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Walji S, Carroll J. Patient-Guided Tours: A Patient-Centered Methodology to Understand Patient Experiences of Health Care. Ann Fam Med 2023; 21:269-273. [PMID: 37217337 DOI: 10.1370/afm.2971] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/30/2022] [Accepted: 12/13/2022] [Indexed: 05/24/2023] Open
Abstract
PURPOSE The experience-based design approach using patient-guided tours (PGT) has been suggested as an effective way to understand the patient experience and may better allow the patient to recall thoughts and feelings. The objective of this study was to assess how patients with a disability perceive the effectiveness of PGTs for understanding their experiences of receiving primary health care. METHODS A qualitative study design was used. Participants were chosen by convenience sampling. The patient was asked to walk through the clinic as they would on a "typical visit" while describing their experiences. They were questioned about their experience and perception of PGTs. The tour was audiotaped and transcribed. The investigators took field notes and completed thematic content analysis. RESULTS Eighteen patients participated. The main findings were: (1) Touchpoints and physical cues were effective in eliciting experiences that participants stated they would not have recalled using other research methods, (2) The ability for participants to show the investigator aspects of the space that impacted their experience enabled the investigator to "see through their eyes" resulting in ease of communication and a sense of empowerment, (3) PGTs encouraged individuals to be active participants which fostered comfort and collaboration, and (4) PGTs may exclude those that are severely disabled. CONCLUSION This method was perceived as effective at eliciting experiences of patients with a disability. It has benefits over more traditional research methods by allowing the participant to refresh their memory at "touchpoints" and enabling them to be active participants.
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Affiliation(s)
- Sakina Walji
- Ray D. Wolfe Department of Family Medicine, Mount Sinai Hospital, Sinai Health, Toronto, Ontario, Canada
| | - June Carroll
- Department of Family & Community Medicine, University of Toronto, Toronto, Ontario, Canada
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Davies EL, Bulto LN, Walsh A, Pollock D, Langton VM, Laing RE, Graham A, Arnold-Chamney M, Kelly J. Reporting and conducting patient journey mapping research in healthcare: A scoping review. J Adv Nurs 2023; 79:83-100. [PMID: 36330555 PMCID: PMC10099758 DOI: 10.1111/jan.15479] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [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: 06/16/2022] [Revised: 09/09/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Abstract
AIM To identify how patient journey mapping is being undertaken and reported. DESIGN A scoping review of the literature was undertaken using JBI guidance. DATA SOURCES Databases were searched in July 2021 (16th-21st), including Ovid's Medline, Embase, Emcare and PsycINFO; Scopus; Web of Science Core Collection, the Directory of Open Access Journals; Informit and; ProQuest Dissertations and Theses Global. REVIEW METHODS Eligible articles included peer-reviewed literature documenting journey mapping methodologies and studies conducted in healthcare services. Reviewers used Covidence to screen titles and abstracts of located sources, and to screen full-text articles. A table was used to extract data and synthesize results. RESULTS Eighty-one articles were included. An acceleration of patient journey mapping research was observed, with 76.5% (n = 62) of articles published since 2015. Diverse mapping approaches were identified. Reporting of studies was inconsistent and largely non-adherent with relevant, established reporting guidelines. CONCLUSION Patient journey mapping is a relatively novel approach for understanding patient experiences and is increasingly being adopted. There is variation in process details reported. Considerations for improving reporting standards are provided. IMPACT Patient journey mapping is a rapidly growing approach for better understanding how people enter, experience and exit health services. This type of methodology has significant potential to inform new, patient centred models of care and facilitate clinicians, patients and health professionals to better understand gaps and strategies in health services. The synthesised results of this review alert researchers to options available for journey mapping research and provide preliminary guidance for elevating reporting quality.
