Health Services Research Commons^™

Nebraska Public Guardianship Of Unbefriended Patients: A Preliminary Review Of Health Outcomes And Cost Savings, Emily N. Berzonsky

Capstone Experience: Master of Public Health

Unbefriended patients often experience an extended length of stay in the hospital while their medical providers await legal appointment of a public guardian to make their medical decisions. The medically unnecessary days the unbefriended patient spends in the hospital equates to high costs for the hospital, but more importantly, negative health outcomes for the patient. The purpose of this study is to provide literature and data to support recommendations for possible changes in Nebraska’s public guardianship appointment process. A literature review seeks to answer: (1) What is the median hospital length of stay for an unbefriended patient without a guardian …

Improving Data Access And Use For Hiv Biomedical Prevention Interventions, Project Soar

HIV and AIDS

Over the past decade, biomedical prevention interventions—including voluntary medical male circumcision (VMMC) and oral pre-exposure prophylaxis (PrEP)—have resulted in substantial gains in controlling the global HIV epidemic. Despite the inclusion of these highly effective interventions in multinational strategies and global prevention toolkits, their effective implementation rests upon context-specific, data-driven delivery to priority populations and geographies. Project SOAR has contributed to the evidence base by increasing access to and use of data through user-friendly interfaces and dissemination strategies, advancing VMMC and PrEP as vital prevention interventions in the global discourse. SOAR’s biomedical prevention portfolio has supported data-driven planning, implementation, and monitoring …

Optimizing Delivery Of Hiv Testing Services To Strengthen The Continuum Of Care, Project Soar

HIV and AIDS

HIV testing is a critical entry point to life-saving antiretroviral therapy (ART) for those diagnosed with HIV and to prevention services for those at high risk of acquiring HIV. Despite advances in testing, there remain a variety of social and programmatic challenges that prevent access to HIV testing services, particularly for men and key populations. HIV program managers and policymakers are increasingly invested in understanding how best to deliver HIV testing services to different populations and to maximize health system resources at facility and community levels. Project SOAR has contributed to the evidence base and catalyzed research use by examining …

Approaches To Research Utilization And Capacity Strengthening, Project Soar

HIV and AIDS

Research plays a critical role in strengthening programming and policymaking. Donors and other stakeholders are increasingly focused on ensuring that their research investments yield positive health and development outcomes. Yet, there are many challenges in ensuring study findings are used by relevant decisionmakers to inform policies and programs. Recognizing the need to invest in research uptake efforts beyond dissemination of final findings, Project SOAR utilized an active approach to facilitating research utilization (RU) to fulfil the commitment of implementation science to promote the systematic uptake of research finding into routine practice. Project SOAR assembled and implemented a systematic and proactive …

Improving Patient Outcomes Through Innovative, Community-Based Hiv Treatment Strategies, Project Soar

HIV and AIDS

Despite the availability of life-saving treatment for HIV, several barriers prevent patient access to high-quality services. HIV program managers and policymakers have shown increasing interest in understanding how best to deliver HIV treatment to different populations and maximize health-system resources at facility and community levels. Project SOAR recognizes the key role that treatment services play in achieving UNAIDS’ 90-90-90 goals for controlling the HIV epidemic through testing, treatment, and viral suppression by 2020. Project SOAR has contributed to the evidence base and catalyzed research use by assessing innovative strategies for antiretroviral treatment (ART) delivery that support different populations in remaining …

Advances In Conceptualizing And Measuring Stigma Among People Living With Hiv, Project Soar

HIV and AIDS

Stigma, defined as the co-occurrence of labeling, stereotyping, separation, status loss, and discrimination in a context in which power is exercised, has a negative impact on the health of people living with HIV (PLHIV), contributing to psychosocial stress, coercion and violence, job loss, and social exclusion. Widely recognized as a barrier to accessing HIV care, it is paramount that programs and policies are designed to mitigate HIV-related stigma to achieve the UNAIDS’ 90-90-90 goals. Project SOAR recognizes the importance of addressing stigma to control the HIV epidemic through testing, treatment, and viral suppression. Project SOAR has contributed to the evidence …

