Health Services Research Commons^™

Vision, Mission, And Values: From Concept To Execution At Mayo Clinic, Sandhya Pruthi, Dawn Marie R. Davis, Dawn L. Hucke, Francesca B. Ripple, Barbara S. Tatzel, James A. Dilling, Paula J. Santrach, Jeffrey W. Bolton, John H. Noseworthy

Patient Experience Journal

Mayo Clinic displays steadfast commitment to patient care, referral relations, and health care quality through institutional examples of unique, value-add endeavors that are under way with the Mayo Clinic Patient Experience Subcommittee and the Referring Physician Office. In this article, we share the Mayo Model of Care and patient stories that embody the 8 Mayo Clinic values of respect, compassion, integrity, healing, teamwork, excellence, innovation, and stewardship. The Mayo founders imparted to their staff the passion for patient care by encouraging a fair and just culture for its employees. This culture allows the creation, maintenance, and improvement of clinical care, …

Randomized Clinical Trial Comparing Perioperative Care For Breast Cancer Patients At A Patient Hotel Versus A General Surgical Ward, Madleen Anna Camilla Huzell, Johan Frisack, Kristina Dalberg

Patient Experience Journal

Breast cancer is the most frequent cancer among women in Europe and the US. The aim of this study was to assess whether perioperative care, for breast cancer patients, provided at a patient hotel could be an alternative to the conventional care in an ordinary surgical ward. The study focuses solely on the patients’ experience of the provided care with a primary outcome that perioperative care at the patient hotel would be valued better than care in a general ward. Prospective, randomized single centre study. Between 2010 and 2012 a total of 151 patients < 80 years and without severe comorbidities were included in the trial, whereof 76 patients were randomised to the ward group and 75 patients to the hotel group. Five patients were excluded from each group. The validated IN2005-E questionnaire was used to evaluate the patients’ experiences of the care. The response rate was high with 65 patients answering the IN2005-E in each group. No difference could be found between the two groups regarding patient characteristics, type of surgery or tumour characteristics. The patients generally perceived the quality of the provided care as high. However, in the hotel group there was a better experience of care regarding issues such as coordination, privacy, some aspects of medical information, availability and the courtesy of the nurses. For selected patients, perioperative care at a patient hotel is an appreciated alternative to care at a surgical ward.

The Comparative Impact Of Different Patient-Centered Medical Home Domains On Satisfaction Among Individuals Living With Type Ii Diabetes, Jon Mills, Allyson Hall, Rebecca Tanner, Jeffrey Harman, David L. Wood, Charles Lorbeer

Patient Experience Journal

Chronic illnesses like type 2 diabetes are costly and difficult to treat. Patient-centered medical homes (PCMH) have the potential to improve patient satisfaction in this population. However, which domains have the most impact on patient satisfaction has not been established. The aim of this study was to assess the relative strength of association between seven PCMH domains and two measures of satisfaction. Cross-sectional data were used in this observational study collected from a random sample of adults aged 18-89 with type 2 diabetes (n=1301) seen at 4 PCMHs. The Ambulatory Care Experiences Survey instrument was used to assess all measures. …

Improving Process And Enhancing Parent And Therapist Satisfaction Through A Coordinated Intake Approach, Sharla Piecowye, Devona Gibson, Janis Carscadden, Kayla Ueland, Gregory Wells, Scott Oddie

Patient Experience Journal

Recent research indicates that, in Canada, approximately one in five children entering school are not meeting age appropriate milestones in physical, social, language, or cognitive development. Even where support services are available families often face barriers in accessing these. With the goals of improving access to programs, reducing barriers and increasing consistency and efficiency, a new Coordinated Intake Approach (CIA) was developed for families accessing Children’s Rehabilitation Services. It was expected that the CIA would result in 1) parents finding the intake process more satisfactory and easier to complete, 2) therapists feeling more supported and satisfied and 3) a decrease …

Should I Stay Or Should I Go? Patient Understandings Of And Responses To Source-Isolation Practices, Mary Wyer, Rick Iedema, Christine Jorm, Gary Armstrong, Su-Yin Hor, Claire Hooker, Debra Jackson, Clarissa Hughes, Matthew V.N. O'Sullivan, Gwendolyn L. Gilbert

