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Fabian A, Rühle A, Domschikowski J, Trommer M, Wegen S, Becker JN, Wurschi G, Boeke S, Sonnhoff M, Fink CA, Käsmann L, Schneider M, Bockelmann E, Treppner M, Mehnert-Theuerkauf A, Nicolay NH, Krug D. Satisfaction with radiotherapy care among cancer patients treated in Germany-secondary analysis of a large multicenter study. Strahlenther Onkol 2024; 200:487-496. [PMID: 37975882 PMCID: PMC11111518 DOI: 10.1007/s00066-023-02176-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Accepted: 10/22/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE Patient satisfaction with healthcare has been linked to clinical outcomes and regulatory agencies demand its regular assessment. Therefore, we aimed to investigate patient satisfaction with radiotherapy care and its determinants. METHODS This is a secondary analysis of a multicenter prospective cross-sectional study. Eligible cancer patients anonymously completed questionnaires at the end of a course of radiotherapy. The outcome variable was overall patient satisfaction with radiotherapy care measured with a 10-point Likert scaled single-item. Given patient satisfaction was defined for patients scoring ≥ 8 points. Determinants of given patient satisfaction were assessed by univariable and multivariable analyses. A p-value < 0.05 was considered statistically significant. RESULTS Out of 2341 eligible patients, 1075 participated (participation rate 46%). Data on patient satisfaction was provided by 1054 patients. There was a right-skewed distribution towards more patient satisfaction (mean = 8.8; SD = 1.68). Given patient satisfaction was reported by 85% (899/1054) of the patients. Univariable analyses revealed significant associations of lower patient satisfaction with tumor entity (rectal cancer), concomitant chemotherapy, inpatient care, treating center, lower income, higher costs, and lower quality of life. Rectal cancer as tumor entity, treating center, and higher quality of life remained significant determinants of patient satisfaction in a multivariable logistic regression. CONCLUSION Overall patient satisfaction with radiotherapy care was high across 11 centers in Germany. Determinants of patient satisfaction were tumor entity, treating center, and quality of life. Although these data are exploratory, they may inform other centers and future efforts to maintain high levels of patient satisfaction with radiotherapy care.
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Affiliation(s)
- Alexander Fabian
- Department of Radiation Oncology, University Hospital Schleswig-Holstein, Arnold-Heller-Str. 3, 24105, Kiel, Germany.
| | - Alexander Rühle
- Department of Radiation Oncology, Medical Center, Faculty of Medicine, University of Freiburg, 79106, Freiburg, Germany
- Department of Radiotherapy and Radiation Oncology, University Hospital Leipzig, 04103, Leipzig, Germany
| | - Justus Domschikowski
- Department of Radiation Oncology, University Hospital Schleswig-Holstein, Arnold-Heller-Str. 3, 24105, Kiel, Germany
| | - Maike Trommer
- Department of Radiation Oncology, Cyberknife and Radiotherapy, Faculty of Medicine and University Hospital Cologne, 50937, Cologne, Germany
- Center for Molecular Medicine Cologne, University of Cologne, 50931, Cologne, Germany
| | - Simone Wegen
- Department of Radiation Oncology, Cyberknife and Radiotherapy, Faculty of Medicine and University Hospital Cologne, 50937, Cologne, Germany
| | - Jan-Niklas Becker
- Department of Radiotherapy and Special Oncology, Medical School Hannover, 30625, Hannover, Germany
| | - Georg Wurschi
- Department of Radiotherapy and Radiation Oncology, Jena University Hospital, 07747, Jena, Germany
| | - Simon Boeke
- Department of Radiation Oncology, University Hospital Tübingen, 72076, Tübingen, Germany
| | - Mathias Sonnhoff
- Center for Radiotherapy and Radiation Oncology, 28239, Bremen, Germany
| | - Christoph A Fink
- Department of Radiation Oncology, University Hospital Heidelberg, 69120, Heidelberg, Germany
| | - Lukas Käsmann
- Department of Radiation Oncology, University Hospital, LMU Munich, 81377, Munich, Germany
- Member of the German Center for Lung Research (DZL), Comprehensive Pneumology Center Munich (CPC-M), 81377, Munich, Germany
- Partner Site Munich, German Cancer Consortium (DKTK), 81377, Munich, Germany
| | - Melanie Schneider
- Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307, Dresden, Germany
| | - Elodie Bockelmann
- Department of Radiotherapy and Radiation Oncology, University Hospital Hamburg-Eppendorf, 20251, Hamburg, Germany
| | - Martin Treppner
- Institute of Medical Biometry and Statistics, University Hospital Freiburg, 79106, Freiburg, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, 04103, Leipzig, Germany
| | - Nils H Nicolay
- Department of Radiotherapy and Radiation Oncology, University Hospital Leipzig, 04103, Leipzig, Germany
- Partner Site Leipzig, Cancer Center Central Germany, 04103, Leipzig, Germany
| | - David Krug
- Department of Radiation Oncology, University Hospital Schleswig-Holstein, Arnold-Heller-Str. 3, 24105, Kiel, Germany
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Anastasio AT, Baumann AN, Curtis DP, Rogers H, Hogge C, Ryan SF, Walley KC, Adams SB. An examination of negative one-star patient reviews for foot and ankle orthopedic surgery: A retrospective analysis. Foot Ankle Surg 2024; 30:252-257. [PMID: 38195290 DOI: 10.1016/j.fas.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 11/21/2023] [Accepted: 12/22/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND Despite the questionable validity of online-based physician review websites (PRWs), negative reviews can adversely affect a provider's practice. Several investigations have explored the effect of extremely negative "one-star" reviews across subspecialties such as adult reconstruction, sports medicine, and orthopaedic traumatology; however, to date, no study has explored one-star reviews in foot and ankle surgery. The goal of this study was to characterize factors that contribute to extremely negative, one-star reviews for foot and ankle surgeons on Vitals.com. METHODS A retrospective analysis of negative one-star reviews with corresponding patient complaints for foot and ankle surgeons (both orthopaedic surgeons as well as podiatrists) in the United States. Physicians included were selected within a 10-mile radius of the top ten largest cities in the United States. Data was stratified by patient type (e.g., those receiving surgery and those not undergoing surgical intervention) and binned according to type of patient complaint, as previously described. RESULTS Of the 2645 foot and ankle surgeons identified in our initial query, 13.8% of surgeons contained one-star reviews eligible for analysis. Patient complaints related to bedside manner and patient experience are the causative factors accounting for 41.5% of the one-star reviews of foot and ankle surgeons for nonsurgical-related complaints. Surgical complications and other outcomes-related factors comprised roughly 50% of the complaints related to surgical patients. CONCLUSION In conclusion, complaints related to bedside manner and patient experience are the causative factors accounting for 41.5% of the one-star reviews of foot and ankle surgeons for nonsurgical-related complaints. Surgical complications and other outcomes-related factors comprised roughly half of the complaints related to surgery. This data serves to inform practicing foot and ankle surgeons as to the influences behind patients leaving extremely negative reviews on PRWs. LEVEL OF CLINICAL EVIDENCE IV.
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Affiliation(s)
| | - Anthony N Baumann
- College of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Deven P Curtis
- College of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Hudson Rogers
- College of Medicine, Northeast Ohio Medical University, Rootstown, OH, USA
| | - Caleb Hogge
- School of Osteopathic Medicine, Lake Erie College of Medicine, Erie, PA, USA
| | - Savannah F Ryan
- Department of Orthopaedics, University of Michigan | Michigan Medicine, Ann Arbor, MI, USA.
| | - Kempland C Walley
- Department of Orthopaedics, University of Michigan | Michigan Medicine, Ann Arbor, MI, USA
| | - Samuel B Adams
- Department of Orthopaedics, Duke University, Durham, NC, USA
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Rajeswaran T, Kennedy SKF, Gojsevic M, Herst P, Safavi AH, Corbin K, Hill R, Karam I, Tran W, Gallant F, Carothers K, Lam J, Trombetta M, Arscott WT, Shariati S, Akkila S, Behroozian T, Zhang E, Chow E. Perceptions of healthcare professionals on the use of Mepitel Film for the prevention of acute radiation dermatitis in breast cancer. Support Care Cancer 2023; 31:725. [PMID: 38012460 DOI: 10.1007/s00520-023-08205-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 11/23/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION Randomized clinical trials support Mepitel Film (MF) as a prophylactic treatment for radiation dermatitis (RD) in patients undergoing breast radiotherapy. Although several studies have canvassed the opinion of patients on using MF, no such studies have been done to investigate the perception of healthcare professionals (HCPs). The objective of this study was therefore to investigate the perceptions of HCPs on MF as a treatment option for RD. METHODS Anonymized responses to a web-based survey sent to HCPs at a single institution managing patients using MF during breast radiotherapy were analyzed. RESULTS Of the 28 HCPs contacted, 22 completed the survey, including 6 radiation oncologists (ROs), 11 radiation therapists (RTTs), and 5 nurses. Most HCPs reported MF was better at preventing severe RD than the standard of care and improved radiation-induced skin reactions (n = 20/22, 91%, and n = 19/22, 86%, respectively). MF was recommended for mastectomy patients without reconstruction (n = 15/21, 71%). The majority of HCPs believed that patients' families could be trained to apply and remove MF (n = 19/22, 86%). Many HCPs perceived that implementation of MF would be difficult in terms of maintaining patient flow and wide-scale implementation within their institution (n = 11/22, 50%, and n = 10/22, 46%, respectively). Most HCPs perceived that fewer than 50% of their patients could afford MF if priced at $100 CAD (n = 15/20, 75%). CONCLUSION These findings provide insights into the possibility of MF to be incorporated into standard practice of care for RD. Although most HCPs were satisfied with MF as a prophylactic treatment for RD, there are concerns about its resource-intensive operationalization and financial accessibility to patients. Future research should focus on ways to improve HCP experience with MF and to improve its implementation into clinical settings as standard of care.
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Affiliation(s)
- Thenugaa Rajeswaran
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
| | - Samantha K F Kennedy
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
| | - Milena Gojsevic
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
| | - Patries Herst
- Department of Radiation Therapy, University of Otago, Wellington, New Zealand
| | - Amir H Safavi
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
| | - Kimberly Corbin
- Department of Radiation Oncology, Mayo Clinic, Rochester, USA
| | - Rosemary Hill
- Lions Gate Hospital, Vancouver, British Columbia, Canada
| | - Irene Karam
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
| | - William Tran
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
| | - François Gallant
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
| | - Katherine Carothers
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
| | - Jacqueline Lam
- Health Sciences North, Sudbury, Ontario, Canada
- Sault Area Hospital, Sault Ste. Marie, Ontario, Canada
| | - Mark Trombetta
- Division of Radiation Oncology, Allegheny General Hospital, Drexel University College of Medicine, Pittsburgh, USA
| | - William T Arscott
- Division of Radiation Oncology, West Cancer Center, Compass Oncology, Tigard, USA
| | - Saba Shariati
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
| | - Shereen Akkila
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
| | - Tara Behroozian
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Elwyn Zhang
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada
| | - Edward Chow
- Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, 2075 Bayview Avenue, Toronto, Ontario, M4N 3M5, Canada.
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Song JE, Lee S, Lee MK, Chae HJ. Ecological factors affecting first-time mothers' satisfaction with Sanhujoriwons (postpartum care centres) from South Korea: a cross-sectional and correlational study. BMC Pregnancy Childbirth 2023; 23:454. [PMID: 37340327 PMCID: PMC10280916 DOI: 10.1186/s12884-023-05770-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/09/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND In South Korea, commercial postpartum care centres, known as Sanhujoriwons, have emerged as important institutions aiding mothers' physical recovery after childbirth. Although previous studies have measured mothers' satisfaction level with Sanhujoriwons, this study applies Bronfenbrenner's ecological model to identify the factors influencing first-time mothers' satisfaction with Sanhujoriwons. METHODS This descriptive correlational study involved 212 first-time mothers admitted to Sanhujoriwons for two weeks with their new-borns (healthy babies weighing at least 2.5 kg) after giving birth after 37 weeks of pregnancy. Data were collected using a self-report questionnaire at five postpartum care centres in the metropolitan area of South Korea from October to December 2021, on the day of the mothers' discharge. This study considered ecological factors such as perceived health status, postpartum depression, childcare stress, maternal identity at the individual level; partnership with Sanhujoriwon staff at the microsystem level; and the Sanhujoriwons' education support system at the exo-system level. The data were analysed using descriptive statistics, t-test, one-way ANOVA, correlation analysis, and hierarchical regression analysis using the SPSS 25.0 Win program. RESULTS The mean score of satisfaction with Sanhujoriwons was 59.67 ± 10.14 out of 70, indicating a high level of satisfaction. The hierarchical regression analysis showed that satisfaction with Sanhujoriwons was significantly affected by the perceived health status (β = 0.19, p < 0.001), partnership between mothers and the caregivers (β = 0.26, p < 0.001), and education support system of the Sanhujoriwons (β = 0.47, p < 0.001). The explanatory power of the model for these variables was 62.3%. CONCLUSIONS Our results indicate that not only the mother's health status but also the educational support system of postpartum care centres and partnerships are important for improving first-time mothers' satisfaction with postpartum care centres. Thus, when developing an intervention program for postpartum care centres, practitioners should focus on developing various kinds of support and strategies to improve the physical health condition of mothers, build partnerships between mothers and care staff, and improve the quality of the educational support offered to mothers. Further studies to develop and test the effectiveness of such intervention programs are strongly suggested.
