Public Health Commons^™

Enhancing System-Level Quality Improvement Through Patient-Inclusive Teamwork: A Review, Shaik Mohiuddin

Patient Experience Journal

Engaging patients in quality improvement (QI) initiatives offers significant advantages, including increased patient satisfaction, improved outcomes, and the integration of creative insights from patient perspectives. This review synthesizes findings from 14 peer-reviewed articles retrieved from PubMed and Google Scholar, focusing on patient-inclusive teamwork in healthcare settings. Despite the recognized benefits, patient involvement remains limited due to cultural and professional barriers, logistical challenges, and the need for structured training programs. The review contrasts conventional provider-centered approaches with patient-centered models, emphasizing the importance of policy reform, organizational culture change, and supportive training to enhance patient engagement. Traditional QI strategies often overlook patient …

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

Patient Experience Journal

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

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

Patient Experience Journal

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

The Patient Experience Of The #Hellomynameis... Campaign And The Value Of Personalised Embroidered Student Uniforms, Julie Derbyshire, Gemma Bradley, Sasha Ban, Lianne Horscroft, Joanne Woodhead

Patient Experience Journal

Background: The #hellomynameis... campaign was an international initiative implemented to improve Person Centred Practice by increasing the number of health professionals who introduce themselves to every patient and place them at the centre of each interaction. To add to this campaign, the idea of personalised uniforms for undergraduate health care students was introduced at one University in the UK, embroidered with the #hellomynameis...logo and their name. This paper will present findings from a study that explored this initiative from the patient perspective. Methods: A case study research design was used, with semi-structured questionnaires consisting of open and closed questions to …

Communicating Effectively When Engaging People With Lived Experience In Mental Health And Substance Use Health Research: A Qualitative Descriptive Study, Lisa D. Hawke, Wuraola Dada-Phillips, Charlotte Munro, Shoshana Hauer, Claudia Sendanyoye, Yona Lunsky, Gillian Strudwick, Tanya Halsall, Natasha Y. Sheikhan

Patient Experience Journal

Background. People with lived experience of mental health and/or substance use challenges and families (PWLE/F) are increasingly engaged in research, providing positive impacts. However, effective engagement can be challenging, including ensuring effective communication. This qualitative study sought to understand the communication preferences of PWLE/F who are engaged in mental health and substance use health research. Method. A total of 18 participants (aged 19 to 79) took part in one of four focus group discussions. A semi-structured interview guide was used to facilitate the discussions. Focus group transcripts were analyzed using codebook thematic analysis. PWLE/F were engaged in all stages of …

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

Patient Experience Journal

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

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

Patient Experience Journal

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

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

Patient Experience Journal

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

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

Patient Experience Journal

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

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

Patient Experience Journal

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

Narrative Medicine Skills For End-Of-Life, Elizabeth Summerfield

Patient Experience Journal

This paper looks at the potential of applying the skills of narrative medicine to end-of-life and palliative care as a means of enabling its spiritual and existential dimensions often overlooked in clinical practice. It tells the story of a family navigating the complex problem of managing the ending of a beloved mother’s life. It reflects on how the World Medical Association’s 2022 list of essential elements of care may be enacted. Amidst the dominant daily physical regime of medication and physical care, it captures the rare, unscripted moments of meaning and purpose of a lived life. It shows why these …

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

Patient Experience Journal

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

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

Patient Experience Journal

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

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

Patient Experience Journal

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

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

Patient Experience Journal

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

Increasing Pediatric Hpv Vaccination Rates, Brooke A. Nicholas

Dissertations

Increasing Pediatric HPV Vaccination Rates

Abstract

Problem: The human papillomavirus (HPV) is a sexually transmitted infection that affects more than 80% of the population within the United States (Eisenhauer et al., 2020). HPV can develop into cervical, anogenital, and oropharyngeal cancers (Eisenhauer et al., 2020). About 4,000 individuals die from cervical cancer alone each year (O’Leary, 2022). The HPV vaccine, though recommended by the ACIP and AAP, is below national vaccination rates in comparison to other vaccines (O’Leary, 2022).

Methods: This quality improvement project is a non-randomized controlled trial that observed HPV vaccine dose completion rates for patients aged 9-14 …

N Y State Dent J November 2025

The New York State Dental Journal

In the November 2025 issue, the reader will find the following feature articles:

• "Attitudes of New York State Pediatric Dentists Toward Treating Hasidic Patients"
• "A Qualitative Assessment of the Role of Dental Specialists in U.S. Opioid Epidemic"
• "Revolutionizing Dental Operatories"
• "An Update on Non-Cigarette Nicotine-Containing Products and the Periodontal Patient"

This issue includes regular columns with regional news impacting the New York membership including: editorial and legal columns, association activities, component news, continuing education opportunities, and classifieds.

