Quality Improvement Commons^™

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. …

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 …

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 …

“What We Say Matters”: Reducing Drug Use Stigmatization By Healthcare Professionals Through A Narrative-Based Awareness Campaign, Adam M. Traugott

DNP Projects

Background: Stigma towards substance use has been identified as a contributor to poor care and health outcomes amongst people who use drugs (PWUD), a vulnerable population. Healthcare worker stigma negatively affects the outcomes of individual patients and may have greater public health implications. Methods of addressing drug-use stigma have previously been implemented in a variety of clinical settings. Presenting the lived experience of PWUD to healthcare workers via emotionally compelling narratives has been found to be an effective means of stigma reduction.

Purpose: This study utilized two psychometrically validated tools to measure (1) the baseline prevalence of drug use stigma …

Quality Of Outpatient Care In Lebanon: A Cross-Sectional Survey, Georges Choueiry, Anna Maria Henaine, Rayan Darwish, Pascale Salameh

Patient Experience Journal

Patient experience is an important driver of healthcare improvement. Yet, in Lebanon, there is a lack of studies focusing on the satisfaction of outpatients with healthcare quality. This study aims to assess the quality of outpatient care in Lebanon from the patient’s perspective and identify its determinants. A cross-sectional survey was administered, between December 2023 and January 2024, to 265 participants over 18 years old who consulted a healthcare provider, excluding dentists. We used linear regression to determine factors affecting consultation quality as perceived by the participants. Waiting time before consultations typically ranged from 5 to 15 minutes, the average …

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 …

Customer Service Revisited, Allen Vean Dmd

Metro Denver Dental Society Articulator Magazine

MDDS Co-Editor, Dr. Allen Vean reflects on the importance of excellent customer service in dentistry. The article draws on personal experience and underscores the significance of patient retention, personal touches and creating a welcoming office environment.

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, …

Evaluation Of Online Patient Complaints Regarding City Hospitals In Türkiye During The Covid-19 Pandemic: A Content Analysis Study, Canan Çınar, Elif Erbay, Gökçen Çeliker, Ahmet Selçuk Yıldırım

Patient Experience Journal

The COVID-19 pandemic put tremendous pressure on healthcare systems worldwide, which led to heightened scrutiny of the medical services offered by hospitals. This article aims to evaluate complaints about city hospitals in Türkiye during the COVID-19 pandemic using the Healthcare Complaints Analysis Tool, which includes three main domains and seven problem categories. The complaints submitted by users on the site via “sikayetvar.com” were systematically collected. Document analysis was used as the data collection method, and 925 complaints were included in the analysis. The most common motive for complaining was “just to express” and problems occurred at the stage of admission, …

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 …

Draws And Windfalls: Comparing Patient Experiences In Inpatient Telehealth And Non-Telehealth Acute Care Units, Geoffrey A. Silvera, Erin Blanchard, Varun Natarajan, Eric Wallace, William Steve Stigler, Bart Kelly, Terri Scarborough, Sue S. Feldman

Patient Experience Journal

The global COVID-19 pandemic has challenged health care delivery in many ways. One solution from the pandemic that offers potential upside is the expansion of telehealth as a means to provide high quality, cost-effective, and safe care while also maintaining excellence in patient and family experience. While most examinations of the use of telehealth over the pandemic have focused on the expansion of outpatient telehealth, few have explored the use of telehealth for hospitalized patients. This article will examine the influence of telehealth use on patient experiences among acute care patients. Inpatient telehealth acute care (ITAC) is a …

Assessing The Patient Experience Evaluation Methodology: A Review Of The Hcahps Survey And Related Processes, Michael Molta

Full-Text Theses & Dissertations

The healthcare industry has undergone substantial changes that influence how hospitals evaluate success. Legislation from the Centers for Medicare and Medicaid Services (CMS.gov, 2023) that informs reimbursement levels of patient populations in all U.S. hospitals require organizations to focus on patient experiences, more specifically on scores from the Hospital Consumer Assessment of Healthcare Providers and Systems Survey, referred to as HCAHPS (pronounced H-caps). The Consumer Assessment of Healthcare Providers and Systems Survey or CAHPS® Hospital Survey or Hospital CAHPS® (CAHPS ® is a registered trademark of the Agency for Healthcare Research and Quality). This standardized survey instrument and data collection …

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 …

Going From An Academic Medical Center To A Community Hospital: Patient Experiences With Transfers, Alexander Kazberouk, Nicole Boyd, Sandra Oreper, Michael Chang, James D. Harrison, Priya A. Prasad, Ari Hoffman

Patient Experience Journal

Academic medical centers (AMCs) often operate at or near full capacity, which leads to delays in care while smaller community hospitals may have excess capacity. To address this issue and to match patient needs to care acuity, patients may be transferred from an AMC emergency department for direct admission to a community hospital. We aimed to explore the experiences and perspectives of patients who were transferred. We randomly selected patients transferred between February 2019 and February 2020. We conducted structured thirty-minute interviews containing fixed response and open-ended questions focusing on the transfer rationale and experience, care quality, and patient financial …

