Evaluating Patient Engagement and User Experience of a Positive Technology Intervention: The H-CIM Case

The present chapter will provide an example of an intervention evaluation from the joint viewpoints of patient engagement and user experience. The authors evaluated H-CIM, a technological platform for the intelligent monitoring of physiological data of elderly patients performing physiotherapy exercises. Descriptive quantitative measures, behavioral observation, and qualitative interviews are integrated to evaluate H-CIM ability in (1) guaranteeing a positive experience to its users and (2) supporting them in advancing through a patient engagement development. This contribution would constitute a practical example of how these fundamental factors should be considered and evaluated when implementing positive technology for healthcare

An Educational Intervention to Train Professional Nurses in Promoting Patient Engagement: A Pilot Feasibility Study

Introduction: Growing evidence recognizes that patients who are motivated to take an active role in their care can experience a range of health benefits and reduced healthcare costs. Nurses play a critical role in the effort to make patients fully engaged in their disease management. Trainings devoted to increase nurses' skills and knowledge to assess and promote patient engagement are today a medical education priority. To address this goal, we developed a program of nurse education training in patient engagement strategies (NET-PES). This paper presents pilot feasibility study and preliminary participants outcomes for NET-PES. Methods: This is a pilot feasibility study of a 2-session program on patient engagement designed to improve professional nurses' ability to engage chronic patients in their medical journey; the training mainly focused on passing patient engagement assessment skills to clinicians as a crucial mean to improve care experience. A pre-post pilot evaluation of NET-PES included 46 nurses working with chronic conditions. A course specific competence test has been developed and validated to measure patient engagement skills. The design included self-report questionnaire completed before and after the training for evaluation purposes. Participants met in a large group for didactic presentations and then they were split into small groups in which they used role-play and case discussion to reflect upon the value of patient engagement measurement in relation to difficult cases from own practice. Results: Forty-six nurses participated in the training program. The satisfaction questionnaire showed that the program met the educational objectives and was considered to be useful and relevant by the participants. Results demonstrated changes on clinicians' attitudes and skills in promoting engagement. Moreover, practitioners demonstrated increases on confidence regarding their ability to support their patients' engagement in the care process. Conclusions: Learning programs teaching nurses about patient engagement strategies and assessment measures in clinical practice are key in supporting the realization of patient engagement in healthcare. Training nurses in this area is feasible and accepted and might have an impact on their ability to engage patients in the chronic care journey. Due to the limitation of the research design, further research is needed to assess the effectiveness of such a program and to verify if the benefits envisaged in this pilot are maintained on a long-term perspective and to test results by employing a randomized control study design

Quale ruolo per le società scientifiche all’interfaccia tra mondo accademico e mondo professionale? : L’esperienza di EACH = Which role for scientific societies at the interface between academia and the profession? : The experience of EACH

La domanda intorno al compito che le societ\ue0 scientifiche si trovano ad assolvere sia nei confronti dei propri membri che della collettivit\ue0 ritorna periodicamente nel dibattito pubblico e merita attenzione. Sin dalla loro fondazione, alle societ\ue0 scientifiche si riconoscono il compito di difendere gli interessi professionali dei membri, favorire gli scambi di informazioni, competenze e ricerche, e offrire strumenti di formazione e aggiornamento costante ai propri membri. In particolare, l\u2019oggetto di questo contributo \ue8 il ruolo che tali societ\ue0 possono ricoprire all\u2019interfaccia tra mondo della ricerca, mondo professionale e livello decisionale e politico. A partire dalle progettualit\ue0 di una societ\ue0 scientifica internazionale operante nell\u2019ambito della comunicazione in sanit\ue0, si auspica l\u2019individuazione di modalit\ue0 attraverso le quali le societ\ue0 scientifiche possano emergere come protagoniste di cambiamento e innovazione.The issue about the role of scientific societies for their affiliates and civil society is recurrent and deserves attention. Ever since their foundation, scientific societies have been known to operate at the levels of advocacy, networking and lifelong learning. More specifically, this contribution focuses on the role such societies may play at the interface between the world of scientific research, the profession and policy making. Referring to the example set by an international scientific society operating in the domain of health communication, we advocate the identification of pathways through which scientific societies can become main promoters of innovation and change

Patient and public involvement facilitators: Could they be the key to the NHS quality improvement agenda?

