Exploring the hospital patient journey: What does the patient experience?
Autoři:
Raffaella Gualandi aff001; Cristina Masella aff002; Daniela Viglione aff001; Daniela Tartaglini aff001
Působiště autorů:
Department of Nursing, Università Campus Bio-Medico di Roma, Rome, Italy
aff001; Department of Management Economics and Industrial Engineering, Politecnico di Milano, Milan, Italy
aff002
Vyšlo v časopise:
PLoS ONE 14(12)
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pone.0224899
Souhrn
Purpose
To understand how different methodologies of qualitative research are able to capture patient experience of the hospital journey.
Methods
A qualitative study of orthopaedic patients admitted for hip and knee replacement surgery in a 250-bed university hospital was performed. Eight patients were shadowed from the time they entered the hospital to the time of transfer to rehabilitation. Four patients and sixteen professionals, including orthopaedists, head nurses, nurses and administrative staff, were interviewed.
Results
Through analysis of the data collected four main themes emerged: the information gap; the covering patient-professionals relationship; the effectiveness of family closeness; and the micro-integration of hospital services. The three different standpoints (patient shadowing, health professionals’ interviews and patients’ interviews) allowed different issues to be captured in the various phases of the journey.
Conclusions
Hospitals can significantly improve the quality of the service provided by exploring and understanding the individual patient journey. When dealing with a key cross-functional business process, the time-space dynamics of the activities performed have to be considered. Further research in the academic field can explore practical, methodological and ethical challenges more deeply in capturing the whole patient journey experience by using multiple methods and integrated tools.
Klíčová slova:
Emotions – Health care – Hospitals – Nurses – Patients – Surgical and invasive medical procedures – Total hip arthroplasty – Total knee arthroplasty
Zdroje
1. Ford RC, Fottler MD. Creating customer-focused health care organizations. Health Care Manage Rev. 2000;25:18–33. doi: 10.1097/00004010-200010000-00003 11072629
2. Thorne SE, Paterson BL. Two decades of insider research: what we know and don’t know about chronic illness experience. Annu Rev Nurs Res. 2000;18:3–25. 10918930
3. Iedema RA, Angell B. What are patients’ care experience priorities? BMJ Quality & Safety. 2015;24:356–59.
4. Sibley M, Earwicker R, Huber JW. Making best use of patient experience. J Clin Nurs. 2018;27:4239–41. doi: 10.1111/jocn.14504 29752838
5. Sheard L, Peacock R, Marsh C, Lawton R. What's the problem with patient experience feedback? A macro and micro understanding, based on findings from a three-site UK qualitative study. Health Expect. 2019;22:46–53. doi: 10.1111/hex.12829 30244499
6. The Beryl Institute Website, Defining Patient Experience. Available from: http://www.theberylinstitute.org/?page=DefiningPatientExp. Accessed April 20, 2019
7. Wolf JA, Niederhauser V, Marshburn D, LaVela SL. Defining Patient Experience. Patient Exp J. 2014;1:3.
8. Jain R, Aagja J, Bagdare S. Customer experience–a review and research agenda. JSTP. 2017;27:642–62.
9. Haraden C, Resar R. Patient flow in hospitals: understanding and controlling it better. Front Health Serv Manage. 2004;20:3–15.
10. Litvak E. Managing Patient Flow in Hospitals: Strategies and Solutions, Joint Commission Resources; 2nd Ed. Eugene Litvak Editor; 2010.
11. The Health Foundation. Improving patient flow. Learning report. The Health Foundation, 90 Long Acre, London WC2E 9RA; 2013.
12. Ben-Tovim DI, Dougherty ML, O’Connell TJ, McGrath KM. Patient journeys: the process of clinical redesign. Med J Aust. 2008;188:S14. 18341470
13. Samaranayake P, Dadich A, Fitzgerald A, Zeitz K. Developing an evaluation framework for clinical redesign programs: lessons learnt. J Health Organ Manag. 2016;30:950–70. doi: 10.1108/JHOM-07-2015-0109 27681027
14. Trbovich P, Vincent C. From incident reporting to the analysis of the patient journey. BMJ Qual Saf. 2018;28:169–71. doi: 10.1136/bmjqs-2018-008485 30337497
15. Beattie M, Murphy DJ, Atherton I, Lauder W. Instruments to measure patient experience of healthcare quality in hospitals: a systematic review. Syst Rev. 2015;4:97. doi: 10.1186/s13643-015-0089-0 26202326
16. Coulter A, Fitzpatrick R, Cornwell J. The point of care measures of patients’ experience in hospital: purpose, methods and uses. The Kings fund. 2009;1–32.