Learning From Covid-19: Clinical Trials, Health Information Technology, And Patient Mortality, Christos Nicolaides, Avinash Collis, Seth Benzell, Indranil Bardhan

Economics Faculty Articles and Research

During the COVID-19 pandemic, deaths per case in the United States decreased from 7.46% in April 2020 to 1.76% in April 2021. One mechanism that could explain this decline is a learning effect associated with testing of new treatments by hospitals. Hospitals that participated in clinical trials developed better organizational capabilities to diagnose and treat COVID-19 patients. Simultaneously, hospitals used health information technologies (IT) that integrated health information across healthcare providers to facilitate greater learning and sharing of best practices. Using US county-level data on clinical trial participation, use of health IT, and COVID-19 cases and deaths, we show that …

Effect Of Establishing A Separate Outpatient Pharmacy Counter On Reducing Waiting Time In Mayapada Hospital, Hanifan Irham, Masyitoh Basabih

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Pharmacy waiting time is one of the quality indicators that affects patient satisfaction in hospitals. One of the various efforts to reduce drug waiting times is adding outpatient pharmacies. This study aims to see whether the addition of pharmacies based on guarantors can reduce drug waiting times for outpatients. This is an observational study with a cross-sectional design. The sample included 11,703 patients who received prescriptions at Mayapada Hospital Bogor outpatient with insurance and private coverage. Data were collected over four months, two months before and two months after the separation of pharmacies. Waiting time data were obtained from the …

The Role Of The Triage Nurse Deployment In Reducing Triage Time In Emergency Department, Ristanti Karina, Masyitoh Basabih

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Emergency Departments (ED) operate under high-pressure conditions where rapid and accurate triage is essential to ensure optimal patient outcomes. This study aimed to evaluate whether the assignment of dedicated triage nurses could reduce triage procedure time in the ED. The study employed an observational cross-sectional design using secondary data extracted from the Hospital Information System (HIS) at XYZ Private Hospital, Bogor. The intervention involved assigning trained triage nurses for each shift starting in June 2024, replacing the previous practice of ad hoc triage by available nurses. The results showed a significant reduction in median triage time from 4 minutes and …

Determinant Factors Of Completeness Of Medical Resume Filling By Doctors At Pesawaran Regional General Hospital, Achmad Deza Farista, Aila Karyus, Abikusno Djamaluddin

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

A medical resume serves as a vital document that compiles essential information related to a patient’s clinical management. In 2019, the completeness rate of medical resume documentation at Pesawaran Regional General Hospital was only 37.4%. This study aimed to identify factors influencing the completeness of medical resume documentation by doctors through a quantitative, cross-sectional design involving 37 inpatient care doctors. Data were collected via questionnaires and direct observation, then analyzed using univariate, bivariate (Chi-Square), and multivariate (Logistic Regression) methods. Observation showed that 56.8% of medical resumes were incomplete. Questionnaire results indicated that 54.1% of respondents had negative perceptions of Standard …

Towards The Four-Hour Rule: Impact Of Observation Units And Emergency Medicine Specialists In An Indonesian Tertiary Hospital, Septo Sulistio, Ascobat Gani

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Emergency Department (ED) overcrowding is a global challenge. In response, the government of Indonesia mandates an ED Length of Stay (LOS) of ≤4 hours. This study aims to evaluate the impact of implementing an Emergency Department Observation Unit (EDOU) combined with an Emergency Medicine (EM) specialist-led disposition process on ED LOS at a national referral hospital in Indonesia. This was a retrospective, pre-post analysis comparing all ED visits in 2023 (pre-intervention, n = 26,282) with all visits in 2024 (post-intervention, n = 31,483). The primary outcome was the proportion of patients with an ED LOS ≤4 hours. Secondary outcomes included …

Analisis Implementasi Rekam Medis Elektronik Terhadap Kelengkapan Dokumentasi Rekam Medis, Novita Purnamasari, Adang Bachtiar

Jurnal ARSI : Administrasi Rumah Sakit Indonesia

Completeness of medical records is one of the important factors in improving the quality of health services. Despite its importance, incomplete documentation remains a prevalent issue, and the adoption of Electronic Medical Records (EMRs) is anticipated to address this challenge. This study is a narrative review and utilized the PRISMA 2020 flow diagram for literature selection. Articles were sourced from the ProQuest and Scopus databases for articles published in 2019-2024. From an initial selection of 431 articles, eight articles met the inclusion criteria for this study. The analysis of these studies shows that the implementation of electronic medical records positively …

Orthostatic Hypotension In Older Adults And Its Economic Impact On The Healthcare System: A Systematic Literature Review, Olushola E. Ilogho, Jennifer Broyles, Viet Le, Denise Rizzolo