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Affiliation(s)
- Ju-Eun Song
- College of Nursing & Research Institute of Nursing Science, Ajou University, Suwon, Republic of Korea
| | - Soyeon Lee
- College of Nursing & Research Institute of Nursing Science, Ajou University, Suwon, Republic of Korea
- Department of Nursing, Ajou University Medical Center, Suwon, Republic of Korea
| | - Min Kyong Lee
- College of Nursing & Research Institute of Nursing Science, Ajou University, Suwon, Republic of Korea
- Department of Nursing, Samsung Medical Center, Seoul, Republic of Korea
| | - Hyun-Ju Chae
- Department of Nursing, Joongbu University, 201, Daehak-ro, Chubu-myeon, Geumsan-gun, Chungnam, 32713, Republic of Korea.
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Abebe DD, Temesgen MM, Abozin AT. Clinicians' satisfaction with laboratory services and associated factors at public health facilities in Northeast Ethiopia. BMC Health Serv Res 2023; 23:475. [PMID: 37170228 PMCID: PMC10173562 DOI: 10.1186/s12913-023-09429-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 04/20/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Satisfaction has become a key measure of quality and an important tool for improvement. Laboratories are increasingly required to regularly assess satisfaction of their customers. This study aimed to assess clinicians' satisfaction with laboratory services and associated factors at public health facilities. METHODS A facility-based cross-sectional study was conducted in Northeast Ethiopia from May to June 2019. Eight hospitals and 24 health centres were first selected using a stratified sampling method, and a total of 224 randomly selected clinicians were included. Satisfaction with multiple aspects of laboratory services was assessed using a self-administered questionnaire, on a rating scale of 1 (very dissatisfied) to 5 points (very satisfied). Laboratory quality assessment was performed using WHO-AFRO's stepwise accreditation checklist. Multivariable logistic regression model was fitted to determine the association between independent variables and clinicians' overall satisfaction level using STATA ver14.1. A p-value < 0.05 was considered significant. RESULTS Overall, 72.8% of the clinicians were satisfied. Lowest mean ratings were obtained for the helpfulness of the laboratory handbook (3.3), provision of STAT/urgent services (3.7), and adequacy of tests provided (3.8). The clinicians' timely receipt of results (AOR = 2.3, 95% CI = 1.1-5.0), notification of panic results (AOR = 2.5, 95% CI = 1.1-5.6), perceived quality/reliability of test results (AOR = 3.1, 95% CI = 1.5-6.3), and the laboratories' rate of concordant malaria microscopy results (AOR = 4.1, 95% CI = 1.8-9.3), were significantly associated with satisfaction. CONCLUSIONS Nearly one-third of clinicians were not satisfied with the laboratory services. Laboratory managers should emphasize the timely communication of STAT/urgent and panic results, and the reliability of test results, to improve users' satisfaction and overall quality of care.
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Affiliation(s)
- Daniel Dagne Abebe
- Amhara Public Health Institute Dessie Branch, Dessie, Amhara region, Ethiopia.
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Does prospective payment influence quality of care? A systematic review of the literature. Soc Sci Med 2023; 323:115812. [PMID: 36913795 DOI: 10.1016/j.socscimed.2023.115812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 01/30/2023] [Accepted: 02/24/2023] [Indexed: 03/06/2023]
Abstract
In the light of rising health expenditures, the cost-efficient provision of high-quality inpatient care is on the agenda of policy-makers worldwide. In the last decades, prospective payment systems (PPS) for inpatient care were used as an instrument to contain costs and increase transparency of provided services. It is well documented in the literature that prospective payment has an impact on structure and processes of inpatient care. However, less is known about its effect on key outcome indicators of quality of care. In this systematic review, we synthesize evidence from studies investigating how financial incentives induced by PPS affect indicators of outcome quality domains of care, i.e. health status and user evaluation outcomes. We conduct a review of evidence published in English, German, French, Portuguese and Spanish language produced since 1983 and synthesize results of the studies narratively by comparing direction of effects and statistical significance of different PPS interventions. We included 64 studies, where 10 are of high, 18 of moderate and 36 of low quality. The most commonly observed PPS intervention is the introduction of per-case payment with prospectively set reimbursement rates. Abstracting evidence on mortality, readmission, complications, discharge disposition and discharge destination, we find the evidence to be inconclusive. Thus, claims that PPS either cause great harm or significantly improve the quality of care are not supported by our findings. Further, the results suggest that reductions of length of stay and shifting treatment to post-acute care facilities may occur in the course of PPS implementations. Accordingly, decision-makers should avoid low capacity in this area.
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Gaucher N, Trottier ED, Ridha Z, Simard F, Duran B, Pinard C, Larose G, Arsenault M, D'Angelo A, Janvier A. Care of suspected long bone fractures in the emergency department: Families' perspectives and priorities. Am J Emerg Med 2023; 64:106-112. [PMID: 36508754 DOI: 10.1016/j.ajem.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 12/01/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE Despite growing interests in patient-reported outcomes, youth and families are rarely involved in designing quality improvement measures. Few quality indicators exist for the care of children with injuries in the Emergency Department (ED) and extremity fractures are among the most common injuries in children. This study's aim was to identify both parents' and youth's perspectives about ED care in the context of a suspected long-bone fracture. METHODS Youth (10-18 years old) and their parents were surveyed prospectively during their ED visit. Participants were asked: 1) to identify their main concerns, 2) to identify quality measures that were most important to them, and 3) to evaluate the ED care they received. Descriptive analyses present participants' responses. Continuous data was analyzed using a Student t-test and categorical data using a Chi-square test. RESULTS Over 15 months, 350 families met eligibility criteria and were approached to participate, of which 300 participants consented and 249 surveys were completed (71% response rate): 148 parents and 101 youth (median age: 12) completed their respective surveys. Participants placed a high importance on several themes: pain management, short length of stay, and quality interactions with ED clinicians. Youth as a group prioritized their overall wellbeing and the ED environment (e.g., waiting room comfort, signage), while parents focused on accurate diagnoses and treatments. The following items were less prioritized: that radiology be close to the ED, to see the radiograph, to have access to a wheelchair, to know the identities of clinicians on the team, and to have access to entertainment. Parents and youth within the same family often did not share the same priorities. Ninety-two percent of parents reported their child's pain was treated, while 81% and 63% of youth reported their pain was treated sufficiently and quickly, respectively. CONCLUSIONS Parents and youth can identify their priorities for ED care and should be engaged in efforts to improve and report on the quality of care in the ED. Youths' and parents' perspectives are complimentary and may not align, even within families. The priorities identified in this study can help inform quality improvement initiatives and personalized patient care.
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Affiliation(s)
- Nathalie Gaucher
- Department of pediatric emergency medicine, CHU Sainte-Justine, Montreal, Canada; CHU Sainte-Justine Research Center, Montreal, Canada; Clinical Ethics Unit, CHU Sainte-Justine, Montreal, Canada; Department of Pediatrics, Université de Montréal, Montreal, Canada; Parent partner, CHU Sainte-Justine, Montreal, Canada.
| | - Evelyne D Trottier
- Department of pediatric emergency medicine, CHU Sainte-Justine, Montreal, Canada; Department of Pediatrics, Université de Montréal, Montreal, Canada
| | - Zainab Ridha
- Department of Pediatrics, Université de Montréal, Montreal, Canada
| | | | - Brenda Duran
- Faculty of Medicine, Université Laval, Quebec City, Canada
| | - Celine Pinard
- Department of pediatric emergency medicine, CHU Sainte-Justine, Montreal, Canada
| | - Guylaine Larose
- Department of pediatric emergency medicine, CHU Sainte-Justine, Montreal, Canada; Department of Pediatrics, Université de Montréal, Montreal, Canada
| | - Michael Arsenault
- Department of pediatric emergency medicine, CHU Sainte-Justine, Montreal, Canada; Department of Pediatrics, Université de Montréal, Montreal, Canada
| | - Antonio D'Angelo
- Department of pediatric emergency medicine, CHU Sainte-Justine, Montreal, Canada; Department of Pediatrics, Université de Montréal, Montreal, Canada
| | - Annie Janvier
- CHU Sainte-Justine Research Center, Montreal, Canada; Clinical Ethics Unit, CHU Sainte-Justine, Montreal, Canada; Department of Pediatrics, Université de Montréal, Montreal, Canada; Division of neonatology, CHU Sainte-Justine, Montreal, Canada; Research unit in clinical ethics and family partnerships, CHU Sainte-Justine Research Center, Montreal, Canada
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Characterizing Single-star Negative Online Reviews of Orthopaedic Trauma Association Members. J Am Acad Orthop Surg 2023; 31:397-404. [PMID: 36727955 DOI: 10.5435/jaaos-d-22-00631] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 12/14/2022] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION The purpose of this study was to characterize factors that contribute to 1-star negative reviews regarding orthopaedic trauma surgeons. METHODS A search was done for Orthopaedic Trauma Association members on Yelp.com, Healthgrade.com, and Vitals.com in New York, Boston, San Francisco, Los Angeles, Dallas, Phoenix, Seattle, Baltimore, Denver, Houston, Philadelphia, and Washington, DC. All single-star reviews (out of a possible 5 stars) were included in this study. Reviews were categorized as either clinical or nonclinical and then further subcategorized. Categorical variables were analyzed using a chi-square test. The rate ratio (the ratio of the rate for nonsurgical divided by surgical reviews) was determined for each category. RESULTS Two hundred eighty-eight single-star reviews were included in the study, comprising 655 total complaints. Of all complaints, 274 (41.8%) were clinically related and 381 (58.2%) were nonclinical. Of the 288 single-star reviews, 96 (33.3%) were from surgically treated patients and 192 (66.7%) were from nonsurgical patients. Most complaints were in reference to nonclinical aspects of care such as physician bedside manner (173 reviews, 60%), not enough time spent with provider (58 reviews, 20%), and wait time (42 complaints, 15%). The most common clinical complaints were for complication (61 reviews, 21%), disagree with decision/plan (49 reviews, 17%), and uncontrolled pain (45 reviews, 16%). Surgical patients had a significantly higher rate of clinical complaints than nonsurgical patients (1.57 vs. 0.64 clinical complaints per review, P < 0.001). Nonsurgical patients had a significantly higher rate of nonclinical complaints than surgical patients (1.43 vs. 1.10 nonclinical complaints per review, P < 0.001). DISCUSSION Most 1-star reviews referenced a nonclinical aspect of care with a physician's bedside manner being the most common complaint. Surgical patients were markedly more likely to reference a clinical aspect of care, such as complications or misdiagnosis compared with nonsurgical patients, who more commonly referenced nonclinical aspects of care.
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Marcin JP, Tancredi DJ, Galante JM, Rinderknecht TN, Haus BM, Leshikar HB, Zwienenberg M, Rosenthal JL, Grether-Jones KL, Hamline MY, Hoch JS, Kuppermann N. Measuring the impact of a "Virtual Pediatric Trauma Center" (VPTC) model of care using telemedicine for acutely injured children versus the standard of care: study protocol for a prospective stepped-wedge trial. Trials 2022; 23:1051. [PMID: 36575536 PMCID: PMC9793356 DOI: 10.1186/s13063-022-06996-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 12/08/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The current standard of care in the treatment of children with physical trauma presenting to non-designated pediatric trauma centers is consultation with a pediatric trauma center by telephone. This includes contacting a pediatric trauma specialist and transferring any child with a potentially serious injury to a regionalized level I pediatric trauma center. This approach to care frequently results in medically unnecessary transfers and may place undue burdens on families. A newer model of care, the "Virtual Pediatric Trauma Center" (VPTC), uses telemedicine to make the expertise of a level I pediatric trauma center virtually available to any hospital. While the use of the VPTC model of care is increasing, there have been no studies comparing the VPTC to standard care of injured children at non-designated trauma centers with respect to patient- and family-centered outcomes. The goal of this study is to compare the current standard of care to the VPTC with respect to family-centered outcomes developed by parents and community advisory boards. METHODS We will use a stepped-wedge trial design to enroll children with physical trauma presenting to ten hospitals, including level II, level III, and non-designated trauma centers. The primary outcome measures are parent/family experience of care and distress 3 days following injury. Secondary aims include 30-day healthcare utilization, parent/family out-of-pocket costs at 3 days and 30 days after injury, transfer rates, and parent/family distress 30 days following injury. We expect at least 380 parents/families of children will be eligible for the study following an emergency department physician's request for a level I pediatric trauma center consultation. We will evaluate parent/family experience of care and distress using previously validated instruments, healthcare utilization by family recollection and medical record abstraction, and out-of-pocket costs using standard economic analyses. DISCUSSION We expect that the findings from this study will inform other level I pediatric trauma centers and non-pediatric trauma centers on how to improve their systems of care for injured children. The results will help to optimize communication, confidence, and shared decision-making between parents/families and clinical staff from both the transferring and receiving hospitals. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04469036. Registered July 13, 2020 before start of inclusion.
