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Nadeau M, Chabot D, Breton M, Guertin JR, Harvey Labbé L, Roberge D, Lefebvre G, Mallet M, Beaulieu S, Kavanagh É, Cloutier N, Garant P, Bélanger L, Vaillancourt S, Boumenna T, Bareil K, Savard J, Simonyan D, Ulrich Singbo MN, Berthelot S. Development of a Patient-Reported Experience Measure Tool for Ambulatory Patients With Acute Unexpected Needs: The APEX Questionnaire. J Patient Exp 2024; 11:23743735241229373. [PMID: 38618513 PMCID: PMC11010752 DOI: 10.1177/23743735241229373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2024] Open
Abstract
Background: The aim of this study was to develop a patient-reported experience measure (PREM) for comparing the experience of care received by ambulatory patients with acute unexpected needs presenting in emergency departments (EDs), walk-in clinics, and primary care practices. Methods: The Ambulatory Patient EXperience (APEX) questionnaire was developed using a 5-phase mixed-methods approach. The questionnaire was pretested by asking potential users to rate its clarity, usefulness, redundancy, content and face validities, and discrimination on a 9-point scale (1 = strongly disagree to 9 = strongly agree). The pre-final version was then tested in a pilot study. Results: The final questionnaire is composed of 61 questions divided into 7 sections. In the pretest (n = 25), median responses were 8 and above for all dimensions assessed. In the pilot study, 63 participants were enrolled. Adjusted results show that access, cleanliness, and feeling treated with respect and dignity by nurses and physicians were significantly better in the clinics than in the ED. Conclusion: We developed a questionnaire to assess and compare experience of ambulatory care in different clinical settings.
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Affiliation(s)
- Myriam Nadeau
- Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
- Département de médecine de famille et de médecine d’urgence, Université Laval, Québec, QC, Canada
- CHU de Québec-Université Laval, Québec, QC, Canada
| | - Dominique Chabot
- Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
| | - Mylaine Breton
- Département des sciences de la santé communautaire, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Jason R. Guertin
- Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
- Département de médecine sociale et préventive, Université Laval, Québec, QC, Canada
| | | | | | - Gabrielle Lefebvre
- Direction de la santé publique, CIUSSS de la Capitale-Nationale, Québec, QC, Canada
| | - Myriam Mallet
- Centre de valorisation et d'exploitation de la donnée du CHU de Québec-Université Laval, Québec, QC, Canada
| | - Sandrine Beaulieu
- Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
| | - Éric Kavanagh
- École de design, Université Laval, Québec, QC, Canada
| | | | | | - Lynda Bélanger
- CHU de Québec-Université Laval, Québec, QC, Canada
- École de design, Université Laval, Québec, QC, Canada
| | | | - Tarek Boumenna
- Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
| | - Kathryn Bareil
- Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
| | - Joanie Savard
- Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
| | - David Simonyan
- Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
| | | | - Simon Berthelot
- Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
- Département de médecine de famille et de médecine d’urgence, Université Laval, Québec, QC, Canada
- CHU de Québec-Université Laval, Québec, QC, Canada
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Roos AKØ, Skaug EA, Helgesen AK. The Importance of Being Taken Care of-Patients' Experience with the Quality of Healthcare in a Norwegian Hospital. Nurs Rep 2023; 13:1742-1750. [PMID: 38133120 PMCID: PMC10745341 DOI: 10.3390/nursrep13040144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 12/03/2023] [Accepted: 12/13/2023] [Indexed: 12/23/2023] Open
Abstract
As recipients of healthcare, patients provide invaluable contributions when assessing quality. The aim of this qualitative study was to explore and describe how patients experienced quality of care during their stay in a Norwegian hospital. In this study, 39 patients were interviewed. The data were analyzed via conventional content analysis. The results showed that patients' experiences of quality were associated with interactions with medical staff, while their physical surroundings had less of an impact. The quality of healthcare was described on a continuum from good to bad. Patients assessed quality positively when they felt they were taken care of. The feeling of not being taken care of provoked feelings of insecurity, resignation, being "overlooked", and inferiority. A prerequisite for patients to feel cared for was staff presence, which enabled and encouraged patients to share their thoughts. This required medical staff to have competency, interpersonal skills, and time accessibility. In addition, a culture that is person-oriented and not task-oriented was valued. From our study, we see the opportunity within healthcare systems to improve the quality of care by having staff engage in active listening, promote an environment of mutual respect, and encourage active participation from patients in their healthcare decisions and plans. This study was prospectively registered with the Norwegian Social Science Data Services on 9 July 2015 with registration number 44034.
