Health Services Administration Commons^™

Is It Fair To Compare? A Patient And Family Experience Of Two Healthcare Systems And Neurosurgical Teams Within A Two-Week Period, Laura Miller Cpxp

Patient Experience Journal

As the mother of a 28-year-old son with cerebral palsy and hydrocephalus, and as a healthcare consultant focused on patient experience and professional development, I have a unique perspective and skill set. Recently he experienced symptoms that included an excruciating headache, neck pain and lethargy. Fearing his ventriculoperitoneal shunt had malfunctioned, he went to the emergency room and was later admitted on the neuro inpatient floor for a three-day hospitalization. His original shunt had been placed in 1991, and he never had an issue with until August 2018. While in the hospital, he was informed that he was no longer …

Awakening From A Medical Mystery: One Patient’S Experience Of Being Undiagnosed, Dwane Unruh

Patient Experience Journal

This personal narrative pleads for a supportive and comprehensive system or sub-system similar to that which exists for cancer patients, to deal with undiagnosed illnesses. By describing the torment of living with a debilitating illness that medicine could not easily recognize, then by contrasting this experience with my wife’s experience of the cancer care system, and by referring along the way to lessons learned many years ago from reading the works of the inciteful neurologist, Dr. Oliver Sacks, I hope to inspire the medical system to develop a separate, supportive and comprehensive system to deal with the undiagnosed. As it …

Call For Submissions Special Issue - July 2020: Patient & Family Experience In Behavioral Health, Patient Experience Journal

Patient Experience Journal

Patient Experience Journal (PXJ) is excited to announce the call for submissions for its July 2020 special issue on the topic of patient & family experience in behavioral health. With a continued focus on the critical role of behavioral health in society today and a growing recognition of the importance of experience for those in behavioral health settings, a conversation on the practices in place and the identification of evidence of efforts leading to positive outcomes will be essential expanding the experience conversation in this setting. This special issue is open to all authors conducting cutting-edge research, implementing innovative practices …

“Anyone Can Co-Design?”: A Case Study Synthesis Of Six Experience-Based Co-Design (Ebcd) Projects For Healthcare Systems Improvement In New South Wales, Australia, Tara L. Dimopoulos-Bick, Claire O'Connor, Jane Montgomery, Tracey Szanto, Marion Fisher, Violeta Sutherland, Helen Baines, Phillip Orcher, John Stubbs, Lynne Maher, Raj Verma, Victoria J. Palmer

Patient Experience Journal

Experience-based co-design (EBCD) is a quality improvement approach that is being used internationally to bring service users and health professionals together to improve healthcare experiences, systems and processes. Early evaluations and case studies of EBCD have shown promise in terms of improvements to experience and organisational processes, however challenges remain in participation around shared power and decision making, mobilisation for implementation, sustainment of improvements and measurement of outcomes. The objective of this case study was to explore the emergent issues in EBCD participation and implementation in six quality improvement projects conducted in mental health, rehabilitation, blood and bone marrow transplant, …

A Next-Day, Brief E-Survey Overcomes The Excessive Variability Seen In Cahps-Style Emergency Department Surveys So That Individual Physician Performance Can Be Assessed On A Regular Basis, Tom Scaletta, Eva Hare, Christopher Sung Lee

Patient Experience Journal

Traditional CAHPS-style emergency department (ED) surveys result in excessive variability when assessing individual physician performance. The objective of this study is to measure the variability of a brief, electronic survey (e-survey). The study team also measured the association of individual physicians to demographic data, physician and patient factors, and a physician burnout assessment tool. Data from SmartContact (SmartER, La Grange, IL) is a next-day, e-survey that takes about 30-seconds to complete. This tool was used by a hospital-employed emergency department (ED) group during calendar year 2017 across 2 EDs and 37 physicians.^1,2 Variability was estimated regarding raw patient experience …

Beneath The Surface Of Talking About Physicians: A Statistical Model Of Language For Patient Experience Comments, Taylor Turpen, Lea Matthews Md, Senem Guney Phd, Cpxp

Patient Experience Journal

This study applies natural language processing (NLP) techniques to patient experience comments. Our goal was to examine the language describing care experiences with two groups of physicians: those with scores in the top 100 and those with scores in the bottom 100 among all physicians (n=498) who received scores from patient satisfaction surveys. Our analysis showed a statistically significant difference in the language used to describe care experiences with these two distinct groups of physicians. This analysis illustrates how to apply NLP techniques in categorizing and building a statistical model for language use in order to identify meaningful language and …

The Digital Revolution Will See You Now: Transforming Patient Experience In The Digital Era, Emily Kagan Trenchard, Laura Semlies, Sven Gierlinger