Evaluation Of Glutaminase Expression In Prostate Adenocarcinoma And Correlation With Clinicopathologic Parameters, Zin W. Myint, Ramon C. Sun, Patrick J. Hensley, Andrew C. James, Peng Wang, Stephen E. Strup, Robert J. Mcdonald, Donglin Yan, William H. St. Clair, Derek B. Allison

Internal Medicine Faculty Publications

High Glutaminase (GLS1) expression may have prognostic implications in colorectal and breast cancers; however, high quality data for expression in prostate cancer (PCa) are lacking. The purpose of this study is to investigate the status of GLS1 expression in PCa and correlated expression levels with clinicopathologic parameters. This study was conducted in two phases: an exploratory cohort analyzing RNA-Seq data for GLS1 from The Cancer Genome Atlas (TCGA) data portal (246 PCa samples) and a GLS1 immunohistochemical protein expression cohort utilizing a tissue microarray (TMA) (154 PCa samples; 41 benign samples) for correlation with clinicopathologic parameters. In the TCGA cohort, …

Testing Of Patients First In A Real-World Setting, As A Patient Experience Accreditation Tool For Hospitals And Clinics, Carlos Bezos, Rosa M. Salazar, María Caballero

Patient Experience Journal

Many healthcare providers are developing patient experience strategies and investing in this area. Yet, patients have no means to know if a hospital is following proper patient experience standards. For this reason, it is important to certify that hospitals and clinics follow own a patient experience policy and apply patient experience standards. This is the reason why the accreditation Patients First was developed. The goal of this study is to test the accreditations’ feasibility in a real-life environment. The accreditation was tested at the Guadarrama Hospital, nearby Madrid in Spain. A mixed team between Guadarrama staff and the Institute for …

Patient And Provider Perspectives Regarding Criteria For Patient Prioritization In Two Specialized Rehabilitation Programs, Julien Déry, Angel Ruiz, François Routhier, Marie-Pierre Gagnon, André Côté, Daoud Ait-Kadi, Valérie Bélanger, Marie-Eve Lamontagne

Patient Experience Journal

To increase fairness and equity in access to rehabilitation services, a strategy emerging from the literature is patient prioritization. Selecting explicit prioritization criteria is a complex task because it is important to simultaneously consider the objectives of all stakeholders. The of this study was to compare service users’ and service providers’ perspectives regarding patient prioritization criteria in two rehabilitation programs. We conducted a multiple case study in two rehabilitation programs, i.e., a driving evaluation program and a compression garment manufacturing program. We sent a web-based survey asking two groups (patients and providers) to individually produce a set of criteria, then …

Exploring Mental Health Experience In Individuals Living With Temporomandibular Disorders, Wafaa Safour, Richard Hovey

Patient Experience Journal

Despite the evidence supporting deteriorating mental health because of temporomandibular disorders (TMDs) conditions, there is limited evidence of TMD patients' experience regarding how their mental health is affected by the disorders. As a sequence of these conditions, TMD patients suffer from physical and mental complications, not to mention the loss of food enjoyment. In this study, we aim to explore TMD patients' lived experiences who had changed their dietary habits concerning their mental health. Six participants were interviewed to answer open-ended questions during semi-structured interviews regarding their mental health experiences with TMD-related food routine changes. These interviews were held face-to-face …

Co-Production Of The Quality Of Patient-Centered Outcomes Research Partnerships Instrument For People With Mental Health Conditions, Karen L. Fortuna, Amanda Myers, Jessica Brooks, Caroline Collins-Pisano, Skyla Marceau, Sarah Pratt, Kathy Lyons, Robert Walker, Shavon Thompson, Kaycie Greene, Willie Pringle, Katina Carter

Patient Experience Journal

Mounting scientific evidence over the past decades in the field of psychiatry has shown community engagement in research produces more relevant research, increased uptake of research findings, and better clinical outcomes. Despite the need for the integration of community engagement methodologies into the scientific method, doctoral and master's level competencies in the field of psychiatry commonly do not include dedicated training or coursework on community engagement methodologies. Without appropriate training or research experience, attempts to facilitate community engagement are often ineffective and burdensome and leave stakeholders feeling disenfranchised. The goal of this study was to co-produce an instrument designed to …

