Health Services Research Commons^™

Caring For Kids In The Time Of Covid-19, Laurie S. Strongin

Patient Experience Journal

The proliferation of COVID-19 has disrupted tens of millions of children’s lives. Aside from the monotony of living indoors for extended periods, being quarantined can cause feelings of helplessness, anxiety, and fear in kids and parents. These feelings are familiar to chronically ill children whose treatment often necessitates years in and out of hospitals, but COVID-19 has made life harsher for these kids. While otherwise healthy children tend to have milder symptoms than adults, the same isn’t true for kids with compromised immune systems. Keeping these children safe requires hospitals to make adjustments that exacerbate their isolation from everything they …

Getting Comfortable With Being Uncomfortable: A Conversation With Marsha Sinanan-Vasishta, Jason A. Wolf

Patient Experience Journal

We find ourselves managing two critical moments and a powerful confluence of events, one a crisis in health. We are still facing the COVID crisis, and we are trying very hard to rely on evidence and truth that will lead us forward in addressing that in the best way possible. We are also in a crisis of humanity, one that has been simmering beneath the surface for years, the issue of systemic racism and disparities in healthcare, further highlighted by the COVID crisis. This article shares the conversation I had with Marsha Sinanan-Vasishta, MSN, MBA, RN, NEA-BC, CPXP, Deputy Chief …

Leadership Matters: A Conversation With Dr. James Hildreth, Jason A. Wolf

Patient Experience Journal

I was extremely honored at this moment in the midst of our current health crisis to have a conversation with Dr. James Hildreth, president and chief executive officer of Meharry Medical College. The focus and commitment expressed by Dr. Hildreth reflects the very mission statement of Meharry Medical College itself, to advance health equity through innovative research, transformative education, exceptional and compassionate health services and policy-influencing thought leadership. As equally important is the alignment of Meharry’s purpose with our very own at the Institute, as Meharry’s mission continues to empower diverse populations to improve the well-being of humankind. Dr. Hildreth …

A Commitment To Hope, Jason A. Wolf Phd, Geoffrey A. Silvera

Patient Experience Journal

On April 1, we made the decision to reconfigure our scheduled special issue on Behavioral Health to the topic of this issue - Sustaining a Focus on Human Experience in the Face of COVID-19. In the midst of crisis, we were uncertain how people would respond to this call or even if they could in the face of the realities they were addressing each day. Yet, the research, cases and stories started to arrive. The contributions in this special issue represent a patchwork of powerful insights and a historic record to document this moment. What we have brought together …

Special Issue – July/August 2020: Sustaining A Focus On Human Experience In The Face Of Covid-19, Patient Experience Journal

Patient Experience Journal

At this critical time in our shared history, we are faced with a powerful challenge, the rapid impact of COVID-19 on our healthcare systems and community. With that acknowledgement, we are refocusing our 2020 special issue of Patient Experience Journal (PXJ) to address Sustaining a Focus on Human Experience in the Face of COVID-19. Submissions received for our initially planned special issue on patient & family experience in behavioral health will remain in review and consideration for future issues of PXJ.

There are heroic efforts taking place minute-by-minute to address the clinical and personal needs of patients, while also …

Patient Experience Journal Awards: Celebrating Our 2019 Recipients, Patient Experience Journal

Patient Experience Journal

In association with The Beryl Institute, Patient Experience Journal introduced the inaugural Patient Experience Journal (PXJ) Awards. The annual awards celebrate important contributions to the literature and articles of impact in research and practice. They also introduce groundbreaking authors who are working to expand evidence and insights on patient experience and the human experience in healthcare. The winners are selected from the articles published in PXJ and chosen by the Editorial Board of the journal. The award categories are shared and recipients introduced.