Patient Experience Journal

Industry after industry has reinvented itself in response to upstart challengers and shifting consumer expectations that are the hallmarks of this new era. The same is true in healthcare, where we have weathered the introduction of the electronic medical records, patient portals and now interoperability. But to date our industry’s digital transformation has been guided largely by government regulation – leaving the design of the future of healthcare to be driven by policy makers and executed largely by IT departments. Meanwhile, most other industries have turned to a different guru for inspiration and guidance: the consumer. Northwell Health has undertaken …

Transformations In Health Information Technology And The Impact On Patient Experience, Cynthia J. Sieck Phd, Mph, Tim R. Huerta Phd, Ms

Patient Experience Journal

Changes in the way we collect and use health information, and the technology that enables these processes, have transformed the patient experience in health care. Compared to an earlier focus on using health information technology (HIT) for clinical purposes, patients are now also significant users of HIT, spurring the development of Patient-Facing Health Information Technology (PFHIT). These tools allow patients to use and interact with their health information and healthcare providers is new and transformative ways. We suggest that while these transformations have significant positive impacts, there are three important considerations which must be included as HIT continues to evolve: …

Reframing Innovation And Technology For Healthcare: A Commitment To The Human Experience, Jason A. Wolf Phd, Cpxp

Patient Experience Journal

This latest special issue of Patient Experience Journal focuses on the role of technology and innovation in patient experience. The articles included in this issue help us think about the ideas of innovation and health information technology (HIT) in some new and interesting ways. They also have us push the boundaries of what has framed what innovation and technology application look like in healthcare today. With this perspective, we explore the idea that HIT is not simply a process improvement tool; it is a means to elevate the human interactions at the heart of healthcare. Simultaneously in healthcare, innovation has …

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 …

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 …

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). …

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 …

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 …

What Older Adults Want From Their Health Care Providers, Hazel Williams-Roberts, Sylvia Abonyi, Julie Kryzanowski

Patient Experience Journal

Changing demographic trends and population needs have increased demand for chronic complex care and contributed to rising health care costs. The study sought to identify unmet health care needs of older adults and opportunities for service improvement in a high need suburban neighborhood of a prairie province. The insights provided by older adults informed the service design for a new model of integrated care in community settings. Narrative inquiry methodology was used to understand care experiences through stories. Stories of older adults’ health care journeys were elicited with semi-structured interviews. A paradigmatic approach to analysis was applied with holistic coding, …

Barriers And Enablers Of Patient And Family Centred Care In An Australian Acute Care Hospital: Perspectives Of Health Managers, Bradley Lloyd, Mark Elkins, Lesley Innes

Patient Experience Journal

The aim of this study was to identify and explore organisational barriers to, and enablers of, patient and family centred care within an Australian acute care hospital from the perspective of that hospital’s management staff. A qualitative study, incorporating purposive sampling and semi-structured interviews was undertaken in a 215-bed metropolitan acute care public hospital in Sydney, Australia. Fifteen health managers from a broad range of professional groups, including Medicine, Nursing, Allied Health and non-clinical services were interviewed. Interview data were recorded, transcribed, and analysed for key themes using the Framework Approach. The key barriers to patient and family centred care …

Improving The Patient Experience Through Patient Portals: Insights From Experienced Portal Users, Cynthia J. Sieck, Jennifer L. Hefner, Ann Scheck Mcalearney

Patient Experience Journal

Background: Patient portals have become part of the ecosystem of care as both patients and providers use them for a range of activities both individually and collaboratively. As patients and providers gain greater experience using portals, their use and needs related to portals may evolve. Objective: This study aimed to learn from experienced patient portal users to improve our understanding of their perspectives on portal use for collaboration and engagement as well as explore how using a portal influenced their experiences with primary care providers. Methods: Qualitative study involving 29 semi-structured interviews with family medicine patients from a large Academic …

Can Specific Feedback Improve Patients’ Satisfaction With Hospitalist Physicians? A Feasibility Study Using A Validated Tool To Assess Inpatient Satisfaction, Sarah E. Richards, Rachel Thompson, Steven Paulmeyer, Ashvita Garg, Sarah Malik, Kristy Carlson, Elizabeth Lyden, Jason Shiffermiller

Patient Experience Journal

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a patient satisfaction survey utilized for hospital reimbursement calculations. It is not, however, considered a valid measure of individual physician performance. The object of this study was to determine if the “Tool to Assess Inpatient Satisfaction with Care from Hospitalists” (TAISCH) instrument could be leveraged to improve patient satisfaction. A pragmatic pre/post study was conducted with adult inpatients admitted to either teaching or non-teaching general internal medicine services at a large mid-western academic medical center. TAISCH surveys were administered to patients (n=192) who were able to identify their hospitalist …

Developing The First Pan-Canadian Acute Care Patient Experiences Survey, Salima Hadibhai, Jeanie Lacroix, Kira Leeb