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Affiliation(s)
- James P. Marcin
- grid.27860.3b0000 0004 1936 9684Department of Pediatrics, University of California, Davis, Sacramento, CA USA
| | - Daniel J. Tancredi
- grid.27860.3b0000 0004 1936 9684Department of Pediatrics, University of California, Davis, Sacramento, CA USA
| | - Joseph M. Galante
- grid.27860.3b0000 0004 1936 9684Department of Surgery, University of California, Davis, Sacramento, CA USA
| | - Tanya N. Rinderknecht
- grid.27860.3b0000 0004 1936 9684Department of Surgery, University of California, Davis, Sacramento, CA USA
| | - Brian M. Haus
- grid.27860.3b0000 0004 1936 9684Department of Orthopedic Surgery, University of California, Davis, Sacramento, CA USA
| | - Holly B. Leshikar
- grid.27860.3b0000 0004 1936 9684Department of Orthopedic Surgery, University of California, Davis, Sacramento, CA USA
| | - Marike Zwienenberg
- grid.27860.3b0000 0004 1936 9684Department of Neurological Surgery, University of California, Davis, Sacramento, CA USA
| | - Jennifer L. Rosenthal
- grid.27860.3b0000 0004 1936 9684Department of Pediatrics, University of California, Davis, Sacramento, CA USA
| | - Kendra L. Grether-Jones
- grid.27860.3b0000 0004 1936 9684Department of Emergency Medicine, University of California, Davis, Sacramento, CA USA
| | - Michelle Y. Hamline
- grid.27860.3b0000 0004 1936 9684Department of Pediatrics, University of California, Davis, Sacramento, CA USA
| | - Jeffrey S. Hoch
- grid.27860.3b0000 0004 1936 9684Department of Public Health Sciences, University of California, Davis, Sacramento, CA USA
| | - Nathan Kuppermann
- grid.27860.3b0000 0004 1936 9684Department of Pediatrics, University of California, Davis, Sacramento, CA USA ,grid.27860.3b0000 0004 1936 9684Department of Emergency Medicine, University of California, Davis, Sacramento, CA USA
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10
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Analysis of Negative Reviews of Orthopedic Oncology Surgeons: An Investigation of Reviews from Healthgrades, Vitals, and Google. Sarcoma 2022; 2022:4351427. [DOI: 10.1155/2022/4351427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 11/13/2022] [Accepted: 11/21/2022] [Indexed: 12/14/2022] Open
Abstract
Background. Physician review websites (PRWs) are increasing in usage and popularity. Our purpose is to characterize one-star reviews of orthopedic oncology surgeons to understand factors in healthcare that contribute to patient satisfaction. Methods. Orthopedic oncology surgeons were randomly selected from the Musculoskeletal Tumor Society. A search for one-star reviews was performed on Google Reviews, Healthgrades, and Vitals.com. Reviews were classified as clinical or nonclinical. Statistical analyses were performed regarding the frequency of reviews and complaints for each category. Results. Of the 7,733 reviews discovered, 908 (11.7%) were identified as one-star reviews. Of 907 usable complaints, 362 (40.8%) were clinical and 545 (59.2%) were nonclinical. The most common nonclinical complaints included bedside manner (65%) and limited time with providers (19%). The most common clinical complaints included complications (26%) and disagreements with the treatment plan (26%). There were 120 surgical and 221 nonsurgical reviews. Surgical patients had a higher rate of clinical complaints. Nonsurgical patients had a higher rate of total complaints. Conclusion. To the best of our knowledge, this is the first study examining PRWs regarding orthopedic oncology surgeons. Most one-star reviews were due to nonclinical complaints from nonsurgical patients. The most common factors are bedside manner, limited time with provider, phone communication issues, and rude/unprofessional conduct.
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11
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Malathi A, Jasim K. Validating the relationship between service quality, patient sensitivity and experience towards medical applications using SERVQUAL. Int J Med Inform 2022; 168:104883. [DOI: 10.1016/j.ijmedinf.2022.104883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 11/07/2022]
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Christian Z, Curley KL, Richards AE, Zhang N, Lyons MK, Bendok BR, Patel NP, Kalani MA, Neal MT. Factors associated with greater patient satisfaction in outpatient neurosurgical clinics: Recommendation for surgery, older age, cranial chief complaint, and public health insurance. Clin Neurol Neurosurg 2022; 222:107436. [PMID: 36115271 DOI: 10.1016/j.clineuro.2022.107436] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 09/08/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Patient satisfaction has increasingly played a role in determining care quality. Surveys are used to gauge patient experience, satisfaction of care, and likelihood to recommend providers and facilities. The aim of the study is to evaluate whether clinical and demographic data predict greater patient satisfaction with providers in the outpatient neurosurgery clinic. METHODS Press-Ganey (Press Ganey Associates, South Bend, IL) evaluations of 1521 patients were reviewed in an academic neurosurgical clinic from January 1, 2019 through February 1, 2021. We analyzed associations between Press-Ganey ratings and patient demographics, chief complaint, psychiatric comorbidities, number of orders placed, medication prescriptions, surgical recommendation, payor status, and referral source. We used univariate logistic regression to assess for associations between independent variables and Press-Ganey ratings. Multivariable logistic regression was used for associated factors. RESULTS For the Likelihood to Recommend question, older age (p = 0.003), cranial chief complaint (p = 0.046), and recommendations for surgery (p < 0.001) were significantly associated with "good" ratings. For the rating of Care Received, older age (p = 0.002), cranial chief complaint (p = 0.05), and recommendations for surgery (p = 0.002) were significantly associated with "good" ratings. For Confidence in Care Provider question, recommendations for surgery (p = <0.001) and government insurance type (p = 0.002) were significantly associated with "good" ratings. CONCLUSIONS Patients with older age, cranial pathologies, a recommendation for surgery, and government health insurance were significantly associated with favorable patient satisfaction with providers in the outpatient neurosurgery clinic. Prospective studies should target patient populations who are younger, have spinal complaints, have non-surgical needs, and have commercial insurance to improve satisfaction.
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Affiliation(s)
- Zachary Christian
- Baylor College of Medicine, Department of General Surgery, Houston, TX, USA
| | - Kara L Curley
- Mayo Clinic Arizona, Department of Neurological Surgery, Phoenix, AZ, USA.
| | | | - Nan Zhang
- Mayo Clinic Arizona, Department of Neurological Surgery, Phoenix, AZ, USA
| | - Mark K Lyons
- Mayo Clinic Arizona, Department of Neurological Surgery, Phoenix, AZ, USA
| | - Bernard R Bendok
- Mayo Clinic Arizona, Department of Neurological Surgery, Phoenix, AZ, USA
| | - Naresh P Patel
- Mayo Clinic Arizona, Department of Neurological Surgery, Phoenix, AZ, USA
| | - Maziyar A Kalani
- Mayo Clinic Arizona, Department of Neurological Surgery, Phoenix, AZ, USA
| | - Matthew T Neal
- Mayo Clinic Arizona, Department of Neurological Surgery, Phoenix, AZ, USA
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13
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Amankwah O, Choong WW, Boakye-Agyeman NA. Patients satisfaction of core health-care business: the mediating effect of the quality of health-care infrastructure and equipment. JOURNAL OF FACILITIES MANAGEMENT 2022. [DOI: 10.1108/jfm-12-2021-0154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Although the quality of health-care infrastructure and equipment influences patient’s overall health-care experience, health-care infrastructure and equipment are not always managed and maintained with the attention required. This is due mainly to the complexity of health-care infrastructure and equipment and shortage of maintenance budget. This study aims to determine if patient’s satisfaction of core health-care business is mediated by the quality of health-care infrastructure and equipment.
Design/methodology/approach
This cross-sectional study comprises 622 adult patients at the Physician OPD and Polyclinic of Komfo Anokye Teaching hospital, Tamale Teaching hospital and Cape Coast Teaching hospital in Ghana. Structural equation model Smart PLS was used to analyse the data.
Findings
The study results showed that the quality of health-care infrastructure and equipment has a positive significant influence (mediation) on the relationship between health-care delivery and patient’s satisfaction as well as the relationship between adequacy of health-care resources and patient’s satisfaction. However, it was shown not to have a positive significant influence (mediation) on the relationship between quality of health-care personnel and patients’ satisfaction as well as health-care administrative process and patient’s satisfaction.
Research limitations/implications
First, the study findings are centred on cross-sectional data, which capture the opinion of the patients at a specific time period instead of over a period of time. Consequently, in future, though difficult to achieve, a longitudinal study can be piloted to provide more insight. Second, the data was collected from only one country (Ghana); thus, the ability to generalise the results may be a challenge.
Practical implications
The implication of this study is that there is the need to prudently maintain hospital infrastructure and equipment in good working condition as it has a positive effect on patients’ satisfaction of their overall health-care experience.
Originality/value
Most studies have concentrated on patient’s health-care experience. This study extends the knowledge of patient’s health-care experience by determining the mediating role of quality of health-care infrastructure and equipment on the relationship between patient’s satisfaction and core health-care business. There are limited studies of such nature in Ghana. Therefore, this study will provide invaluable empirical data for the health-care sector of a developing African country.
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Kurz D, McCrea-Robertson S, Nelson-Brantley H, Befort C. Rural engagement in primary care for optimizing weight reduction (REPOWER): A mixed methods study of patient perceptions. PATIENT EDUCATION AND COUNSELING 2022; 105:2371-2381. [PMID: 34865892 DOI: 10.1016/j.pec.2021.11.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/10/2021] [Accepted: 11/27/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To report on patients' satisfaction and experience of care across three different modes of weight loss counseling. METHODS 1407 patients with obesity in the rural Midwest were enrolled to a 2-year weight management trial through their primary care practice and assigned to one of three treatment conditions: in-clinic individual, in-clinic group, phone group counseling. Patients completed surveys assessing seven domains of satisfaction and experience of care at 6 and 24-months. Post-treatment interviews were conducted to add context to survey responses. RESULTS 1295 (92.0%) and 1230 (87.4%) completed surveys at 6 and 24-months, respectively. Patients in phone group counseling reported lower satisfaction than patients who received in-clinic group or in-clinic individual counseling across all domains at 6-months and five out of seven domains at 24-months. Interviews revealed that patients were more satisfied when they received face-to-face counseling and had meaningful interactions with their primary care provider (PCP) about their weight. CONCLUSION Rural patients with obesity have higher satisfaction and experience of care when weight loss counseling is delivered in a face-to-face environment and when their PCP is involved with their treatment. PRACTICE IMPLICATIONS Primary care practices looking to offer weight loss treatment should consider incorporating some level of face-to-face treatment plans that involves meaningful interaction with the PCP.
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Affiliation(s)
- Daniel Kurz
- University of Kansas School of Medicine, Department of Population Health, Kansas City, KS USA.
| | - Stacy McCrea-Robertson
- University of Kansas School of Medicine, Department of Population Health, Kansas City, KS USA
| | | | - Christie Befort
- University of Kansas School of Medicine, Department of Population Health, Kansas City, KS USA
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15
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Morin M, Rivard M, Morin D, Mello C, Coulombe P. Parents' satisfaction with a Canadian pilot clinic to reduce waiting lists for the assessment and diagnosis of autism spectrum disorder and intellectual disability in young children. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:1186-1198. [PMID: 35638232 DOI: 10.1111/jar.13012] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 05/13/2022] [Accepted: 05/14/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND A large body of evidence suggest that parents of young children with autism spectrum disorder or intellectual disability experience low levels of satisfaction with the diagnostic evaluation process. This study sought to document parents' satisfaction with the services of a pilot clinic implemented in Québec, Canada. METHOD Two-hundred fifty-nine (259) parents were recruited following their child's diagnosis. A mixed methods approach was used to investigate parents' satisfaction globally and with specific aspects of the assessment process. RESULTS Parents expressed overall high satisfaction with the assessment process. Parental satisfaction with specific aspects of the assessment process was negatively related to paternal stress, fathers' unemployment and household income and positively related to maternal stress. CONCLUSIONS This pilot clinic could meet parents' needs at this crucial moment in their care and services trajectory. The factors associated with satisfaction in the present study may inform future improvements to its services.
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Affiliation(s)
- Marjorie Morin
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Mélina Rivard
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Diane Morin
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Catherine Mello
- Department of Psychology, Penn State University, Berks, Pennsylvania, USA
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16
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Richman EH, Ogbaudu E, Pollock JR, Brinkman JC, Moore ML, Arthur JR, Karlen JW. Characterizing Negative Online Reviews of Pediatric Orthopaedic Surgeons. J Pediatr Orthop 2022; 42:e533-e537. [PMID: 35200216 DOI: 10.1097/bpo.0000000000002121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The growing focus on subjective patient experiences has created an increase in popularity for physician rating websites. The purpose of this study was to characterize extremely negative reviews of pediatric orthopaedic surgeons. METHODS Pediatric orthopaedic surgeons were randomly selected using the Pediatric Orthopaedic Society of North America comprehensive list of surgeons. A search was then performed on Healthgrades.com, Vitals.com, and Yelp.com for 1-star reviews. Reviews were classified into clinical and nonclinical categories. Statistical analyses were performed regarding the frequency of reviews and complaints for each respective category. RESULTS Of the 279 one-star reviews categorized, 248 reviews (88.9% of reviews) included nonclinical complaints, and 182 reviews (65.2% of reviews) included clinical complaints. Nonsurgical patients were associated with 255 reviews, and the remaining 24 were related to surgical patients. Of the 430 comments within reviews, 248 referenced nonclinical aspects of care, and 182 referenced clinical care. Clinical factors most frequently noted included clinical disagreement (37%), unclear treatment plan (25%), complication (17%), misdiagnosis (15%), uncontrolled pain (13%), and delay in care (8%). The most addressed nonclinical factors included physician bedside manner (68%), time spent with provider (21%), wait time (18%), unprofessional staff (17%), scheduling issues (9%), cost (8%), and billing (8%). Compared with surgical reviews, nonsurgical reviews were more likely to contain nonclinical complaints (rate ratio: 1.5; P<0.05) and less likely to contain clinical complaints (rate ratio: 0.7; P<0.05). The most common complaint by surgical patients was complications (91.7%). CONCLUSIONS To our knowledge, this is the first study to examine the factors associated with negative reviews of pediatric orthopaedic surgeons. The majority of reviews of pediatric orthopaedic surgeons were left by nonsurgical patients and were related to nonclinical aspects of care. We also found surgeon-dependent factors such as poor physician bedside manner, unclear treatment plan, or parents' disagreement with treatment plan were the most common reasons for negative reviews. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Evan H Richman
- Creighton University School of Medicine-Phoenix Regional Campus
| | | | | | | | | | | | - Judson W Karlen
- Department of Orthopaedic Surgery, Phoenix Children's Hospital, Phoenix
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17
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Bratches RWR, Freundlich NZ, Dionne-Odom JN, O'Malley AJ, Barr PJ. Perceptions of the impact of COVID-19 on healthcare communication in a nationally representative cross-sectional survey of family caregivers. BMJ Open 2022; 12:e051154. [PMID: 35418422 PMCID: PMC9016173 DOI: 10.1136/bmjopen-2021-051154] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To understand the perceptions of the impact of the COVID-19 pandemic on healthcare communication with family caregivers. DESIGN Nationally representative survey. SETTING USA (national). PARTICIPANTS 340 family caregivers, demographically representative of the US population by race/ethnicity. PRIMARY OUTCOME MEASURES Communication outcomes (feeling involved by the provider, feeling involved by the care recipient, feeling more encouraged to be involved in care, feeling contributory to discussions, feeling questions are being answered), behavioural/wellness outcomes (feeling anxious, feeling isolated, feeling it is easier to attend the clinic visit), and desire to continue using telemedicine. RESULTS Having less than a college degree was associated with decreased odds of feeling involved by the provider (OR 0.46; 95% CI 0.26 to 0.83; p=0.01), feeling involved by the care recipient (OR 0.44; 95% CI 0.24 to 0.79; p=0.01), feeling more encouraged to be involved in care (OR 0.49; 95% CI 0.27 to 0.86; p=0.01), feeling like they contribute to discussions (OR 0.45; 95% CI 0.25 to 0.82; p=0.01) and feeling like their questions are being answered (OR 0.33; 95% CI 0.18 to 0.60; p<0.001). CONCLUSION In our sample, the shift to telemedicine during COVID-19 was well received but caregivers of low educational attainment reported poorer health communication, and a greater proportion of black/African American and Hispanic caregivers reported a desire to return to in-person visits. There is an opportunity to improve health systems and increase equity as telemedicine becomes more widespread.
