Search results

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.

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.

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.

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.

The objective of this study is to examine developments in the discursive practice of non-financial reporting in the public healthcare sector. In doing so, the authors investigate how the main reform foci of productivity and quality are represented, with a specific focus on the patient.

Drawing on critical discourse analysis (CDA), the authors conduct a longitudinal study (2007–2018) of healthcare reporting foci across the five administrative regions responsible for public hospitals in Denmark. The study analyses sixty annual reports and draws on contemporary reform documents over this period. CDA enables a micro-textual analysis, combined with macro-insights and discussions on social practice.

The findings show complex webs of presentation strategies, but in particular two changes occur during the period. First, the patient is centred throughout but the framing changes from productivity and waiting lists to quality and dialogue. Second, in the first years, the regions present themselves as actively highlighting financial and quality concerns, which changes to a passive and indirect form of presentation steered by indicators and patient legislation enforced by central government. This enhances passivity and distance in healthcare regional non-financial reporting where the regions seek to conform to such demands. Simultaneously, however, the authors find a tendency to highlight very different local initiatives, which shows an attempt to go beyond a pure automatic mode of reporting found in earlier studies.

Responding to the literature on both healthcare and financial reporting, this study identifies novel links between micro-level texts and macro-level social practices, enabling insights into the potentially intertwined impacts of public-sector reporting. The authors offer insights into the complexity of the construction of non-financial reporting in the public sector, which has a wider impact and different intentions than private-sector reporting.

To better understand the reality of living with the diseases and conditions that its drugs and therapies are developed to treat, the Novartis leadership determined a need for more meaningful insights into patients’ lives. They sought to develop a systematic, creative methodology – informed by the psychology of insightful rather than analytical thinking – to properly integrate and deploy the research commissioned into its day-to-day business decision-making. For it is well established that better understanding of the patient reality drives both compliance and adherence “beyond the pill”. The purpose of this paper is to bring the novel methodology of creativity to a wider audience and ensure that many others – notably in patient advocacy organizations – can benefit from this approach.

A core team of Insight and Analytics and Patient Engagement leads from various therapeutic area teams worked in partnership with a psychologist and practitioner in the field of insightful thinking, to develop an effective methodology that could reliably surface and articulate genuine patient insights. This methodology – the i4i Insights Discovery™ process – was developed, piloted, refined and codified in 2020 and implemented across the company in 2021–2022. It uses a combination of convergent and divergent thinking techniques – human rather than artificial intelligence, combining diverse research outputs – to understand patients’ lives better. With enhanced understanding, the insights then shape educational and behavioral strategies to drive adherence and compliance.

At a time of tightening budgets and demands to deliver enhanced impact from research budgets, i4i Insights Discovery™ has enabled Novartis teams to turn existing research outputs into profound and useful understandings of what it means to live with specific diseases and develop evidence-based patient engagement strategies; insight-driven decision-making around the lifecycle of any compound. i4i Insights Discovery™ has been applied across Novartis’s diverse areas of expertise, from heart disease to cancer, from organ transplantation to dermatology, from food allergy to ophthalmology.

The i4i Insights Discovery™ process enables Novartis teams to gain deeper understanding of patients’ lives without the need to commission additional research; to do more with less. These insights enable cross-functional Novartis teams to develop better-informed strategies that better address the needs of patients and their care partners, of health-care professionals and health-care systems. The team creating the process is looking to make the i4i Insights Discovery™ approach a gold standard of insight discovery, both for pharma and health care and in other categories, too.

The i4i Insights Discovery™ process is a practical, novel application of well-established principles in the psychology of insightful thinking to address a clear business imperative. By repurposing and reinterpreting existing research outputs using creative verbal and visual exercises, it delivers a more human and empathetic understanding of the patient reality. It moves teams from “So what?” – this is what the data mean – to “Now what?” – this is what we should do as a result.

The purpose of this investigation is to scrutinize the unexplored realm concerning the interplay of hospital brand gestalt on patient satisfaction and revisit intentions.

A self-administered online survey was conducted with 227 patients who had stayed at and received health-care services from a private hospital in the city of Manado, Indonesia, within the past 12 months. The quantitative data were subsequently analyzed using a structural equation model with the assistance of Smart PLS statistical software.

The results suggest that the hospital brand gestalt significantly and positively influences patient satisfaction, which, in turn, leads to patients’ intentions to revisit. Furthermore, patient satisfaction serves as a significant mediator in the relationship between brand gestalt and revisit intentions.

