Patient experience in an interprofessional collaborative practice for underserved patients with heart failure

Heart failure is a complex chronic condition that results in multiple patient visits throughout the care continuum. Patient experience has associations with clinical outcomes. The purpose of this study was to examine patient experience among the underserved in a specialized interprofessional collaborative practice heart failure clinic. This prospective study utilized both qualitative and quantitative data to describe the patient experience within an interprofessional collaborative practice. Data were collected from patient experience surveys in 1128 patients seen in the Heart Failure Transitional Care Services for Adults (HRTSA) clinic between January 1, 2018, and December 31, 2021. Interprofessional collaborative practice surveys were completed by clinic staff members. When examining relationships associated with patient experience, we found three significant associations. Being single was negatively associated with patient experience. When examining IPCP and patient experience, overall interprofessional collaborative practice alignment [t(237)=2.00, p=.046 ] and the team’s alignment of mission, vision and purpose [t(254)=1.99, p=.047] were positively related to patients’ care satisfaction. Interprofessional collaborative practice team alignment can positively impact patient experience in underserved patients with heart failure. Experience Framework This article is associated with the Quality & Clinical Excellence lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework). Access other PXJ articles related to this lens. Access other resources related to this lens

Everything I needed to know to be a pediatric emergency room doctor, I learned as a waitress

When I began my career as a pediatric emergency medicine physician, I believed I was prepared to take on any medical emergency. However, I was not prepared to provide a good patient family experience. Throughout my years of training, I was not taught productive ways of interacting with patients and was unaware of how impactful the patient family experience would be. Negative patient family experience scores affected my interactions with patients, my shared decision making and my ability to provide quality care. After working to improve my scores, I focused on skills I obtained in a non-medical setting, as a waitress, and applied them to my patient interactions. These 10 tips, which I have adapted from the hospitality industry, will help with not only improving your patient-family experience scores, but improving your entire interaction with patients in the emergency room or any clinical environment in which you work. Experience Framework This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework). Access other PXJ articles related to this lens. Access other resources related to this lens

Patient experiences through head and neck cancer: Information delivery combatting psychological distress

As part of a larger study investigating the utility of electronic decision support tools for patients with head and neck cancer (HNC), this article describes the patient experience of receiving cancer treatment in British Columbia, Canada. It aims to give voice to the patient experience and recommend a model of psychological adjustment for clinicians and clinical service management to consider to refine patient centric care pathways for HNC. Based in phenomenology, semi-structured interviews were conducted with 12 survivors of HNC, audio-video recorded, and thematically analyzed. Three themes were identified: (1) patients have high, though varying information needs; (2) an emotional experience; and (3) coping, strength, and resiliency. These themes arose from six concepts: (1) information needs; (2) fear of the unknown; (3) desire for personalized information; (4) varying degrees of information needs; (5) fear as a motivator versus stressor; and (6) high information needs on life after treatment. Conclusions: The patient experience must be considered through the full care trajectory and into survivorship to provide the right information to the correct patient at the optimal time. Patient journey mapping may be a novel approach to exploring the temporal relationship between information needs and the patient experience along the cancer continuum to uncover opportune moments, from the patient perspective, for knowledge and supportive care intervention. The model of psychological adjustment by Calver et al. (2019) can be considered to inform the delivery of cancer care information in a method recognizing the patient as the ultimate knowledge holder. Experience Framework This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework). Access other PXJ articles related to this lens. Access other resources related to this lens

A roadmap to engaging patients in research: The experience of a large academic research hospital in Canada

Recent definitions of patient engagement in research (PER) emphasize that engagement should be meaningful, active and an equal collaboration across the research continuum. The increased interest in patient engagement is predicated on the recognition by researchers of the unique experiential knowledge provided by individuals with lived experience, ethical obligations to democratize science and that patient involvement can potentially lead to improved outcomes for patients and researchers. Sunnybrook Health Sciences Center is a large academic research hospital in Toronto, Canada which aimed to create clearer pathways for patients to have a more prominent voice in the development, implementation, and dissemination of research. However, to ensure that the policies, practices and resources to support PER would be viewed as meaningful to all stakeholders (including, but not limited to, administrators, clinicians, clinician researchers, scientists, patients, family members and caregivers), a series of structured activities were undertaken to foster collective buy-in and co-create an operational implementation plan for PER. The activities consisted of a consecutive mixed methods approach of three phases of discovery: a survey, focus groups and interviews, and an in-person town hall. We describe our approach to implementation and operationalization of PER at an academic hospital based on five identified priority themes: education and training, partnerships, matching programs, policies and measures. Experience Framework This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework). Access other PXJ articles related to this lens. Access other resources related to this lens