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Affiliation(s)
- Reed W R Bratches
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
| | | | | | - A James O'Malley
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
- Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
| | - Paul J Barr
- The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, USA
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire, USA
- Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
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18
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Williams PAH, Lovelock B, Cabarrus T. A Sense of Coherence approach to improving patient experience using information infrastructure modelling. JMIR Form Res 2022; 6:e35418. [PMID: 35307641 PMCID: PMC9044153 DOI: 10.2196/35418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/03/2022] [Accepted: 03/17/2022] [Indexed: 11/17/2022] Open
Abstract
Background Health care provider organizations are complex and dynamic environments. Consequently, how the physical and social environment of such organizations interact with an individual is a primary driver of an individual’s experience. Increasingly, the capabilities required for them to successfully interact with those within their care are critically dependent on the information infrastructure they have in place, which enables people, both patients and staff, to work optimally together to deliver their clinical and operational objectives. Objective This study aims to design a framework to address the challenge of how to assemble information systems in health care to support an improved sense of coherence for patients, as well as potentially innovate patients’ experiences, by connecting and orchestrating the synergy among people, processes, and systems. Methods It is necessary to understand the needs of health care providers and patients to address this challenge at a level relevant to information process design and technology development. This paper describes the design science research method used to combine the sense of coherence, which is a core concept within the Antonosky salutogenic approach to health and well-being, with an established information infrastructure maturity framework, demonstrating the coalescence of 2 distinct conceptual perspectives on care delivery. This paper provides an approach to defining a positive and supportive health care experience and linking this to the capabilities of an information- and technology-enabled environment. Results This research delivers a methodology for describing the patient experience in a form relevant to information infrastructure design, articulating a pathway from information infrastructure to patient experience. It proposes that patient experience can be viewed pragmatically in terms of the established sense of coherence concept, with its ability to identify and guide resources to modulate a patient’s environmental stressors. This research establishes a framework for determining and optimizing the capability of a facility’s information infrastructure to support the sense of coherence defined by the experiences of its patients. Conclusions This groundbreaking research provides a framework for health care provider organizations to understand and assess the ability of their information infrastructure to support and improve the patient experience. The tool assists providers in defining their technology-dependent operational goals around patient experience and, consequently, in identifying the information capabilities needed to support these goals. The results demonstrate how a fundamental shift in thinking about the use of information infrastructure can transform the patient experience. This study details an approach to describing information infrastructure within an experience-oriented framework that enables the impact of technology on experience to be designed explicitly. The contribution to knowledge is a new perspective on modeling how information infrastructure can contribute to supportive health-promoting environments. Furthermore, it may significantly affect the design and deployment of future digital infrastructures in health care.
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Affiliation(s)
- Patricia Anne Helen Williams
- Flinders-Cisco Digital Health Design Lab, Flinders Digital Health Research Centre, College of Science and Engineering, Flinders University, Tonsley CampusGPO Box 2100, Adelaide, SA, AU
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Konateke S, Yılmaz M. Turkish validity and reliability study of the Brief Emergency Department Patient Satisfaction Scale. Int Emerg Nurs 2022; 61:101145. [DOI: 10.1016/j.ienj.2022.101145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 12/01/2021] [Accepted: 01/05/2022] [Indexed: 11/05/2022]
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Ahmad MS, Hicks SR, Watson R, Ahmed RA, Jones L, Vaselli M, Wu MS, Hayat F, Ratcliffe L, McKenna M, Hine P, Defres S, Wingfield T. A patient satisfaction survey and educational package to improve the care of people hospitalised with COVID-19: a quality improvement project, Liverpool, UK. Wellcome Open Res 2022; 6:222. [PMID: 35118199 PMCID: PMC8787571 DOI: 10.12688/wellcomeopenres.17163.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2022] [Indexed: 11/20/2022] Open
Abstract
Background: The perspectives and experiences of people hospitalised with COVID-19 have been under-reported during the coronavirus pandemic. We developed and conducted a COVID-19 patient satisfaction survey in a large university-affiliated secondary healthcare centre in Liverpool, UK, during Europe’s first coronavirus wave (April-June 2020). The survey found that care was rated highly, including among people of Black Asian and Minority Ethnic (BAME) backgrounds. However, sleep-quality and communication about medications and discharge-planning were identified as areas for improvement. Methods: To improve care for people with COVID-19 admitted to our centre, we designed an educational package for healthcare professionals working on COVID-19 wards. The package, implemented in August 2020, included healthcare worker training sessions on providing holistic care and placement of “Practice Pointers” posters. Patient satisfaction was re-evaluated during the second/third COVID-19 waves in Liverpool (September 2020 - February 2021). Results: Across waves, most (95%) respondents reported that they would recommend our hospital to friends and/or family and rated overall care highly. Comparison of the responses of second/third-wave respondents (n=101) with first-wave respondents (n=94) suggested improved patient satisfaction across most care domains but especially those related to having worries and fears addressed and being consulted about medications and their side-effects. Conclusions: People admitted with COVID-19 to our centre in Liverpool, including those from BAME backgrounds, rated the care they received highly. A simple education package improved the feedback on care received by respondents between the first and second/third waves. These UK-first findings are informing regional strategies to improve person-centred care of hospitalised people with COVID-19.
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Affiliation(s)
- Muhammad Shamsher Ahmad
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
- Clinical Infection Microbiology and Immunology, Institute of Infection and Global Health, Liverpool, UK
| | - Scott Rory Hicks
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
| | - Rebecca Watson
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
| | - Rajia Akter Ahmed
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
| | - Lewis Jones
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
| | - Marcella Vaselli
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
| | - Meng-San Wu
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
| | - Fatima Hayat
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
| | - Libuse Ratcliffe
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
| | - Mark McKenna
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
| | - Paul Hine
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
- Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Liverpool, Merseyside, L3 5QA, UK
| | - Sylviane Defres
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
- Clinical Infection Microbiology and Immunology, Institute of Infection and Global Health, Liverpool, UK
- Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Liverpool, Merseyside, L3 5QA, UK
| | - Tom Wingfield
- Tropical and Infectious Disease Unit, Liverpool University Hospital NHS Foundation Trust, Liverpool, Merseyside, L7 8XP, UK
- Clinical Infection Microbiology and Immunology, Institute of Infection and Global Health, Liverpool, UK
- Clinical Sciences and International Public Health, Liverpool School of Tropical Medicine, Liverpool, Merseyside, L3 5QA, UK
- WHO Collaborating Centre for Social Medicine and Tuberculosis, Department of Global Public Health Sciences, Karolinska Institute, Stockholm, Sweden
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21
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Jewell C, Kraut A, Miller D, Ray K, Werley E, Schnapp B. Metrics of Resident Achievement for Defining Program Aims. West J Emerg Med 2022; 23:1-8. [PMID: 35060852 PMCID: PMC8782131 DOI: 10.5811/westjem.2021.12.53554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 12/06/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction Resident achievement data is a powerful but underutilized means of program evaluation, allowing programs to empirically measure whether they are meeting their program aims, facilitate refinement of curricula and improve resident recruitment efforts. The goal was to provide an overview of available metrics of resident achievement and how these metrics can be used to inform program aims. Methods A literature search was performed using PubMed and Google Scholar between May and November of 2020. Publications were eligible for inclusion if they discussed or assessed “excellence” or “success” during residency training. A narrative review structure was chosen due to the intention to provide an examination of the literature on available resident achievement metrics. Results 57 publications met inclusion criteria and were included in the review. Metrics of excellence were grouped into larger categories, including success defined by program factors, academics, national competencies, employer factors, and possible new metrics. Conclusions Programs can best evaluate whether they are meeting their program aims by creating a list of important resident-level metrics based on their stated goals and values using one or more of the published definitions as a foundation. Each program must define which metrics align best with their individual program aims and mission.
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Affiliation(s)
- Corlin Jewell
- University of Wisconsin School of Medicine and Public Health, BerbeeWalsh Department of Emergency Medicine, Madison, Wisconsin
| | - Aaron Kraut
- University of Wisconsin School of Medicine and Public Health, BerbeeWalsh Department of Emergency Medicine, Madison, Wisconsin
| | - Danielle Miller
- University of Colorado School of Medicine, Department of Emergency Medicine, Aurora, Colorado
| | - Kaitlin Ray
- University of Wisconsin School of Medicine and Public Health, BerbeeWalsh Department of Emergency Medicine, Madison, Wisconsin
| | - Elizabeth Werley
- PennState College of Medicine, Department of Emergency Medicine, Hershey, Pennsylvania
| | - Bejamin Schnapp
- University of Wisconsin School of Medicine and Public Health, BerbeeWalsh Department of Emergency Medicine, Madison, Wisconsin
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22
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Alhajri N, Simsekler MCE, Alfalasi B, Alhashmi M, Memon H, Housser E, Abdi AM, Balalaa N, Al Ali M, Almaashari R, Al Memari S, Al Hosani F, Al Zaabi Y, Almazroui S, Alhashemi H. Exploring Quality Differences in Telemedicine Between Hospital Outpatient Departments and Community Clinics: A Cross-Sectional Study. JMIR Med Inform 2021; 10:e32373. [PMID: 34978281 PMCID: PMC8849258 DOI: 10.2196/32373] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 08/26/2021] [Accepted: 12/21/2021] [Indexed: 11/18/2022] Open
Abstract
Background Telemedicine is a care delivery modality that has the potential to broaden the reach and flexibility of health care services. In the United Arab Emirates, telemedicine services are mainly delivered through either integrated hospital outpatient department (OPDs) or community clinics. However, it is unknown if patients’ perceptions of, and satisfaction with, telemedicine services differ between these two types of health care systems during the COVID-19 pandemic. Objective We aimed to explore the differences in patients’ perceptions of, and satisfaction with, telemedicine between hospital OPDs and community clinics during the COVID-19 pandemic. We also aimed to identify patient- or visit-related characteristics contributing to patient satisfaction with telemedicine. Methods In this cross-sectional study that was conducted at Abu Dhabi health care centers, we invited outpatients aged 18 years or over, who completed a telemedicine visit during the COVID-19 pandemic, to participate in our study. Patients’ perceptions of, and satisfaction with, telemedicine regarding the two system types (ie, hospital OPDs and community clinics) were assessed using an online survey that was sent as a link through the SMS system. Regression models were used to describe the association between patient- and visit-related characteristics, as well as the perception of, and satisfaction with, telemedicine services. Results A total of 515 patients participated in this survey. Patients’ satisfaction with telemedicine services was equally high among the settings, with no statistically significant difference between the two setting types (hospital OPDs: 253/343, 73.8%; community clinics: 114/172, 66.3%; P=.19). Video consultation was significantly associated with increased patient satisfaction (odds ratio [OR] 2.57, 95% CI 1.04-6.33; P=.04) and patients’ support of the transition to telemedicine use during and after the pandemic (OR 2.88, 95% CI 1.18-7.07; P=.02). Patients who used video consultations were more likely to report that telemedicine improved access to health care services (OR 3.06, 95% CI 1.71-8.03; P=.02), reduced waiting times and travel costs (OR 4.94, 95% CI 1.15-21.19; P=.03), addressed patients’ needs (OR 2.63, 95% CI 1.13-6.11; P=.03), and eased expression of patients’ medical concerns during the COVID-19 pandemic (OR 2.19, 95% CI 0.89-5.38; P=.09). Surprisingly, middle-aged patients were two times more likely to be satisfied with telemedicine services (OR 2.12, 95% CI 1.09-4.14; P=.03), as compared to any other age group in this study. Conclusions These findings suggest that patient satisfaction was unaffected by the health system setting in which patients received the teleconsultations, whether they were at hospitals or community clinics. Video consultation was associated with increased patient satisfaction with telemedicine services. Efforts should be focused on strategic planning for enhanced telemedicine services, video consultation in particular, for both emergent circumstances, such as the COVID-19 pandemic, and day-to-day health care delivery.
