Automated analysis of free-text comments and dashboard representations in patient experience surveys: a multimethod co-design study

BACKGROUND: Patient experience surveys (PESs) often include informative free-text comments, but with no way of systematically, efficiently and usefully analysing and reporting these. The National Cancer Patient Experience Survey (CPES), used to model the approach reported here, generates > 70,000 free-text comments annually. MAIN AIM: To improve the use and usefulness of PES free-text comments in driving health service changes that improve the patient experience. SECONDARY AIMS: (1) To structure CPES free-text comments using rule-based information retrieval (IR) (‘text engineering’), drawing on health-care domain-specific gazetteers of terms, with in-built transferability to other surveys and conditions; (2) to display the results usefully for health-care professionals, in a digital toolkit dashboard display that drills down to the original free text; (3) to explore the usefulness of interdisciplinary mixed stakeholder co-design and consensus-forming approaches in technology development, ensuring that outputs have meaning for all; and (4) to explore the usefulness of Normalisation Process Theory (NPT) in structuring outputs for implementation and sustainability. DESIGN: A scoping review, rapid review and surveys with stakeholders in health care (patients, carers, health-care providers, commissioners, policy-makers and charities) explored clinical dashboard design/patient experience themes. The findings informed the rules for the draft rule-based IR [developed using half of the 2013 Wales CPES (WCPES) data set] and prototype toolkit dashboards summarising PES data. These were refined following mixed stakeholder, concept-mapping workshops and interviews, which were structured to enable consensus-forming ‘co-design’ work. IR validation used the second half of the WCPES, with comparison against its manual analysis; transferability was tested using further health-care data sets. A discrete choice experiment (DCE) explored which toolkit features were preferred by health-care professionals, with a simple cost–benefit analysis. Structured walk-throughs with NHS managers in Wessex, London and Leeds explored usability and general implementation into practice. KEY OUTCOMES: A taxonomy of ranked PES themes, a checklist of key features recommended for digital clinical toolkits, rule-based IR validation and transferability scores, usability, and goal-oriented, cost–benefit and marketability results. The secondary outputs were a survey, scoping and rapid review findings, and concordance and discordance between stakeholders and methods. RESULTS: (1) The surveys, rapid review and workshops showed that stakeholders differed in their understandings of the patient experience and priorities for change, but that they reached consensus on a shortlist of 19 themes; six were considered to be core; (2) the scoping review and one survey explored the clinical toolkit design, emphasising that such toolkits should be quick and easy to use, and embedded in workflows; the workshop discussions, the DCE and the walk-throughs confirmed this and foregrounded other features to form the toolkit design checklist; and (3) the rule-based IR, developed using noun and verb phrases and lookup gazetteers, was 86% accurate on the WCPES, but needs modification to improve this and to be accurate with other data sets. The DCE and the walk-through suggest that the toolkit would be well accepted, with a favourable cost–benefit ratio, if implemented into practice with appropriate infrastructure support. LIMITATIONS: Small participant numbers and sampling bias across component studies. The scoping review studies mostly used top-down approaches and focused on professional dashboards. The rapid review of themes had limited scope, with no second reviewer. The IR needs further refinement, especially for transferability. New governance restrictions further limit immediate use. CONCLUSIONS: Using a multidisciplinary, mixed stakeholder, use of co-design, proof of concept was shown for an automated display of patient experience free-text comments in a way that could drive health-care improvements in real time. The approach is easily modified for transferable application. FUTURE WORK: Further exploration is needed of implementation into practice, transferable uses and technology development co-design approaches. FUNDING: The National Institute for Health Research Health Services and Delivery Research programme