Patient Experience Journal

Isolation of patients, who are colonised or infected with a multidrug-resistant organism (source-isolation), is a common practice in most acute health-care settings, to prevent transmission to other patients. Efforts to improve the efficacy of source-isolation in hospitals focus on healthcare staff compliance with isolation precautions. In this article we examine patients’ awareness, understandings and observance of source-isolation practices and directives with a view to understanding better the roles patients play or could play in transmitting, or limiting transmission, of multidrug-resistant organisms (MRO). Seventeen source-isolated adult surgical patients and two relatives participated in video-reflexive ethnography and interviews. We learned that, although …

The Effect Of Soothing Sound Machines And Meditation Using Cd Players On Relaxation In Acute Care Orthopedic Patients, Barbara Ellen Bauer, Carolyn Mitchell, Erin Salmon

Patient Experience Journal

This research studied the relaxation effect in orthopedic surgical patients using guided meditation or soothing sounds (SS) machines. The study used a comparative study design to evaluate differences in the effect of SS or guided meditation on patients’ perceptions of relaxation. IRB approval was obtained prior to initiating the study. A convenience sample of orthopedic surgery patients consented to voluntarily rate their perceptions of relaxation on a 5-point Likert scale ranging from “none”, “mild”, “moderate”, “good” or “very good”. A demographic survey was used to describe the sample. The sample included 50 patients with ages ranging from 40 to 70 …

The State Of Patient Experience, Jason A. Wolf Phd

Patient Experience Journal

As the patient experience movement continues to flourish, there is greater alignment that experience encompasses all we do in healthcare – not simply a customer encounter, but how we engage people in mind, body and spirit, how we integrate the critical aspects of care from quality to safety to service and how we link the very complexities of our healthcare systems globally to provide for easy journeys for those receiving care. In sharing data from the latest study for The Beryl Institute on patient experience, the trends of this growing movement are seen as positive and a set of clear …

Book Review: Being Mortal: Illness, Medicine And What Matters In The End, Sue Sutton

Patient Experience Journal

In her review of Being Mortal: Illness, Medicine and What Matters in the End written by Atul Gawande, MD, Sue Sutton shares both the insights of Dr. Gawande and their important perspectives for person-centered experience. She reinforces that in this day of increased focus on understanding patient’s expectations and patient-focused care, Dr. Gawande compels us to learn how to have the difficult conversations about what really matters. She closes the review with a compelling quote from the author, "I never expected that among the most meaningful experiences I’d have as a doctor— and, really, as a human being— would come …

Creating And Integrating A New Patient Experience Leadership Role: A Consultative Approach For Partnering With Executive And Clinical Leaders, Denise M. Kennedy

Patient Experience Journal

Many healthcare organizations are creating new leadership roles to add subject matter expertise and structure to their patient experience improvement efforts. The patient experience field is emerging, however, so there are many questions about this role’s function and how best to structure it in the organization for maximal effectiveness.

This article explores the benefits of a consultative approach for improving the patient experience. Previous research on management consulting and the integration of new roles in established organizations is briefly reviewed. Mayo Clinic Arizona’s (MCA) comprehensive, "7-prong" service model is revisited. Developed and implemented in 2008, the model is predicated on …

Health Information Technology: A Key Ingredient Of The Patient Experience, Matthew Werder

Patient Experience Journal

In this exploration to understand the linkages of health information technology (HIT) and patient experience, a comprehensive literature search was conducted using the key words, “information technology, HIT, patient experience, patient satisfaction, and technology”, on the MEDLINE, PubMed, and EMBASE databases resulting in over 1,000 citations. Eventually, 35 of the most relevant articles were reviewed and 11 identified as key references to include in beginning to explore the question, as the transformation of healthcare continues, how can technology enable a positive return on investment to a patients’ perception of their care in an organization and how can technology impact the …

Variations In The Patients’ Hospital Care Experience By States’ Strategy For Medicaid Expansion: 2009-2013, Edmund Becker, Kenton Johnston Phd, Jaeyong Bae, Jason M. Hockenberry Phd, Ariel C. Avgar, Sandra Liu, Ira Wilson, Arnold Milstein Md, Mph

Patient Experience Journal

Our investigation evaluates the extent of differences in the patient’s hospital experience due to variations among state strategies to adopt, or not adopt, their Medicaid plans to the 2010 ACA legislation. Using ten HCAHPS measures, we analyze patient hospital experience data for the 2009 - 2013 period for all 50 states and the District of Columbia grouped by those states that (1) did not expand, (2) expanded Medicaid through Section 1115 waivers, (3) expanders early, and (4) expanded Medicaid concurrent with the new ACA legislation.