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Affiliation(s)
- Noora Alhajri
- Khalifa University College of Medicine and Health Science, Al-Saada road, Zone 1 - Abu Dhabi, Abu Dhabi, AE
| | | | - Buthaina Alfalasi
- Zayed Military Hospital, Department of Family Medicine, Abu Dhabi, AE
| | - Mohamed Alhashmi
- Khalifa University College of Medicine and Health Science, Al-Saada road, Zone 1 - Abu Dhabi, Abu Dhabi, AE
| | - Hamda Memon
- Khalifa University College of Medicine and Health Science, Al-Saada road, Zone 1 - Abu Dhabi, Abu Dhabi, AE
| | - Emma Housser
- Khalifa University College of Medicine and Health Science, Al-Saada road, Zone 1 - Abu Dhabi, Abu Dhabi, AE
| | - Abdulhamid Mustafa Abdi
- Khalifa University College of Medicine and Health Science, Al-Saada road, Zone 1 - Abu Dhabi, Abu Dhabi, AE
| | - Nahed Balalaa
- Department of General Surgery, Sheikh Shakhbout Medical City (SSMC), Abu Dhabi, AE
| | | | - Raghda Almaashari
- Department of Dermatology, Sheikh Khalifa Medical City (SKMC), Abu Dhabi, AE
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Ahmad MS, Hicks SR, Watson R, Ahmed RA, Jones L, Vaselli M, Wu MS, Hayat F, Ratcliffe L, McKenna M, Hine P, Defres S, Wingfield T. A patient satisfaction survey and educational package to improve the care of people hospitalised with COVID-19: a quality improvement project, Liverpool, UK. Wellcome Open Res 2021; 6:222. [DOI: 10.12688/wellcomeopenres.17163.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2021] [Indexed: 11/20/2022] Open
Abstract
Background: The perspectives and experiences of people hospitalised with COVID-19 have been under-reported during the coronavirus pandemic. We developed and conducted a COVID-19 patient satisfaction survey in a large university-affiliated secondary healthcare centre in Liverpool, UK, during Europe’s first coronavirus wave (April-June 2020). The survey found that care was rated highly, including among people of Black Asian and Minority Ethnic (BAME) background. However, sleep-quality and communication about medications and discharge-planning were identified as areas for improvement. Methods: To improve care for people with COVID-19 admitted to our centre, we designed an educational package for healthcare professionals working on COVID-19 wards. The package, implemented in August 2020, included healthcare worker training sessions on providing holistic care and placement of “Practice Pointers” posters. Patient satisfaction was re-evaluated during the second/third COVID-19 waves in Liverpool (September 2020 - February 2021). Results: Across waves, most (95%) respondents reported that they would recommend our hospital to friends and/or family and rated overall care highly. Comparison of the responses of second/third-wave respondents (n=101) with first-wave respondents (n=94) suggested improved patient satisfaction across most care domains but especially those related to having worries and fears addressed and being consulted about medications and their side-effects. Conclusions: People admitted with COVID-19 to our centre in Liverpool, including those from BAME background, rated the care they received highly. A simple education package improved the feedback on care received by respondents between the first and second/third waves. These UK-first findings are informing regional strategies to improve person-centred care of hospitalised people with COVID-19.
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Reznek MA, Larkin CM, Scheulen JJ, Harbertson CA, Michael SS. Operational factors associated with emergency department patient satisfaction: Analysis of the Academy of Administrators of Emergency Medicine/Association of Academic Chairs of Emergency Medicine national survey. Acad Emerg Med 2021; 28:753-760. [PMID: 33977605 DOI: 10.1111/acem.14278] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 05/03/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Patient satisfaction is a focus for emergency department (ED) and hospital administrators. ED patient satisfaction studies have tended to be single site and focused on patient and clinician factors. Inclusion of satisfaction scores in a large, national operations database provided an opportunity to conduct an investigation that included diverse operational factors. METHODS We performed a retrospective analysis of the 2019 Academy of Administrators in Academic Emergency Medicine/Association of Academic Chairs of Emergency Medicine (AAAEM/AACEM) benchmarking survey to identify associations between operational factors and patient satisfaction. We identified 59 database variables as potential predictors of Press Ganey likelihood-to-recommend and physician overall scores. Using random forest modeling, we identified the top eight predictors in the models and described their associations. RESULTS Forty-three (57.3%) academic departments responding to the AAAEM/AACEM survey reported patient satisfaction scores for 78 EDs. Likelihood to recommend ranged from 30.0 to 93.0 (median = 74.8) and was associated with ED length of stay, boarding, use of hallway spaces, hospital annual admissions, faculty base clinical hours, proportion of patients leaving before treatment complete (LBTC), and provider in triage hours per day. Physician overall score ranged from 53.3 to 93.4 (median = 81.9) and was associated with faculty base clinical hours, x-ray utilization, annual ED arrivals, LBTC, use of hallway spaces, arrivals per attending hour, and CT utilization. CONCLUSIONS ED patient satisfaction was associated with intrinsic and extrinsic factors, some being potentially manageable within the ED but others being relatively fixed or outside the control of ED operations. For likelihood to recommend, patient flow was dominant, with erosion of satisfaction observed with increased boarding and longer LOS. Factors associated with physician overall score were more varied. The use of hallway spaces and base clinical hours greater than 1,500 per year were associated with both lower likelihood-to-recommend and lower physician overall scores.
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Affiliation(s)
- Martin A. Reznek
- Department of Emergency Medicine University of Massachusetts Medical School Worcester Massachusetts USA
| | - Celine M. Larkin
- Department of Emergency Medicine University of Massachusetts Medical School Worcester Massachusetts USA
| | - James J. Scheulen
- Department of Emergency Medicine Johns Hopkins University School of Medicine Baltimore Maryland USA
| | - Cathi A. Harbertson
- Department of Emergency Medicine Johns Hopkins University School of Medicine Baltimore Maryland USA
| | - Sean S. Michael
- Department of Emergency Medicine University of Colorado School of Medicine Aurora Colorado USA
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25
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Granata RT, Guillen NR, Lucero AD, Lagerhausen ST. Do Automated Reminders for Emergency Department Resident Physicians to Review Their Patient List Improve Efficiency? AEM EDUCATION AND TRAINING 2021; 5:e10552. [PMID: 34124500 PMCID: PMC8171450 DOI: 10.1002/aet2.10552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 10/14/2020] [Accepted: 10/20/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Navigating the emergency department (ED) workflow in an efficient manner is an important skill every emergency physician or advanced provider must master. There is a paucity of research into ways to improve how efficiently an ED provider works amid these distractions. This study seeks to determine whether the addition of an hourly automated reminder for resident physicians to review their patient list improves throughput metrics. METHODS This a double-blinded randomized controlled trial in which resident physicians at a single community ED were randomly assigned to two groups: the intervention group, which received automated hourly notifications within the electronic medical record (EMR) to review their patient list for those whose workup is completed, and the control group, which received no notifications. We prospectively analyzed records for 25,255 encounters with 19,264 individual patients seen by 64 residents over the study period. Three-level mixed-effects regression models were used to examine whether notifications improved ED length of stay (ED-LOS), turnaround time to discharge (TAT-D), or turnaround time to admission (TAT-A). RESULTS There was no statistically significant difference in ED-LOS or TAT-D between groups, but the average TAT-A was 20.00 minutes longer in the intervention group compared to the control group (p < 0.001), after accounting for patient- and resident-specific effects. Secondary analysis demonstrated no statistically significant effect of residency specialty on the effect of notifications on ED-LOS, TAT-D, or TAT-A. CONCLUSIONS Automated hourly notifications within the EMR reminding residents in the ED to review their patient list did not reduce the ED-LOS, TAT-D, or TAT-A. However, the TAT-A was 20.00 minutes longer in the intervention group compared to the control group. It is unclear whether this represents an unintended effect of the automated reminders or is simply a spurious correlation.
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Affiliation(s)
- Robert T. Granata
- From theDepartment of Emergency MedicineKaweah Delta Medical CenterVisaliaCAUSA
| | - Nicole R. Guillen
- From theDepartment of Emergency MedicineKaweah Delta Medical CenterVisaliaCAUSA
| | - Anthony D. Lucero
- From theDepartment of Emergency MedicineKaweah Delta Medical CenterVisaliaCAUSA
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Visperas AT, Greene KA, Krebs VE, Klika AK, Piuzzi NS, Higuera-Rueda CA. A Web-Based Interactive Patient-Provider Software Platform Does Not Increase Patient Satisfaction or Decrease Hospital Resource Utilization in Total Knee and Hip Arthroplasty Patients in a Single Large Hospital System. J Arthroplasty 2021; 36:2290-2296.e1. [PMID: 33581971 DOI: 10.1016/j.arth.2021.01.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/21/2020] [Accepted: 01/13/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Web-based platforms used to enhance patient-provider communication are being explored to improve patient satisfaction and care delivery, and decrease cost. This study tested a web-based interactive patient-provider software platform (IPSP), JointCOACH, which enabled patient communication with their care team and preparatory/recovery guidance. The aims of this study are to compare (1) patient satisfaction and (2) healthcare resource utilization by patients who underwent total knee and hip replacements and added IPSP to standard of care (SOC). METHODS This study is a prospective, randomized clinical trial at a single large academic healthcare system. Between May 2018 and March 2020, 399 patients undergoing elective total hip or knee arthroplasty were randomized to SOC arm (n = 204) or SOC + IPSP arm (n = 195). Patient demographics, surgical details, and comorbidities were collected. Patient satisfaction was assessed using Visual Analog Scale and the Picker Patient Experience-15. Healthcare utilization was measured using length of stay, emergency department and office visits, office calls, readmissions, and reoperations at 30 and 90 days after surgery. RESULTS No difference was found in length of stay between SOC and SOC + IPSP. No differences were found in 30-day or 90-day satisfaction or in healthcare resource utilization (P > .05) including number of office and emergency department visits, phone calls, and readmissions. CONCLUSION Statistical differences were not found in satisfaction and healthcare utilization with the addition of IPSP to SOC. IPSP can be used to reinforce patient education and communication between the patient and provider, and should be evaluated as an element of virtual care rather than supplementing traditional in-office follow-up. CLINICALTRIALS.GOV: More information on this study can be found at clinicaltrials.gov NCT03499028.
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Affiliation(s)
- Anabelle T Visperas
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH
| | - Kenneth A Greene
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH
| | - Viktor E Krebs
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH
| | - Alison K Klika
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH
| | - Nicolas S Piuzzi
- Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, OH
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Scholz M, Haase R, Trentzsch K, Stölzer-Hutsch H, Ziemssen T. Improving Digital Patient Care: Lessons Learned from Patient-Reported and Expert-Reported Experience Measures for the Clinical Practice of Multidimensional Walking Assessment. Brain Sci 2021; 11:brainsci11060786. [PMID: 34198702 PMCID: PMC8232326 DOI: 10.3390/brainsci11060786] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Walking assessment (WA) enables meaningful patient mobility assessment. In this context, patient satisfaction with WA can influence assessment compliance and indirectly affect outcomes. One opportunity to assess patient satisfaction is patient-reported and expert-reported experience measures (PREM). Research on PREMs and WA in daily clinical multiple sclerosis (MS) practice does not exist yet. Methods: We surveyed people with MS about their experience and assessed healthcare professionals’ experience via an interview after patients completed WA. Results: Gait parameters were related to perceived difficulty and strain during performance. Less impaired patients perceived the WA to be less difficult and exhausting but were less likely to use WA results for themselves. Men and patients with higher impairment would perform WA more frequently. A good workflow, a fully performed WA with standardized testing, fully functional measurement systems, support and safeguarding by staff in case of falls, direct feedback after the testing, and patients’ motivation are identified by the experts as necessary factors for a successful WA. Conclusions: As patients’ experience has an impact on patients’ outcomes, long-term monitoring of PREMs should become an integral part of the healthcare service to identify and avoid problems early.
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Zakkar MA, Meyer SB, Janes CR. Evidence and politics of patient experience in Ontario: The perspective of healthcare providers and administrators. Int J Health Plann Manage 2021; 36:1189-1206. [PMID: 33829549 DOI: 10.1002/hpm.3153] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 09/22/2020] [Accepted: 03/01/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Patient experience has a direct impact on patients' engagement in healthcare, their commitment to treatment plans, and their relationship with their healthcare providers, all of which can impact their health outcomes. The complexity of the healthcare system, the increasing health needs of the population, and the priority and knowledge differences among healthcare stakeholders impact how they conceptualize and seek to achieve the ideal patient experience and the weights that they give to different elements of this experience. AIMS This study sought to understand the perspectives of healthcare providers and administrators in Ontario regarding the factors affecting the patient experience. MATERIALS & METHODS Qualitative data were collected between April 2018 and May 2019. Twenty-one semi-structured interviews were conducted. Interviewees included physicians, nurses, optometrists, dietitians, quality managers, and policymakers. Thematic analysis was used to analyse the data, utilizing and extending a previously developed patient experience framework. RESULTS Several themes emerged in the data, and they represent two perspectives on patient experience: the biomedical perspective, which prioritizes health outcomes and gives high weights to healthcare experience factors that can be controlled by healthcare providers, while ignoring other factors, and the sociopolitical perspective, which recognizes the impacts of healthcare politics and the social context of health on patient experience in Ontario. CONCLUSION The study is timely in light of the current changes in the Ontario healthcare system and the healthcare reform started by the new government, as it sheds light on the possible negative impact of healthcare policy and politics on patient experience.
