Health Policy Commons^™

Using Appreciative Inquiry As A Framework To Enhance The Patient Experience, Kerry Moorer Mba, Schawan Kunupakaphun, Elilzabeth Delgado, Matthew Moody, Christina Wolf Msn, Rn, Cnl, Karen Moore Rn, Ms, Fache, Pracha Eamranond Md, Mph

Patient Experience Journal

The following case depicts the journey of a non-profit hospital in an under-served community and its attempts to turn around suffering patient experience. The Hospital turned to the theories of Appreciative Inquiry and the power of a strengths-based approach to create a framework to support the patient experience initiatives. Hospital leadership led the formation of a Patient Experience Team to implement ten initiatives in order increase the top box score in the domain of willingness to recommend the hospital, as that was selected as a global measure of success for the overall improvement project.

Patient Experiences In Intensive Care Units: A Systematic Review, Serpil Topçu, Şule Ecevit Alpar, Bilgi Gülseven, Ayda Kebapçı

Patient Experience Journal

The aim of this systematic review is to analyze the data gathered from studies conducted to determine patient experiences in intensive care and levels of the recollection of the intensive care period that were published between December, 1998 – April, 2013. The systematic review was carried out screening of the related publications. The findings of the systematic review were studied under the following two titles: “remembering the intensive care period” and “recalled experiences” of patients. Studying 15 papers which were found suitable to the inclusion criteria of the review indicated that majority of the patients had recollection of the intensive …

Operationalizing Person-Centered Care Practices In Long-Term Care: Recommendations From A “Resident For A Day” Experience, Jennifer L. Johs-Artisensi

Patient Experience Journal

As the senior population continues to age, long-term care is positioned for growth and care recipients are demanding more person-centered care. While long-term care leaders may understand and believe in the value of person-centered care, sometimes operationalizing practices to ensure its delivery can be challenging. Using an ethnographic approach, over three years, 159 long-term care administrator-in-training practicum students each lived as a resident for 24 hours in a nursing home. Following the experience, using the Picker Institute’s framework, each participant identified and justified an Always Experience® – an optimal experience they believed should routinely occur for every long-term care resident. …

The Impact Of Provider Service Networks In Florida Medicaid Managed Care On Enrollees’ Satisfaction, Sinyoung Park, Jeffrey S. Harman, Allyson G. Hall

Patient Experience Journal

Two counties in Florida were selected as pilots in 2006 for the Medicaid Demonstration Program. In reform counties, Medicaid enrollees were required to pick a managed care plan; either a Health Maintenance Organization or a Provider Service Network (PSN). PSNs are a form of managed care that provides health care services directly through a provider or network of organizations to a defined population without an intermediary. There are two types of PSNs: Physician-based PSNs and Healthcare system-based PSNs. The objective of this study is to find the differences in enrollees’ satisfaction between two different types of PSNs. To assess the …

Maintaining Public Health Insurance Benefits: How Primary Care Clinics Help Keep Low-Income Patients Insured, Rose L. Harding, Jennifer D. Hall, Jennifer Devoe, Heather Angier, Rachel Gold, Christine Nelson, Sonja Likumahuwa-Ackman, John Heintzman, Aleksandra Sumic, Deborah J. Cohen

Patient Experience Journal

Low-income families struggle to obtain and maintain public health insurance. We identified strategies used by Community Health Centers (CHCs) to assist patients with insurance applications, and assessed patients’ receptivity to these efforts. Observational cross-case comparative study with four CHCs in Oregon. We observed insurance assistance processes, and interviewed 26 clinic staff and 18 patients/family members. Qualitative data were analyzed using a grounded theory approach. Patients’ understanding of eligibility status, reapplication schedules, and how to apply, were major barriers to insurance enrollment. Clinic staff addressed these barriers by reminding patients when applications were due, assisting with applications as needed, and tracking …

Patient Safety: Just Ask. Patients As Reporters Of Real-Time Safety Data; A Pilot Project To Improve Patient Safety In Secondary Care, Thomas A. Cairns Dr, Iain Mccallum Mr

Patient Experience Journal

The Berwick review into patient safety recommended ‘involving patients in the healthcare organisation and seeking out the patient voice as an essential asset to monitor safety.’ (1) However routine data collection from patients in our institution is retrospective and doesn't focus on safety. Our objective was to create a patient-centred mechanism to monitor patient-perceived safety concerns and provide immediate resolution of highlighted issues. A pragmatic 6-question questionnaire was developed containing 4 scored and 2 free text questions. This questionnaire was piloted and adjusted before being administered to all inpatients meeting the inclusion criteria in our institution on one day. Safety …