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Affiliation(s)
| | - Eli-Anne Skaug
- Faculty of Health, Welfare and Organisation, Østfold University College, P.O. Box 700, 1757 Halden, Norway; (E.-A.S.); (A.K.H.)
| | - Ann Karin Helgesen
- Faculty of Health, Welfare and Organisation, Østfold University College, P.O. Box 700, 1757 Halden, Norway; (E.-A.S.); (A.K.H.)
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Tolpadi A, Elliott MN, Becker K, Lehrman WG, Stark D, Parast L. Exploring Which Patients Use Their Closest Emergency Departments Using Geocoded Data. J Emerg Med 2023; 65:e290-e302. [PMID: 37689542 DOI: 10.1016/j.jemermed.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 05/04/2023] [Accepted: 05/26/2023] [Indexed: 09/11/2023]
Abstract
BACKGROUND Each year, roughly 20% of U.S. adults visit an emergency department (ED), but little is known about patients' choice of ED. OBJECTIVES Examine the discretion patients have to choose among EDs, characteristics associated with ED choice, and relationship between ED choice and self-reported care experiences of ED patients. METHODS We surveyed adult patients discharged to the community (DTC) in January-March 2018 from 16 geographically dispersed hospital-based EDs, geocoded patient and hospital-based ED addresses within 100 miles of patient addresses, and calculated travel distances. We examined the likelihood of visiting the closest ED based on patient and ED characteristics. Linear regression models examined the association of choosing the closest ED with seven measures of patient experience of care (scaled 0-100), adjusting for patient characteristics. RESULTS 43.6% of 4647 responding patients visited the ED nearest their home (on average, 5.7 miles away). Patients who chose a farther ED had more urgent conditions, were more educated, and were less likely to be non-Hispanic White. They were significantly more likely to have visited an ED in a higher-rated, metropolitan, network hospital with major teaching status, a cardiac intensive care unit, and a certified trauma center. Patients who chose a farther ED were more likely to recommend that ED, with "medium-to-large" differences in scores (+4.3% more selected "definitely yes", p < 0.05). CONCLUSIONS Fewer than half of patients visited the closest ED. Patients who chose a farther ED tended to seek higher-rated hospitals and report more favorable experiences.
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Affiliation(s)
| | | | | | | | - Debra Stark
- Centers for Medicare & Medicaid Services, Baltimore, Maryland
| | - Layla Parast
- Department of Statistics and Data Sciences, The University of Texas at Austin, Austin, Texas.
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Abrahamsen C, Jensen CM, Elkjaer M, Østervang C, Knudsen BM, Jensen SS, Moos C, Viberg B, Mogensen CB. Translation and cultural adaption of the emergency department-consumer assessment of healthcare providers and systems (ED CAPHS)-A questionnaire to measure patient experience in Denmark. Scand J Caring Sci 2023; 37:872-879. [PMID: 36710584 DOI: 10.1111/scs.13146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 12/23/2022] [Accepted: 01/05/2023] [Indexed: 01/31/2023]
Abstract
AIM The aim of this study was to translate and culturally adapt The Emergency Department-Consumer Assessment of Healthcare Providers and Systems (ED CAPHS) to the Danish ED context. BACKGROUND In Denmark, a large number of patients attend emergency departments (ED) every year. During their ED visits, examinations, tests and encounters with different healthcare professionals occur frequently. Moreover, patients receive much information. Patients' direct experiences of care can provide valuable insights into what works and what does not in health care. The emergency department-consumer assessment of healthcare providers and systems (ED CAPHS) is a valid questionnaire designed to measure patients' experiences with ED care and is intended for patients discharged home following their ED visit. METHOD The translation process was systematically planned and executed using the principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) guidelines by the ISPOR. RESULTS The translation and cultural adaption process were successfully conducted. Three items concerning language and race were omitted as they are not distinct in Danish ED context. Furthermore, a few conceptual factors and linguistic challenges were discussed and harmonised during the reconciliation and harmonisation process respectively. The Danish survey ED CAPHS DK containing 32 items was proofread and finalised. CONCLUSION Overall, patients reported that the survey was relevant and comprehensive, as it focused on essential factors when discharged directly home after an ED admission. ED CAPHS DK is found to be content valid and ready for use. However, a future study testing the Danish version using confirmative factor analysis and internal consistency reliability is needed to ensure construct validity and reliability.