This study enhances the comprehension of brand gestalt’s influence on customer attitudes and behaviors within the health-care context, contributing to the expanding body of literature concerning holistic brand perception. For health-care providers, the study underscores the significance of creating a uniform and distinctive brand experience to boost patient satisfaction and cultivate loyalty. In summary, this study paves the way for strategic branding initiatives in health care, ultimately enhancing patient experiences and organizational outcomes.

For health-care providers, this study emphasizes the importance of crafting a consistent and differentiated brand experience to enhance patient satisfaction and foster loyalty. Overall, this study opens avenues for strategic branding efforts in health care, ultimately improving patient experiences and organizational outcomes.

While there is a growing interest in the role of brand gestalt in marketing research, there is still a need for more empirical research to explore the link between brand gestalt, customer satisfaction and revisit intention. Surprisingly, to the best of the authors’ knowledge, no previous studies have investigated the role of brand gestalt in the context of health care.

Designing digital artifacts is not a linear, straightforward process. This is particularly true when applying a user-centered design approach, or co-design, with users who are unable to participate in the design process. Although the reduced participation of a particular user group may harm the end result, the literature on solving this issue is sparse. In this article, proxy design is outlined as a method for involving a user group as proxy users to speak on behalf of a group that is difficult to reach. The article investigates the following research question: How can roleplaying be embedded in co-design to engage users as proxies on behalf of those who are unable to represent themselves?

The article presents a design ethnography spanning three years at a cancer rehabilitation clinic, where digital artifacts were designed to be used collaboratively by nurses and patients. The empirical data were analyzed using content analysis and consisted of 20 observation days at the clinic, six proxy design workshops, 21 telephone consultations between patients and nurses, and log data from the digital artifact.

The article shows that simulated consultations, with nurses roleplaying as proxies for patients ignited and initiated the design process and enabled an efficient in-depth understanding of patients. Moreover, the article reveals how proxy design as a method further expanded the design. The study findings illustrate: (1) proxy design as a method for initiating design, (2) proxy design as an embedded element in co-design and (3) six design guidelines that should be considered when engaging in proxy design.

The main contribution is the conceptualization of proxy design as a method that can ignite and initiate the co-design process when important users are unreachable, vulnerable or unable to represent themselves in the co-design process. More specifically, based on the empirical findings from a design ethnography that involved nurses as proxy users speaking on behalf of patients, the article shows that roleplaying in proxy design is a fitting way of initiating the design process, outlining proxy design as an embedded element of co-design.

This study examines the determinants of medical crowdfunding performance. Drawing on signaling theory, the authors investigate how funding-related signals (funding goal and duration), story-related signals (text length, text sentiment, and use of first-person pronouns), and donor-related signals (donor identity disclosure) affect medical crowdfunding performance.

This study analyzed the data of 754 medical crowdfunding projects collected from the Qingsongchou platform in China to test the proposed model.

The empirical findings reveal that both funding goal and funding duration exhibit a U-shaped relationship with crowdfunding performance. Additionally, the authors find evidence that story text length and donor identity disclosure are positively related to crowdfunding performance, whereas the use of first-person pronouns is negatively related to crowdfunding performance.

This study extends the understanding of the determinants of medical crowdfunding performance through the signaling theory. Specifically, this study provides new insights into the roles of funding goal and funding duration in predicting medical crowdfunding performance and identifies several new predictors of crowdfunding performance, including the use of first-person pronouns in project story text and donor identity disclosure.

Service users’ voice is at the forefront of movements within psychiatry that look to create more humanising care. Although genuine co-production of knowledge is limited by the power differential intrinsically functional to the health care setting, the arts have the potential to create collaborative environments and equalise relationships. The purpose of this case study is to describe and discuss the design and pilot evaluation of creative writing workshops in a forensic mental health ward as an innovative method for humanising care.

A creative writing intervention focussing on everyday experiences was implemented in a forensic mental health ward and involved four residents and four mental health professionals working together. Interviews were conducted with the four mental health professionals as part of a service evaluation. Transcripts were analysed using thematic analysis.

Two themes emerged from the analysis of interviews with mental health professionals: “a new way of learning about each other” and “imagining beyond the staff-resident relationship”. The authors discuss the intervention’s benefits in terms of its potential to foster mutuality and empathy beyond the illness narrative.