Partnering With Patients To Design A Prehabilitation Program For Optimizing The Patient Experience Through General Surgery, Jacqueline Francis-Coad, Dale Edgar, Caroline E. Bulsara, Alix Barrett-Lennard, Kristine Owen, David Fletcher, Fiona Wood, Anne-Marie Hill

Patient Experience Journal

The objective of this study was to explore patients’ experiences when preparing for and undergoing general surgery at a large tertiary hospital. Findings aimed to inform the development of a prehabilitation program to empower patients to optimize their recovery and enhance their experience of general surgery. A qualitative exploratory research approach was utilized. Patients (>18 years) attending for elective general surgery between May and July 2018 were invited to participate. Four focus groups (n=18) and an interview were conducted to reach saturation. Deductive content analysis was used to map responses against theoretical determinants of health behavior change. Patients described …

The Experiences Of Rural British Columbians Accessing Surgical And Obstetrical Care, Aria Jazdarehee, Anshu Parajulee, Jude Kornelsen

Patient Experience Journal

The attrition of small volume surgical and maternity services in rural Canada over the past three decades has made access to these services especially challenging for rural citizens. While many of these closures have occurred as consequences of regionalization, a strategy to regionally centralize healthcare services, many studies investigating outcomes of regionalization have focused on costs and medical endpoints rather than the direct experiences of the rural patients affected. In this study, we aimed to understand and document the experiences of rural residents accessing procedural and maternity care both locally and away from home. This study is part of a …

Needle Phobia: How To Improve The Child's Experience During Blood Drawing, Maria D. Navarro, Helena Illera, Bonaventura Ruíz, Montserrat Naudó, Núria Serrallonga, Sonia Tordera, David Kornmehl, Lola Crevillén, Ana Bosque, David Nadal, Mercedes Jabalera

Patient Experience Journal

Pediatric diseases, pain and hospitalization have an important impact on children and their families. This is especially significant when considering common invasive procedures, such as blood drawing. The objectives of the study were to assess the experience of children and families during the blood drawing procedure and suggest methods for improvement. The study was conducted in a children’s hospital in Barcelona, Spain, between 2018 and 2020. A mix-method design or combination of qualitative and quantitative methodologies was developed. We carried out a search of the literature, a design thinking approach, and a survey. Results from the qualitative approach identified areas …

Surveying Pediatric Caregivers’ Readiness For Dyad Isolation In The Hospital During Covid-19, Shanqing Yin, Mei Zi Quek, Celestine Mun Ting Yeo, Sylvia Mun, Ronghui Li, Derrick Chan

Patient Experience Journal

The onset of any emerging outbreak is stressful for everyone. Singapore was one of many countries affected early by COVID-19. In response, many precautionary measures were quickly initiated, including the isolation of suspected COVID-19 pediatric cases, and their caregivers were isolated together with their hospitalized children as a result. Caregivers play an important role in facilitating their child’s health in the hospital. Rooming in with their children during hospitalization promotes the benefits of parental presence and reduces separation effects. However, sudden admission with strict movement restrictions poses stress to these caregivers too. This study ran a 3-part paper-based survey to …

Patients’ And Family Caregivers’ Perceptions Of Doctor-To-Doctor Advice And Electronic Referral Notifications In Alberta, Yong Li, Annabelle Wong

Patient Experience Journal

Effective communication between health professionals and patients is essential to patient safety and quality care. Primary care providers seeking specialist advice to manage patients’ conditions in the community has recently been adopted to improve timely access to specialty care and increase the efficacy of the referral process. To understand patients’ and family caregivers’ perceptions on doctor-to-doctor advice for non-urgent clinical questions and electronic referral communications with patients in Alberta, a mixed method online survey was conducted by Alberta Health Services’ Access Improvement team. A total of 1,422 patients and family caregivers living in Alberta were included in the quantitative and …