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Affiliation(s)
- Charlotte Abrahamsen
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Emergency Department, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
- Department of Orthopaedic Surgery and Traumatology, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
| | - Charlotte Myhre Jensen
- Department of Orthopaedic Surgery and Traumatology, University Hospital Odense, Odense, Denmark
| | - Mette Elkjaer
- Emergency Department, Hospital Southern Jutland, Aabenraa, Denmark
- Emergency Department, University Hospital Odense, Odense, Denmark
| | - Christina Østervang
- Department of Clinical Research, Hospital Southern Jutland, Aabenraa, Denmark
| | - Bettina Mølri Knudsen
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Administration, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
| | - Signe Steenstrup Jensen
- Department of Orthopaedic Surgery and Traumatology, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
| | - Caroline Moos
- Emergency Department, University Hospital Odense, Odense, Denmark
| | - Bjarke Viberg
- Department of Orthopaedic Surgery and Traumatology, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark
- Department of Orthopaedic Surgery and Traumatology, University Hospital Odense, Odense, Denmark
| | - Christian Backer Mogensen
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Emergency Department, University Hospital Odense, Odense, Denmark
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Mathews M, Parast L, Elliott MN, Lehrman WG, Stark D, Waxman DA. Associations between Emergency Severity Index and patient experience of care in the emergency department. Acad Emerg Med 2023; 30:59-61. [PMID: 36197297 DOI: 10.1111/acem.14604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 09/27/2022] [Accepted: 09/30/2022] [Indexed: 01/26/2023]
Affiliation(s)
- Megan Mathews
- Economics, Sociology, and Statistics, RAND Corporation, Santa Monica, California, USA
| | - Layla Parast
- Economics, Sociology, and Statistics, RAND Corporation, Santa Monica, California, USA
| | - Marc N Elliott
- Economics, Sociology, and Statistics, RAND Corporation, Santa Monica, California, USA
| | - William G Lehrman
- Department of Health and Human Services, Center for Medicare & Medicaid Services, Baltimore, Maryland, USA
| | - Debra Stark
- Department of Health and Human Services, Center for Medicare & Medicaid Services, Baltimore, Maryland, USA
| | - Daniel A Waxman
- Behavioral and Policy Sciences, RAND Corporation, Santa Monica, California, USA.,Department of Emergency Medicine, University of California, Los Angeles, California, USA
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Cordasco KM, Gable AR, Tan GJ, Yuan AH, Yip K, Khafaf M, Hays RD, Faiz JP, Chawla N, Ganz DA. Veteran knowledge, perceptions, and receipt of care following visits to VA emergency departments for ambulatory care sensitive conditions. Acad Emerg Med 2022; 30:252-261. [PMID: 36578158 DOI: 10.1111/acem.14649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 12/22/2022] [Accepted: 12/22/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Receipt of follow-up care after emergency department (ED) visits for chronic ambulatory care sensitive conditions (ACSCs)-asthma, chronic obstructive pulmonary disease, heart failure, diabetes, and/or hypertension-is crucial. We assessed Veterans' follow-up care knowledge, perceptions, and receipt of care after visits to Veterans Health Administration (VA) EDs for chronic ACSCs. METHODS Using explanatory sequential mixed methods, we interviewed Veterans with follow-up care needs after ACSC-related ED visits, and manually reviewed ED notes, abstracting interviewees' documented follow-up needs and care received. RESULTS We interviewed and reviewed ED notes of 35 Veterans, 12-27 (mean 19) days after ED visits. Follow-up care was completely received/scheduled in 20, partially received/scheduled in eight, and not received in seven Veterans. Among those who received care, it was received within specified time frames half the time. However, interviewees often did not recall these time frames or reported them to be longer than specified in the ED notes. Veterans who had not yet received or scheduled follow-up care commonly did not recall follow-up care instructions, believed that they did not need this care since they were not currently having symptoms, or thought that such care would be difficult to obtain due to appointment unavailability and/or difficulties communicating with follow-up care providers. Among the 28 Veterans in whom all or some follow-up care had been received/scheduled, for 25 cases VA staff reached out to the Veteran or the appointment was scheduled prior to or during the ED visit. CONCLUSIONS VA should prioritize implementing processes for EDs to efficiently communicate Veterans' needs to follow-up care providers and systems for reaching out to Veterans and/or arranging for care prior to Veterans leaving the ED. VA should also enhance practices using multimodal approaches for educating Veterans about recommended ED follow-up care and improve mechanisms for Veterans to communicate with follow-up care providers.
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Affiliation(s)
- Kristina M Cordasco
- Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.,Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.,Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California, USA
| | - Alicia R Gable
- Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - Gracielle J Tan
- Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - Anita H Yuan
- Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - Kathleen Yip
- Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.,Department of Emergency Medicine, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California, USA
| | - Mana Khafaf
- Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.,Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California, USA
| | - Ron D Hays
- Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California, USA.,RAND Corporation, Santa Monica, California, USA
| | - Jessica P Faiz
- Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.,National Clinician Scholars Program, University of California, Los Angeles, Los Angeles, California, USA
| | - Neetu Chawla
- Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | - David A Ganz
- Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.,Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA.,Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California, USA.,RAND Corporation, Santa Monica, California, USA
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