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Affiliation(s)
- Moutasem A Zakkar
- The School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Samantha B Meyer
- The School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Craig R Janes
- The School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
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Grissom MO, Farra M, Cruzen ES, Barlow E, Gupta S. What can COVID-19 teach us about patient satisfaction in the emergency department? A mixed-methods approach. J Am Coll Emerg Physicians Open 2021; 2:e12436. [PMID: 33969346 PMCID: PMC8082698 DOI: 10.1002/emp2.12436] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 03/07/2021] [Accepted: 03/25/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The current study explored improved patient satisfaction scores at a single emergency department (ED) during the early phase of the COVID-19 pandemic (March to May 2020). METHODS A mixed-methods design, integrating qualitative and quantitative data analyses, was employed to explore a total of 289 patient satisfaction survey ratings and 421 comments based on care that took place in the ED during the initial phase of the COVID-19 epidemic. This allowed for comparisons to a more typical time period in the ED along with the emergence of novel categories of influence. RESULTS The ED census was 31% lower during 2020 (COVID-19) than the previous year, and a significantly greater percentage of patients in 2020 indicated that they would "definitely recommend" the ED compared with 2019. Wait time was mentioned in >40% of dissatisfied patient comments in 2019 but <20% of dissatisfied patient comments in 2020. General negative comments were proportionately greater than general positive comments in 2019, whereas in 2020 the reverse pattern held. Other categories did not differ significantly across 2019 and 2020. CONCLUSIONS The general circumstances surrounding the early stages of the COVID-19 pandemic included a lower census in the ED and higher reported satisfaction among patients. A comparison of the content of patient comments revealed less concern about wait times and a more positive overall view toward receiving care during the first 3 months of the pandemic.
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Affiliation(s)
- Maureen O. Grissom
- Department of Emergency MedicineSouth Shore University Hospital‐NorthwellBay ShoreNew YorkUSA
- Department of Behavioral and Social SciencesUniversity of Houston College of MedicineHoustonTexasUSA
| | - Morgan Farra
- Department of Emergency MedicineSouth Shore University Hospital‐NorthwellBay ShoreNew YorkUSA
| | - Eric S. Cruzen
- Department of Emergency MedicineSouth Shore University Hospital‐NorthwellBay ShoreNew YorkUSA
| | - Erin Barlow
- Department of Emergency MedicineSouth Shore University Hospital‐NorthwellBay ShoreNew YorkUSA
| | - Sanjey Gupta
- Department of Emergency MedicineSouth Shore University Hospital‐NorthwellBay ShoreNew YorkUSA
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30
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Diercks L, Courtney DM, Piel C, Overstreet S, Mayo M, Diercks D. Minimal Differences in Responses but Big Differences in Rankings: Press Ganey Versus Professional Research Consultants. Acad Emerg Med 2021; 28:459-462. [PMID: 32889740 DOI: 10.1111/acem.14121] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 08/27/2020] [Accepted: 08/28/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Lauren Diercks
- From the UT Southwestern Medical School Dallas Dallas TXUSA
| | | | - Carl Piel
- From the UT Southwestern Medical School Dallas Dallas TXUSA
| | | | - Mike Mayo
- From the UT Southwestern Medical School Dallas Dallas TXUSA
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31
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Evaluation of electronic prescriptions in Turkey: A community pharmacy perspective. HEALTH POLICY AND TECHNOLOGY 2021. [DOI: 10.1016/j.hlpt.2020.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Anderson PM, Krallman R, Montgomery D, Kline-Rogers E, Bumpus SM. The Relationship Between Patient Satisfaction With Hospitalization and Outcomes Up to 6 Months Post-Discharge in Cardiac Patients. J Patient Exp 2021; 7:1685-1692. [PMID: 33457631 PMCID: PMC7786784 DOI: 10.1177/2374373520948389] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Little is known about the relationship between patient satisfaction with inpatient care and post-discharge outcomes. This study examined inpatient hospital satisfaction after a cardiac event and outcomes through 6 months post-discharge. We examined 327 cardiac patients from the Bridging the Discharge Gap Effectively database who completed a patient satisfaction survey about their hospital admission and had post-discharge outcomes data. Higher patient satisfaction with the discharge process correlated with fewer readmissions at 90 days post-discharge. Higher patient satisfaction with hospital staff management of personal issues correlated with fewer emergency department visits at 6 months post-discharge. Higher patient satisfaction with overall assessment of care and hospitalization correlated with lower mortality rate at 6 months post-discharge. Being nonwhite correlated with lower nursing care satisfaction. Associations between cardiac patient satisfaction and outcomes exist. In this population, higher patient satisfaction correlated with better outcomes. Patient satisfaction data may be able to inform areas for health system improvement.
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Affiliation(s)
| | - Rachel Krallman
- Michigan Clinical Outcomes Research and Reporting Program, University of Michigan Health System, Ann Arbor, MI, USA
| | - Daniel Montgomery
- Michigan Clinical Outcomes Research and Reporting Program, University of Michigan Health System, Ann Arbor, MI, USA
| | - Eva Kline-Rogers
- Michigan Clinical Outcomes Research and Reporting Program, University of Michigan Health System, Ann Arbor, MI, USA
| | - Sherry M Bumpus
- Michigan Clinical Outcomes Research and Reporting Program, University of Michigan Health System, Ann Arbor, MI, USA.,School of Nursing, Eastern Michigan University, Ypsilanti, MI, USA
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Puppala M, Ezeana CF, Alvarado MVY, Goode KN, Danforth RL, Wong SS, Vassallo ML, Wong ST. A multifaceted study of hospital variables and interventions to improve inpatient satisfaction in a multi-hospital system. Medicine (Baltimore) 2020; 99:e23669. [PMID: 33371105 PMCID: PMC7748194 DOI: 10.1097/md.0000000000023669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 11/09/2020] [Indexed: 11/27/2022] Open
Abstract
Knowing the areas of service, actions, and parameters that can influence patient perception about a service provided can help hospital executives and healthcare workers to devise improvement plans, leading to higher patient satisfaction. To identify inpatient satisfaction determinants, assess their relationships with hospital variables, and improve patient satisfaction through interventions. We studied the inpatient population of an eight-hospital tertiary medical center in 2015. The satisfaction determinants were based on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey answers and included clinical and organizational variables. Interventions began at the end of 2016 included bedside care coordination rounds (BCCR), medications best practices alert (BPA), connect transitions post-discharge calls (CONNECT Transitions) and a framework for provider-patient interactions called AIDET (Acknowledge, Introduce, Duration, Explain, and Thank). Substantial impact upon patient satisfaction was observed after the introduction of these interventions. Three groups were identified: 1. high satisfaction, which correlated with race, surgery, and cancer care; 2. low satisfaction, correlated with elderly, emergency room, intensive care unit, chronic obstructive pulmonary disease, and vascular diseases; and 3. neutral, correlated with hospital-acquired complications, several diagnostic procedures, and medical care delay. Significant improvements in the 3 groups were achieved with interventions that optimize care provider interactions with patients and their families. Based on the HCAHPS-based analysis, we implemented new measures and programs for addressing coordination of care, improving patient safety, reducing the length of stay, and ultimately improving patient satisfaction.
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Affiliation(s)
| | | | | | | | | | - Solomon S.Y. Wong
- Department of Systems Medicine and Bioengineering
- Present address: Baylor University School of Law, Waco, TX
| | - Mark L. Vassallo
- Department of Quality Operations, Houston Methodist Hospital, Houston, Texas
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Chaturvedi S, Hughes JT, Cherian S, Morris P. EARLY EVALUATION OF A NEWLY COMMENCED PAEDIATRIC NEPHROLOGY SERVICE IN THE NORTHERN TERRITORY OF AUSTRALIA: A CARER'S AND PROVIDER'S PERSPECTIVE. J Paediatr Child Health 2020; 56:1999. [PMID: 33351244 DOI: 10.1111/jpc.15260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/18/2020] [Accepted: 10/23/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Swasti Chaturvedi
- Department of Paediatrics, Royal Darwin Hospital, Darwin, Northern Territory, Australia.,Menzies School of Health Research, Darwin, Northern Territory, Australia
| | - Jaquilyne T Hughes
- Menzies School of Health Research, Darwin, Northern Territory, Australia.,Department of Renal Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Sajiv Cherian
- Department of Renal Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia
| | - Peter Morris
- Department of Paediatrics, Royal Darwin Hospital, Darwin, Northern Territory, Australia.,Menzies School of Health Research, Darwin, Northern Territory, Australia
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Jehle D, Leggett J, Short R, Pangia J, Wilson C, Gutovitz S. Influence of COVID-19 outbreak on emergency department Press Ganey scores of emergency physicians. J Am Coll Emerg Physicians Open 2020; 1:1413-1417. [PMID: 33230508 PMCID: PMC7675637 DOI: 10.1002/emp2.12287] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 09/14/2020] [Accepted: 09/29/2020] [Indexed: 12/04/2022] Open
Abstract
Background and Hypothesis The authors investigate whether there is a difference in Press Ganey (PG; patient satisfaction scores) scores for the emergency physicians before and during the coronavirus disease 2019 (COVID-19) outbreak at a regional group of emergency departments in the southeastern United States. The authors hypothesize that decreases in emergency department volume, less emergency department boarding of admissions, reduced use of hallway beds, and favorable attitudes toward emergency physicians during the COVID-19 outbreak may influence patient satisfaction scores measured in the Press Ganey surveys. Study Design and Methods The authors performed a retrospective review of PG scores obtained over the prior 7 months at 8 larger teaching hospitals in the Southeast region (Florida, Georgia, and South Carolina). Averaged physician PG Scores and their 4 components-courtesy, time to listen, informative regarding treatment, concern for comfort-were collected. The authors evaluated the overall physician PG ratings for March through May 2020 (COVID outbreak) vs the prior 4 months. Overall emergency physician scores, using top box methodology of percent highest response, were averaged from 4 questions regarding the emergency physician's care. Results There were 6272 patient satisfaction surveys returned in the 7-month study period; 4003 responses during the pre-COVID months (November 2019-February 2020) and 2296 during the COVID months (March through May 2020). Results showed that in the "pre-COVID time" the PG surveys scored in the 17% of all PGs in the country (63.9% "top-box" or highest rating score) as compared to scoring in the 34% of all PGs (68.1% "top-box") during "COVID time." These data were statistically significant using a chi-square analysis with P < 0.001. Conclusions Emergency physician patient satisfaction scores, as represented by the PG score, were significantly higher during the COVID months, in comparison to the pre-COVID months, for 8 teaching hospitals in the Southeast region of the United States.
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Affiliation(s)
- Dietrich Jehle
- Grand Strand Medical Center Emergency MedicineMyrtle BeachSouth CarolinaUSA
| | - Jonathan Leggett
- Emergency Medicine Grand Strand Medical CenterMyrtle BeachSouth CarolinaUSA
| | - Radley Short
- Grand Strand Medical CenterMyrtle BeachSouth CarolinaUSA
| | | | - Casey Wilson
- Grand Strand Medical CenterMyrtle BeachSouth CarolinaUSA
| | - Scott Gutovitz
- Grand Strand Medical CenterMyrtle BeachSouth CarolinaUSA
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Lehrich BM, Goshtasbi K, Brown NJ, Shahrestani S, Lien BV, Ransom SC, Tafreshi AR, Ransom RC, Chan AY, Diaz-Aguilar LD, Sahyouni R, Pham MH, Osorio JA, Oh MY. Predictors of Patient Satisfaction in Spine Surgery: A Systematic Review. World Neurosurg 2020; 146:e1160-e1170. [PMID: 33253954 DOI: 10.1016/j.wneu.2020.11.125] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 11/20/2020] [Accepted: 11/21/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Recently, there has been increased interest in patient satisfaction measures such as Press Ganey and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys. In this systematic review, the spine surgery literature is analyzed to evaluate factors predictive of patient satisfaction as measured by these surveys. METHODS A thorough literature search was performed in PubMed/MEDLINE, Google Scholar, and Cochrane databases. All English-language articles from database inception to July 2020 were screened for study inclusion according to PRISMA guidelines. RESULTS Twenty-four of the 1899 published studies were included for qualitative analysis. There has been a statistically significant increase in the number of publications across years (P = 0.04). Overall, the studies evaluated the relationship between patient satisfaction and patient demographics (71%), preoperative and intraoperative clinical factors (21%), and postoperative factors (33%). Top positive predictors of patient satisfaction were patient and nursing/medical staff relationship (n = 4; 17%), physician-patient relationship (n = 4; 17%), managerial oversight of received care (n = 3; 13%), same sex/ethnicity between patient and physician (n = 2; 8%), and older age (n = 2; 8%). Top negative predictors of patient satisfaction were high Charlson Comorbidity Index/high disability/worse overall health functioning (n = 7; 29%), increased length of hospital stay (n = 4; 17%), high rating for pain/complications/readmissions (n = 4; 17%), and psychosocial factors (n = 3; 13%). CONCLUSIONS There is heterogeneity in terms of different factors, both clinical and nonclinically related, that affect patient satisfaction ratings. More research is warranted to investigate the role of hospital consumer surveys in the spine surgical patient population.