Objective Research into patient and public involvement (PPI) has not examined in detail patient and public involvement facilitators’ (PPIFs) roles and activities. This study analysed PPIFs’ roles using qualitative data gathered from three different UK health‐care organizations. Design Thematic analysis was used to examine cross‐sectional data collected using a mixed‐methods approach from three organizations: a mental health trust, a community health social enterprise and an acute hospital trust. The data set comprised of 27 interviews and 48 observations. Findings Patient and public involvement facilitators roles included the leadership and management of PPI interventions, developing health‐care practices and influencing quality improvements (QI). They usually occupied middle‐management grades but their PPIF role involved working in isolation or in small teams. They reported facilitating the development and maintenance of relationships between patients and the public, and health‐care professionals and service managers. These roles sometimes required them to use conflict resolution skills and involved considerable emotional labour. Integrating information from PPI into service improvement processes was reported to be a challenge for these individuals. Conclusions Patient and public involvement facilitators capture and hold information that can be used in service improvement. However, they work with limited resources and support. Health‐care organizations need to offer more practical support to PPIFs in their efforts to improve care quality, particularly by making their role integral to developing QI strategies

Patient centredness, values, equity and sustainability: Professional, organizational and institutional implications

The concept of “patient centredness”, or “patient-centred care”, has been studied so far in a variety of declinations, perspectives, and practices. This paper suggests conceiving it as a collective achievement that is negotiated between multiple actors of a system, and that includes social practices and relationships that are woven together through the material and immaterial resources available in organizational settings and contexts. By focusing on the three core dimensions that compose the value of patient centredness, which are the attention to the individual, to the relational and to the organizational dimension, the paper invites to consider new and critical perspectives for research and intervention on such essential topic. Three directions are indicated for future studies: (1) Rec-onciling evidence-based medicine and patient-centred care through mixed-method sensitivity to healthcare research; (2) Revisiting the traditional assumptions on validity and impact, investing on new ways for assessing, measuring, and monitoring patient-centred care; (3) Investing in participa-tive, practice-based and situated processes for guaranteeing the possibility to get close to the com-plexity of processes and to work on personal, professional, and organizational developments. The invitation is to consider these pathways to connect patient-centred care with new meanings of value, sustainability, and ethics in healthcare

Neurological assessment with validated tools in general ICU : multicenter, randomized, before and after, pragmatic study to evaluate the effectiveness of an e-learning platform for continuous medical education

BACKGROUND: International guidelines recommend systematic assessment of pain, agitation/sedation and delirium with validated scales for all ICU patients. However, these evaluations are often not done. We have created an e-learning training platform for the continuous medical education, and assessed its efficacy in increasing the use of validated tools by all medical and nursing staff of the participating ICUs during their daily practice. METHODS: Multicenter, randomized, before and after study. The eight participating centers were randomized in two groups, and received training at different times. The use of validated tools (Verbal Numeric Rating or Behavioral Pain Scale for pain; Richmond Agitation-Sedation Scale for agitation; Confusion Assessment Method for the ICU for delirium) was evaluated from clinical data recorded in medical charts during a week, with follow-up up to six months after the training. All the operators were invited to complete a questionnaire, at baseline and after the training. RESULTS : Among the 374 nurses and physicians involved, 140 (37.4%) completed at least one of the three courses. The assessment of pain (38.1 vs. 92.9%, P<0.01) and delirium (0 vs. 78.6%, P<0.01) using validated tools significantly increased after training. Observation in the follow-up showed further improvement in delirium monitoring, with no signs of extinction for pain and sedation/agitation measurements. CONCLUSIONS: This e-learning program shows encouraging effectiveness, and the increase in the use of validated tools for neurological monitoring in critically ill patients lasts over time.BACKGROUND: International guidelines recommend systematic assessment of pain, agitation/sedation and delirium with validated scales for all ICU patients. However, these evaluations are often not done. We have created an e-learning training platform for the continuous medical education, and assessed its efficacy in increasing the use of validated tools by all medical and nursing staff of the participating ICUs during their daily practice. METHODS: Multicenter, randomized, before and after study. The eight participating centers were randomized in two groups, and received training at different times. The use of validated tools (Verbal Numeric Rating or Behavioral Pain Scale for pain; Richmond Agitation-Sedation Scale for agitation; Confusion Assessment Method for the ICU for delirium) was evaluated from clinical data recorded in medical charts during a week, with follow-up up to six months after the training. All the operators were invited to complete a questionnaire, at baseline and after the training. RESULTS : Among the 374 nurses and physicians involved, 140 (37.4%) completed at least one of the three courses. The assessment of pain (38.1 vs. 92.9%, P<0.01) and delirium (0 vs. 78.6%, P<0.01) using validated tools significantly increased after training. Observation in the follow-up showed further improvement in delirium monitoring, with no signs of extinction for pain and sedation/agitation measurements. CONCLUSIONS: This e-learning program shows encouraging effectiveness, and the increase in the use of validated tools for neurological monitoring in critically ill patients lasts over time