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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 requirements…

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.

Details

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

Keywords

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 experience”…

1933

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

Keywords

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 hospitalisation. As…

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

Keywords

Article
Publication date: 12 July 2023

Karen Humphries, Caroline Clarke, Kate Willoughby and Jake Smithson

The purpose of this paper is to develop an understanding of the experience of secure care from the patients’ perspective.

Abstract

Purpose

The purpose of this paper is to develop an understanding of the experience of secure care from the patients’ perspective.

Design/methodology/approach

A systematic review of qualitative literature was conducted. The data was sourced from the electronic databases: PsychINFO, CINAHL, Medline and the Web of Science Core Collection using pre-defined search terms. A total of 17 studies, conducted in various countries worldwide and covering high, medium and low secure inpatient settings, were included for review. The analysis involved integrating findings from across the literature and was guided by thematic synthesis.

Findings

A total of eight themes were generated from the data, three of which provided an understanding of the experience of forensic secure care, and the remaining five themes provided an understanding of the factors which may influence the experience of secure care.

Practical implications

Developing understanding of patient experience can lead to service improvements, potentially impacting patients’ motivation and engagement and thus reducing admission times, potential recalls and recidivism.

Originality/value

To the best of the authors’ knowledge, this is the first systematic review to date to exclusively explore the broad topic of the patient experience of secure mental health care.

Details

The Journal of Forensic Practice, vol. 25 no. 4
Type: Research Article
ISSN: 2050-8794

Keywords

Article
Publication date: 14 June 2023

Amit Desai, Giulia Zoccatelli, Sara Donetto, Glenn Robert, Davina Allen, Anne Marie Rafferty and Sally Brearley

To investigate ethnographically how patient experience data, as a named category in healthcare organisations, is actively “made” through the co-creative interactions of data…

Abstract

Purpose

To investigate ethnographically how patient experience data, as a named category in healthcare organisations, is actively “made” through the co-creative interactions of data, people and meanings in English hospitals.

Design/methodology/approach

The authors draw on fieldnotes, interview recordings and transcripts produced from 13 months (2016–2017) of ethnographic research on patient experience data work at five acute English National Health Service (NHS) hospitals, including observation, chats, semi-structured interviews and documentary analysis. Research sites were selected based on performance in a national Adult Inpatient Survey, location, size, willingness to participate and research burden. Using an analytical approach inspired by actor–network theory (ANT), the authors examine how data acquired meanings and were made to act by clinical and administrative staff during a type of meeting called a “learning session” at one of the hospital study sites.

Findings

The authors found that the processes of systematisation in healthcare organisations to act on patient feedback to improve to the quality of care, and involving frontline healthcare staff and their senior managers, produced shifting understandings of what counts as “data” and how to make changes in response to it. Their interactions produced multiple definitions of “experience”, “data” and “improvement” which came to co-exist in the same systematised encounter.

Originality/value

The article's distinctive contribution is to analyse how patient experience data gain particular attributes. It suggests that healthcare organisations and researchers should recognise that acting on data in standardised ways will constantly create new definitions and possibilities of such data, escaping organisational and scholarly attempts at mastery.

Details

Journal of Organizational Ethnography, vol. 12 no. 2
Type: Research Article
ISSN: 2046-6749

Keywords

Article
Publication date: 28 November 2022

Oti Amankwah, Weng Wai Choong and Naana Amakie Boakye-Agyeman

With challenges in health-care facilities management (FM) and adequacy of health-care resources constraints in most developing countries, improving patient’s health-care experience

Abstract

Purpose

With challenges in health-care facilities management (FM) and adequacy of health-care resources constraints in most developing countries, improving patient’s health-care experience has become of strategic importance in public health-care delivery. This paper aims to investigate the mediating effect of adequacy of health-care resources on the relationship between the quality of health-care FM services and patient’s health-care experience.

Design/methodology/approach

This cross-sectional study adopts a quantitative approach based on a questionnaire survey conducted on 660 patients of three teaching hospitals in Ghana. In total, 622 valid questionnaires were used for data analysis using partial least squares structural equation modelling.

Findings

The mediating effect of adequacy of health-care resources on the relationship between responsiveness and tangibility and patients’ health-care experience were supported, while that of empathy, reliability and assurance were not supported. The relationship between and adequacy of health-care resources and patients’ health-care experience was also supported.

Research limitations/implications

The study limitation is that it was only the teaching hospitals that were surveyed. In future studies, a comparative analysis can be conducted between both public and private hospitals. Other constructs and relationships such as the mediating effect of the quality of health-care administrative process on the relationship between FM service quality and patients’ health-care experience as well as the moderation effect of adequacy of health-care resource on the relationship between FM service quality and patients’ health-care experience can also be tested. Future studies on the same subject can use health-care workers as the respondents of the study.