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 …

Asking The Question ‘What Matters To You?’ In A London Intensive Care Unit, Harriet Pittaway, Laura White, Karen Turner, Angelique Mcgillivary

Journal of Patient-Centered Research and Reviews

Purpose: At the heart of the paradigm shift in approach to patient care from paternalism toward shared decision-making lies the international “What Matters To You?” (WMTY) movement. However, WMTY principles are not frequently applied to the critical care setting. The aim of this quality improvement project work was to design and integrate a tool for all patients admitted to the intensive care unit (ICU) that helped answer WMTY.

Methods: Using Plan-Do-Study-Act (PDSA) methodology across 8 cycles, a multidisciplinary team designed and integrated a bedside poster into the ICU. Quantitative and qualitative data were collected via a bedside audit process on …

From Liability To Asset: A Large Health System’S Approach To Transforming Hospital Food, Sven Gierlinger, Bruno Tison, Nicole Giammarinaro

Patient Experience Journal

Historically, hospitals are infamous for poor food quality. Valuing food as a tenant of health and well-being, Northwell Health, New York’s largest healthcare system, is transforming its hospital food program to become an asset and market competition differentiator. By focusing on structure, workforce, procurement and process, Northwell has improved patient experience performance “Quality of Food” by 61 percentile rank points within three years with minimal impact on budgetary cost.

Experience Framework

This article is associated with the Environment & Hospitality lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework).

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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 …

Beyond Hcahps: Analysis Of Patients’ Comments Provides An Expanded View Of Their Hospital Experiences, Andrew S. Gallan, Rakesh Niraj, Awanindra Singh

Patient Experience Journal

An important concern for health care professionals is that standardized patient surveys may not fully capture all the topics that are important to patients. As a result, health care professionals may not have a complete picture of what their patients experience. The purpose of this research is to utilize a state-of-the-art Natural Language Processing technique to make sense of patients’ solicited, unstructured comments to gain a deeper and broader understanding of their experiences in the hospital. We analyzed a large dataset of inpatient survey responses (48,592 patients generating 65,998 comments) by a patient experience survey vendor for an eleven-hospital health …

Patient Reported Experience In A Radiation Oncology Department, Demetra Yannitsos, Petra Grendarova, Abdulla Al-Rashdan, Linda Watson, Wendy Smith, Fiona Lochray, Jackson Wu, Lisa Barbera

Patient Experience Journal

Understanding patient experience is essential to providing high quality, person-centered care. A real-time baseline cross-sectional study was completed to identify gaps in patient experience that can be targeted for quality improvement (QI). This study is part of PROSE (Person-centered Radiation Oncology Service Enhancement), a QI initiative developed to improve patient experience at a tertiary cancer centre Radiation Oncology (RO) Department. Data was collected using the Your Voice Matters (YVM) questionnaire. The YVM captures information on the patient’s last visit, and questions are organized based on dimensions of person-centered care. Recruitment occurred between May and August 2019 in the radiation department. …

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 …

The Impact Of Patient-Centered Care On Health Outcomes In Adolescents Living With Diabetes, Rashida Farhad Vasanwala Dr, Amos Lim, Lim Soo Ting, Lim Pei Kwee, Hui Yuen Ching, Tan Xiang Feng

Patient Experience Journal

There is increasing evidence from research studies that suggest patient-centered care has a relationship with good clinical outcomes. In Singapore, there are no studies done to assess and address the issue of patient-centered care and its association with the adolescent’s ability to manage their chronic medical condition, such as Type 1 Diabetes Mellitus. The relationship between the patient and clinicians has changed from a paternalistic form to a position which aims to foster patient-centered care. More importantly, this study aims to show the adolescent’s readiness and ability to assume a more mature role in management of their own medical condition. …

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 …

Evaluating Patient Experience At A Novel Health Service For Aboriginal And Torres Strait Islander Prisoners: A Pilot Study, Lachlan Arthur, Ana Herceg, Heidi Shukralla, Jason Payne, Julie Tongs Oam

Journal of the Australian Indigenous HealthInfoNet

Background
The Winnunga Alexander Maconochie Centre Health and Wellbeing Service (AMCHWS) is the first prison health service operated by an Aboriginal Community Controlled Health Organisation in Australia. This pilot study developed and implemented a patient experience survey to evaluate the novel model of healthcare delivered by the Winnunga AMCHWS to Aboriginal and Torres Strait Islander prisoners.

Methods
Patients accessing the Winnunga AMCHWS between February and May 2020 were invited to participate in the study. Descriptive data were analysed and compiled for demographics, patient satisfaction, patient perception of care quality, cultural safety, and patient thoughts on the Winnunga AMCHWS.

Findings
Sixteen …

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. …