Patient Experience Diagnosis: Using Telemed Simulation to Assess Health Care Provider Verbal and Nonverbal Communication Issues to Prescribe Potential Interventions

Patient experience contributes to health outcomes, and a host of healthcare organization success factors, including profitability. Often applied and academic analysis of patient experience applies macro-level approaches to defining issues and suggesting improvements. Guided by the theoretical framework of provider-patient communication during telemedicine, this study used a simulation to measure impacts of provider behaviors that might be improved through communication training to positively impact outcomes on both sides of patient care. The study employed between-subject experimental design to investigate impacts of provider verbal and nonverbal communication on patient satisfaction during telemedicine consultations. Participants, randomly assigned to one of eight experimental conditions, watched a recorded telemedicine “consultation” with either a male or female provider that displayed either high- or low-immediacy nonverbal cues. Participants imagined being the patient and completed a survey regarding perceptions of provider communication and evaluation of the experience. Results suggest a healthcare provider’s verbal and nonverbal communication represents a significant predictor of patient satisfaction, even during telemedicine. The findings provide empirical evidence for Miller’s model and point to the importance and potential of improving providers’ verbal and nonverbal communication skills through communication training on specific interpersonal skills

Exploration of emotion regulation experiences associated with borderline personality features in a non-clinical sample

Background Emotion dysregulation is a core feature associated with borderline personality features (BPF). Little research has explored how individuals with high levels of BPF regulate their emotions. This study aimed to explore how individuals with high versus low levels of BPF compare on the strategies they use to regulate emotions and in their experiences of emotion regulation. Methods Twenty-nine university students were recruited and assessed for the presence of BPF using self-report questionnaires. Each participant took part in a semi-structured interview about their experiences of emotion regulation. All interview transcripts then underwent thematic analysis. In addition chi square analyses were conducted to explore the association between level of BPF (High vs Low) and each qualitative theme identified. Results Findings indicated similarities in the types of emotion regulation strategies used by the high and low-BPF groups. However, the groups differed in their experiences and thought processes surrounding emotion regulation. High-BPF participants were found to describe a need to communicate negative emotions with others and demonstrated difficulty maintaining attention on positive experiences. In addition there was a trend towards High-BPF participants demonstrating less forward-planning in emotion regulation. Conclusions This study provides insights into some of the unique aspects of emotion regulation in individuals with high BPF that may make emotion regulation attempts less successful

Morale among general practitioners:qualitative study exploring relations between partnership arrangements, personal style, and workload

OBJECTIVES: To explore general practitioners' experiences of wellbeing and distress at work, to identify their perceptions of the causes of and solutions to distress, and to draw out implications for improving morale in general practice. DESIGN: Three stage qualitative study consisting of one to one unstructured interviews, one to one guided interviews, and focus groups. SETTING: Fife, Lothian, and the Borders, South East Scotland. PARTICIPANTS: 63 general practitioner principals. RESULTS: Morale of general practitioners was explained by the complex interrelations between factors. Three key factors were identified: workload, personal style, and practice arrangements. Workload was commonly identified as a cause of low morale, but partnership arrangements were also a key mediating variable between increasing workload and external changes in general practice on the one hand and individual responses to these changes on the other. Integrated interventions at personal, partnership, and practice levels were seen to make considerable contributions to improving morale. Effective partnerships helped individuals to manage workload, but increasing workload was also seen to take away time and opportunities for practices to manage change and to build supportive and effective working environments. CONCLUSIONS: Solutions to the problem of low morale need integrated initiatives at individual, partnership, practice, and policy levels. Improving partnership arrangements is a key intervention, and rigorous action research is needed to evaluate different approaches

Make Art Real

The Make Art Real project aims to introduce new audiences to the arts. It supports Theme II of VCU’s Quest for Distinction by promoting and fostering creative expression through innovative collaborations. The project involves displaying existing connections between art and non-art disciplines, as well as making new connections. These unusual pairings are then placed on exhibition through a lunch-time lecture series named “Unexpected_Connections,” which allow faculty, staff, and students to lead and participate in discussions about the reality of art. The lecture series is the first sustainable and reoccurring program to be held in the Depot building, a multidisciplinary facility which is intended to foster interdisciplinary collaborations. The targeted audience includes faculty, staff, students, and members of the greater VCU community

Patient-level data linkage across ambulance services and acute trusts: assessing the potential for improving patient care

ABSTRACT Objectives The potential of linked healthcare data to support improvements to the care quality, efficiency and service planning is recognised by the Department of Health and NHS England. UK ambulance services however, have little information regarding the outcome of patients as there is no routine data sharing. An urban ambulance service has previously piloted linked data with one acute trust. The Pre-Hospital Emergency Department Data Linking Project (PHED Data) aims to assess the potential opportunities for and challenges to routinely linking data for several sites. It aims to define what indicator sets can be developed from these linked data, with a view to informing commissioning and improvement of healthcare delivery. Approach The project is a two-year mixed-methods observational study, funded by the Health Foundation, working with six acute trusts of various size and CQC-derived performance, to carry out six work packages. Work package one uses liaison activities with trust senior staff to negotiate information sharing agreements, and a learning log to enable an economic assessment of the set-up costs. Work packages two to five analyse ambulance response time, referrals from healthcare professionals, ED mortality, and frequent ED diagnoses, respectively, exploring relationships with ED outcomes, quantitatively. Qualitative analysis will explore, with staff groups, how the findings might influence commissioning and pre-hospital care. Work package six will examine commissioning decisions and patient care, through interviews with commissioners and performance managers. Results In work package one, we have successfully negotiated overall research ethics and governance approval, involving in-depth discussion about definitions of identifiable patient data, and protecting against potential re-identification. We have recruited six acute trusts, comprising 13 hospital sites, for whom equivalent data is available. We have been working for six months in liaison with these Trusts to deliver information sharing agreements (three are currently approved) and data transfer, working with research governance, information governance and clinical staff. The processes have varied, with intra-Trust co-dependencies introducing delays and non-linear processes being common. For work packages two to five, some data analysis will be available for presentation at the conference. Conclusion This project has the potential to shed light on the practicalities of data linkage for health service providers who face similar challenges with patient data held in multiple organisations. The study also anticipates being able to recommend quality improvement to support the development of new pathways in pre-hospital care

Ariel - Volume 2 Number 5

Editors Delvyn C. Case, Jr. Paul M. Fernhoff News Editors Richard Bonanno Robin A. Edwards Features Editors Stephen P. Flynn Steven A. Ager Lay-Out Editor Carol Dolinskas Contributing Editors Michael J. Blecker W. Cherry Light Eugenia Miller Lin Sey Edwards Jack Guralnik Tom Williams James Noco

Living and dying with severe chronic obstructive pulmonary disease: multi-perspective longitudinal qualitative study

Objectives To understand the perspectives of people with severe chronic obstructive pulmonary disease (COPD) as their illness progresses, and of their informal and professional carers, to inform provision of care for people living and dying with COPD

Options for Affordable Fission Surface Power Systems

Fission surface power systems could provide abundant power anywhere on free surface of the moon or Mars. Locations could include permanently shaded regions on the moon and high latitudes on Mars. To be fully utilized; however, fission surface power systems must be safe, have adequate performance, and be affordable. This paper discusses options for the design and development of such systems