Caregiver burden: Support needed for those who support others and the National Health Service

This literature review focuses on the complexities and inequalities of informal caregiving in the UK and was inspired by the story of the following individual: EL is a 68-year-old Caucasian lady who attended Movement Disorder Clinic and was diagnosed with Parkinson\u27s Disease Dementia following many years of symptoms. The diagnosis came as a big relief to EL and her daughter (SL) who were eager to get treatment started as soon as possible. EL lives alone with SL and solely relies on her for care and support. SL does not have children and devotes her daily routine to looking after her mother, never spending more than a few hours away from her. SL has found this situation very challenging, while EL has felt she has lost her independence. This frustration on a background of mutual love and concern was evident from both parties during the appointment. Informal carers play a crucial role in looking after individuals and provide massive relief to healthcare systems but are often left without support. This puts themselves and the people they care for at risk of poor physical and psychological outcomes. The number of informal carers continues to rise but staggering rates of burnout are still observed. By understanding the complexities and emotional impact of this role, together with the inadequacies of current social care policies, we can strive to reveal areas of improvement that can grant carers the support they deserve to carry on performing their invaluable roles. Experience Framework This article is associated with the Staff & Provider Engagement lens of The Beryl Institute Experience Framework (https://theberylinstitute.org/experience-framework/). Access other PXJ articles related to this lens. Access other resources related to this lens

The silence of mitotic figures

A career in medicine is guided by the patients you treat and those who have taught you to treat these individuals. Communication is of utmost importance in all aspects of healthcare. However, there are times when communication can be difficult. This story takes you through a physician’s experience that led to a career in women’s healthcare, reflecting on the silence that prevailed as her journey began. Experience Framework This article is associated with the Staff & Provider Engagement lens of The Beryl Institute Experience Framework (https://theberylinstitute.org/experience-framework/). Access other PXJ articles related to this lens. Access other resources related to this len

Storytelling at board meetings: A case study of co-developing recommendations

In healthcare, stories shared by patients often provide details and insights into experiences of illness and care. Stories are a way to educate healthcare providers and others to improve care and systems to become more patient and family centred and to better meet patients’ needs and priorities. Telling stories may bring benefits to both storytellers and audience members but also presents risks of harm. A reflective storytelling practice aims to honor stories and storytellers by ensuring there is time to prepare, reflect, learn, ask questions, and engage in dialogue with the storyteller to explore what went well and where there are learning and improvement opportunities. Healthcare Excellence Canada (HEC) is a pan-Canadian health organization focused on improving the quality and safety of care in Canada. HEC commits to engage patients, caregivers, and communities and aims to develop practices and structures to enable engagement activities. At the request of the HEC Board, the Patient Engagement and Partnerships team co-developed recommendations on the process for how best to meaningfully share stories at Board meetings, including stories from those leading, providing, and receiving care. This Case Study outlines the process HEC used to co-develop storytelling recommendations, focusing on a trauma-informed approach to create safe spaces for preparing, learning from and reflecting on stories, to clearly articulate their purpose, and to ensure the locus of control for storytelling rests with the storytellers. This Case Study shares these recommendations and invites other organizations to use these recommendations and/or adapt them within their own context. Experience Framework This article is associated with the Infrastructure & Governance lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework). Access other PXJ articles related to this lens. Access other resources related to this lens

The role of patient-centered communication scale in patients’ satisfaction of healthcare providers before and during the COVID-19 pandemic