Development And Reliability Of A Patient Experience Inventory Tool For Hospitals, Agnes Barden, Nicole Giammarinaro, Natalie Bashkin, Larry Lutsky

Patient Experience Journal

This study explores the development and reliability testing of the newly developed Patient Experience Inventory for Hospitals (PXI-H). Created as an organizational self-assessment patient experience tool, it guides healthcare leaders in evaluating attitudes and behaviors as well as structures and programs impacting patient experience within a hospital setting. The PXI-H is organized within four pillars: Leadership, Education and Development, Data and Analytics and Patient-and-Family Centeredness, which were determined to be internally consistent based on examining coefficient alphas and the item-total correlations. Principal component analysis also determined items with highest loadings aligned onto the pillars in which there were assigned, confirming …

Deploying An Improvement Strategy Across A Rapidly Expanding Health System: A Framework For Repeatability And Cost-Effectiveness, Steve Meth Jd, Ms, Jan Gnida Cpxp, Karla Cardoza, Elizabeth Nikels

Patient Experience Journal

With nearly 40,000 employees and physicians spread across 14 states, a robust system was needed to engage front line teams at the point of care to meaningfully enhance patient and family communication practices in Prime Healthcare, an award-winning, community hospital system with 45 hospitals. Among its key elements, Prime’s system-wide road map for deploying relationship-centered communication tools involved identification of and investment in frontline champions, education that was synchronized with leader-deployed digital rounding, and online self-reflection modules that promoted true behavior change. This economical and easy-to-follow road map is shared for others seeking a high return on investment from their …

Implementing Inter-Professional Patient-Family Centered Plan Of Care Meetings On An Inpatient Hospital Unit, Nicolas Hernandez, Alice Fornari, Sage Rose, Leanne Tortez

Patient Experience Journal

Inpatient plan of care meetings support efforts to encourage collaborative practice and patient-family centered care and result in an effective strategy to enhance communication and patient satisfaction. Clinical team members participated in patient/family centered plan of care meetings at a community hospital in a selected inpatient unit with full time hospitalist physicians. Quantitative data were gathered pre/post implementation from the external Hospital Consumer Assessment of Health Care Providers (HCAHPS) survey. HCAHPS data were collected independently, specifically for questions related to communication between patients, family members/guardians and the medical team and also the effects of care transition. There was a slow …

Patient Education In The Hospital-At-Home Care Context, Heli Vaartio-Rajalin, Linda Nyholm, Lisbeth Fagerström

Patient Experience Journal

The objective of this study is to describe adult patients’ and their family caregivers’ experiences of patient education in the hospital-at-home care context. Methods included a cross-sectional descriptive study including three hospital-at-home units in Finland. Adult, non-palliative patients (n = 27) and their family caregivers (n = 18) were interviewed pairwise by telephone, and the data analyzed with inductive thematic content analysis. COREQ guidelines were used to plan and guide the study design. Results concluded both patients and family caregivers seemed to have quite similar knowledge expectations, which only differs slightly from findings in other in- or outpatient contexts. In …

Is There A Correlation Between The Patient-Doctor Relationship Questionnaire And Other Patient-Reported Experience Measures?, Amanda I. Gonzalez, Joost T.P. Kortlever, Léon Rijk, David Ring, Laura E. Brown, Lee M. Reichel

Patient Experience Journal

Patient reported experience measures (PREMs) can quantify the quality of the patient-clinician relationship, which is associated with adherence and improved health. However, the scales used to assess PREMs have large ceiling effects, which limits our ability to learn and improve. This study assessed the correlation of four PREMs: the patient-doctor relationship questionnaire (PDRQ), a measure of perceived empathy, a measure of satisfaction with the visit, and a measure of communication effectiveness. We also assessed ceiling effects. We prospectively enrolled 103 new and return patients in this cross-sectional study. Patients completed a demographic questionnaire, the PDRQ, Jefferson Scale of Patient Perceptions …

The Little Things: Exploring Perceptions And Experiences Of Client And Family-Centred Care Through Photovoice, Sonia Nizzer, Stacey Ryan, Sandra M. Mckay

Patient Experience Journal

Healthcare in Canada is undergoing a paradigm shift, moving away from a prescriptive approach to care delivery to one that prioritizes clients and their families at the center of their care. In the homecare sector, this approach is commonly referred to as client- and family-centred care (CFCC), a philosophy emphasizing the need for point-of-care providers to partner with those receiving care and their families in a way that is respectful and attuned to their individual needs and goals. This philosophy helps homecare agencies like VHA Home HealthCare deliver care to families that embraces what is most important to them. At …

