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1 – 10 of over 6000Patient experience is a complex multidimensional phenomenon that has been linked to constructs that are also complex to conceptualize, such as patient-centeredness, patient…
Abstract
Purpose
Patient experience is a complex multidimensional phenomenon that has been linked to constructs that are also complex to conceptualize, such as patient-centeredness, patient expectations and patient satisfaction. The purpose of this paper is to shed light on the different dimensions of patient experience, including those that receive inadequate attention from policymakers such as the patient’s lived experience of illness and the impact of healthcare politics. The paper proposes a simple classification for these dimensions, which differentiates between two types of dimensions: the determinants and the manifestations of patient experience.
Design/methodology/approach
This paper uses a narrative review of the literature to explore select constructs and initiatives developed for theorizing or operationalizing patient experience. Literature topics reviewed include healthcare quality, medical anthropology, health policy, healthcare system and public health.
Findings
The paper identifies five determinants for patient experience: the experience of illness, patient’s subjective influences, quality of healthcare services, health system responsiveness and the politics of healthcare. The paper identifies two manifestations of patient experience: patient satisfaction and patient engagement.
Originality/value
The paper proposes a classification scheme of the dimensions of patient experience and a concept map that links together heterogeneous constructs related to patient experience. The proposed classification and the concept map provide a holistic view of patient experience and help healthcare providers, quality managers and policymakers organize and focus their healthcare quality improvement endeavors on specific dimensions of patient experience while taking into consideration the other dimensions.
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This study aims to identify the dimensions of patient recovery flexibility in the public healthcare context and its impact on the service experience. The study also explores the…
Abstract
Purpose
This study aims to identify the dimensions of patient recovery flexibility in the public healthcare context and its impact on the service experience. The study also explores the strategies and contextual influences to attain patient recovery flexibility.
Design/methodology/approach
This paper uses a case study method based on a semi-structured interview with healthcare professionals, observations and informal discussions.
Findings
In the present study, several dimensions of patient recovery flexibility are reported. Different internal and external strategies to exhibit patient recovery flexibility, as well as two contextual influences, are identified. An integrative framework is developed to establish the relationship of patient recovery flexibility with service experience in public healthcare.
Research limitations/implications
The study was conducted in a public healthcare setting in India. The sample size for the semi-structured interview was limited to healthcare professionals, and the patient’s perspective is missing.
Originality/value
This paper contributes to the growing need for patient recovery flexibility as a strategy in the public healthcare delivery system. It offers new insights to address the gap in the literature regarding the linkage of patient recovery flexibility and service experience. The study provides an integrative framework of dimensions of patient recovery flexibility, strategies, contextual influences and the impact on the service experience. The framework and propositions presented in the study will guide future research that is needed in this area. This study provides an overview to shape and redesign the after-service support from a flexibility perspective in public healthcare for the improved service experience.
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Patricia Drentea, Beverly Rosa Williams, Karen Hoefer, F. Amos Bailey and Kathryn L. Burgio
Purpose: To explore how families respond to the death and dying of their loved ones in a hospital setting, archival research was conducted using eight qualitative articles…
Abstract
Purpose: To explore how families respond to the death and dying of their loved ones in a hospital setting, archival research was conducted using eight qualitative articles describing next-of-kins’ perceptions of end-of-life care in Veterans Affairs Medical Centers (VAMCs). The articles were based on the qualitative arm of the VA Health Services Research and Development (HSR&D) study entitled, “Best Practices for End-of-life Care and Comfort Care Order Sets for our Nation’s Veterans” (BEACON).
Design: The archival research consisted of an interactive methodological process of data immersion, analysis, and interpretation which resulted in the emergence of two overarching thematic frameworks called “losing control” and “holding on.”
Findings: “Losing control” is the process that occurs when the patient experiences a cascading sequence of deleterious biological events and situations rendering the caregiver no longer able to direct the timing or setting of the dying trajectory. The notion of “holding on” captures family member’s responses to the need to maintain control after relinquishing the patient’s care to the institutional setting. During the patient’s hospitalization, the dual dynamics of “losing control” and “holding on” unfolded in the spatial, temporal, and life narrative domains.
Originality: The findings not only contribute to better overall understanding of family members’ responses to death in the pre-COVID-19 hospital setting but also heighten the awareness of the complex spatial, temporal, and narrative issues faced by family members who lost a hospitalized loved one during the COVID-19 pandemic.
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Dawn Connolly and Fiona Wright
The purpose of this paper is to develop a nursing quality indicator (NQI) framework and provide a comprehensive reporting mechanism for nursing care.
Abstract
Purpose
The purpose of this paper is to develop a nursing quality indicator (NQI) framework and provide a comprehensive reporting mechanism for nursing care.
