Public Health Commons^™

Nhs England Always Events® Program: Developing A National Model For Co-Production, Claire Marshall, Angela Zambeaux, Esther Ainley, David Mcnally, Jenny King Miss, Lorraine Wolfenden, Helen Lee

Patient Experience Journal

NHS England, the Institute for Healthcare Improvement, Picker and NHS Improvement started the work described in this article to strengthen how patients, carers and staff working together in co-design and co-production can make a real difference in improving experience of care. Always Events®, which is an improvement methodology for the co-design and consistent implementation of those aspects of patient experience that matter most to patients in a health care setting, was chosen. The approach has been to first test the methodology with three organizations then to spread to a substantial proportion of acute health care providers, with concurrent scale-up within …

Interprofessional Collaboration To Improve And Sustain Patient Experience Outcomes In An Ambulatory Setting, Natalie Sanchez, Kimberly Hermis

Patient Experience Journal

Patient experience is an important factor across diverse healthcare delivery settings. Despite enhanced attention to and advances in patient experience, many of the published initiatives focus on in-hospital care and opportunities have been identified to continue to strategically address patient experience in the ambulatory setting. This quality improvement initiative presents the development of an interprofessional approach to patient experience in a freestanding ambulatory oncology center. The objective of this initiative was to improve and sustain patient experience, as reflected in the Consumer Assessment of Healthcare Providers and Systems (CAHPS) scores via Press Ganey. This approach consisted of redesigning a previously …

Twelve Principles To Support Caregiver Engagement In Health Care Systems And Health Research, Kerry Kuluski, Kristina M. Kokorelias, Allie Peckham, Jodeme Goldhar, John Petrie, Carole Anne Alloway

Patient Experience Journal

Family and friend caregivers (i.e., unpaid carers) play a critical role in meeting the needs of people across various ages and illness circumstances. Caregiver experiences and expertise, which are currently overlooked, should be considered in practice (such as designing and evaluating services) and when designing and conducting research. In order to improve the quality of health care we need to understand how best to meaningfully engage caregivers in research, policy and program development to fill this important gap. Our study aimed to determine principles to support caregiver engagement in practice and research. A pan Canadian meeting brought together 48 stakeholders …

The Importance Of Physician To Physician Coaching, Medical Director And Staff Engagement And Doing “One Thing Different”, Ghazala Q. Sharieff

Patient Experience Journal

With the Center for Medicare and Medicaid Services incorporating patient experience into the Value Based Purchasing metrics, there is increasing hospital focus on improving this important aspect of patient care. The Value Based Purchasing program bases 25% of its value on the patient experience domain and is based on patient perspective as gathered via the Healthcare Consumer Assessment of Healthcare Providers and Systems survey (HCAHPS). Our system chose to implement simultaneous pilot activities to train our 6 Hospitalist groups, obtain Hospitalist medical director buy in and deliver timely physician group feedback in a transparent manner. In addition, a single hospital …

Does The Use Of Volunteers And Playbooks In Pediatric Primary Care Clinic Waiting Rooms Influence Patient Experience?, Tara Servati, Kalpana Pethe, Victoria Tiase

Patient Experience Journal

The purpose of this secondary data analysis was (1) to understand the use of a playbook as a positive distraction technique and (2) to explore the use of volunteers in the waiting room of an outpatient pediatric clinic setting. Specifically, the study examined the impact on perceived wait time, overall quality of care, and patient experience in a convenience sample of patients. Data obtained for a pilot program for improving patient experience were aggregated for exploratory analysis. Although significant differences in perceived wait time or patient experience were not found, the cohort exposed to both the playbook and volunteer intervention …

A Case Study Of The Patient Wait Experience In An Emergency Department With Therapy Dogs, Colleen A. Dell, James Stempien, Lindsey Broberg, Alicia Husband, Lacey Jurke, Betty Rohr, Jane Smith, Joseph Rubin, Susan Tupper, Donna Goodridge, Cathie Fornssler, Logan Fele-Slaferek

Patient Experience Journal

The quality of patient healthcare is a growing concern in Canada’s hospital emergency departments (ED) due to increasing wait times and associated adverse outcomes. A developing body of literature indicates that therapy dogs can positively impact the patient experience. In 2016, members of our team partnered with the Royal University Hospital (RUH) in Saskatchewan to become the first ED in Canada to integrate a visiting therapy dog to positively impact the patient wait experience. The aim of this preliminary case study was to examine if and how this unique initiative impacted patients’ feelings during their ED wait. A brief questionnaire …