17. Tsianakas V, Maben J, Wiseman T, et al. Using patients' experiences to identify priorities for quality improvement in breast cancer care: patient narratives, surveys or both? BMC Health Serv Res. 2012;22:271.
18. Yanes AF, McElroy LM, Abecassis ZA, et al. Observation for assessment of clinician performance: a narrative review. BMJ Qual Saf. 2016;25: 46–55. doi: 10.1136/bmjqs-2015-004171 26424762
19. Czarniawska B. Shadowing and Other Techniques for Doing Fieldwork in Modern Societies. ISBN: 978-91-47-08780-8. Liber/Copenhagen Business School Press; 2007.
20. Ziebland S, Coulter A, Calabrese JD, Locock L. Understanding and using health experiences. Oxford University Press; 2013.
21. Kjellsson G, Clarke P, Gerdtham UG. Forgetting to remember or remembering to forget: a study of the recall period length in health care survey questions. J Health Econ. 2014;35:34–46. doi: 10.1016/j.jhealeco.2014.01.007 24595066
22. Icks A, Dittrich A, Brüne M, et al. Agreement found between self-reported and health insurance data on physician visits comparing different recall lengths. J Clin Epidemiol. 2017;82: 167–72. doi: 10.1016/j.jclinepi.2016.10.009 27825891
23. Webster CS, Jowsey T, Lu LM, et al. Capturing the experience of the hospital-stay journey from admission to discharge using diaries completed by patients in their own words: a qualitative study. BMJ Open.2019;9:e027258. doi: 10.1136/bmjopen-2018-027258 30862638
24. McDonald S. Studying actions in context: a qualitative shadowing method for organizational research. QRJ. 2005;5(4):455–473.
25. McDonald S, Simpson B. Shadowing research in organizations: the methodological debates. QROM. 2014;9(1):3–20.
26. van der Meide H, Leget C, Olthuis G. Giving voice to vulnerable people: the value of shadowing for phenomenological healthcare research. Med Health Care Philos. 2013;16:731–737. doi: 10.1007/s11019-012-9456-y 23212578
27. van der Meide H, Olthuis G, Leget C. Participating in a world that is out of tune: shadowing an older hospital patient. Med Health Care and Philos. 2015;18:577–585.
28. Shaw J, Pemberton S, Pratt C, Salter L. Shadowing: a central component of patient and family-centred care. Nurs Manag (Harrow). 2014;21(3):20–3.
29. Marcus-Aiyeku U, DeBari M, Salmond S. Assessment of the Patient-Centered and Family-Centered Care Experience of Total Joint Replacement Patients Using a Shadowing Technique. Orthop Nurs. 2015;34(5):269–77. doi: 10.1097/NOR.0000000000000177 26375835
30. Liberati EG (2017) What is the potential of patient shadowing as a patient-centred method? BMJ Qual Saf 26: 343–46. doi: 10.1136/bmjqs-2016-005308 27164848
31. Bate P, Robert G (2006) Experience-based design: from redesigning the system around the patient to co-designing services with the patient. Qual Saf Health Care 15: 307–10. doi: 10.1136/qshc.2005.016527 17074863
32. Krol MW, De Boer D, Sixma H, et al. (2015) Patient experiences of inpatient hospital care: a department matter and a hospital matter. Int J Qual Health Care 27: 17–25. doi: 10.1093/intqhc/mzu090 25502552
33. Honeyford K, Greaves F, Aylin P, Bottle A (2017) Secondary analysis of hospital patient experience scores across England's National Health Service—How much has improved since 2005? PLoS ONE 12: e0187012. doi: 10.1371/journal.pone.0187012 29073218
34. Laverty SM. Hermeneutic Phenomenology and Phenomenology: A Comparison of Historical and Methodological Considerations. IJQM. 2003:21–35.