Lynchburg Journal of Medical Science

ABSTRACT

Orthostatic Hypotension (OH) has been shown to lead to poor quality of life, falls, and death. Literature suggests that falls from OH may be preventable, therefore opportunities to reduce its associated cost to the healthcare system exist. This literature review aims to evaluate the importance of diagnosing and treating OH in older adult patients. OH is the drop in blood pressure upon changing to an upright position. This acute hemodynamic drop in blood pressure causes hypoperfusion in the brain, leading to dizziness, syncope, and falls. An extensive literature search for publications in PubMed and Cumulative Index in Nursing and …

The Home Visiting Referral Quality Improvement Initiative (Thrive) Change Package, Elizabeth Yakes Jimenez, Theresa Cruz, Rebecca Craig, Ivan De La Rosa

Population Health Research and Scholarship

Early childhood home visiting programs improve maternal and child health outcomes but remain underutilized. Healthcare providers are well-positioned to connect families to home visiting services; however, structural barriers in clinical settings limit consistent and effective referral practices. The Home Visiting Referral Quality Improvement Initiative (THRIVE) change package was developed to provide a starting point for addressing these challenges. The THRIVE change package outlines actionable improvement strategies to test, such as standardizing referral workflows, training clinical teams, and establishing relationships and feedback loops with home visiting programs. It offers a scalable approach to strengthening clinical–community linkages and improving family engagement with …

Dermatological Primary Health Care Services For Older Adults In Thailand, Chinmanat Lekhavat, Jiruth Sriratanaban

Journal of Health Research

Background: The increasing population aging worldwide poses challenges to accessibility to dermatological care, especially in rural areas with limited dermatologist availability. Establishing dermatological primary health care (PHC) services for older adults is crucial for improving access, efficiency, and equity. However, no study has systematically explored such a system.

Method: This mixed-methods study employed a participatory action research (PAR) model to identify structural and procedural requirements, patient journeys, health needs, and expectations. Data were collected through focus groups, in-depth interviews, and surveys. Design thinking workshops, guided by PAR principles, were used to develop dermatological PHC services. A survey was conducted across …

Glucometer Cleanliness On A Neuro-Medical Intensive Care Unit, Abbey Camire

Operations Transformation

Glucometers on the Neuro-Medical ICU are being docked with visible reddish/brown residue, indicating they are not properly cleaned beforehand. This poses a risk of transmitting pathogens, endangering patient and staff safety, and violates hospital policy and regulatory standards. Proper disinfection of mobile medical equipment is essential for infection control and hospital accreditation.

Investigation Of The Optimal Length Of Discharge Summaries In Care Transitions: A Cross-Sectional Study, Taku Harada, Shintaro Kosaka, Aki Morishima, Seitaro Iguchi

Journal of Community Hospital Internal Medicine Perspectives

Introduction

Discharge summaries are essential documents that support continuity of care during patient transitions between inpatient and outpatient settings. They help ensure that crucial clinical information is conveyed accurately and completely. However, while their clinical significance is well established, there is little consensus on the optimal format, particularly in terms of length and structural clarity. Excessively brief summaries may omit key details, while overly lengthy ones can hinder efficient information transfer. Despite varied suggestions in the literature—ranging from half a page to four pages—empirical data on physician preferences are limited.

Methods

We conducted a cross-sectional, web-based survey among physicians who …

Enhancing Patient Outcomes: Developing A Comprehensive Database For Tracking Post- Dural Puncture Headache Incidence And Contributing Factors, Meredith B. Auge, Brittany Bogonovich

Doctor of Nurse Anesthesia Practice (DNAP) Manuscripts

Post-dural puncture headache (PDPH) is a debilitating complication following labor analgesia, often resulting from unintentional dural puncture (UDP). While national incidence is approximately 1.5%, institutional rates may vary due to provider experience, documentation practices, and patient factors. This Doctor of Nurse Anesthesia Practice (DNAP) quality improvement project aimed to improve identification and monitoring of UDP and PDPH through a revised tracking tool, retrospective review of 2024 data, and planning for an electronic registry. A multidisciplinary team of anesthesiologists, Certified Registered Nurse Anesthetists (CRNAs), Student Registered Nurse Anesthetists (SRNAs), and IT and quality specialists revised an existing tracking tool to better …

Vitamin B12 Deficiency: Confidence, Perspectives, And Practices Among Registered Dietitian Nutritionists, Avery Miller Adams

Master's Theses

Vitamin B12 deficiency is common in the United States, occurring in 20% of adults aged 60 and above (Andres et al., 2004). Veterans are susceptible to B12 deficiency due to tobacco product usage, alcohol consumption, and poor diet quality. Megaloblastic anemia is the second most prevalent vitamin deficiency disorder recorded in military personnel from 1997 to 2015 (Knapik et al., 2021). This exploratory, analytic research aims to assess registered dietitian RDN nutritionists’ (RDN) knowledge, perceptions, and intentions regarding treating vitamin B12 deficiency in a clinical setting. Due to population prevalence differences, responses from VA and non-VA practicing registered dietitian-nutritionists (RDNs) …