The Impact Of Response Rate On Hospital Consumer Assessment Of Healthcare Providers And System (Hcahps) Dimension Scores, Erin Godden, Andrea Paseka, Jan Gnida, Joe Inguanzo

Patient Experience Journal

Patient experience measurement is receiving considerable attention from hospital executives, healthcare leaders, purchasers such as the Centers for Medicare and Medicaid Services (CMS), and patients. It is therefore appropriate and necessary to examine the methods of survey administration, and the analysis presented here seeks to understand the impact of one particular aspect of the measurement: response rate. Utilizing publicly reported HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) data from Hospital Compare, a positive correlation between response rate and HCAHPS scores nationwide was identified and replicated. This correlation, which was most recently published by the Hospital Quality Institute (HQI) …

Comparing Psychiatric Care Experiences Shared Online With Validated Questionnaires; Do They Include The Same Content?, Rebecca Baines, John Donovan, Samantha Regan De Bere, Julian Archer, Ray Jones

Patient Experience Journal

Patient feedback is considered integral to patient safety and quality of care. However, limited research has compared the content of validated questionnaires with subjective patient experiences shared online. The aim of this study was to therefore identify and compare the content of psychiatric care experiences shared online with validated questionnaires. All research was conducted in co-production with a volunteer mental-health-patient-research-partner. We analysed all reviews published on the United Kingdom’s leading health and social care feedback platform Care Opinion, between 2005-2017 that discussed adult psychiatric care and compared findings with two validated questionnaires (ACP360 and General Medical Council patient feedback questionnaire). …

“Can I Still Get A Tattoo?” Patients’ Experiences Across The Clinical Trajectory For Metastatic Melanoma: A Dynamic Narrative Model Of Patient Journey, Klay Lamprell, Melvin Chin, Jeffrey Braithwaite

Patient Experience Journal

Advanced and metastatic cancer has a complex diagnostic and management profile that places a heavy long-term burden on patients and healthcare systems. Little attention has been given to patients’ experiences across their entire clinical journey. Using a qualitative, longitudinal methodology over a ten-month period, we examined the symptom-to-outcome trajectories of seven people attending a medical oncology clinic at a large, public tertiary referral center in Sydney, Australia. Rather than care being experienced as a largely linear progression through diagnosis, treatment and onto surveillance in which life may return to ‘normal’, participants are embedded in a cyclical clinical pathway. Recurrence or …

Patient Perception Of Telephone Follow-Up After Resection For Colorectal Cancer: Is It Time For An Alternative To The Out-Patient Clinic?, Marcus Gilmartin, Nicholas Leaver, George Hall, Helena Fawdry, Seung Lee, James Nicholson, Ramya Kalaiselvan, Raj Rajaganeshan

Patient Experience Journal

The economic reality of modern healthcare provides a timely reminder to clinicians of their duty to provide outstanding and cost-effective care. Although multiple guidelines outline investigation, management and surveillance of colorectal cancer, none advocate a particular delivery method. Nurse-led telephone follow-up in multiple specialties has demonstrated equivalent clinical outcomes and patient satisfaction when compared to traditional outpatient department follow-up. This paper aims to compare nurse-led telephone and outpatient follow-up, following surgical resection of colorectal cancer (CRC), focusing on patient perceptions. This cross-sectional study distributed adapted patient satisfaction questionnaire (PS-Q 18) to patients undergoing surveillance following CRC resection via either nurse-led …

How Have Patients' Experiences Of Cancer Care Been Linked To Survival? A Systematic Review, Saleh A. Alessy, Margreet Lüchtenborg Dr, Elizabeth A. Davies Dr.

Patient Experience Journal

Patient experience of care remains an important indicator of health care quality. Although studies show care experiences are associated with health outcomes for some conditions, the situation for cancer is unclear. New datasets on cancer patients in the US, Canada, and UK linking information on experiences and survival may enable an exploration of any association. This review aimed to identify studies linking any aspect of cancer patients’ experiences to their survival, to inform future analyses. We performed a systematic review using Medline database from January 1998 until March 2018.