35. Lindseth A, Norberg A. A phenomenological hermeneutical method for researching lived experience. Scand J Caring Sci. 2004;18:145–153. doi: 10.1111/j.1471-6712.2004.00258.x 15147477
36. Tong A, Sainsbury P, Craig J (2007) Consolidated criteria for reporting qualitative research (COREQ): A 32‐item checklist for interviews and focus groups. Int J Qual Health Care 19: 349–57. doi: 10.1093/intqhc/mzm042 17872937
37. Plutchik R. The Nature of Emotions: Clinical Implications. In: Clynes M., Panksepp J. (eds) Emotions and Psychopathology. Springer, Boston, MA; 1988.
38. Benner P. From novice to expert: Excellence and power in clinical nursing practice. Menlo Park: Addison-Wesley:13–34; 1984.
39. Halvorsrud R, Kvale K, Følstad A. Improving service quality through customer journey analysis. JSTP. 2016;26:840–67.
40. Gleeson H, Calderon A, Swami V, et al. Systematic review of approaches to using patient experience data for quality improvement in healthcare settings. BMJ Open. 2016;6:e011907. doi: 10.1136/bmjopen-2016-011907 27531733
41. Specht K, Kjaersgaard-Andersen P, Pedersen BD. Patient experience in fast-track hip and knee arthroplasty-a qualitative study. J Clin Nurs. 2016;25:836–45. doi: 10.1111/jocn.13121 26708610
42. Kaptain K, Ulsøe ML, Dreyer P. Surgical perioperative pathways-Patient experiences of unmet needs show that a person-centred approach is needed. J Clin Nurs. 2019;28: 2214–24. doi: 10.1111/jocn.14817 30786078
43. Andersen‐Hollekim TE, Kvangarsnes M, Landstad BJ, et al. Patient participation in the clinical pathway—Nurses’ perceptions of adults’ involvement in haemodialysis. Nursing Open. 2019:6:574–82. doi: 10.1002/nop2.241 30918708
44. Gill R. The shadow in organizational ethnography: Moving beyond shadowing to spect-acting. Qualitative Research in Organizations and Management. Qual Res Org Manag Int J. 2011;6:115–133.
45. Altringer B. The emotional experience of patient care: a case for innovation in health care design. J Health Serv Res Policy. 2010;15:174–77. doi: 10.1258/jhsrp.2009.009064 20203081
46. Edwards PK, Mears SC, Barnes CL. Preoperative Education for Hip and Knee Replacement: Never Stop Learning. Curr Rev Musculoskelet Med. 2017;10:356–364. doi: 10.1007/s12178-017-9417-4 28647838
47. Feng JE, Novikov D, Anoushiravani AA, Schwarzkopf R. Total knee arthroplasty: improving outcomes with a multidisciplinary approach. J Multidiscip Healthc. 2018; 5;11:63–73. doi: 10.2147/JMDH.S140550 29416347
48. Agozzino E, Borrelli S, Cancellieri M, Carfora FM, Di Lorenzo T, Attena F. Does written informed consent adequately inform surgical patients? A cross sectional study. BMC Med Ethics. 2019;7;20(1):1. doi: 10.1186/s12910-018-0340-z 30616673
49. Manary MP, Boulding W, Staelin R, Glickman SW (2013) The patient experience and health outcomes. N Engl J Med 368: 201–203. doi: 10.1056/NEJMp1211775 23268647
Článek vyšel v časopise
PLOS One
2019 Číslo 12
- Tisícileté topoly, mokří psi, stárnoucí kočky a ospalé octomilky – „jednohubky“ z výzkumu 2024/41
- Jaké jsou aktuální trendy v léčbě karcinomu slinivky?
- Může hubnutí souviset s vyšším rizikem nádorových onemocnění?
- Menstruační krev má značný diagnostický potenciál, mimo jiné u diabetu
- Metamizol jako analgetikum první volby: kdy, pro koho, jak a proč?
Nejčtenější v tomto čísle
- Methylsulfonylmethane increases osteogenesis and regulates the mineralization of the matrix by transglutaminase 2 in SHED cells
- Oregano powder reduces Streptococcus and increases SCFA concentration in a mixed bacterial culture assay
- The characteristic of patulous eustachian tube patients diagnosed by the JOS diagnostic criteria
- Parametric CAD modeling for open source scientific hardware: Comparing OpenSCAD and FreeCAD Python scripts
Zvyšte si kvalifikaci online z pohodlí domova
Všechny kurzy