Our findings reveal that those states that opted out of Medicaid expansion typically started with …

Patient Complaints As Predictors Of Patient Safety Incidents, Helen L. Kroening, Bronwyn Kerr, James Bruce, Iain Yardley

Patient Experience Journal

Patients remain an underused resource in efforts to improve quality and safety in healthcare, despite evidence that they can provide valuable insights into the care they receive. This study aimed to establish whether high-level patient safety incidents (HLIs) were predictable from preceding complaints, enabling complaints to be used to prevent HLIs. For this study complaints received from November 2011 through June 2012 and HLI incident reports from April through September 2012 were examined. Complaints and HLIs were categorised according to location or specialty and the themes they included. Data were analysed to look for correlations between number of complaints and …

Measuring Patient Experience In A Safety Net Setting: Lessons Learned, Nina Shabbat, Katy Dobbins, Sonja Seglin, Kristin Davis

Patient Experience Journal

Safety net providers have faced barriers in administering patient experience surveys due to a lack of resources and survey expertise, but this problem has received little attention in the literature. In this manuscript, we offer lessons learned from the administration of a patient experience survey at a mid-size behavioral health care agency serving a safety net population. Specifically, we discuss resource needs, methods of increasing response rate among transient populations, methods for engaging stakeholders and clinical staff in quality improvement initiatives, and considerations for responding to setbacks and challenges dynamically. We also offer insight on the effective dissemination of results …

The Power Of Patient Ownership: The Path From Engagement To Equity, Zal Press, Dawn Richards

Patient Experience Journal

Understanding patient engagement from the lens of a person who is suffering, who is in pain and anguish, who is wracked with fear of the impact of this pain on their body, their family, their career, and their mortality, is a complex undertaking. The authors provide an important patient perspective in acknowledging and highlighting efforts to shift the conversation on experience from one about patients and families to one with patients and families. They challenge us to consider the power that can be found in creating ownership for patients and suggest it may be the one true path to moving …

Patient Experience Established: One Year Later, Geoffrey A. Silvera, Jason A. Wolf Phd

Patient Experience Journal

Scholars and administrators have long dedicated themselves to centering healthcare conversations and debates on the experiences of patients and their families. Patient experience advocates view these experiences as critical to evaluations of healthcare quality. There have been a great multitude of important contributions, yet, for decades, these calls for patient-centric care experiences and healthcare systems have been confined to the fringes of disparate health policy and reform debates. This bygone reality created a diaspora of scholars and administrators dedicated to understanding, evaluating, and improving the patient experience. This article begins to explore a coalescing around patient experience research efforts citing …

The Patient Experience Movement Moves On, Jason A. Wolf Phd

Patient Experience Journal

As we present Volume 2 of Patient Experience Journal (PXJ) we both recognize the contributions that helped launch this publication and acknowledge the work that helped build the foundation of the broader research exploration in the emerging field of patient experience. On this base of knowledge we have worked to establish a new home for expanding the exploration of new ideas and practices through this publication. The importance of building, supporting and sustaining an outlet for research in patient experience is grounded in the belief that positive patient experience is good for healthcare, it is good for the people who …

Book Review: Questioning Protocol, Barbara Lewis Mba

Patient Experience Journal

In her review of Questioning Protocol by Randi Redmond Oster, Barbara Lewis shares how this new and award winning book takes the reader on Randi Oster's harrowing journey of navigating the healthcare system while helping her teenage son’s battle with Crohn’s disease. Seventeen chapters build a chronological story of success, frustration and failure in dealing with modern medicine and a healthcare industry that may appear foreign to the outsider.