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Affiliation(s)
- Ellen L Davies
- Adelaide Health Simulation, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Lemma N Bulto
- Adelaide Nursing School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia.,Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Alison Walsh
- Adelaide Nursing School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Danielle Pollock
- JBI, School of Public Health, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Vikki M Langton
- The University of Adelaide Library, The University of Adelaide, Adelaide, South Australia, Australia
| | - Robert E Laing
- Adelaide Nursing School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Amy Graham
- Adelaide Nursing School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Melissa Arnold-Chamney
- Adelaide Nursing School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Janet Kelly
- Adelaide Nursing School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
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Parke S, Dauda N, Ayarza R. Behaviour Insight Shadowing: examining daily life settings for the prevention of neglected tropical disease. Int Health 2022; 14:ii25-ii32. [PMID: 36130248 PMCID: PMC9492261 DOI: 10.1093/inthealth/ihac042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 05/03/2022] [Accepted: 05/23/2022] [Indexed: 11/19/2022] Open
Abstract
Background Adaptation of daily behaviours can play a significant role in disease prevention. Behaviour Insight Shadowing (BIS) is a novel qualitative methodology, designed and used for the first time in this study, which applies the Behaviour Settings Theory as a framework for interrogating daily life patterns and identifying optimal opportunities for behaviour change. Methods Nine participant households were shadowed for a day, in Nigeria, the Democratic Republic of Congo and Guinea Bissau. Shadowing involved close ethnographic observation alongside integrated interviewing techniques, and then followed up with a semistructured cross-examination at the end of the observation period. Real-time insights about the attitudes and behaviours of households at high risk of neglected tropical diseases (NTDs) were then categorised by context and analysed thematically. Themes were then applied to a framework of understanding specific to NTD behaviour change and therefore informing more effective social behaviour change communications (SBCC) design. The methodology is adaptable, simple to replicate and produces in-depth, qualitative ethnographic stories. Results Findings highlighted important spatial and temporal aspects of target behaviours, with key differences between private and group activities. Ethnographic stories illustrated hierarchies between economic, social and temporal drivers of behaviour, and highlighted the ways in which health messages were introduced and responded to within and between households. This provided cultural levers for more impactful SBCC interventions that could tie into existing norms. Conclusions BIS methodology, as an adaptive ethnographic approach, provides valuable insights that enhance the findings from surveys and focus groups, specifically in the context of NTD prevention. Contextual categorisation of relevant daily behaviours is key to developing culturally appropriate SBCC and in determining whether such intervention needs to be in alignment with everyday routines and attitudes, or in disruption of them.
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Affiliation(s)
- Sherrelle Parke
- M&C Saatchi World Services, 36 Golden Square, London W1F 9JX, UK
| | - Nurudeen Dauda
- Sightsavers, 1 Golf Course Road, P.O. Box 503, Kaduna, Nigeria
| | - Ruth Ayarza
- Sightsavers, 35 Perrymount Road, Haywards Heath, West Sussex RH16 3BZ, UK
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Egan P, Pierce A, Flynn A, Teeling SP, Ward M, McNamara M. Releasing Operating Room Nursing Time to Care through the Reduction of Surgical Case Preparation Time: A Lean Six Sigma Pilot Study. Int J Environ Res Public Health 2021; 18:ijerph182212098. [PMID: 34831852 PMCID: PMC8621029 DOI: 10.3390/ijerph182212098] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 11/17/2022]
Abstract
Healthcare systems internationally are working under increasing demand to use finite resources with greater efficiency. The drive for efficiency utilises process improvement methodologies such as Lean Six Sigma. This study outlines a pilot Lean Six Sigma intervention designed to release nursing time to care within a peri-operative environment; this was achieved by collaborating with stakeholders to redesign the process for laparoscopic hernia surgical case preparation (set up) material. Across 128 laparoscopic hernia surgical cases, the pilot resulted in a 55% decrease in overall nursing time spent in gathering and preparing materials for laparoscopic hernia surgical cases, with a corresponding reduction in packaging waste. The major impact of releasing nursing time to care within busy Operating Room environments enabled nurses to focus on continuing to deliver high-quality care to their patients and reduce pressure expressed by the Operating Room nurses. The results have led to an ongoing review of other surgical procedures preparation to further release nursing time and will be of interest to perioperative teams internationally.
