Feasibility of using emergency department patient experience surveys as a proxy for equity of care

Collecting and examining equity data can help inform quality improvement initiatives but is a relatively new practice in health care. The overall goal of this study was to assess different methods of administering patient experience surveys as a feasible starting point in measuring equity in an urban Emergency Department (ED) that serves a diverse patient population. Socio-demographic characteristics of patients visiting an ED were compared with those of patients who responded to provincial patient experience surveys routinely administered by mail. Patient experience survey data were collected over an 11-week period in an urban ED using different survey administration methods (face-to-face interviews vs. handout) among study participants from vulnerable populations (elderly, low income, homeless, and mental health or substance use issues). Patient populations receiving care in the ED were shown to be different from those who responded to routinely mailed patient experience surveys with elderly patients over-represented, and contrarily, low income, mental health or substance use and homeless/unstable housing populations under-represented in survey responses. From a total of 111 study participants, the response rate for face-to-face surveys was significantly higher than for surveys that were handed out (p = 0.002), but no significant difference in the percentage of positive responses was evident. Delivering patient experience surveys immediately upon discharge is an effective way of capturing unique responses from patients in vulnerable populations, supporting a valuable means of assessing equity in the ED. Survey administration method poses important implications when used to inform quality improvement efforts and performance measurement

Implementing PODS (Patient Oriented Discharge Summary) in an acute medical urban health setting in Vancouver, Canada

The transition from hospital to home or community is a vulnerable time for patients and families, who face risks associated with misunderstanding instructions about medications, self-monitoring and when to seek emergency care. The quality of the discharge process can have a significant impact on patient confidence, overall patient experience, ability to manage health at home, and hospital readmission rates. Patient Oriented Discharge Summary (PODS) is a standardized form and set of process changes, utilized to overcome communication barriers faced at discharge. We implemented PODS in two Acute Medicine units of a tertiary care hospital in western Canada and used a mixed-methods approach to evaluate the four process changes (PODS form, use of teach-back, engagement of caregivers in discharge teaching, follow-up phone calls). Evaluation showed that 60% of patients received PODS and 87% found the form helpful. There was a large increase in the percentage of patients who felt adequately prepared at the time of discharge, and a 10% increase in the number of patients who rated their overall hospital experience positively. Healthcare providers reported that using PODS they were more confident that patients were adequately prepared to return home. The update of PODS on the implementation units has been sustained at 60% for 18 months. Implementation of the PODS form and process can be accomplished with an interdisciplinary team, leadership support and by working closely with Patient Family Partners. PODS can improve the discharge process even in the complex urban acute medical environment in ways that offer wide-reaching benefits. 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