Using Shared Mental Models To Conceptualize Patients As Professionals, Decision-Makers, Collaborators, And Members Of Interprofessional Healthcare Teams, Umair Majid

Patient Experience Journal

Patient engagement has become the buzz-phrase of 21^st Century health care. Around the world, healthcare systems involve patients in a wide range of activities including drug development, research, and policy design. There are strong institutional pressures for patient engagement in healthcare activities that have been bolstered by ethical imperatives and social and organizational benefits from patient engagement. There is a trend to center efforts to cultivate engagement initiatives that are meaningful to patients and family. However, these efforts are characterized by multiple challenges, for example, tokenism and the lack of organizational support. These barriers may persist in healthcare professionals’ …

Patient Feedback: Listening And Responding To Patient Voices, Simon J. Radmore, Kathy Eljiz, David Greenfield

Patient Experience Journal

The study aim was to identify key strategies to improve organisational systems and care experiences, to confront the challenges of achieving effective patient feedback throughout a large healthcare organisation. A mixed methods exploratory approach was used. Purposive and snowball sampling, semi-structured interviews with key stakeholders, and document analysis of existing feedback processes was utilised. The setting was a large metropolitan Local Health District in Sydney, Australia. Data was examined using thematic and content analysis. Participants identified no single feedback process was able to adequately gather all feedback necessary to reflect the patient experience. Patient feedback processes that are most useful: …

Measuring Patient-Centered Care For Specific Populations: A Necessity For Improvement, Sara C. Handley Md, Msce, Ingrid M. Nembhard Phd, Ms

Patient Experience Journal

The measurement of patient-centered care (PCC) is a fundamental component of assessing and improving health care quality. There are a variety of PCC measures available which have been tailored to different health care conditions and settings. These distinct measures are valuable given the diversity of health conditions and contexts encountered in the health care system. However, the type of patient has received significantly less attention when measuring PCC despite the multitude of unique patient populations that exist. Specific patient populations raise several core challenges for PCC measurement to which researchers and practitioners need to attend: identifying what principles to measure, …

Paying It Forward: A Cancer Survivor And His Wife Share Their Reflections And Recommendations As A Patient And Caregiver, Justin Sandler

Patient Experience Journal

I grew up in the north suburbs of Chicago and had a relatively normal childhood but not necessarily an easy one. Shortly after graduating from Indiana University, I moved out west and have been working in the entertainment industry ever since. My life has been a beautiful and interesting adventure with twists and turns I could have never predicted.

In 2016 it seemed like everything was really coming together. I had been happily married to my wife and business partner Mary Lou Sandler since 2011, and we had been growing our photography/film production studio for as many years. I was …

The Essential Nature Of Experience In A Time Of Crisis And Beyond, Jason A. Wolf

Patient Experience Journal

As we have engaged with community members around the world, the last few weeks have provided a unique window into the face of this crisis as we have seen not only the deadliest days on record, but have also had some of the most hopeful conversations at the same time. While we are and still will face challenges in the weeks to come, we too have seen humanity elevated in profound and powerful ways. While it can be offered with little argument that things will never be the same, in moving forward, we too can assert and I believe, that …

Seven Steps To Successful Change: How A Large Academic Medical Center Prepared Patients For Organizational Change, Brian Carlson, Madison Agee, Terrell Smith, Paul Sternberg Jr, Jason Morgan

Patient Experience Journal

Vanderbilt University Medical Center (VUMC) launched a new electronic health record (EHR) in a “big bang” implementation that saw the new software go live across multiple hospitals, clinics and geographic locations in a single morning. The organization rightly focused most of its energy on preparing its nearly 25,000 employees for the impacts of the transition, but it also considered the effects that would be felt by its patients and families. Survey data indicate that patient satisfaction scores demonstrably dip before, during and after an EHR implementation, and take approximately a year to recover. A team at DMC employed a seven-step …

Are You My Doctor? Utilizing Personalized Provider Cards To Improve Patient/Doctor Connections, Jessica Colyer, Tina Halley, Melissa Winter, Jennifer Coldren, Martha Parra