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Affiliation(s)
- Brandon M Lehrich
- Medical Scientist Training Program, University of Pittsburgh and Carnegie Mellon University, Pittsburgh, Pennsylvania, USA.
| | - Khodayar Goshtasbi
- School of Medicine, University of California, Irvine, Irvine, California, USA
| | - Nolan J Brown
- Department of Neurosurgery, University of California, Irvine, Irvine, California, USA
| | - Shane Shahrestani
- Keck School of Medicine, University of Southern California, Los Angeles, California, USA; Department of Medical Engineering, California Institute of Technology, Pasadena, California, USA
| | - Brian V Lien
- Department of Neurosurgery, University of California, Irvine, Irvine, California, USA
| | - Seth C Ransom
- School of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Ali R Tafreshi
- Department of Neurological Surgery, Geisinger Health System, Danville, Pennsylvania, USA
| | - Ryan C Ransom
- Department of Neurological Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Alvin Y Chan
- Department of Neurosurgery, University of California, Irvine, Irvine, California, USA
| | - Luis D Diaz-Aguilar
- Department of Neurological Surgery, University of California, San Diego, La Jolla, California, USA
| | - Ronald Sahyouni
- Department of Neurological Surgery, University of California, San Diego, La Jolla, California, USA
| | - Martin H Pham
- Department of Neurological Surgery, University of California, San Diego, La Jolla, California, USA
| | - Joseph A Osorio
- Department of Neurological Surgery, University of California, San Diego, La Jolla, California, USA
| | - Michael Y Oh
- Department of Neurosurgery, University of California, Irvine, Irvine, California, USA
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Trotta RL, Rao AD, McHugh MD, Yoho M, Cunningham RS. Moving beyond the measure: Understanding patients' experiences of communication with nurses. Res Nurs Health 2020; 43:568-578. [PMID: 33141484 DOI: 10.1002/nur.22087] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 10/21/2020] [Accepted: 10/22/2020] [Indexed: 11/12/2022]
Abstract
Under Medicare's Value-Based Purchasing Program, scores derived from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey are used in the determination of incentive payments and financial penalties for healthcare organizations. Organizations, therefore, invest in approaches to improve the likelihood of positive patient responses. Evidence suggests that nurse communication as measured by HCAHPS influences overall patient satisfaction, yet little is known regarding what patients believe constitutes effective communication with nurses. In this qualitative descriptive study, we conducted phone interviews with 49 recently hospitalized patients to better understand patients' perceptions of their communication with nurses. Our findings indicate that patients perceived their communication with nurses to unfold via nurses' behaviors. Namely, nurses' engagement with patients, anticipation of patients' needs, responsiveness to patients' concerns, and teaching practices positively influence patient satisfaction with communication with nurses. These behaviors resonated most strongly with patients during particularly memorable moments of uncertainty and vulnerability over the course of a hospital stay. These findings suggest that focusing on the development of nurses' behaviors, ensuring processes are in place to support positive behaviors and creating organizational environments that position nurses to consistently apply these behaviors, can improve patients' perceptions of their communication with nurses. These findings also provide a foundation for further research focused on developing and testing specific behavioral interventions and their effect on communication perception.
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Affiliation(s)
- Rebecca L Trotta
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.,University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Aditi D Rao
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.,University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Matthew D McHugh
- University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Margaret Yoho
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Regina S Cunningham
- Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.,University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
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Chiou SJ, Lee LH, Lee PC, Lin KC. Better Self-report Health Status and Provider-Patient Communication in Dental Service Can Improve the Patient Experience: A Cross-year Comparison from the NHI Survey. HEALTH COMMUNICATION 2020; 35:1569-1575. [PMID: 31423836 DOI: 10.1080/10410236.2019.1652390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Several factors, including healthcare outcomes and quality, influence patients' expectations of healthcare services. Currently, as patients have more understanding about dental care services, patient satisfaction is essential for continually improving the services being provided. The purpose of this study is to analyze the multiyear annual National Health Insurance (NHI) patient experience survey in Taiwan to explore the factors associated with the satisfaction rate from 2012-2016. This study used the annual NHI survey to explore patients' experiences of receiving medical service in dental care from 2012 to 2016. There were over 40 major items in the survey each year; however, we only selected suitable items that followed the Andersen model. We ran a logistics regression testing the relationship between the covariates and the items related to satisfaction in outcomes in different years. Patients who received health education from a provider in most time, self-reported better health status, felt that cost of care was not expensive, did not wait too long for counseling time and found it easy to make an appointment, had two to ten times greater satisfaction in outcomes compared with those who did not (OR: 1.83-10.06). Individuals working in the healthcare industry should implement communication strategies to improve patients' experience in the care process by including easy-to-understand explanations or sharing decision-making with patients. Furthermore, in patient experience surveys in dental care, less attention should be paid to whether patients can provide meaningful quality measures and more attention to ways in which patient experiences can be improved. This can be achieved by providing easy-to-understand explanations, giving patients an opportunity to express their concerns, and by sharing decision-making with patients.
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Affiliation(s)
- Shang-Jyh Chiou
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences
| | - Li-Hui Lee
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences
| | - Pei-Chen Lee
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences
| | - Kuan-Chia Lin
- Institute of Hospital and Health Care Administration, National Yang-Ming University
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Borrelli M, Ting JY, Rabbani CC, Tan BK, Higgins TS, Walgama ES, Liu GC, Chen HH, Lee MK, Hopp ML, Illing EA, Mirocha J, Wu AW. Patient satisfaction survey experience among American otolaryngologists. Am J Otolaryngol 2020; 41:102656. [PMID: 32836038 DOI: 10.1016/j.amjoto.2020.102656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 08/02/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Patient Satisfaction (PS) is a commonly used metric in health care settings to assess the quality of care given by physicians. Monitoring physicians in this way may impact physician quality of life. Studies evaluating this impact are not available. This study sought to examine the physician experience of measuring PS among practicing otolaryngologists. METHODS Using an online survey platform, a 34-item survey was given to practicing otolaryngologists through email distribution. The survey included questions about physician, practice and patient demographics, as well as inquiries regarding the way in which PS was measured and how it affected physician work and personal life. Data from these questions were reviewed and analyzed. RESULTS 174 otolaryngologists responded to the survey. A majority of physicians' (55.3%) PS scores had been tracked with 89.9% reporting being tracked for a length of at least 1 year. PS scores for individual physicians were noted to be inconsistent and vary significantly between reports. Measuring patient satisfaction led to increased occupational stress, yet most physicians (63.8%) felt the monitoring did not lead to improvements in their practice. Some physicians (36.2%) reported that the collection of patient satisfaction scores had negatively influenced the way they practiced medicine, including the pressure to order superfluous tests or to prescribe unnecessary medications. CONCLUSION Overall, physicians are negatively affected by the tracking of patient satisfaction scores. Occupational stress caused by the collection of patient satisfaction scores may contribute to physician burnout.
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Færden A, Bølgen B, Løvhaug L, Thoresen C, Dieset I. Patient satisfaction and acute psychiatric inpatient treatment. Nord J Psychiatry 2020; 74:577-584. [PMID: 32427019 DOI: 10.1080/08039488.2020.1764620] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background: Patient satisfaction (PS) with treatment is one of different outcome- and quality measures used by health care providers worldwide to improve service. We report from a study of patients admitted to the Department of Acute Psychiatry at the Oslo University Hospital where we investigated PS and difference between genders, days of hospital stay, diagnostic groups, voluntary-and involuntary admitted patients according to hospital records and perceived voluntary-and involuntary admittance.Materials and methods: All admitted patients during a 9-month period in 2014 were asked to participate by written consent. We used The Psychiatric Inpatient Questionnaire (PIPEQ), a self-report survey validated for assessment post-discharge. Analyses were conducted for a general dimension of PS and individual questions. A user representative was a part of the study from the beginning.Results: A total of 357 patients were asked and 256 consented. Results show that 68% were over all satisfied and 14% dissatisfied. Highest PS was found for cooperation with relatives and lowest for influence on choice of treatment and medication. We found no significant difference in PS between men and women, but patients with a personality disorder and with short stay were less satisfied. PS was significantly less for those perceiving involuntary admission regardless of legal status.Conclusion: The PIPEQ gives important input of patient's experience with the delivery of care. Answers range from very much satisfied to not at all depending on what was asked for. Exploring PS provides valuable information for quality improvements for different patient groups.
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Affiliation(s)
- Ann Færden
- Division of Mental Health and Addiction, Department of Acute Psychiatry, Oslo University Hospital, Oslo, Norway
| | | | - Lars Løvhaug
- Division of Mental Health and Addiction, Department of Acute Psychiatry, Oslo University Hospital, Oslo, Norway
| | | | - Ingrid Dieset
- Division of Mental Health and Addiction, Department of Acute Psychiatry, Oslo University Hospital, Oslo, Norway
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Abstract
OBJECTIVES Although different forms of patient feedback are available, their use in hospital management is still limited. The objective of this study is to explore how patient feedback is currently used in hospitals to improve quality. DESIGN This is a qualitative exploratory multiple case study. Data collection included nine interviews, of an average duration of 50 min, conducted between March and June 2019. Additionally, a document and secondary data analysis were performed. SETTING This study was conducted in three Brazilian hospitals selected for their solid patient feedback practises. PARTICIPANTS Managers from the customer service, quality, nursing, operations, projects and patient experience departments of the three hospitals. RESULTS Despite literature suggesting that organisational objectives regarding patient feedback are not clear, data show that there is managerial concern regarding the promotion of an environment capable of changing according to patient feedback. In these instances, organisational processes were structured to focus on patients' feedback and its receipt by the staff, including a non-punitive culture. Several patient feedback forms are available: voluntary events, patient surveys and informal feedback. Instruments to measure patient feedback focused on specific aspects of healthcare, to identify and clarify the problems for addressal by the management. The net promoter score was the main strategic indicator of patient feedback, used to assess the impact of improvement action. CONCLUSIONS The hospitals had established objectives that valued the patient's perspective. Involvement of the health team, availability of different channels for feedback and the use of quality tools are considered a good basis for using patient feedback to drive quality improvement.
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Affiliation(s)
- Simone Berger
- Department of Production Engineering, University of São Paulo, Sao Paulo, Brazil
| | - Ana Maria Saut
- Department of Production Engineering, University of São Paulo, Sao Paulo, Brazil
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Chekijian S, Kinsman J, Taylor RA, Ravi S, Parwani V, Ulrich A, Venkatesh A, Agrawal P. Association between patient-physician gender concordance and patient experience scores. Is there gender bias? Am J Emerg Med 2020; 45:476-482. [PMID: 33069544 DOI: 10.1016/j.ajem.2020.09.090] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/23/2020] [Accepted: 09/25/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Patient satisfaction, a commonly measured indicator of quality of care and patient experience, is often used in physician performance reviews and promotion decisions. Patient satisfaction surveys may introduce gender-related bias. OBJECTIVE Examine the effect of patient and physician gender concordance on patient satisfaction with emergency care. METHODS We performed a cross-sectional analysis of electronic health record and Press Ganey patient satisfaction survey data of adult patients discharged from the emergency department (2015-2018). Logistic regression models were used to examine relationships between physician gender, patient gender, and physician-patient gender dyads. Binary outcomes included: perfect care provider score and perfect overall assessment score. RESULTS Female patients returned surveys more often (n=7 612; 61.55%) and accounted for more visits (n=232 024; 55.26%). Female patients had lower odds of perfect scores for provider score and overall assessment score (OR: 0.852, 95% CI: 0.790, 0.918; OR: 0.782, 95% CI: 0.723, 0.846). Female physicians had 1.102 (95% CI: 1.001, 1.213) times the odds of receiving a perfect provider score. Physician gender did not influence male patients' odds of reporting a perfect care provider score (95% CI: 0.916, 1.158) whereas female patients treated by female physicians had 1.146 times the odds (95% CI: 1.019, 1.289) of a perfect provider score. CONCLUSION Female patients prefer female emergency physicians but were less satisfied with their physician and emergency department visit overall. Over-representation of female patients on patient satisfaction surveys introduces bias. Patient satisfaction surveys should be deemphasized from physician compensation and promotion decisions.
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Affiliation(s)
- Sharon Chekijian
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA.
| | - Jeremiah Kinsman
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - R Andrew Taylor
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Shashank Ravi
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA; Stanford University School of Medicine, USA
| | - Vivek Parwani
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Andrew Ulrich
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Arjun Venkatesh
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA; Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, CT, USA
| | - Pooja Agrawal
- Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA
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The effect of nonmodifiable physician demographics on Press Ganey patient satisfaction scores in ophthalmology. J AAPOS 2020; 24:299-301. [PMID: 32890735 DOI: 10.1016/j.jaapos.2020.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/28/2020] [Accepted: 05/28/2020] [Indexed: 11/23/2022]
Abstract
Press Ganey patient satisfaction scores are increasingly being used as a physician quality metric. In this retrospective review of over 25,000 patient surveys for 61 ophthalmologists, pediatric ophthalmologists and neuro-ophthalmologists received significantly lower patient satisfaction scores than their peers, suggesting that the problem for which a patient seeks care may affect whether he or she is satisfied with the care received. These findings should be taken into account when considering the validity of Press Ganey scores as an equitable, modifiable measure of physician performance, especially when considering factoring these scores into physician evaluation and reimbursement.