The settings included outpatient oncology clinics, primary care, hospitals, and cancer …

Representing The Patient Experience Of Heart Failure Through Empathy, Journey And Stakeholder Mapping, Leanna Woods, Jed Duff, Erin Roehrer, Kim Walker, Elizabeth Cummings

Patient Experience Journal

Heart failure is a long-term condition requiring those affected to manage numerous self-care related activities. People with heart failure report multiple challenges accommodating self-care activities in their every-day life. The aim of this study is to (1) understand the experience of people with heart failure and their caregivers in the local patient population, and (2) visually represent these experiences to inform the design of a mobile health intervention supporting self-care. Seven patients and four family caregivers were interviewed using an empathic approach. Data was collected using rapid design methods including an empathy map to uncover patient and caregiver perspectives and …

Using Experience-Based Design To Understand The Patient And Caregiver Experience With Delirium, Lauren Russ, Jennifer Phillips, Val Ferris, Amy London, Logan Kendall, Craig Blackmore

Patient Experience Journal

Hospital-acquired delirium negatively affects clinical outcomes and the care experience for patients and family caregivers. Following the qualitative methods of experience-based design, we completed observations of hospital units and interviews of patients, caregivers (including family members and other companions), and hospital nurses and other staff regarding their experiences with delirium. In addition, we administered an experience-based design questionnaire to another 130 subjects from the same groups. Key findings included: there is a need for preparation of the patients and family caregivers for the possibility of delirium (particularly before surgery), and patients and caregivers lack understanding of delirium and its potential …

Can Doctors Improve The Patient Experience By Rearranging The Furniture And Equipment In Their Office? A Video Recorded Simulation, Moyez Jiwa, Catherine Krejany, Lee Gaedtke, Epi Kanjo, Ruthra Nagendran, Carolyn O'Shea, Iain Greenlees

Patient Experience Journal

The design of this study is a video-recorded simulated consultation. Its aim is to evaluate the effect of changing seating arrangements and stethoscope visibility on patient enablement and non-verbal behaviour. Twelve simulated consultations with six actor-patients and a ‘real’ doctor were video recorded. Either the ‘real’ doctor or actor-patient, blind to the hypothesis sat in large executive office chair during the consult. The patient entered the room afresh for each consult. Consultation quality and outcomes were independently evaluated on three measures: The Patient Enablement Index (PEI), the Leicester Assessment Package (LAP); Non-Verbal Communication (NVC). Both expert reviewers were also blind …

Exploring Interventions To Increase Primary Care Providers’ Use Of Self-Management Goals, Nanci Reiland, Kathleen Fitzgerald, Mary E. Maragos

Patient Experience Journal

Accreditors, such as the Joint Commission, consider evidence of patient engagement strategies for awarding Primary Care/Patient-Centered Medical Home (PCMH) accreditation. This project explored the use of brief Motivational Interviewing (MI) training at a local county health center and evaluated the impact on the documented use of self-management goals (SMGs) for patients with diabetes and hypertension. Methods included a professional development program, including an online module, presentation, and educational materials. The goal was to increase providers’ MI knowledge and skills to better construct and document SMGs. The program impact was evaluated by chart review to determine the use of SMGs by …

Patient Participation In Medical Consultations: The Experience Of Patients From Various Ethnolinguistic Backgrounds, Rhéa Rocque, Annabel Levesque, Yvan Leanza

Patient Experience Journal

Patient participation in health care is a priority. Yet, patients’ perspective with regards to their experiences of participation is not well understood. Moreover, few studies have attempted to explore the perspective of ethnolinguistic minority patients. The objectives of this study, to explore 1) patients’ experiences of participation in medical consultations with physicians, and 2) potential variations in these experiences based on participants’ ethnolinguistic status. Using a qualitative design, 60 participants, from various ethnolinguistic background, took part in individual semi-structured interviews. A content analysis was performed to identify emerging themes. The results, five themes emerged in response to the first objective …

One Patient's Experiences And Expectations In The Healthcare System: Complicated And Critical Illness With Rare Diagnosis Described By His Advocate, Jennifer Cademartori

Patient Experience Journal

The health care business serves as a profession in the art of human illness. But unlike other businesses there is the human side, the patient experience. These patients are the “customers” receiving the care, but they, unlike customers at a retail store, are vulnerable and scared and must trust their lives in the hands of people they don’t know. The paradigm must change to reflect how the health care business is handled from the eyes of the person receiving the care from the first office visit, through the inpatient stay, to follow up visits. Patient focused training on all levels …