Exploring The Impact Of An Interprofessional Care Protocol On The Patient Experience And Outcomes For Seniors With Diabetes, Linda J. Mast Phd, Facmpe, Ateequr Rahman Phd, Diane Bridges Phd, Neil L. Horsley Dpm

Patient Experience Journal

Contemporary healthcare has placed intensified focus on the patient experience. Ultimately the patient experience is influenced by relationships with healthcare providers. In order to make a positive impact on patient outcomes and quality of care, the patient experience must be positive. Interprofessional collaboration is recognized as a key aspect of a culture that fosters patient-centered care and a positive patient experience. This quasi-experimental study explores the impact of interprofessional collaboration to develop a preventive services care protocol for seniors with diabetes. Patients were studied over six months using pre-test and post-test measures. Both quantitative data from clinical outcomes and qualitative …

Are We Providing Patient-Centered Care? Preferences About Paracentesis And Thoracentesis Procedures, Jeffrey H. Barsuk, Sarah E. Kozmic, Jordan Scher, Joe Feinglass, Aimee Hoyer, Diane B. Wayne

Patient Experience Journal

Procedures performed at the bedside are as safe and less expensive than Interventional Radiology (IR) procedures. Patient preferences regarding location are rarely taken into account. Therefore, in this study we compared patient satisfaction with bedside and IR paracentesis and thoracentesis procedures, and identified reasons for patient location preferences. We performed a cross-sectional survey of medical inpatients undergoing paracentesis or thoracentesis procedures at a tertiary care academic medical center. The survey had eight domains: overall experience, pain control, expertise, courtesy, bedside manner of the physician, time required, explanation of risks/benefits, comfort and privacy. Patients were also asked about their preference for …

Using A Data-Driven Organizational Improvement Model To Engage An Interdisciplinary Team In Transforming A Public Women’S Health Clinic, Kenneth J. Feldman, Molly Lopez, Morris Gagliardi

Patient Experience Journal

Gouverneur Health is the largest diagnostic and treatment center in New York State, and part of the New York City Health and Hospitals Corporation (HHC), a public benefit corporation with $6.7 billion in annual revenues. HHC is the largest municipal healthcare system in the United States serving 1.4 million patients, including more than 475,000 uninsured city residents.[1] Within Gouverneur, the Women’s Health department is committed to providing high quality services that improve patients' health and wellbeing, yet patient experience, flow, clinic access and education are in need of process improvements. To enhance patient experience and identify strategies replicable for other …

The Patient Experience Movement Moment, William Lehrman Phd, Geoffrey Silvera Mha, Jason A. Wolf Phd

Patient Experience Journal

For years, the patient experience movement has continued to gain momentum. From a novel concept, there is an emerging consensus that the patient experience is a fundamental aspect of provider quality; one that complements established clinical process and outcome measures but is neither subsumed nor secondary to them. An increasing volume of research as encouraged by publications such as Patient Experience Journal show this to be true. As the expectation of a high-quality patient experience becomes the norm, these developments have brought us to what we call the patient experience movement moment and there is little doubt that the patient …

A Gathering Place For Patient Experience Research: The Power Of Community, Jason A. Wolf Phd

Patient Experience Journal

In introducing Issue 2, we explore the power of community and its implications in shaping not only the purpose and intent of Patient Experience Journal, but of the patient experience movement itself. Community defined in this moment is simple, yet significant, the key being unity around common interest and its focus on ownership and participation. The idea of community bears great weight and has provided strong guidance and purpose for the work of experience excellence. It supports the goal of elevating the conversation, helps align the voices engaged and provides the space for listening, learning and impact.

Experience Framework …

Defining Patient Experience, Jason A. Wolf Phd, Cpxp, Victoria Niederhauser Drph, Rn, Dianne Marshburn Phd, Rn, Ne-Bc, Sherri L. Lavela Phd, Mph, Mba

Patient Experience Journal

In recent years, perceptions of performance and quality of healthcare organizations have begun to move beyond examining the provision of excellent clinical care, alone, and to consider and embrace the patient experience as an important indicator. There is a need to determine the extent to which clear and formal definitions exist, have common overarching themes, and/or have unique, but important constructs that should be considered more widely. In this article, we provide a 14-year synthesis of existing literature and other sources (2000-2014) that have been used to define patient experience. A total of 18 sources (articles or organizational websites) were …