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Book part
Publication date: 24 October 2019

Jennifer L. Hefner, Ann Scheck McAlearney, Nicole Spatafora and Susan D. Moffatt-Bruce

High patient satisfaction is not simply a customer service goal; it is an important dimension of quality and part of financial incentives and public reporting…

Abstract

High patient satisfaction is not simply a customer service goal; it is an important dimension of quality and part of financial incentives and public reporting requirements. However, patient experience is often siloed within health system organizational charts and considered separately from quality and safety initiatives, instead of being seen predominantly as a “customer service” initiative. Representatives from 52 health care systems across the United States completed an online survey to explore both the processes and infrastructure hospitals employ to improve patient experience, and the metrics hospitals use to assess the quality of patient experience beyond patient satisfaction survey data. When asked about performance metrics beyond satisfaction, most hospitals or systems noted other metrics of the entire patient experience such as the rate of complaints or grievances and direct feedback from patient and family advisors. Additionally, respondents suggested that a broader definition of “quality of the patient experience” may be appropriate to encompass measures of access, clinical processes, and quality of care and patient safety outcomes. Almost all respondents that we surveyed listed metrics from these less traditional categories, indicating that performance improvement within the patient experience domain in these organizations is linked with other areas of hospital performance that rely on the same metrics, such as clinical quality and patient safety.

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Structural Approaches to Address Issues in Patient Safety
Type: Book
ISBN: 978-1-83867-085-6

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Article
Publication date: 14 October 2013

Suzanne Shale

There is growing focus on the importance of attending to “patient experience” in delivery of health services, and the design of clinical quality indicators. “Patient

Abstract

Purpose

There is growing focus on the importance of attending to “patient experience” in delivery of health services, and the design of clinical quality indicators. “Patient experience” (also termed “user experience”) has been augmented by “staff” and “carer” experience in the “service experience” quality indicator for emergency care in England. But “patient experience” is a contested concept which patients, clinicians, politicians, managers and academics view differently.

Design/methodology/approach

The purpose of this paper is to examine approaches to thinking about patient experience. The author describes three key approaches to conceptualising patient experience and identify their philosophical origins, then asks what aspects of patient experience ought to be treated as key to measuring the quality of emergency care. The discussion is illustrated with extracts from a patient interview describing emergency care following placental abruption.The author demonstrates that differing purposes and differing conceptions of care direct attention to different aspects of patient experience.

Findings

Donabedian's insight was that conceptions of quality are inevitably related to conceptions of value and the author concurs, arguing that decisions about which aspects of patient experience to include in clinical quality indicators are ethical as well as technical judgements.

Practical implications

This paper is of value to those concerned with quality improvement because it clarifies the meaning of patient experience in the context of care quality measurement, and highlights the ethical implications of experiential data.

Originality/value

It is a novel synthesis of understandings of patient experience and clinical quality in emergency care.

Details

Clinical Governance: An International Journal, vol. 18 no. 4
Type: Research Article
ISSN: 1477-7274

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Article
Publication date: 8 June 2015

Virginia Minogue

“Let me back into the world” was the heart rending response by an older relative to a question about his wellbeing following a difficult period of illness and…

Abstract

Purpose

“Let me back into the world” was the heart rending response by an older relative to a question about his wellbeing following a difficult period of illness and hospitalisation. As his main carer, the author of the paper was struck, when visiting the hospital, by a small poster, on a notice board near to the entrance to the hospital ward, outlining the staff’s commitment to Compassion in Practice. Compassion in Practice was enshrined in the Compassion in Practice vision and strategy (Department of Health, NHS Commissioning Board, 2012) for building a culture of compassionate care across health and social care. A key element of the strategy was to make the values of care, compassion, courage, communication, competence and commitment, real and visible to patients and the public. The purpose of this paper is to seek to compare the values being stated with the care experience.

Design/methodology/approach

This paper records a personal perspective from a patient and their family carers of compassionate care in practice. This experience is one case study and does not seek to represent the experience of other patients and their families.

