'Let me take care of you': what can healthcare learn from a high-end restaurant to improve the patient experience?

Background: The patient experience is associated with patient satisfaction and health outcomes, presenting a key challenge in healthcare. The objective of the study was to explore the principles of care in and beyond healthcare, namely in a three Michelin-starred restaurant, and consider what, if any, principles of care from the diners’ experience could be transferrable to healthcare. Methods: The principles of care were first explored as part of observational fieldwork in a healthcare day surgery unit and restaurant respectively, focusing on communication between the professionals and the patients or the diners. Care was subsequently explored in a series of public engagement events across the UK. The events used immersive simulation to recreate the healthcare and the dining experiences for the general public, and to stimulate discussion. Results: A thematic analysis of the engagement discussions identified overarching themes in how care was experienced in and through communication; “informed, not bombarded”, “conversation, not interrogation”, “environment is communication”, and “being met as a person”. The themes suggested how the participants in simulation felt about the care they received in real time and provided recommendations for improved clinical practice. Conclusions: While practice improvements in healthcare are challenging, the patient experience could be enhanced by learning relational aspects of care from other sectors, including the high-end restaurant industry that focuses on meeting persons’ needs. Simulation provides a new kind of opportunity to bring professionals and patients together for focused discussions, prompted by immersive experiences of care and communication

Assessing seasonality of travel distance to harm reduction service providers among persons who inject drugs

BACKGROUND: Prior research has examined access to syringe exchange program (SEP) services among persons who inject drugs (PWID), but no research has been conducted to evaluate variations in SEP access based on season. This is an important gap in the literature given that seasonal weather patterns and inclement weather may affect SEP service utilization. The purpose of this research is to examine differences in access to SEPs by season among PWID in the District of Columbia (DC). FINDINGS: A geometric point distance estimation technique was applied to records from a DC SEP that operated from 1996 to 2011. We calculated the walking distance (via sidewalks) from the centroid point of zip code of home residence to the exchange site where PWID presented for services. Analysis of variance (ANOVA) was used to examine differences in walking distance measures by season. Differences in mean walking distance measures were statistically significant between winter and spring with PWID traveling approximately 2.88 and 2.77 miles, respectively, to access the SEP during these seasons. CONCLUSIONS: The results of this study suggest that seasonal differences in SEP accessibility may exist between winter and spring. PWID may benefit from harm reduction providers adapting their SEP operations to provide a greater diversity of exchange locations during seasons in which inclement weather may negatively influence engagement with SEPs. Increasing the number of exchange locations based on season may help resolve unmet needs among injectors

Difficulty Accessing Syringes Mediates the Relationship Between Methamphetamine Use and Syringe Sharing Among Young Injection Drug Users

Injection drug users (IDU) who use methamphetamine (MA) are at an increased risk of HIV infection due to engagement in injection-related risk behavior including syringe sharing. In this cohort study of young IDU aged 18-30, we investigated the relationship between injection MA use and syringe sharing, and whether difficulty accessing sterile syringes mediated this association. Behavioral questionnaires were completed by 384 IDU in Vancouver, Canada between October 2005 and May 2008. Generalized estimating equations were used to estimate direct and indirect effects. The median age of participants was 24 (IQR: 22–27) and 214 (55.7%) were male. Injecting MA was independently associated with syringe sharing. Mediation analyses revealed that difficulty accessing sterile syringes partially mediated the association between injecting MA and syringe sharing. Interventions to reduce syringe sharing among young methamphetamine injectors must address social and structural barriers to accessing HIV prevention programs