Personalising patient Internet searching using electronic patient records

The research reported in this thesis addresses a patient's information requirements when searching the Internet for health information. A patient's lack of information about his/her health condition and its care is officially acknowledged and traditional patient information sources do not address today's patient information needs. Internet health information resources have become the foremost health information platform. However, patient Internet searching is currently manual, uncustomised and hindered by health information vocabulary and quality challenges. Patient access to quality Internet health information is currently ensured through national health gateways, medical search engines, third-party accredited search engines and charity health websites. However, such resources are generic, i.e. do not cater for a patient particular information needs. In this study, we propose personalising patient Internet searching by enabling a patient's access to their Electronic Patient Records (EPRs) and using this EPR data in Internet information searching. The feasibility of patient access to EPRs has recently been promoted by national health information programmes. Very recently, in the literature, there are reports about pilot studies on personal Health Record (PHR) systems that offer a patient online access to their medical records and related health information. However, the extensive literature searching shows no reports about patient-personalised search engines, within the reported PHR prototypes, that utilise a patient's own data to personalise the search features for a patient especially with regard to health information vocabulary needs. The thesis presents a novel approach to personalising patient information searching based on linking EPR data with relevant Internet Information resources, integrating medical and lay perspectives in a diagnosis vocabulary that distinguishes between medical and lay information needs, and accommodating a variable perspective on online information quality. To demonstrate our research work, we have implemented a prototype online patient personal health information system, known as the Patient Health Base (PHB) that offers a patient a Summary Medical Record (SMR) and a Personal Internet Search (PerlS) service. PerlS addresses patient Internet search challenges identified in the project. Evaluation of PerlS's approach to improving a patient's medical Internet searching demonstrated improvements in terms of search capabilities, focusing techniques and results. This research explored a new direction for patient Internet searching and foresees a great potential for further customising Internet information searching for patients, families and the public as a whole

Front-Line Physicians' Satisfaction with Information Systems in Hospitals

Day-to-day operations management in hospital units is difficult due to continuously varying situations, several actors involved and a vast number of information systems in use. The aim of this study was to describe front-line physicians' satisfaction with existing information systems needed to support the day-to-day operations management in hospitals. A cross-sectional survey was used and data chosen with stratified random sampling were collected in nine hospitals. Data were analyzed with descriptive and inferential statistical methods. The response rate was 65 % (n = 111). The physicians reported that information systems support their decision making to some extent, but they do not improve access to information nor are they tailored for physicians. The respondents also reported that they need to use several information systems to support decision making and that they would prefer one information system to access important information. Improved information access would better support physicians' decision making and has the potential to improve the quality of decisions and speed up the decision making process.Peer reviewe

Narrative motion on the two-dimensional plane: the “video-ization” of photography and characterization of reality

"Art is not truth. Art is a lie that enables us to recognize truth" Pablo Picasso Time, as known to many, is an indispensable component of photography. Period(s) included in “single” photographs are usually and naturally much shorter than periods documented in video works. Yet, when it comes to combining photos taken at different times on one photographical surface, it becomes possible to see remnants of longer periods of time. Whatever method you use, the many traces left by different moments, lead to the positive notion of timelessness (lack of time dependence) due to the plural presences of time at once. This concept of timelessness sometimes carries the content of the photo to anonymity, the substance becomes multi-layered and hierarchy disappears. This paper focuses on creating photographical narratives within the two-dimensional world. The possibility of working in layers with transparency within the computer environment enables us to overlay succession of moments seized from time on top of each other, in order to create a storyline spread in time that is otherwise not possible to express in a single photograph, unless properly staged. Truth with the capital T is not taken as the departure point in this article; on the contrary, personal delineations of temporary yet experienced smaller realities is suggested

An integrative evidence review on service user participation in the design and delivery of drug treatment, recovery and harm reduction services.

