc, Pg Dip Sc, Katy Mukai Ba, Mpa, Michelle Riddle, Beth Bourke Bscn, Rn, Lisa Thompson Bsc, Elizabeth Borycki Rn, Phd, Facmi, Fcahs, Fiahsi, David Forbes Bsc(Pharm), Mpa, Acpr, Bcps, Cte, Taylor Hainstock Bhsc, Ma, Curtis K. Harder Bsc(Pharm), Acpr, Pharmd, Fcshp, Nancy Humber Bsc, Md, Ccfp, Cfpc, Mha, Ffrms, Andre Kushniruk Phd, Facmi, Fcahs, Fiahsi, Tara Mcmillan Bsc, Shauna Tierney Md, Ccfp, Melinda Zeron Mullins Md, Phd, Ccfp

Patient Experience Journal

The Hospital at Home (HaH) model of care, which enables the provision of acute-level care in the patient’s own home as an alternative to brick and mortar hospital admission, was introduced in British Columbia, Canada in November 2020, starting with 9 inpatient “beds” in the community. The AT-HOME research group applied a patient-oriented approach to evaluate the patients’ and family caregivers’ (FCGs) experiences with the program as it was implemented and expanded throughout Victoria, BC. In this paper, we discuss the development of the survey instruments, including process and timelines (three phases); and present preliminary findings of the observational research …

Home Health Care Cahps® Survey: Predicting Patient Experience Performance, Stephanie Ballengee, Girlyn Cachaper, Kim S. Bradley, Hessamaldin Sadatsafavi, Ralitsa S. Maduro, Merri K. Morgan, Kathie S. Zimbro

Patient Experience Journal

Our home health (HH) division has collected Home Health Care CAHPS® Survey (HHCAHPS) data since 2011. To date, HH providers have not met performance thresholds related to patient experience. This study aimed to explore HHCAHPS composite measures and specific questions to predict 1) overall rating of care provided by the agency (Care Rating) and 2) willingness to recommend home health agency to family and friends (Recommend Agency). We also explored survey comments to identify specific themes related to positive and negative patient experiences. Logistic regression (N = 7 268) revealed being treated with courtesy and respect, and providers being informed …

Improving The Accuracy Of Interactive Voice Response (Ivr) Technology For Pediatric Experience Scores, Elizabeth Spaargaren Ms, Mph, Cpxp, Abigail Kozak Mba, Cpxp, Cara Herbener Cpxp, Barbara Lawlor Burke Ma, Cpxp

Patient Experience Journal

The increased use of interactive voice response (IVR) in assessing patient and family experience should be paired with evidence-based practices on how to obtain the most accurate information via this survey mode. We added a brief clarification sentence of the survey scale at the start of the IVR call to improve our experience data both qualitatively and quantitatively. Our setting was an urban pediatric hospital. We gathered lived experiences from our patients, families, and providers to understand and design a change to the IVR survey mode that would reduce survey inaccuracies. Outcome measures were assessed by baseline measurement and post-intervention …

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 …

When Healthcare Leadership And Philanthropy Lead To An Improved Patient Experience: The Paul Lepsoe Music Initiative, Sara Olivier Rn Bscn Mn, Corianne Bell Ba Mus, Cheryl Jones Registered Psychotherapist, Mta, Phd, Jerry M. Maniate Md, M.Ed, Frcpc, Facp

Patient Experience Journal

Through an unprecedented collaboration between an academic acute tertiary care hospital (The Ottawa Hospital (TOH) and a community-based professional orchestra (Ottawa Symphony Orchestra (OSO), the Paul Lepsoe Music Initiative represented an innovative partnership focused on improving patient care via (a) the integration of live music in waiting areas of the hospital’s Cancer Center and (b) the creation of individualized music therapy interventions on the inpatient Palliative Care Unit. Patient, family, and volunteer/staff feedback further refined the intervention throughout the duration of the Initiative; a qualitative process that provided insight into the overall patient experience and opportunities for patients and families …

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 …

Adapting And Responding To A Pandemic: Patient And Family Advisory Councils In Children's Hospitals During Covid-19, Pam Dardess, Deborah L. Dokken, Ndidi I. Unaka, Jesse Hsu, Mindy Hoang, Andrew F. Beck, Beverley H. Johnson