Findings

This highlights the importance of communication and demonstrates that care and compassion are human emotions and values that have to be lived in practice and are part of the interaction between patient, clinician and family. Simply believing in those core nursing values does not make them real for the patient in practice.

Originality/value

Both patient and the family carers had extensive experience of working in health and social care including the NHS. This account demonstrates the challenges of turning strategy into actions that can ultimately improve the patient experience of care.

Details

Quality in Ageing and Older Adults, vol. 16 no. 2
Type: Research Article
ISSN: 1471-7794

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Article
Publication date: 30 June 2021

Hongze Yang, Zeyu Peng, Xitong Guo and Kee-Hung Lai

The purpose of this study is to identify patient experience unique to online pharmacy services (OPS) based on the characteristics of OPS (i.e. interactivity and…

Abstract

Purpose

The purpose of this study is to identify patient experience unique to online pharmacy services (OPS) based on the characteristics of OPS (i.e. interactivity and virtuality) and to reveal how patient experience is derived from OPS and thereby enhances patient adherence from both online social support and patient experience perspectives.

Design/methodology/approach

The Stimulus-Organism-Response framework was used to conceptualize this study; both primary and secondary data for 296 validated participants were collected on a real OPS platform. A structural equation modeling approach combined with partial least squares was employed for the quantitative analysis.

Findings

Social presence and user engagement can be identified as patient experience in the OPS context; online emotional support has a stronger association with patients' social presence than it does with patients' user engagement; patients' social presence has a stronger association with their medication adherence than it does with diet adherence, while patients' user engagement has a stronger association with their diet adherence than it does with medication adherence; patients' medication knowledge negatively moderates the relationship between user engagement and diet adherence.

Originality/value

This study identifies patient experience in accordance with unique characteristics of OPS, and it reveals the nuanced underlying mechanisms by which online social support is associated with patient experience and by which patients' experience is associated with their adherence. This study enriches the literature on patient adherence, patient experience and OPS, providing insights for healthcare providers, OPS designers and policymakers.

Details

Internet Research, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1066-2243

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Article
Publication date: 24 January 2020

Pradeep Kumar

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…

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.

Details

Journal of Asia Business Studies, vol. 14 no. 2
Type: Research Article
ISSN: 1558-7894

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Article
Publication date: 25 January 2008

John Pickles, Elaine Hide and Lynne Maher

The purpose of this paper is to describe a study which aims to provide an alternative approach to clinical governance. This involves patients in redesigning services based…

Abstract

Purpose

The purpose of this paper is to describe a study which aims to provide an alternative approach to clinical governance. This involves patients in redesigning services based on their actual experiences of health services. This will be of interest to front line health care staff and public and patient involvement leads.

Design/methodology/approach

The paper illustrates Experience Based Design (EBD) as a structured, formal methodology with clearly defined roles, actions and timescales. A case study approach is used to describe the implementation of this model in a District General Hospital.

Findings

This study demonstrates how three theoretical components of good design: functionality, engineering and aesthetics can be used as a framework to improve performance, safety and governance and in addition, actual experience of the service for patients and staff.

Research limitations/implications

The case study approach used has provided a good range of learning and transferable information; however, the results are currently based on a single site.

Practical implications

The use of the EBD approach will ensure that healthcare services truly reflect the needs of patients and carers based on their specific experience. It provides a mechanism whereby patients' views contribute fully to the change process leading to safer, more effective and reliable care. This approach will require the application of the non‐clinical competencies included in the Medical Leadership Competency Framework and specific health and wellbeing dimensions in the Knowledge and Skills Framework.

Originality/value

This paper offers a new model that can be incorporated into service redesign. The model enables greater understanding of clinical governance as described by patients through narrative of their actual experiences.