This study aims to provide an overview of what user involvement entails within the context of drug treatment services in Ireland. The objective of the study is to provide policy-makers, practitioners, researchers and service users with a clearer understanding of the challenges associated with user involvement, a fundamental paradigm or principle when seeking to develop more effective and satisfactory services. The study involved a lengthy and complex series of research tasks, including an extensive literature search, a service user consultation and discussions with a number of stakeholders. Julie Glanville was responsible for designing the literature search, Feline Engling Cardoso coordinated the stakeholder interviews and Jonathan Pratschke carried out the service user consultation, as well as analysing the interview transcripts and supervising the study. Brian Galvin from the Health Research Board provided oversight and guidance, the Royal College of Physicians of Ireland provided ethical approval for the service user consultation

Culture, People and Technology: The Driving Forces for Tourism Cities Proceedings of 8th ITSA Biennial Conference 2020

This is the proceedings of the 8th Biennial Conference of the International Tourism Studies Association, held in Jakarta and Singapore, 2nd December 202

Proceedings of 8th ITSA Biennial Conference 2020

Over the past few decades, hotel guests’ service expectations grew from services such as check-in and check-out (Cobanoglu, Corbaci, Moreo & Ekinci, 2003) to expecting hotels to, amongst others, provide services relating to tourist attractions (Adler & Gordon, 2013; Yeh, Leong, Blecher & Hu, 2005). Despite these developments, South Africa (SA) is amongst the countries confronted by the minimal utilisation of tourist attractions (National Department of Tourism, 2012) and the tourists’ lack of awareness of tourist attractions within major destinations, such as Cape Town (City of Cape Town, 2013) and Durban (eThekwini Municipality, 2014). By providing tourists with services relating to tourist attractions, hotels are likely to contribute towards addressing the minimal utilisation and lack of awareness of tourist attractions. Guest orientation (Lee, 2014), self-efficacy (Jaiswal & Dhar, 2015), motivation (Hon & Leung, 2011) and effort (Marić, Marinković, Marić & Dimitrovski, 2016) are constructs that impact on the service performance of hotel staff. However, studies have not been conducted to determine the impact of these constructs on the performance of hotel staff relating to tourist attractions. This paper forms part of a PhD study in progress which explores the constructs (Guest orientation, Self-efficacy, Motivation and Effort) that impact on hotel staff’s performance of services relating to tourist attractions. The PhD adopted a qual-QUANT research method to, in phase 1, qualitatively identify emerging themes from each construct, which will be quantitatively investigated in phase 2. This paper stems from phase 1 and aims to identify via qualitative research the key themes that emerge in each of the four constructs that are associated with hotel staff’s performance of services relating to tourist attractions. Semi-structured interviews were conducted with four certified hotel concierges belonging to Les Clefs d’ Or in SA. Thematic coding was used to identify the themes emerging from the qualitative data. Eight themes emerged from Guest orientation, five from Self-efficacy, seven from Motivation and ten from Effort

Exploring perceptions of household surface cleaning products and the implications for sustainable consumption

Historically, green cleaning products have performed poorly in comparison with conventional alternatives. Other green product categories are rising in popularity while green cleaning products remain unfavourable. Consumers may view green cleaning products negatively because they believe that green products cannot be as strong as conventional products. This has only been tested in hypothetical products. Consumers also view green cleaning products as safer than conventional cleaning products. This thesis explores these perceptions by answering the following research questions: 1. Are there differences in the composition of green and conventional cleaning products? If so, do these differences have implications for health and the environment? 2. Does a product’s environmental status influence how the product is perceived by consumers in terms of its effectiveness? 3. Does a product’s environmental status influence how the product is perceived by consumers in terms of its safety? 4. Does a product’s environmental status influence the way in which its ingredients are perceived by consumers? Firstly, a comparison of ingredients was made using publicly available information. Secondly, a novel experimental study was used to compare perceptions of product efficacy. Finally, an online survey was utilised to explore perceptions of product and ingredient safety. There are no differences between green and conventional cleaning products in their potential harm to human health. Negative quality perceptions of green household cleaning products are not present for existing green cleaning products. Consumers struggle to identify green cleaning products, but those who correctly identify green cleaning products perceive them as safer for health than conventional products. There were no perceived differences in ingredient safety between green and conventional products. This research contributes an original methodology by exploring perceptions in real over hypothetical products, and outlines principles that future research must follow