The Association Between An Established Chief Experience Officer Role And Hospital Patient Experience Scores, William Breen, Seongwon Choi, Kristina "Ria" Hearld, Stephen J. O'Connor, Edward Rafalski, Nancy Borkowski

Patient Experience Journal

The healthcare industry is currently reacting to multiple stakeholders demanding improvements to the patient experience. Some healthcare organizations are implementing new management structures, i.e., the role of Chief Experience Officer (CXO). This study statistically reviewed descriptors associated with hospitals that have and have not created and filled the role of CXO and, more importantly, measured the association between the CXO role and results of patients’ perceptions of their experience of care as measured by publicly reported Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) results. This study was conducted utilizing data gather on hospitals in three states, California, Florida, …

Safety Participation At The Direct Care Level: Results Of A Patient Questionnaire, Lenora Duhn, Nathaniel Gumapac, Jennifer Medves

Patient Experience Journal

Understanding how patients can be engaged in safety-related activities at the direct care level is of current relevance given global efforts to reduce harm in hospitals. As part of a multiphase study, including a descriptive, exploratory qualitative study (Duhn & Medves, 2018), patients were asked to respond to a brief questionnaire to quantify how they viewed their patient-reported safety participation behaviours while in hospital. This paper is a summary of those responses. The 8-item questionnaire was, in part, used to help address a secondary research question of the larger qualitative study, specifically: What behaviours do patients report in promoting their …

An Evidence-Based Tool (Pe For Ps) For Healthcare Managers To Assess Patient Engagement For Patient Safety In Healthcare Organizations, Ursulla Aho-Glele, Marie-Pascale Pomey, Maiana Regina Gomes De Sousa, Khayreddine Bouabida

Patient Experience Journal

In 1999, the Institute of Medicine had already warned that medical errors caused between 44,000 and 98,000 avoidable deaths per year in the United States. A similar situation was subsequently in 2000, documented in Canadian hospitals. According to a Canadian Patient Safety Institute report (2016), incidents in both acute and home care settings resulted in additional costs of $2.75 billion each year. Research suggests that Patient Engagement (PE) for Patient Safety (PS) can help address this issue. However, the use of PE in various strategies to promote PS has yet to be fully integrated across healthcare systems in OECD countries. …

No Visitors Allowed: How Health Systems Can Better Engage Patients’ Families During A Pandemic, Jennifer Schlimgen, Amy Frye

Patient Experience Journal

The ravages of COVID -19 and the no visitor policies that accompany it have forged a tectonic shift in the patient and family experience. This hit home for me with a recent family member health event and hospitalization, leading me to think “we HAVE to do better!” Why should hospitals and health systems care about family involvement during COVID-19?

Experience Framework

This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework).

• Access other PXJ articles related to this lens.
• Access other resources related to this lens.

The Paradoxical Injunctions Of Partnership In Care: Patient Engagement And Partnership Between Issues And Challenges, Khayreddine Bouabida, Marie-Pascale Pomey, Genevieve Cyr, Ursulla Aho-Glele, Breitner Gomes Chaves

Patient Experience Journal

Partnership in care and patient engagement is an expanding approach and tremendously promising for improving the quality of healthcare services. However, the approach could be subject to many issues and challenges of various kinds. In this paper, we develop a reflection of the challenges and issues that the approach of patient engagement and partnership in care is facing. After a brief presentation of certain key concepts of partnership in care and patient engagement, we discuss in this paper the most worthy of consideration issues that we identified and classified as follows: Political, Financial, Organizational, Clinical, and Ethical Issues. We then …

Exploring Willingness To Pay For Health Insurance And Preferences For A Benefits Package From The Perspective Of Women From Low-Income Households Of Karachi, Pakistan, Shifa Salman Habib, Shehla Zaidi