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Affiliation(s)
- Patricia Egan
- Beacon Hospital Beacon Court, Bracken Rd, Sandyford Business Park, Sandyford, Dublin 18, D18 AK68 Dublin, Ireland; (A.P.); (A.F.)
- Correspondence:
| | - Anthony Pierce
- Beacon Hospital Beacon Court, Bracken Rd, Sandyford Business Park, Sandyford, Dublin 18, D18 AK68 Dublin, Ireland; (A.P.); (A.F.)
| | - Audrey Flynn
- Beacon Hospital Beacon Court, Bracken Rd, Sandyford Business Park, Sandyford, Dublin 18, D18 AK68 Dublin, Ireland; (A.P.); (A.F.)
| | - Sean Paul Teeling
- UCD Centre for Interdisciplinary Research, Education & Innovation in Health Systems, School of Nursing, Midwifery & Health Systems UCD Health Sciences Centre, D04 V1W8 Dublin, Ireland; (S.P.T.); (M.M.)
| | - Marie Ward
- Centre for Innovative Human Systems, School of Psychology, Trinity College, The University of Dublin, D04 V1W8 Dublin, Ireland;
| | - Martin McNamara
- UCD Centre for Interdisciplinary Research, Education & Innovation in Health Systems, School of Nursing, Midwifery & Health Systems UCD Health Sciences Centre, D04 V1W8 Dublin, Ireland; (S.P.T.); (M.M.)
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Chen M, Li K, Cheng G, He K, Li W, Zhang D, Li W, Feng Y, Wei L, Li W, Zhong G, Yang C. Touchpoint-Tailored Ultrasensitive Piezoresistive Pressure Sensors with a Broad Dynamic Response Range and Low Detection Limit. ACS Appl Mater Interfaces 2019; 11:2551-2558. [PMID: 30576104 DOI: 10.1021/acsami.8b20284] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Wearable pressure sensors with high sensitivity, broad dynamic response range, and low detection limit are highly desirable to enable the applications in electronic skins and soft robotics. In this work, we report a high-performance wearable pressure sensor based on microstructured polydimethylsiloxane (PDMS)/Ag and rough polyimide/Au interdigital electrodes. By tailoring the touchpoints, the resulting pressure sensors show ultrahigh sensitivity (259.32 kPa-1 in the range of 0-2.5 kPa), broad dynamic response range (0-54 kPa), fast response (∼200 μs), and low detection limit (0.36 Pa). Furthermore, the effect of different sensor structural configurations, PDMS geometrical feature, and Ag thickness on the performance of the pressure sensors are systematically investigated. Thanks to these merits, the fabricated pressure sensor is capable of real-time monitoring pulse wave and can act as artificial skin for robot hand to detect weak pressure changes, leading to the great application promise in the fields of biomedical, real-time health monitoring, and intelligent robot.