Reframing The Conversation On Patient Experience: Three Considerations, Jason A. Wolf Phd, Cpxp

Patient Experience Journal

In experience, every voice matters, and each of those individual voices are contributing to an ocean of ripples that are positively impacting countless lives. In experience, no one organization owns, nor should claim to own all the answers, but many contribute to the possibilities found in elevating the human experience in healthcare. In experience, when we ensure this is a true strategic focus at the heart of healthcare we will find our way to achieving all the outcomes we aspire to achieve and know are possible in healthcare. This issue helps frame that reality through contributions from around the world …

College Of Public Health News, Georgia Southern University

College of Public Health: News & Publications

• Georgia Southern: Study Identifies Sickle Cell Carrier Unmet Information Needs

• Georgia Southern: Researchers Look at Factors Associated with Autism Spectrum Disorder

Contraception Utilization Among Women, Ages 18-45, Receiving Medication Assisted Therapy For Opioid Use Disorder In Middle Tennessee, Kerry J. Ternes

DNP Projects

The prevalence of unintended pregnancy among women receiving medication assisted treatment (MAT) for opioid use disorder (OUD) exceeds 80%. While much of the existing literature has focused on the consequences of substance use in pregnancy, few have focused on the prevention of unintended pregnancy. This study explored barriers and facilitating factors impacting contraception use among women, ages 18-45, receiving MAT for OUD in Middle Tennessee. A cross-sectional survey design was used to describe the women’s sociodemographic and health characteristics; report their knowledge, attitudes, and behaviors; and to assess if these variables are associated with current use of contraception. Among survey …

Religious Coping And Christ-Centered Recovery For Women With Substance Use Disorders, Mary Beth Bever

DNP Projects

Women have unique risk factors for the development of substance use disorder (SUD), barriers to SUD treatment, and risk factors for SUD relapse that require holistic care models and provide trauma-informed care approaches that address effective coping strategies. The use of religion and spirituality has been commonplace in many SUD programs to inspire the use of positive religious coping; however, negative religious coping may also be drawn on which poses a potential harm for women with SUD. The aim of this project was to assess for a correlation in positive and negative religious coping scores and program completion rates in …

Association Between Inflammatory Potential Of Diet And Bone-Mineral Density In Korean Postmenopausal Women: Data From Fourth And Fifth Korea National Health And Nutrition Examination Surveys, Woori Na, Susan Park, Nitin Shivappa, James F. Thrasher, Mi Kyung Kim, Cheongmin Sohn

Faculty Publications

Post menopause is considered a critical period for bone-mass loss. Impaired bone metabolism during this phase can increase the risk of fractures in old age. Inflammation is a risk factor for bone health, and diet is a potential source of inflammation. However, few studies have examined the association between the dietary inflammatory index (DII^®) and bone-mineral density (BMD) in postmenopausal women in Korea. The objective of this study was to determine, by means of a Korean cross-sectional investigation, whether higher DII scores are associated with decreased BMD in postmenopausal women. To that end, the raw data from the …

Stimulation Of Heat Shock Protein 90 Chaperone Function Through Binding Of A Novobiocin Analog Ku-32, Bhaskar K. Chatterjee, Abhilash Jayaraj, Vinay Kumar, Brian Blagg, Rachel E. Davis, B Jayaram, Shashank Deep, Tapan K. Chaudhuri

Faculty Publications

Heat shock protein 90 (Hsp90) is a eukaryotic chaperone responsible for the folding and functional activation of numerous client proteins, many of which are oncoproteins. Thus, Hsp90 inhibition has been intensely pursued, resulting in the development of many potential Hsp90 inhibitors, not all of which are well-characterized. Hsp90 inhibitors not only abrogate its chaperone functions, but also could help us gain insight into the structure-function relationship of this chaperone. Here, using biochemical and cell-based assays along with isothermal titration calorimetry, we investigate KU-32, a derivative of the Hsp90 inhibitor novobiocin (NB), for its ability to modulate Hsp90 chaperone function. Although …

Overall Microbial Activity On Shopping Carts Handles: Relationship With Ambient Temperature, Relative Humidity, Moisture, And Ultraviolet Radiations, Grayson Rentz, Atin Adhikari

GS4 Student Scholars Symposium

Goals and Objectives: Microbial contamination in shopping cart handles were previously reported but how the microbial load in shopping cart handles vary in different seasons and its relationship with ambient temperature (T), relative humidity (RH), surface moisture, and ultraviolet radiations (UV) are largely understudied. This study aims at exploring microbial loads on shopping cart handles in three grocery stores during fall and winter and its relationship with real-time T, RH, moisture, and UV levels.