Practical implications

The result should inspire health-care managers to prioritize attention on health-care FM to create and sustain a decent health-care environment. Facilities managers should ensure standards are not compromised by keeping health-care resources in good condition through the organisation and management of resources.

Originality/value

To the best of the authors’ knowledge, this paper is one of the pioneer studies to test the mediating effect of adequacy of health-care resources on the relationship between patient’s health-care experience and health-care FM service quality. The proposed framework can be adapted to various sectors and countries as this empirical validation extends knowledge.

Open Access
Article
Publication date: 24 December 2021

Sabina De Rosis, Chiara Barchielli, Milena Vainieri and Nicola Bellé

User experience is key for measuring and improving the quality of services, especially in high personal and relation-intensive sectors, such as healthcare. However, evidence on…

4426

Abstract

Purpose

User experience is key for measuring and improving the quality of services, especially in high personal and relation-intensive sectors, such as healthcare. However, evidence on whether and how the organizational model of healthcare service delivery can affect the patient experience is at an early stage. This study investigates the relationship between healthcare service provision models and patient experience by focusing on the nursing care delivery.

Design/methodology/approach

65 nurses' coordinators were involved to map the nursing models adopted in the healthcare organizations of in an Italian region, Tuscany. This dataset was merged with patient experience measures reported by 9,393 individuals discharged by the same organizations and collected through a Patient-Reported Experience Measures Observatory. The authors run a series of logistic regression models to test the relationships among variables.

Findings

Patients appreciate those characteristics of care delivery related to a specific professional nurse. Having someone who is in charge of the patient, both the reference nurse and the supervisor, makes a real difference. Purely organizational features, for instance those referring to the team working, do not significantly predict an excellent experience with healthcare services.

Research limitations/implications

Different features referring to different nursing models make the difference in producing an excellent user experience with the service.

Practical implications

These findings can support managers and practitioners in taking decisions on the service delivery models to adopt. Instead of applying monolithic pure models, mixing features of different models into a hybrid one seems more effective in meeting users' expectations.

Originality/value

This is one of the first studies on the relationship between provision models of high-contact and relational-intensive services (the healthcare services) and users' experience. This research contributes to the literature on healthcare service management suggesting to acknowledge the importance of hybridization of features from different, purely theoretical service delivery models, in order to fit with providers' practice and users' expectations.

Highlights

  • This is one of the first studies on the relationship between provision models of nursing care and patient experience.

  • Healthcare services' users appreciate service delivery characteristics identified with “be cared by,” or in other words with having a reference nurse.

  • Nursing models' features that relate to the organizations and that providers tend to judge as professionalizing and evolutive, such as team working, appear not key in relation to patient experience.

  • Pure models of service delivery are theoretically useful, but hybrid models can better meet users' expectations.

This is one of the first studies on the relationship between provision models of nursing care and patient experience.

Healthcare services' users appreciate service delivery characteristics identified with “be cared by,” or in other words with having a reference nurse.

Nursing models' features that relate to the organizations and that providers tend to judge as professionalizing and evolutive, such as team working, appear not key in relation to patient experience.

Pure models of service delivery are theoretically useful, but hybrid models can better meet users' expectations.

Details

Journal of Health Organization and Management, vol. 36 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 17 June 2022

Mahmut Selami Akin and Abdullah Okumuş

The study aims to guide private healthcare organizations to create value for patients through service encounters (SE) based on the value-in-use notion. It also intends to reveal…

Abstract

Purpose

The study aims to guide private healthcare organizations to create value for patients through service encounters (SE) based on the value-in-use notion. It also intends to reveal whether SE experiences differ from reputation levels of hospitals.

Design/methodology/approach

Research embraces mixed methods for building theoretical construction and sampling, seven hospital managers and two private hospitals were interviewed and selected via analytical hierarchical process. A number of 1,023 valid data were obtained from patients through survey. Structural equation modeling, PROCESS macro and multigroup analysis were used to test for research model.

Findings

Call center experience among pre-core SE affected patient satisfaction positively and behavioral intention indirectly; however, online and social experiences did not. As core SE, physician and nursing interaction, trust, accessibility and perceived sufficient waiting positively influenced patient satisfaction and behavioral intention, though physical evidence and supportive staff interaction did not. In the post-core stage, patient satisfaction positively impacts behavioral intention. Additionally, those effects were equivalent for high and low reputations.

Originality/value

Study uniquely attempts to shift the paradigm from value-in-exchange to value-in-use in private healthcare context by embracing SE approach. Research differs from others by revealing the remarkable role of intangible assets instead of tangibles on holistic patient experience, essential for creating and managing value for patients.

Details

Asia Pacific Journal of Marketing and Logistics, vol. 35 no. 4
Type: Research Article
ISSN: 1355-5855

Keywords

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 on…

3290

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

Keywords

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 critical. Much…

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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

Keywords

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