Assess the effect of patient-centered communication (PCC) scale on the patient satisfaction of healthcare providers (HCPs). The 2020 Health Information National Trends Survey (HINTS) was used to analyze the patient’s satisfaction of HCPs. This survey includes 2466 patients’ responses and were analyzed using the multivariable binary Hyperbolastic regression model of type II. The study examines the effects of PCC scale on patients’ satisfaction of HCPs while controlling for pandemic status, employment, education, marital status, race, political views, waiting time status, sex, income, and age. PCC scale was the most significant predictor of patients’ satisfaction of their HCPs (P-value \u3c 0.001) followed by waiting time status (P-value \u3c 0.001), and age (P-value = 0.016). The odds of patient satisfaction with the healthcare provider services were approximately 20% higher prior to the pandemic than during the pandemic (P-value = 0.415). The odds of satisfaction for patients earning $100k+ was approximately three times more than those making less than$35,000 (P-value = 0.003). PCC scale is a powerful measure that may be used as a metric for patients’ satisfaction of HCPs. Taking steps to improve communication between HCPs and patients is a key factor in patient satisfaction. Concentrating on the seven domains of PCC will result in higher patient satisfaction of HCPs. The improvement in PCC will encourage each patient to disclose vital information about his or her health. This may increase the accuracy of diagnosis, quality of care, and health outcomes. Experience Framework This article is associated with the Policy & Measurement lens of The Beryl Institute Experience Framework (https://theberylinstitute.org/experience-framework/). Access other PXJ articles related to this lens. Access other resources related to this lens

Breaking the transactional mindset: A new path for healthcare leadership built on a commitment to human experience

Numerous health care publications have focused on the compelling need to improve patient experience and the associated improvements necessary to address workforce well-being. The COVID-19 pandemic exacerbated and illuminated long-standing problems in health care including workforce shortages, inequity in health care delivery outcomes, care provider burnout, and overall societal structural racism.1,2 The Beryl Institute’s Nursing Executive Council (NEC) manuscript Rebuilding a Foundation of Trust: A Call to Action in Creating a Safe Environment for Everyone3 focused on actions and behaviours to heal relationships and build trust between care providers and leaders with commitments to safety, empathy, shared decision making, transparency, growth and development. Research studies abound offering new frameworks and interventions intending to strengthen systems of care that respect whole person needs. The nursing profession has always been anchored in holistic person-centered care yet continues to be challenged in work environments laden with fragmentation and barriers to human caring. The purpose of this paper is to review the dominance of transactional business mindsets and practices today that may foster those challenging environments and assert that the use of Service-Dominant Logic (SDL) demonstrates the importance of human relations in developing effective and sustainable organizational performance. Ultimately it can help us lead differently at all levels as we work to transform the human experience in healthcare. Experience Framework This article is associated with the Culture & Leadership lens of The Beryl Institute Experience Framework (https://theberylinstitute.org/experience-framework/). Access other PXJ articles related to this lens. Access other resources related to this lens

Listening as medicine: A thematic analysis

Realizations of the importance of “the art of medicine” in trust-building and patient satisfaction have resulted in the incorporation of narrative medicine programs into training curricula. By learning how to respond to patient stories as well as communicate their own, healthcare providers can ensure that their patients feel heard and respected. This study seeks to define what constitutes empathetic listening through a qualitative analysis of personal narratives collected from patients, caregivers, and providers across an urban academic healthcare system. Stories (n=41) underwent thematic analysis to note common experiences related to listening during a health system encounter. Eighteen grounded codes were identified which were abstracted to the following five themes: (1) connection and trust, (2) emotion and vulnerability, (3) objectives and experiences, (4) interaction and opportunity, and (5) challenges of listening. The most common theme of “connection and trust” indicated that active listening and person-centered care were key drivers of patient satisfaction and medical adherence. Encouraging patients and providers to become more comfortable verbalizing vulnerability also provided emotional relief. Taking the time to listen to patient needs and values advanced shared-decision making and facilitated the establishment of care objectives. Storytellers also conveyed the challenges inherent to the listening process. By helping to define empathetic listening, these results may enable the development of healthcare training programs centered on improving clinician communication and patient experience. We hope this study encourages future research devoted to quantifying subjective features such as “connection and trust” and “emotion and vulnerability” utilizing psychometrically validated instruments. Experience Framework This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework). Access other PXJ articles related to this lens. Access other resources related to this lens