Theoretical Framework: Most of us do not realize that microbes are often present on many common stuffs outdoors. When we touch shopping cart handles by bare …

Information Seeking Behaviour And Risk Practices Among People Living With Hiv/Aids In South-West, Nigeria, Tajudeen Temitayo Adebayo

Library Philosophy and Practice (e-journal)

People living with HIV/AIDS (PLWHA) need to seek information on set of all-encompassing phenomenon which include information on medical and social packages, medication adherence, indicators of improvement, death and well-being among others. But more importantly, they need to seek information about risk practises to reduce the spread of this virus because they are the main reservoir of the HIV virus and main source of transmission. This work explored the common available sources of information seeking processes to PLWHA and some risk reduction topics.

The study adopted a survey research design which was conducted among PLWHA attending outpatient departments from four …

Differences In Tsimane Children’S Growth Outcomes And Associated Determinants As Estimated By Who Standards Vs. Within-Population References, Melanie Martin, Aaron Blackwell, Hillard Kaplan, Michael Gurven

Economics Faculty Articles and Research

Anthropometric measures are commonly converted to age stratified z-scores to examine variation in growth outcomes in mixed-age and sex samples. For many study populations, z-scores will differ if calculated from World Health Organization (WHO) growth standards or within-population references. The specific growth reference used may influence statistical estimates of growth outcomes and their determinants, with implications for biological inference. We examined factors associated with growth outcomes in a sample of 152 Tsimane children aged 0–36 months. The Tsimane are a subsistence-scale population in the Bolivian Amazon with high rates of infectious disease and growth faltering. To examine the influence of …

Improving Identification And Child-Focused Collaborative Care For Children Of Parents With A Mental Illness In Tyrol, Austria, Hanna Christiansen, Annette Bauer, Batool Fatima, Melinda Goodyear, Ingunn Olea Lund, Ingrid Zechmeister-Koss, Jean Lillian Paul

Community Health Sciences

Background: Children of parents with a mental illness (COPMI) are more likely to experience negative long-term adversities. However, interventions to support their needs early can significantly enhance adjustment and reduce negative outcomes. Approximately one in four children currently lives with a parent with mental illness worldwide. The lifelong impact for individuals, governments, and broader society is likely to be substantial. There are significant workforce barriers to the early identification of COPMI and addressing their needs, particularly within the adult mental health care system. The current study aims to reduce such barriers and to improve identification of COPMI in the current …

Case Study - The Organization And Promotion Of Health Services, Cindy Ramos Rico, Sarah Freschi

The International Undergraduate Journal For Service-Learning, Leadership, and Social Change

Our eight-week partnership took place in Cochabamba, Bolivia. Cochabamba is the third largest city in Bolivia with a population of 630,587. Our group partnered with Pro Mujer, an international microfinance organization founded in El Alto, Bolivia in 1990. Pro Mujer’s vision, as detailed on their website, is “a Latin America where all women thrive” and their mission is “to empower underserved women to achieve their full potential”. Pro Mujer empowers the women they serve through providing access to microfinance loans and communal banks, capacity-building workshops, and health services.

Latin@ Immigrants Use Of United States Medical And Health Services, Marilyn Toc

Undergraduate Research Conference

Latin@ immigrants face social and cultural barriers, which can impact use of medical/health services for this population, including language, cultural forces, and fear of deportation. The purpose of this study is to understand human and health services related behaviors among Latin@ immigrants. Spanish speaking participants reported on health information packets and medical literacy items in an anonymous survey. Medical terminology items were used to determine comprehension and knowledge of medical services concerning the Latin@ community in a Southern state. Participants reported on health behavior and utilization of services. Recommendations for policies and providers are explored.

College Of Public Health News, Georgia Southern University

College of Public Health: News & Publications

• Georgia Southern: Participates in National Study to Assess New Molecular Method That Tests for Microbial Pollution in Water

• Researchers Participte in National Study to Evaluate Performance of New USEPA Method for Monitoring Recreational Waters