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Usmani SZ, Mateos MV, Hungria V, Iida S, Bahlis NJ, Nahi H, Magen H, Cavo M, Hulin C, White D, De Stefano V, Fastenau J, Slavcev M, Heuck C, Qin X, Pei H, Masterson T, Lantz K, Gries KS. Greater treatment satisfaction in patients receiving daratumumab subcutaneous vs. intravenous for relapsed or refractory multiple myeloma: COLUMBA clinical trial results. J Cancer Res Clin Oncol 2020; 147:619-631. [PMID: 32852632 DOI: 10.1007/s00432-020-03365-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 08/18/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE The phase III COLUMBA study evaluated daratumumab (DARA) intravenous (IV) and subcutaneous (SC) in patients with relapsed or refractory multiple myeloma. Here, we report patient-reported satisfaction with therapy (SWT) in COLUMBA. METHODS DARA IV or DARA SC was administered weekly (cycles 1-2), every 2 weeks (cycles 3-6), and every 4 weeks (cycles 7 +). Patients completed a modified version of the Cancer Therapy Satisfaction Questionnaire (CTSQ) at weekly (cycles 1-2) and monthly (cycles 3 +) intervals and at the end of treatment. Results for each item and the SWT domain score were summarized using descriptive statistics. The distribution of responses for individual items was calculated for each assessment. The proportion of patients for whom SWT domain score change from first assessment met or exceeded the minimally important difference (MID) of 5.9 points was calculated at each assessment time point. RESULTS Two-hundred fifty-nine patients were randomized to DARA IV and 263 to DARA SC. Mean scores for SWT domain questions were high and largely positive during treatment. Responses indicating positive perceptions of therapy were given by a numerically greater proportion of patients in the DARA SC group than the DARA IV group for most questions. Changes from the first assessment in SWT domain scores met or exceeded the MID for an average of ~ 40% of patients. CONCLUSION In COLUMBA, modified CTSQ results suggest patients in the DARA SC group were more satisfied with their cancer therapy than those in the DARA IV group. TRIAL REGISTRATION ClinicalTrials.gov identifier NCT03277105. Registered September 8, 2107.
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Affiliation(s)
- Saad Z Usmani
- Plasma Cell Disorders Division, Clinical Research for Hematologic Malignancies, Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute/Atrium Health, Charlotte, NC, USA.
| | | | | | - Shinsuke Iida
- Department of Hematology and Oncology, Nagoya City University Institute of Medical and Pharmaceutical Sciences, Nagoya, Japan
| | - Nizar J Bahlis
- Arnie Charbonneau Cancer Institute, University of Calgary, Calgary, AB, Canada
| | - Hareth Nahi
- Division of Hematology, Department of Medicine, Karolinska Institute, Karolinska University Hospital at Huddinge, Stockholm, Sweden
| | - Hila Magen
- Department of Hematology, Chaim Sheba Medical Center, Ramat-Gan, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michele Cavo
- Department of Experimental, Diagnostic and Specialty Medicine, "Seràgnoli" Institute of Hematology, University of Bologna, Bologna, Italy
| | - Cyrille Hulin
- Department of Hematology, Hôpital Haut Lévêque, University Hospital, Pessac, France
| | - Darrell White
- Dalhousie University and QEII Health Sciences Centre, Halifax, NS, Canada
| | - Valerio De Stefano
- Institute of Hematology, Catholic University, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy
| | | | | | | | - Xiang Qin
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - Huiling Pei
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - Tara Masterson
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - Kristen Lantz
- Janssen Research & Development, LLC, Spring House, PA, USA
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Abstract
Quality assurance (QA) of care in the emergency department encompasses activities ensuring that the care provided meets applicable standards. Health care delivery is complex and many factors affect quality of care. Thus, quantification of health care quality is challenging, especially with regard to attribution of outcomes to various factors contributing to such care. A critical component of the process of QA is determination of quality health care and the concept of (unjustified) deviation from the reference applicable standard of care.
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Affiliation(s)
- William E Baker
- Department of Emergency Medicine, Boston University, Boston University Medical Center, 800 Harrison Avenue, Boston, MA 02118, USA. https://twitter.com/EMDocBaker
| | - Joshua J Solano
- Integrated Medical Science, Florida Atlantic University, Boca Raton, FL, USA.
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Thotam SM, Buhse M. Patient Satisfaction with Physicians and Nurse Practitioners in Multiple Sclerosis Centers. Int J MS Care 2020; 22:129-135. [PMID: 32607075 PMCID: PMC7307871 DOI: 10.7224/1537-2073.2018-042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND With the predicted shortage of neurologists, care of patients with multiple sclerosis (MS) may be affected. Nurse practitioners (NPs) have successfully filled the provider gaps in a variety of care settings, with positive effects on care outcomes, including patient satisfaction. The purpose of this study was to determine patient satisfaction with physicians (MDs) and NPs in MS centers. METHODS This is a cross-sectional pilot study wherein a convenience sample was recruited from two MS centers. Demographic data were collected previsit, and satisfaction surveys were completed postvisit using the Patient Satisfaction Questionnaire Short Form (PSQ-18) and the Visit-Specific Satisfaction Instrument (VSQ-9). Different attributes of satisfaction and visit times were analyzed. RESULTS Patient satisfaction with both types of providers was high. All attributes of satisfaction were comparable for NPs and MDs, and they spent similar amounts of time with their patients, often exceeding the scheduled office visit duration. Encounter length was a strong determinant of patient satisfaction: VSQ-9 scores were significantly lower (P = .01) when duration was less than 20 minutes. Satisfaction was higher (P = .011) in patients who were diagnosed as having MS for 10 years or longer or had progressive MS, irrespective of provider type. CONCLUSIONS This pilot study showed that use of standardized questionnaires to determine patient satisfaction with NPs and MDs was feasible. With the impending neurologist shortage and the increased MS prevalence, a collaborative team approach between NPs and MDs may improve access to care in MS centers without compromising patient satisfaction.
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Vaillancourt S, Cullen JD, Dainty KN, Inrig T, Laupacis A, Linton D, Malherbe S, Maybee A, Schull MJ, Seaton MB, Beaton DE. PROM-ED: Development and Testing of a Patient-Reported Outcome Measure for Emergency Department Patients Who Are Discharged Home. Ann Emerg Med 2020; 76:219-229. [PMID: 32173134 DOI: 10.1016/j.annemergmed.2019.12.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 12/16/2019] [Accepted: 12/20/2019] [Indexed: 11/17/2022]
Abstract
STUDY OBJECTIVE Common outcomes of care valued by emergency department (ED) patients who are not hospitalized have been characterized, but no measurement instrument has been developed to date. We developed and validated a patient-reported outcome measure for use with adult ED patients who are discharged home (PROM-ED). METHODS In previous research, 4 main outcomes of importance to ED patients were defined: symptom relief, understanding, reassurance, and having a plan. We developed a bank of potential questions (phase 1) that were first tested for suitability through cognitive debriefing with patients (phase 2). Revised questions were then tested quantitatively with a large panel of participants who had recently received ED care (phase 3). Informed by these results, a panel of experts used a modified Delphi process to make decisions on item reduction. The resulting instrument (PROM-ED 1.0) was then evaluated for its measurement properties (structural validity, hypothesis testing, and reliability). RESULTS Sixty-seven questions divided among 4 scales (1 for each outcome domain) were assembled. In accordance with cognitive debriefing with 8 patients (phase 2), 15 questions were modified and 13 removed. Testing of these questions with 444 participants (phase 3) identified problematic floor or ceiling effects (n=10), excessive correlations between items (n=11), and low item-total correlations (n=7). The expert panel (22 participants, phase 4) made decisions using this information on the exclusion of items, resulting in 22 questions across 4 scales that together constitute the PROM-ED 1.0. Testing provided good evidence of validity and test-retest reliability (n=200). CONCLUSION The PROM-ED enables the measurement of patient-centered outcomes of importance to patients receiving care in the ED who are not hospitalized. These data could have important applications in research and care improvement.
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Affiliation(s)
- Samuel Vaillancourt
- Department of Emergency Medicine, St. Michael's Hospital, Toronto, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada.
| | - John D Cullen
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Katie N Dainty
- Institute for Health Policy and Management, University of Toronto, Toronto, Canada; North York General Hospital, Toronto, Canada
| | - Taucha Inrig
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Andreas Laupacis
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada
| | - Denise Linton
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
| | - Stéphanie Malherbe
- Hôpital Montfort and Department of Emergency and Family Medicine, University of Ottawa, Ottawa, Canada
| | | | - Michael J Schull
- Department of Medicine, University of Toronto, Toronto, Canada; Institute for Health Policy and Management, University of Toronto, Toronto, Canada; Department of Emergency Medicine, Sunnybrook Health Sciences Centre, Toronto, Canada; the Institute for Clinical Evaluative Sciences, Toronto, Canada
| | | | - Dorcas E Beaton
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada
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Abidova A, da Silva PA, Moreira S. Predictors of Patient Satisfaction and the Perceived Quality of Healthcare in an Emergency Department in Portugal. West J Emerg Med 2020; 21:391-403. [PMID: 31999247 PMCID: PMC7081842 DOI: 10.5811/westjem.2019.9.44667] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 09/19/2019] [Indexed: 11/11/2022] Open
Abstract
Introduction The predictors of patient satisfaction in emergency medicine (EM) have been widely studied and discussed in the scientific literature; the results vary depending on the specific EM attributes, cultural aspects, researchers’ preferences, and approaches. However, it is not clear whether the same predictors of patient satisfaction can contribute to a better-perceived quality of healthcare or whether patients’ perceptions form a different attitude toward satisfaction and perceived quality of healthcare. The goal of this study was to identify the key predictors of patient satisfaction and perceived quality of healthcare in the framework of an emergency department (ED). Methods We conducted a retrospective study of patients seen at an ED between January –December 2016. Data collection took place in the public hospital in Lisbon, Portugal, between May – November 2017. The total sample size included 382 patients. The sample distribution had a 5% margin of error and a 95% confidence interval. Data for this research, using a questionnaire, was collected by mail or e-mail according to the respondent’s preference. Results A detailed analysis showed that three out of the 18 predictors had a statistically significant relationship with satisfaction: overall satisfaction with doctors, with a positive correlation (r = 0.14, p ≤ 0.01); qualitative perceived waiting time for triage, with a positive correlation (r = 0.08, p ≤ 0.05); and meeting expectations, with a positive correlation (r = 0.53, p ≤ 0.01). Furthermore, a detailed analysis showed that only two out of the 18 predictors had a statistically significant relationship with the perceived quality of healthcare (PQHC): overall satisfaction with doctors, with a positive correlation (r = 0.43, p ≤ 0.01) and meeting expectations, with a positive correlation (r = 0.26, p ≤ 0.01). Conclusion The main predictors of satisfaction and perceived quality of healthcare were overall satisfaction with doctors and meeting expectations. We should note that “meeting expectations” plays the most important role in terms of satisfaction; however, in terms of PQHC the predictor “overall satisfaction with doctors” plays the most important role due to its stronger correlation. In addition, the qualitative perceived waiting time for triage could be considered as another predictor, influencing satisfaction only, thus emphasizing similarities and differences between satisfaction and the PQHC in an ED context.
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Affiliation(s)
- Alina Abidova
- NOVA University of Lisbon, National School of Public Health, Lisbon, Portugal
| | | | - Sérgio Moreira
- University of Lisbon, Faculty of Psychology, Lisbon, Portugal
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Bhatnagar H. User-experience and patient satisfaction with quality of tuberculosis care in India: A mixed-methods literature review. J Clin Tuberc Other Mycobact Dis 2019; 17:100127. [PMID: 31788569 PMCID: PMC6880015 DOI: 10.1016/j.jctube.2019.100127] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Tuberculosis affected 2.7 million people in India in 2017. The Revised National TB Control Programme has achieved milestones in coverage, however quality of TB care remains highly variable and often poor, with significant gaps in provider knowledge, practices, and patients consistently lost to follow-up. These quality gaps are largely informed by studies on provider practices or objective chart abstractions and case data. Per the knowledge of the author, no review has been conducted on first-hand patient perspectives on the quality of TB care they receive. This mixed-methods literature review aims to synthesize evidence on user-experience and patient satisfaction with TB care in India and inform areas for service quality improvement. METHODS Five medical databases, including PubMed, EMBASE, Global Health (Ovid), Web of Science, and CINAHL were searched for empirical studies on patient perspectives on TB health services published between January 1st, 2000 to December 31st, 2017. Studies in English with adult patients with any form of TB in the public or private health system were included. Studies prior to entering the health system, on distance to health facilities and cost were excluded. Seven Indian journals were hand searched and a grey literature search was conducted in GoogleScholar. Studies were assessed for methodological quality and thematic analysis was conducted by categorizing data using NVivo 12. RESULTS A total of 498 studies were screened, of which 23 met the inclusion criteria. 16 supplementary studies were identified from Indian journals and grey literature. Of the 39 total studies included most were quantitative (29; 74%), based in South India (17; 44%) and focused on drug-sensitive TB patients (19; 49%) within the public health system (25; 64%). Data collection methods were highly heterogenous which limited synthesis and comparisons across population demographics, health sectors, or regions. Overall quantitative patient satisfaction measured in seven studies was high. Two major themes identified were provider-related factors (n = 26 studies) and convenience (n = 25), and six minor themes were supplies and equipment availability (n = 12), confidence (n = 10), information and communication (n = 10), waiting time (n = 8), stigma (n = 4), and confidentiality (n = 4). Each reported positive and negative user-experiences. Most significantly, DOTS did not fit the daily needs and obligations of many patients, particularly due to conflicts with employment and frequency of visits; while positive provider support, information, and flexibility helped patients adhere to treatment. CONCLUSION Although quantitative patient satisfaction was found to be high, data were not collected using robust, validated tools. Qualitative and quantitative user-experiences in each theme were variable, making them both barriers and facilitators of good quality TB care. Poor user-experiences were often responsible for patients interrupting treatment or dropping out of TB care. Patient-centeredness, or user-friendliness of TB care can be improved by introducing individualized or flexible DOTS that is responsive to user circumstances and needs. User-experience data should be systematically collected using a standardized, national tool for identification of specific bottlenecks and successes in quality of TB care from the patients' perspective.
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Urman RD, Gan TJ. Patient Satisfaction: Measuring the Association Between Anesthetic Management and Patient Experience. Anesth Analg 2019; 129:918-920. [PMID: 31584916 DOI: 10.1213/ane.0000000000004361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Richard D Urman
- From the Department of Anesthesiology, Perioperative and Pain Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts
| | - Tong J Gan
- Department of Anesthesiology, Stony Brook University, Stony Brook, New York
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