Patient And Provider Experiences With Relationship, Information, And Management Continuity, Jeanette Jackson, Gail Mackean, Tim Cooke, Markus Lahtinen

Patient Experience Journal

From 2003 to 2014, the Health Quality Council of Alberta (HQCA) monitored patient experiences with healthcare services through a biennial Satisfaction and Experience with Healthcare Services (SEHCS) survey. The findings consistently showed a direct link between coordination of care, an aspect of continuity of care, and healthcare outcomes. Specifically, it showed that better coordination is linked to positive outcomes; the reverse is also true. Given the critical role continuity of care plays in the healthcare system, the HQCA conducted in-depth interviews, interactive feedback sessions and focus groups with patients and providers to explore factors that influence both seamless and fragmented …

Healthcare Providers Versus Patients' Understanding Of Health Beliefs And Values, Betty M. Kennedy, Matloob Rehman, William D. Johnson, Michelle B. Magee, Robert Leonard, Peter T. Katzmarzyk

Patient Experience Journal

This study examined how well healthcare providers perceive and understand their patients’ health beliefs and values compared to patients’ actual beliefs, and to determine if communication relationships maybe improved as a result of healthcare providers’ understanding of their patients’ illness from their perspective. A total of 61 participants (7 healthcare providers and 54 patients) were enrolled in the study. Healthcare providers and patients individually completed survey instruments and each participated in a structured focus group. Healthcare provider and patient differences revealed that patients perceived greater meaning of their illness (p = 0.038), and a greater preference for partnership (p = …

Turning A Blind Eye: How Lack Of Communication With Er Nurses Nearly Cost A Patient Permanent Vision Loss, Kenneth Royal, April Kedrowicz

Patient Experience Journal

This narrative presents a case in which a patient was treated for conjunctivitis, but a breakdown in several layers of communication (between the hospital and the patient, and between hospital personnel) resulted in multiple medical errors that nearly costs the patient permanent vision loss. This real-life case underscores how simple communication errors may lead to life-altering consequences. Recommendations for improving communication to ensure similar errors do not happen to others are provided.

Rebalancing The Patient Experience: 20 Years Of A Pendulum Swing, Tiffany Christensen

Patient Experience Journal

This essay looks back at two decades of the patient experience movement. The evolution of patient experience includes moving from a belief system in which patients and families are solely the recipients of care to a model in which patients and families are co-designing treatment plans, systems and policies. This evolution has taken time and continues to evolve to this day. As the pendulum swings, we see that we have made great progress and, simultaneously, found ourselves with all new challenges to overcome.

Accelerating Patient Experience Performance: Collaboration And Engagement As Drivers For Success, Sidney Klajner

Patient Experience Journal

The efforts at Albert Einstein Jewish Hospital in São Paulo, Brazil have been focused on principles of excellence for many years as realized in engagement in and commitment to some of the leading global healthcare practices over the last decade. In reinforcing a commitment to excellence and continuous improvement, the patient experience efforts at Einstein have evolved from an operating structure for patient experience efforts to a truly integrated program for action in address all elements in the organization impacting and ultimately driving patient experience outcomes. By grounded efforts in core evidence-based practice, while engaging the hearts and minds of …

The Patchwork Perspective: A New View For Patient Experience, Jason A. Wolf Phd

Patient Experience Journal

As Patient Experience Journal has continued to contribute to the expanding patient experience conversation, we too recognize this has been a significant year of progress for the patient experience movement. This progress has emerged in a number of ways in research, practice and programs that reveal a comprehensive and integrated approach is now more than ever a central consideration in a commitment to experience. This idea of interwoven efforts, begins to frame an image – a patchwork of clear, critical and comprehensive pieces that while operating distinctly each have value, yet when bringing them together have an exponential opportunity to …

Fatigue-Related Medical Conditions Affecting Seafarers : An Exploratory Case-Study Of Indian Seafarers, Saratkumar Chembukkavu Narayanan

World Maritime University Dissertations

No abstract provided.