Patient Experience Journal

In the setting of large, multidisciplinary medical care teams, it can be difficult for patients and families to identify their primary providers in the inpatient hospital setting. A review of our institutional patient satisfaction scores reflected a low rating with respect to families identifying their provider. We sought to improve patient and family connections with front line providers using personalized provider cards. We developed trading cards with pictures and biographies of the doctors on each card as well as an explanation of provider roles. The cards were piloted on a single inpatient unit without trainees. We had great provider engagement …

Effect Of Change In The Cg Cahps Survey Instrument Recall Period On Patient Experience Scores On Healthcare Utilization, Kimberley Marshall-Aiyelawo Phd, Usn, Msc (Ret), Richard Bannick Phd, Usaf, Msc (Ret), Sharon Beamer Aud, Melissa Gliner Phd, Terry Mcdavid Ms, Daniel Muraida Phd, Janice Ellison Usaf Nursing Services (Ret), Beatrice Abiero Phd, Alan Roshwalb Phd, Mark Andrews

Patient Experience Journal

Standardized patient experience survey instruments play an important role in informing healthcare quality and process improvement. However, any changes in standardized instruments can impact the interpretation, trending, and analysis of patient reported data. This study investigates how the change in Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG CAHPS) survey recall period, from 12- to 6-months, can impact the accuracy and quality of patient experience data. This study used primary survey data on patient experience collected in 2016. Analyses included tests of proportion and t-tests for a comparison of: 1) experience ratings, and 2) administrative data to …

Volunteer Contributions In The Emergency Department: A Scoping Review, Sophie Glanz, Brittany Ellis, Shelley L. Mcleod, Cameron Thompson, Don Melady, Michelle Nelson

Patient Experience Journal

The objective of this scoping review was to identify published and unpublished reports that described volunteer programs in the emergency department (ED) and determine how these programs impacted patient experiences or outcomes. Electronic searches of Medline, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews and CINAHL were conducted and reference lists were hand-searched. A grey literature search was also conducted. Two reviewers independently screened titles and abstracts, reviewed full text articles, and extracted data. The search strategy yielded 4,589 potentially relevant citations; 87 reports were included in the review. Volunteer activities were categorized as non-clinical tasks …

Enhancing Emergency Care Environments: Supporting Suicidal Distress And Self-Harm Presentations Through Environmental Safeguards And The Built Environment, Stephanie Liddicoat

Patient Experience Journal

Self-harming and suicidal distress are prevalent, worldwide healthcare issues. Existing literature explains that both self-harm and suicidal presentations at Emergency Departments are increasingly occurring, correlating to high costs in healthcare service delivery. This scoping review aimed to (1) identify the current body of literature which examined the relationship between design practice and service user experiences within Emergency Departments for self-harm and suicidal distress presentations, and (2) identify the ways in which the built environment could increase the efficacy of therapeutic efforts through improving service user outcomes and experiences. This scoping review established that there was a paucity of research at …

Conceptual Frameworks And Degrees Of Patient Engagement In The Planning And Designing Of Health Services: A Scoping Review Of Qualitative Studies, Umair Majid, Anna Gagliardi

Patient Experience Journal

Increasingly, patients are being recognized as essential partners in the solutions to healthcare system problems. Patient engagement has been referred to as the “holy grail” and next “blockbuster drug” of health care because it may be revolutionary for transforming the design, delivery, and responsiveness of health services. Patients engage in a variety of healthcare activities, and there are multiple frameworks that depict the degrees of patient engagement in these activities. The literature also uses a variety of terms and concepts to depict the degrees of patient engagement. Moreover, meaningful patient engagement is a concept widely utilized in the literature without …

Patient-Initiated Second Opinions During Acute Hospital Care, Roni Gagin, Neta Hagani, Esti Zigelboim, Shiri Shinan-Altman