Patient Experience Journal

The Canadian Institute for Health Information (CIHI) in partnership with stakeholders sought to develop the first pan-Canadian patient experiences survey for inpatient care (CPES-IC). The goal was to provide a national survey standard for comparative patient experience measures to facilitate benchmarking for quality improvement. A cognitive and pilot testing study design was performed using survey data from adult inpatient care settings. Participants included the inter-jurisdictional members (IJ), survey subject matter experts and CIHI (The Group). Cognitive testing of the survey took place in three Canadian jurisdictions in English and French languages. Thirty-nine individuals participated in one-on-one interviews. During pilot testing, …

First, Do No Harm: The Patient's Experience Of Avoidable Suffering As Harm, Ashley Bauer Mha

Patient Experience Journal

Although my entire career has been spent in Patient Experience, nothing I have learned from data, evidence-based practice, or experience-based correlations, has been near as impactful as what I learned from being a patient. This article discusses my own experiences as a patient. I ask readers to consider instances of avoidable suffering as sources of harm that negatively impact patient perceptions, erode trust in care providers and healthcare delivery systems, and create barriers to engaging patients in their care. Recognizing how avoidable suffering creates harm challenges traditional views of Patient Experience as hospitality-based “soft skills” and helps to establish patient …

Elevating The Discourse On Experience In Healthcare’S Uncertain Times, Jason A. Wolf Phd, Cpxp

Patient Experience Journal

Over the last five years, we have been inspired by the breadth of contributions that have helped shape the experience landscape through PXJ as well as the reach that the conversation on patient experience has had. Both the authors and readers of PXJ reinforce that the conversation on patient experience and the human experience in healthcare is not one dominated by national intent or even policy. While for some motivation has come in some part from mandated action, for most tackling this idea in healthcare is it grounded in two core realities. The first, in healthcare at its core we …

Call For Submissions - Special Issue July 2019: The Role Of Technology And Innovation In Patient Experience, Patient Experience Journal

Patient Experience Journal

Patient Experience Journal (PXJ) is excited to announce the call for submissions for its July 2019 special issue on the topic of the role of technology in patient & family experience. A focus on technology and innovation will be essential in healthcare experience, requiring new ways of thinking and doing and the technologies and tools to ensure efficiencies, expand capacities and extend boundaries of care.

This special issue is open to all authors conducting cutting-edge research, implementing innovative practices or with powerful experiences to share around efforts in either creating or implementing technology focused on positively impacting the patient experience …

Wait Time Reality Check: The Convergence Of Process, Perception, And Expectation, Marian Hill, Lorianne Classen, Andrea Romay, Erika Diaz

Patient Experience Journal

There are few experiences as ubiquitous to patients as the experience of waiting. It is an occurrence that transcends diagnosis, is common to all demographics, and is shared across the continuum of care. The experience can be frustrating and full of ambiguity for patients and their families. Wait time and delays can lead to patients sensing a loss of control and magnify the feelings of anxiety they may already be suffering. In an effort to improve patient experience, a framework was developed to examine patient satisfaction as a function of expectations, perceptions, and reality. The process domain focused on the …

Family Experience Tracers: Patient Family Advisor Led Interviews Generating Detailed Qualitative Feedback To Influence Performance Improvement, Kathryn Taff, Sheryl Chadwick, Deejo Miller

Patient Experience Journal

Patient Family Advisors (PFAs) are integral partners in quality improvement processes at Children’s Mercy Kansas City. Mimicking Joint Commission patient tracers, the Family Experience Tracer program was created to gather perspectives from end users of care and provide valuable insights regarding the patient experience. The Patient and Family Engagement team collaborates with departmental and organizational leadership to define the scope of the tracer project and determine meaningful topics to elicit feedback from patients and families. Tracers are conducted across the continuum of care and are led by a Patient Family Advisor to establish an immediate peer relationship. Patients and families …

What Constitutes The Patient Experience Of Children? Findings From The Photo Elicitation And The Video Diary Study, Nina Karisalmi, Hanna Stenhammar, Johanna Kaipio

Patient Experience Journal

Patient experience (PX) is getting attention among researchers and healthcare service providers, but little is known about the experiences of child patients and how to explore those. This paper reports findings from a study in which two participatory research methods, photo elicitation and video diary, were applied to investigate the elements of children’s PX in the context of children’s hospital. The aim was to find out what elements constitute the PX of children aged 7–16 years. The research data were gathered in 2016–2017. Twenty-two child patients participated in the study: eight children aged between 7 and 10 in the photo …

What Medicine Can Learn From Pediatrics: A Mother's Perspective, Nancy Michaels

Patient Experience Journal

As a mother of a young adult child with Aspergers syndrome, as well as being a long-term patient myself (liver transplant in 2005), I have extensive experience in both camps. Recently my 20-year old son was admitted to a children’s hospital for a twisted colon that had to be surgically reduced. As the parent of a child with special needs and related physical health-related issues connected to him being on the autism spectrum, I was naturally very concerned about him entering a hospital (perhaps PTSD based on my own experience at moments). Surprising to me, the experience was a very …