Details

Clinical Governance: An International Journal, vol. 13 no. 1
Type: Research Article
ISSN: 1477-7274

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Article
Publication date: 13 August 2018

Esmat Swallmeh, Vivienne Byers and Amr Arisha

Assessing performance and quality in healthcare organisations is moving from focussing solely on clinical care measurement to considering the patient experience as…

Abstract

Purpose

Assessing performance and quality in healthcare organisations is moving from focussing solely on clinical care measurement to considering the patient experience as critical. Much patient experience research is quantitative and survey based. The purpose of this paper is to report a qualitative study gathering in-depth data in an emergency department (ED).

Design/methodology/approach

The authors used empirical data from seven focus groups to understand patient experience as participants progressed through a major teaching hospital in an Ireland ED. A convenience sampling technique was used, and 42 participants were invited to share their perceptions and outline key factors affecting their journey. A role-playing exercise was used to develop improvement themes. Data were analysed using thematic analysis and data analysis software (NVivo 10).

Findings

Capturing ED patient experience increases our understanding and process impact on the patient journey. Factors identified include information, access, assurance, responsiveness and empathy, reliability and tangibles such as surroundings, food and seating.

Research limitations/implications

Owing to the ED patient’s emergency nature, participants were recruited if triaged at levels 3–5 (Manchester Triage System). The study explored patients’ immediate rather than post hoc experiences where recollections may change over time.

Originality/value

To the authors’ knowledge, no study has examined in-depth, ED patient experience in Ireland using qualitative interviewing, obtaining critical process insights as it occurs. The potential to inform patient process improvements in Irish EDs is significant.

Details

International Journal of Health Care Quality Assurance, vol. 31 no. 7
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 3 August 2011

Brigitte S. Cypress

This qualitative phenomenological study examined the experiences of patients, their family members, and the nurses in the intensive care unit during critical illness. Five…

Abstract

This qualitative phenomenological study examined the experiences of patients, their family members, and the nurses in the intensive care unit during critical illness. Five participants from each category participated in two interviews over a period of five months. Content analysis of the interview transcripts revealed five integrating common themes, each reflecting concepts from the Roy Adaptation Model (RAM). The ICU experience among all participants is interdependence. Adaptation in the ICU integrated family as a unit, physical care/comfort, physiological care and psychosocial support, resulting in transformation.

Details

Qualitative Research Journal, vol. 11 no. 2
Type: Research Article
ISSN: 1443-9883

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Article
Publication date: 15 June 2015

Frederic Ponsignon, Andi Smart, Mike Williams and Juliet Hall

The purpose of this paper is to set out to explore how cancer patients and their carers perceive and evaluate the healthcare experience in order to develop and validate a…

Abstract

Purpose

The purpose of this paper is to set out to explore how cancer patients and their carers perceive and evaluate the healthcare experience in order to develop and validate a classification framework for experience quality in healthcare.

Design/methodology/approach

The empirical work is centred on the systematic analysis of 200 cancer patient stories published on an independent healthcare feedback web site. Using the critical incident method, the authors captured 1,351 experience quality data items. Three judges independently sorted and classified these data items.

Findings

The authors identify and describe 22 main categories and 51 sub-categories that underlie the experience quality concept in healthcare and present them in a classification framework. The framework is informed through the categorisation of direct, indirect, and independent interactions. It also suggests a relationship between experience quality and satisfaction and loyalty behaviours.

Research limitations/implications

This study provides researchers with a foundation for the further development and validation of a measurement scale for experience quality in healthcare.

Practical implications

The framework assists managers and healthcare professionals with the definition, evaluation, and improvement of the quality of the experience of patients and their carers.

Originality/value

The main contributions of this study lie in: first, a comprehensive classification framework for experience quality in healthcare; second, dimensions that extend existing health service quality models; third, dimensions that contextualise the generic concept of customer experience quality to healthcare.

Details

Journal of Service Management, vol. 26 no. 3
Type: Research Article
ISSN: 1757-5818

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Article
Publication date: 13 May 2019

Moutasem Zakkar

Patient 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.

Details

International Journal of Health Governance, vol. 24 no. 2
Type: Research Article
ISSN: 2059-4631

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