Patient Experience Journal

This mixed-methods study investigated the effects of the COVID-19 pandemic on Patient and Family Advisory Councils (PFACs) within children’s hospitals in the United States. Specifically, the study sought to understand how PFACs adapted operations as a result of the COVID-19 pandemic, how patient and family advisors (PFAs) were engaged in the response to COVID-19, and the intersection of the COVID-19 pandemic with PFAC diversity, equity, and inclusion. The study consisted of a survey distributed to 228 children’s hospitals, with a 73% response rate, and in-depth interviews with selected survey respondents (n=12). While COVID-19 temporarily disrupted PFAC operations and forced rapid …

Understanding Both Sides Of The Blood Draw: The Experience Of The Pediatric Patient And The Phlebotomist, Julie R. Piazza, Sandra Merkel, Brooke Rothberg, Joan Gargaro, Kristin Kullgren

Patient Experience Journal

A phlebotomist’s words and actions play a crucial role in success of a blood draw and in providing a supportive patient experience. This study examined use of comfort measures during a pediatric blood draw. The phlebotomist’s use of soft words, positioning, distraction, coaching/support were observed with sixty children between 3-14 years of age during a blood draw. The level of fear /anxiety before and during the blood draw was recorded by an RA. The child’s level of fear/anxiety was observed and reported by the parent/caregiver after the procedure. Comfort measures provided by phlebotomists, the parent/caregiver’s report of their child’s usual …

Comparing Patient Experience Survey Scores Between Telehealth And In-Person Ambulatory Pediatric Subspecialty Visits, Sean T. Bomher, Matthew Wood, Elizabeth Uhlhorn, Sandro Marques, Lee Kwiatkowski, Natasa Tekic, Cameron D'Alpe, Natalie M. Pageler, Lane F. Donnelly

Patient Experience Journal

To determine the effect of encounter methods on patient experience, we evaluated patient experience survey data comparing scores between telehealth and in-person visits and pre-COVID-19 and COVID-19 time periods. Pediatric subspecialty visits were either in-person or via telehealth and received the same 16-question patient experience survey. Top box (5/5) scores were compared between in-person and telehealth visits for pre-COVID-19 and COVID-19 periods as well as between periods for in-person and telehealth visits. In addition, for both time periods and encounter methods, correlation analysis was performed to evaluate best correlation between likelihood to recommend practice and the 15 other survey questions. …

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 …

Sociodemographic Characteristics And Patient And Family Experience Survey Response Biases, Lauren N. Brinkman, Myra S. Saeed, Andrew F. Beck, Michael C. Ponti-Zins, Ndidi I. Unaka, Mary C. Burkhardt, Jareen Meinzen-Derr, Samuel P. Hanke

Patient Experience Journal

Enhancing Patient and Family Experience (PFE) is vital to the delivery of quality healthcare services. Sociodemographic differences affect health outcomes and experiences, but research is limited on biases in PFE survey methodology. We sought to assess survey participation rates across sociodemographic characteristics. This retrospective study analyzed a health system’s ambulatory PFE survey data, collected January 1 – July 31, 2019. Outcomes of interest were rates of survey response, completion, and comments. Predictors included respondent-reported race, ethnicity, language, and measure of social deprivation attached to a respondent’s home address. Addresses were geocoded to census tracts. The tract’s degree of socioeconomic deprivation …

An Evaluation Of The Effectiveness Of A Unique Patient Experience Response Program That Provided Virtual, Visual And Emotional Connectivity To Patients And Families During The Covid-19 Crisis, Diane Burshtein, Donna Powers

Patient Experience Journal

In April 2020, the New York State Department of Health issued guidelines regarding suspension of hospital visitation due to coronavirus disease 2019 to protect staff and patients and prevent spread of the virus. Recognizing that patients would need extraordinary emotional support as they faced this frightening journey, two hospitals from a health system in the national epicenter provided avenues to bridge gaps in connectedness and communication. Our program provided virtual, visual and emotional connectivity by utilizing repurposed staff to serve as patient experience ambassadors. This program reduced the burden on clinical staff while preventing furlough. A descriptive correlational study …

The Influence Of Covid-19 Visitation Restrictions On Patient Experience And Safety Outcomes: A Critical Role For Subjective Advocates, Geoffrey A. Silvera, Jason A. Wolf Phd, Anthony Stanowski, Quint Studer

Patient Experience Journal

With the emergence of the coronavirus (COVID-19) pandemic in the United States in early 2020, hospitals across the country made the difficult decision to alter visitation policies, by either limiting visitations or restricting visitations altogether by closing access to family, friends and care partners in an effort to reduce further spread of the virus. While there is foundational research on the impact of family and care partner presence on the experience of patients and patient safety outcomes, the actions driven by the pandemic allowed for a real-time comparison of the impact of family or care partner presence or lack thereof. …