Reducing The Rate Of Cesarean Delivery On Maternal Request Through Institutional And Policy Interventions In Wenzhou, China, Yushan Yu, Xiangyang Zhang, Caixia Sun, Huijie Zhou, Qi Zhang, Chun Chen

Community & Environmental Health Faculty Publications

The objective of this study was to evaluate the effect of institutional and policy interventions on reducing the rate of cesarean delivery on maternal request (CDMR) in Wenzhou, China. Institutional interventions included health education, painless delivery introduction, and doula care. Additionally, a series of health policies were developed by the Chinese central and local governments to control cesarean section rates, mostly through controlling CDMR rates. We conducted a pre-/post-intervention study using 131,312 deliveries between 2006 and 2014 in three tertiary-level public hospitals in Wenzhou, China. Chi-square tests and predictive models were used to examine changes in the CDMR rate before …

An Analysis Of Media Use And Public Opinion Toward The Affordable Care Act, Matthew Cain

The Eastern Illinois University Political Science Review

The author tests a number of hypotheses regarding views of the Affordable Care Act. Using a regression model and a variety of other data sources, the author finds support for the argument that the debate was forged by partisanship and ideology, along with age.

Healthcare: What Comes Next?, William H. Lane

English Faculty Publications

Where do we go from here on healthcare?

America has been talking about fixing its fragmented and overly expensive healthcare system for quite a while now. At times, it seems as though we simply keep having the same conversation (or argument, if you prefer) over and over again without making much progress in ensuring access to affordable care to all Americans. In fact, however, some significant gains have been made. Twenty million left without insurance (our situation now) has got to be better than forty million left without (our situation a decade ago).

Gender Differences In Virologic Response After Antiretroviral Therapy In Treatment-Naïve Hiv-Infected Individuals: Results From The 550 Clinic Hiv Cohort Study., Andrea Reyes-Vega, Alejandra Loban, Kavitha Srinivasan, Stephen P. Furmanek, Conner English, Mary Bishop, Cathy Spencer, Daniel Truelove, Julio A. Ramirez, Anupama Raghuram, Paula Peyrani

Faculty and Staff Scholarship

Background

Controversy still exists regarding gender differences in virologic response between treatment-na•ve HIV-infected individuals. The objective of this study was to evaluate gender difference in virologic and immunologic response to antiretroviral therapy in treatment-na•ve HIV-infected individuals. Methods

This was a retrospective, observational study of treatment-na•ve HIV-infected individuals managed at the 550 clinic who started antiretroviral therapy (ART) between January 1st, 2010 and December 31, 2015. Patients with available viral load and CD4 counts before and one year after initiating ART were included in this study. Virologic suppression was defined as < 48 HIV-1 RNA copies/mL, and mmunologic recovery was defined as a CD4 count increase of at least 150 cells/mm3. Dichotomous variables were reported in number and percentages and analyzed using Chi-squared tests and Fisher’s exact (whichever was appropriate). Continuous variables were reported as median and interquartile range (IQR) and analyzed using Wilcox rank-sum tests. Multivariate analyses performed were logistic regressions with adjustment for other covariates. P value <0.05 was considered statistically significant. R version 3.3.2 was used for the statistical analysis. Results

A total of 70 women and 90 men were included …

Clinician-Investigator Training And The Need To Pilot New Approaches To Recruiting And Retaining This Workforce., Alison K Hall, Sherry L Mills, P Kay Lund

Neurology Faculty Publications

Clinician–investigators, also called physician–scientists, offer critical knowledge and perspectives that benefit research on basic science mechanisms, improved diagnostic and therapeutic approaches, population and outcomes medicine, health policy, and health services, yet few clinically trained health professionals pursue a research career. Sustaining this workforce requires attention to the unique challenges faced by investigators who must achieve clinical and research competence during training and their careers. These challenges include the duration of required clinical training, limited or discontinuous research opportunities, high levels of educational debt, balancing the dual obligations and rewards of clinical care and research, competition for research funding, and the …

Community Paramedicine Pilot Programs: Lessons From Maine, Karen B. Pearson Mlis, Ma, George Shaler Mph

Emergency Medical Services (EMS)

Community paramedicine programs are beginning to flourish across the nation, and the need to provide demonstration or pilot programs is essential to providing a consistent and high-level standard for this model of care. While the overarching goals are to align with the Triple Aim, piloting a community paramedicine program also allows each community to develop and implement a program tailored to the healthcare needs of their specific community. A successful program builds the evidence base that can then be used to create legislative change necessary to financially sustain this model of care across the healthcare delivery system. This article provides …

Key New Hampshire And Federal Statutes Regulating Health Care Delivery And Payment, Lucy Hodder

Law Faculty Scholarship

A summary of New Hampshire and federal regulations by subject matter, chart of New Hampshire state agency responsibilities, federal laws and regulation: An index