Patient Experience Journal

Second opinions are used in medicine in order to make better-informed decisions. Only a few studies have examined patient-initiated second opinions, and even fewer have examined it in the context of acute hospitalization. It is not clear whether patients and families are aware of this right and how often they exercise it during acute hospitalization. The objective of this paper is to identify factors associated with the awareness and utilization of patient-initiated second opinions. A survey was conducted among 92 neurosurgical patients who completed a questionnaire that included information regarding: awareness of second opinion consultations, reasons for not seeking a …

Using Patient Experience In Optimizing The Total Knee Arthroplasty Patient Journey, Nienke Wolterbeek, Dieuwertje J. Hiemstra, Fiona A. Van Der Hoeven, Kiem G. Auw Yang

Patient Experience Journal

Information was used to improve the patient journey and to achieve patient-centered care. Patients (>18 years, purposive sampling) were interviewed once at one point of their total knee arthrosis journey within the hospital setting. Patients were accompanied and observed during their hospital visit by one of the 19 healthcare professionals which were trained as interviewers. A qualitative research approach with in-depth and semi-structured interviews using a standardized interview guide were used to gather an in-depth understanding of the perceptions of patients. Interviews were written out with the emphasis on positive and negative feedback, quotes and observations that were made. …

Service User Interview Panels For Recruitment To Uk Child And Adolescent Mental Health Services: A Questionnaire Study Exploring The Experiences Of Young People, Staff And Candidates, Sophie M. Allan Ms, Emma Travers-Hill Dr

Patient Experience Journal

Service user involvement is increasingly important in health and social care policy, including in Child and Adolescent Mental Health Services (CAMHS), but evidence evaluating involvement initiatives is lacking. This questionnaire study evaluated the use of young people’s (YP) interview panels in the recruitment of CAMHS staff, from the perspectives of YP, candidates and members of the staff interview panels. Self-report questionnaires were administered to YP, candidates and staff interview panel. This included quantitative and qualitative “free text” responses. YP’s panels were found to be important in hearing the voices of YP; participants all stated they would like YP to take …

From Diagnosis To Routine Care In Type 1 Diabetes In Children: Parents’ Experiences, Géraldine Heilporn, Maude Laberge, André Côté, Monia Rekik

Patient Experience Journal

Having a child who lives with a Type 1 Diabetes (T1D) can represent a high burden for parents. The objective of our study is to identify and analyze the main challenges expressed by parents so that health care services better meet the needs of parents of T1D children. Semi-structured interviews were conducted with parents of 19 T1D children regarding detection and diagnosis, initial management at the hospital, post-discharge adaptation including daycare or school reintegration, and long-term T1D monitoring. Data analysis was performed following an inductive approach. The results showed a lack of knowledge regarding T1D in the society, especially for …

Refugees' Perceptions Of Primary Care: What Makes A Good Doctor's Visit?, Anne Mutitu, Bev Zabler, Jeana M. Holt

Patient Experience Journal

Redesigning primary care is a national priority, as the United States (US) struggles with issues of poor access, high cost, and suboptimal quality. Refugees are among the populations who suffer from America’s disjointed health care system, resulting in disproportionate health disparities. Although there are many studies on refugee health, few share refugees' perceptions of primary care. We asked local refugees who were seen for primary care services at a midwestern academic nurse-led clinic, what makes a good doctor's visit?  The clinic served as the hub of a federally funded refugee Community Centered Health Home (CCHH) pilot project. This qualitative study …

Engaging Under- And/Or Never-Engaged Populations In Health Services: A Systematic Review, Lesley Moody, Erica Bridge, Vidhi Thakkar, Naomi Peek, Tanvi Patel, Suman Dhanju, Simron Singh

Patient Experience Journal

Patient engagement is a mechanism used to facilitate person-centred care, however, has not been realized in all patient populations. Often, many marginalized populations still remain under- and/or never-engaged. The purpose of this systematic review was to: 1) identify methods or interventions that have been used to engage under- and/or never-engaged populations in health services and 2) identify outcomes that are associated with engaging under- and/or never-engaged populations in health services. A comprehensive search using the Ovid MEDLINE, EMBASE and CINAHL databases was conducted to examine literature between January 2002 and January 2015. Twenty-nine studies met the inclusion criteria. Data was …

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 …