Community Health Sciences

Background: Achieving universal health coverage (UHC) and reduction in out of pocket (OOP) expenditures on health, is a critical target of the Sustainable Development Goals (SDG). In low-middle income countries, micro-health insurance (MHI) schemes have emerged as a useful financing tool for laying grounds for Universal Health Coverage. The aim of this study was to provide evidence for designing a feasible health insurance scheme targeted at urban poor, by exploring preferences for an insurance benefits package and co-payments among women from low-income households in Karachi, Pakistan.
Methods: This was a descriptive cross-sectional study, conducted using household surveys between July-August 2015. …

Musings On Patient Willingness To Pay, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

The editor-in-chief of the Journal of Patient-Centered Research and Reviews introduces an original research article published within Volume 8, Issue 2, and comments on the relative willingness-to-pay values placed on various medical tests, treatments, and cures. How do we adequately educate patients on the risk of chronic disease and inspire them to embrace advisable lifestyle changes before there is a bigger bill to balk at?

Assessing The Patient-Perceived Monetary Value Of Patient-Reported Outcome Improvement For Patients With Chronic Knee Conditions, Sarah B. Floyd, Alicia Oostdyk, Melanie Cozad, John M. Brooks, Paul Siffri, Brian Burnikel

Journal of Patient-Centered Research and Reviews

Purpose: The high cost of orthopaedic care has attracted criticism in the current value-based health care environment. The objective of this work was to assess the properties of a willingness to pay (WTP)-based approach to estimate the monetary value that patients place on health improvements in chronic knee conditions following orthopaedic treatment.

Methods: A sample of patients with a chronic knee condition were surveyed between January and May of 2018 at a large orthopaedic practice. Each patient provided their WTP for restoration to ideal knee health and completed the Single Assessment Numerical Evaluation (SANE) to describe their baseline knee state. …

Promising Flex Program Initiatives To Support Critical Access Hospitals During The Covid-19 Pandemic, Celia Jewell Rn, Mph, Sara Kahn-Troster Mph, John Gale Ms

Rural Hospitals (Flex Program)

This brief reports on promising State Flex Program (SFP) strategies to support Critical Access Hospitals during the COVID-19 pandemic. SFPs adapted existing initiatives and implemented new activities to address the emerging needs of CAHs during the pandemic. With approval from the Federal Office of Rural Health, the SFPs redirected funds and activities to address the evolving COVID-19 needs of CAHs while maintaining fidelity to Flex Program goals. Based on qualitative interviews with seven SFPs, the authors, members of the Flex Monitoring Team, discuss initiatives such as resiliency training for frontline staff; packaging and dissemination of COVID-19 information; public health messaging; …

Grant Application For The Hearts And Hands Clinic, Christine Cooper, Ariellah Ward

Eagle Showcase: Excellence in Service-Learning (Archived)

During our service-learning course on public health funding and grant writing, we had the opportunity to work at the Hearts and Hands Clinic. During the pandemic, many families lost their income and healthcare insurance. Thus, facing uncertainties about where to obtain medical care. The clinic wanted to expand its existing chronic care program to an underserved community in Evans County. Our task was to prepare a grant application for the clinic to secure the funding needed to help vulnerable adults better manage their chronic disease and prevent further complications. Engaging in this applied experience allowed us to improve our implementation …

B35: Development And Validation Of A Stability Indicating Hplc Method For Quantification Of Estriol In Compounded Glycerinated Gelatin Troches, Tayler Hutto

Annual Research Symposium

No abstract provided.

B30: Identifying New G Protein Coupled Receptor Kinase 6 Substrates Among Proteins Closely Linked To Prognoses Of Pancreatic Cancer, Christine Taing, Jelena Jovanovic, Nicole Khalil, Christopher So

Annual Research Symposium

No abstract provided.

B29: Exploring The Role Of G Protein Coupled Receptor Kinases In Modulating Behaviors To Fluoxetine Using Caenorhabditis Elegans As An Experimental Model, Victoria Pang

Annual Research Symposium

No abstract provided.

B28: Evaluating The Chemotherapeutic Effects Of The Fac Regimen In Mda Mb 231 Breast Cancer Cells With Reduced Beta Arrestin 2 Expression Levels, Angelina Marcee

Annual Research Symposium

No abstract provided.