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Affiliation(s)
- Ming Chen
- Center for Information Photonics and Energy Materials, Shenzhen Institutes of Advanced Technology , Chinese Academy of Sciences , Shenzhen 518055 , People's Republic of China
| | - Kun Li
- Center for Information Photonics and Energy Materials, Shenzhen Institutes of Advanced Technology , Chinese Academy of Sciences , Shenzhen 518055 , People's Republic of China
- Department of Nano Science and Technology Institute , University of Science and Technology of China , Suzhou 215123 , China
| | - Guanming Cheng
- Center for Information Photonics and Energy Materials, Shenzhen Institutes of Advanced Technology , Chinese Academy of Sciences , Shenzhen 518055 , People's Republic of China
| | - Ke He
- Center for Information Photonics and Energy Materials, Shenzhen Institutes of Advanced Technology , Chinese Academy of Sciences , Shenzhen 518055 , People's Republic of China
- Department of Nano Science and Technology Institute , University of Science and Technology of China , Suzhou 215123 , China
| | - Weiwei Li
- Center for Information Photonics and Energy Materials, Shenzhen Institutes of Advanced Technology , Chinese Academy of Sciences , Shenzhen 518055 , People's Republic of China
- Department of Nano Science and Technology Institute , University of Science and Technology of China , Suzhou 215123 , China
| | - Daoshu Zhang
- Center for Information Photonics and Energy Materials, Shenzhen Institutes of Advanced Technology , Chinese Academy of Sciences , Shenzhen 518055 , People's Republic of China
- Department of Nano Science and Technology Institute , University of Science and Technology of China , Suzhou 215123 , China
| | - Weimin Li
- Center for Information Photonics and Energy Materials, Shenzhen Institutes of Advanced Technology , Chinese Academy of Sciences , Shenzhen 518055 , People's Republic of China
| | - Ye Feng
- Center for Information Photonics and Energy Materials, Shenzhen Institutes of Advanced Technology , Chinese Academy of Sciences , Shenzhen 518055 , People's Republic of China
| | - Lei Wei
- School of Electrical and Electronic Engineering , Nanyang Technological University , 50 Nanyang Avenue , 639798 , Singapore
| | - Wenjie Li
- Center for Information Photonics and Energy Materials, Shenzhen Institutes of Advanced Technology , Chinese Academy of Sciences , Shenzhen 518055 , People's Republic of China
| | - Guohua Zhong
- Center for Information Photonics and Energy Materials, Shenzhen Institutes of Advanced Technology , Chinese Academy of Sciences , Shenzhen 518055 , People's Republic of China
| | - Chunlei Yang
- Center for Information Photonics and Energy Materials, Shenzhen Institutes of Advanced Technology , Chinese Academy of Sciences , Shenzhen 518055 , People's Republic of China
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Farr M, Banks J, Edwards HB, Northstone K, Bernard E, Salisbury C, Horwood J. Implementing online consultations in primary care: a mixed-method evaluation extending normalisation process theory through service co-production. BMJ Open 2018; 8:e019966. [PMID: 29555817 PMCID: PMC5875620 DOI: 10.1136/bmjopen-2017-019966] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES To examine patient and staff views, experiences and acceptability of a UK primary care online consultation system and ask how the system and its implementation may be improved. DESIGN Mixed-method evaluation of a primary care e-consultation system. SETTING Primary care practices in South West England. METHODS Qualitative interviews with 23 practice staff in six practices. Patient survey data for 756 e-consultations from 36 practices, with free-text survey comments from 512 patients, were analysed thematically. Anonymised patients' records were abstracted for 485 e-consultations from eight practices, including consultation types and outcomes. Descriptive statistics were used to analyse quantitative data. Analysis of implementation and the usage of the e-consultation system were informed by: (1) normalisation process theory, (2) a framework that illustrates how e-consultations were co-produced and (3) patients' and staff touchpoints. RESULTS We found different expectations between patients and staff on how to use e-consultations 'appropriately'. While some patients used the system to try and save time for themselves and their general practitioners (GPs), some used e-consultations when they could not get a timely face-to-face appointment. Most e-consultations resulted in either follow-on phone (32%) or face-to-face appointments (38%) and GPs felt that this duplicated their workload. Patient satisfaction of the system was high, but a minority were dissatisfied with practice communication about their e-consultation. CONCLUSIONS Where both patients and staff interact with technology, it is in effect 'co-implemented'. How patients used e-consultations impacted on practice staff's experiences and appraisal of the system. Overall, the e-consultation system studied could improve access for some patients, but in its current form, it was not perceived by practices as creating sufficient efficiencies to warrant financial investment. We illustrate how this e-consultation system and its implementation can be improved, through mapping the co-production of e-consultations through touchpoints.
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Affiliation(s)
- Michelle Farr
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) West, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Jonathan Banks
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) West, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Hannah B Edwards
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) West, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Kate Northstone
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) West, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | | | - Chris Salisbury
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) West, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Jeremy Horwood
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC) West, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
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