Design/methodology/approach
Mixed method, including patient records audit, patient experience questionnaire, nurse self-report questionnaire and collecting ward-level information. The sample was 53 patients and 22 nurses.
Findings
Outputs from the NQI framework domains offer a more comprehensive understanding of nursing quality compared to when domains are analysed separately. The NQI framework also provides a more inclusive mechanism for assuring nursing care.
Research limitations/implications
Sample size was limited to 53 English-speaking patients who consented to participating in the study.
Originality/value
One design strength was the ability to describe individual patient care across the four domains and subsequently show relationships between nursing knowledge, nursing interventions and patient outcomes/experiences. Additionally, corroborated information from three sources (documentation review, patient and nurse responses) strengthened the conclusion that the NQI framework could provide more comprehensive assurances on nursing quality and identify care improvements.
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Olivia Mendoza, Anupam Thakur, Ullanda Niel, Kendra Thomson, Yona Lunsky and Nicole Bobbette
This study aims to describe patients presented in an interprofessional, virtual education program focused on the mental health of adults with intellectual and developmental…
Abstract
Purpose
This study aims to describe patients presented in an interprofessional, virtual education program focused on the mental health of adults with intellectual and developmental disabilities (IDD), as well as present interprofessional recommendations for care.
Design/methodology/approach
In this retrospective chart review, descriptive statistics were used to describe patients. Content analysis was used to analyze interprofessional recommendations. The authors used the H.E.L.P. (health, environment, lived experience and psychiatric disorder) framework to conceptualize and analyze the interprofessional recommendations.
Findings
Themes related to the needs of adults with IDD are presented according to the H.E.L.P. framework. Taking a team-based approach to care, as well as ensuring care provider knowledge of health and social histories, may help better tailor care.
Originality/value
This project draws on knowledge presented in a national interprofessional and intersectoral educational initiative, the first in Canada to focus on this population.
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Quinton Nottingham, Dana M. Johnson and Roberta Russell
Pressure from competition; inflexible third-party reimbursements; greater demand from government, regulatory and certifying agencies; discerning patients; and the quest of…
Abstract
Purpose
Pressure from competition; inflexible third-party reimbursements; greater demand from government, regulatory and certifying agencies; discerning patients; and the quest of healthcare entities for greater profitably place demands and high expectations for service quality impacting overall patient experience. Extending a prior multivariate, single-period model of varied medical practices predicting patient experience to a three-year time period to understand whether there was a change in overall assessment using data analytics. The paper aims to discuss these issues.
Design/methodology/approach
SEM was employed on a per year and aggregated, three-year basis to gain insights into qualitative psychometric constructs predicting overall patient experience and strength of the relationships.
Findings
Statistically significant differences were uncovered between years indicating the strength of the relationships of latent variables on overall performance.
Research limitations/implications
Study focused on data gathered from a questionnaire mailed to patients who visited various outpatient medical clinics in a rural community with over 4,000 responses during the three-year study period. A higher percentage of female respondents over the age of 45 may limit the generalizability of the findings.
Practical implications
Practitioners can gain a broader understanding of different factors influencing overall patient experience. Administrative processes associated with the primary care provider are inconsequential. Patients are not as concerned with patient flow as they are with patient safety and health.
Originality/value
This research informs healthcare quality management of psychometrics and analytics to improve the overall patient experience in outpatient medical clinics.
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Purpose: The Internet provides patients easy access to scientific information originally, limited to medical professionals. However, this information may not be entirely relevant…
Abstract
Purpose: The Internet provides patients easy access to scientific information originally, limited to medical professionals. However, this information may not be entirely relevant to the patient’s context. Therefore, doctor–patient conversations need to contextualize this information to the specific circumstances of the patient’s illness. A problem exists insofar as this conversation may not always meet the patient’s expectations. Interpersonal competence, an important aspect of emotional intelligence, is therefore critical for medical practice in the digital era. “Medicine” is viewed as a “masculine” profession requiring competence, while compassion as “feminine”. Gender stereotyped socialization prescribes gender - congruent emotional display norms for men and women thereby, influencing both gender behavior and emotions. Psychological androgyny is the coexistence of masculine and feminine behavior traits in the same individual irrespective of biological sex. This leads to responses, which are appropriate for situations irrespective of biological sex, rather than gender-stereotyped behaviour. In this study, I explored the role of gender personality and interpersonal competence in doctor–patient interaction.
Design/ methodology/approach: Sixty Indian doctors across different specializations completed the self-report format of emotional intelligence appraisal (Emotional Intelligence Appraisal-EIA) as measure of interpersonal competence and Bem’s Sex role Inventory (BSRI) as a measure of psychological androgyny.
Findings: Psychologically androgynous doctors scored significantly higher on interpersonal competence than non-androgynous doctors.