Creative writing can be used to engage patients and mental health professionals to jointly share everyday experiences and identities beyond illness.

The creative writing workshops present an innovative approach concerning the use of creative arts for humanising care through mutuality.

L. Dee Fink proposes that different and more significant kinds of learning should be created in higher education to transition student outcomes from simply “learning” to “significant learning,” and these new types of learning should be situated within significant learning experiences (Fink, 2003). Fink also identified a taxonomy of significant learning that included six components: integration, foundational knowledge, application, human dimension, caring, and learning how to learn. Using Fink’s Taxonomy of Significant Learning as a framework, the authors will share the development of a course on navigating the US Healthcare System that resulted in significant learning outcomes for students completing the first semester of a four-year Doctor of Pharmacy curriculum. Each learning experience will link to a component of the taxonomy and will serve as the mechanism for the authors to share the development and implementation associated with each aspect of the semester-long course. The assessment structure of the course is described in detail. The authors present one or more learning experiences to illustrate each component of Fink’s Taxonomy. Finally, lessons learned from the development and implementation of the course are presented to guide programs considering implementation of a similar significant learning experience.

Milaap is a popular medical crowdfunding platform in India, enabling interaction between those who want to raise funds and those who want to donate. To achieve the critical mass Milaap had to increase the trust among the donors and ensure a higher success rate of the campaigns. Milaap provided two types of services: Do it Yourself (DIY), and Supported Campaign (SC). Milaap charged 5% of the raised amount from the DIY campaigns and 15% of the raised amount from the SC. Overall the chances of success were high in the SC. The case explores the dilemma of type of service to be prioritized.

This article aims to present a systematic review and synthesis of evidence on the experiences, role and use of IPE in IH fields by using a meta-ethnographic approach including key concepts, reciprocal and refutational translation and lines of argument. Inclusion health (IH) practice suggests that the needs of excluded groups are more effectively addressed through collaborative working. Interprofessional education (IPE) occurs when two or more professions engage in shared practice and learning, resulting in improved collaboration and quality of care. Studies on IPE to train staff in fields relating to IH exist, but without a settled consensus on the best approaches/activities to foster inclusive practice.

This synthesis is underpinned by a meta-ethnographic approach. It provides explicit stages of data collection and interpretation, while providing space to engage with emerging themes and concepts iteratively (reflecting on author experiences) and inductively (reasoning and interpretation). This study made use of electronic databases and journals for English language peer reviewed articles between 2000 and 2020. Of the 2217 articles, 19 papers were included. The lead author and reviewer completed the review process and a second reviewer reviewed 10% at each stage. The quality was assessed using a modified CASP checklist. Iterative analysis involved PPI and staff stakeholders.

A total of 16 concepts embedded in 19 papers provide insight into the nature of IPE in IH (IH) for staff. It was found that IPE in IH covers a broad group of practitioners and is a complex activity involving individual and organisation readiness, practical and pedagogical factors, influenced by setting, method, curriculum, lived experience, reflection and a learner-driven approach. Barriers to design, implementation and translation into practice were also found to exist.

Most studies used a combination of core learning and group work. Educational modes include mentoring or coaching, reflective practice, immersive learning and people lived experience of exclusion involved in or facilitation thematically centred in trauma-informed informed care, cultural competence, communities of practice and service learning. The aim of these methods was to promote collaboration through identifying shared experiences, problems and tensions and critical reflection of services and organisations. Such transformative learning is reported to challenge stigma, discrimination and misinformation and promote collective empowerment to address social injustice through human connection. Effective models of IPE re-instated the therapeutic relationship and alliances between patients and staff.

This review also calls for the development of health and care workers’ professionalism in relation to their own reflexivity, establishing anti-racist curricula, challenge stigma and ensuring clinicians are aware of and able to negotiate tension and difference identified within the consultation and between themselves. Apart from developing generalist skills, this analysis suggests that IPE in IH may be able to challenge stigma and discrimination towards IH groups by destabilising existing norms and siloed working with the aim of achieving robust interprofessional practice.

IPE in IH is a complex activity affected by individual and organisation readiness, setting, experiential, practical and pedagogical factors. Models of teaching are focused on re-instating the therapeutic relationship. There are no systematic reviews in this field and previously there was no settled consensus on the best approaches and learning activities to foster inclusive and collaborative practice.