Practical implication: Since both male and female doctors undergo similar training, there is a need to explore in greater depth the nature of the relationship between androgynous gender behaviors in doctors and corresponding interpersonal competence correlates, to understand their impact on patient care and healthcare related outcomes for both patients and doctors. This is especially critical because, in addition to increasing incidents of violence against doctors in Internet-empowered world, previous research also points to varying patient outcomes and legal complications based on biological sex of doctors.
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Oti Amankwah, Weng Wai Choong, Naana Amakie Boakye-Agyeman and Ebenezer Afrane
Patient-centred strategies should be applied in health-care facilities management (HcFM) to guarantee service quality to meet patients’ needs and ensure quality patient…
Abstract
Purpose
Patient-centred strategies should be applied in health-care facilities management (HcFM) to guarantee service quality to meet patients’ needs and ensure quality patient health-care experience. This paper aims to examine the intervening influence of the quality of health-care administrative process (QAP) on the association between health-care facilities service quality and patients’ experiences with medical care.
Design/methodology/approach
A quantitative technique was used for this cross-sectional study in three Ghanaian teaching hospitals. A total of 622 relevant questionnaires were used for the analysis of the study using SEM-PLS.
Findings
The intervening influence of the QAP on the relationship between HcFM service quality (empathy and tangibility) and patients’ health-care experience (PHcE) were reinforced whilst that of reliability, responsiveness and assurance were not reinforced. The association between the QAP and PHcE was also established.
Research limitations/implications
A high-quality health-care workforce (both core and supporting) and quality work environment provided by the FM department and QAP are essential during quality-of-care delivery, to reduce threats to patient safety to achieve exceptional PHcE. The constraint on the study is that information was gathered from only Ghana. Hence, the generalisation of the findings will be a challenge. Thus, in future, it is proposed that a comparative study across a developed country and a developing country can be conducted. Future research can assess the influence of the health-care internal appearance on patients’ satisfaction.
Practical implications
Practically, the administrative system can be improved by reducing patients overall waiting time. Steps must also be taken to reduce the problem of needless administrative tasks and practices to simplify administrative practices and improve patients’ total health-care experience (core health-care delivery and HcFM), as this influence patients’ total health-care experience.
Originality/value
To the best of the authors’ knowledge, this empirical validation is one of the initial studies in service quality and FM to examine how health-care administrative process quality affects the relationship between FM service quality and patients’ experiences with medical care. This framework can be adapted for research in different countries to extend knowledge.
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Denise C. Tahara and Richard P. Green
This paper proposes an organizational change process to prepare physicians and other health professionals for their new roles in patient-centered medical homes (PCMHs). It…
Abstract
Purpose
This paper proposes an organizational change process to prepare physicians and other health professionals for their new roles in patient-centered medical homes (PCMHs). It provides physician-centered tools, models, concepts, and the language to implement transformational patient-centered medical care.
Design/methodology/approach
To improve care delivery, quality, and patient engagement, a systems approach to care is required. This paper examines a systems approach to patient care where all inputs that influence patient interactions and participation are considered in the design of health care delivery and follow-up treatment plans. Applying systems thinking, organizational change models, and team-building, we have examined the continuum of this change process from ideation through the diffusion of new methods and behaviors.
Findings
PCMHs make compelling business sense. Studies have shown that the PCMH improves patient satisfaction, clinical outcomes and reduces underuse and overuse of medical services. Patient-centered care necessitates transitioning from an adversarial to a collaborative culture. It is a transformation process predicated on strong leadership able to align an organization toward a vision of patient-centered care, creating a collaborative culture committed to health-goal achievement.
Originality/value
This paper proposes that the PCMH is a rigorous team-building transformational organizational change, a radical departure from the current hierarchical, silo-oriented, medical practice model. It requires that participants within and across health care organizations learn new skills and behaviors to achieve the anticipated quality and efficiency improvements. It is an innovative health care organization model of the future whose success is premised on teams supplanting the individual as the building block and unit of health care performance.
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In the spirit of the theme of this current volume, this chapter offers a contribution to care/user-involved research in terms of a personal experience. It is argued that while…
Abstract
In the spirit of the theme of this current volume, this chapter offers a contribution to care/user-involved research in terms of a personal experience. It is argued that while recognizing how difficult it is for patients/care users to be ‘fully informed’, they should at least be ‘adequately’ informed. Full information can be confusing, daunting, anxiety-inducing and not necessarily helpful to the patient or service user. But adequate information can reduce uncertainty, return some power and sense of control to the user and consequently improve the patient experience. This experience is reflected by a former educator of health professionals who is now a full-time service user – hence the ‘expertise’ offered comes from both sides of the engagement. The focus is on problems associated with waiting for treatment.
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