A call to excellence in patient experience

In this address, the incoming associate editor describes his early experience with the Patient Experience Journal (PXJ) and issues a call to action to the PXJ community. In the call to action, the PXJ community is asked to build upon our collective history of scholastic and practical excellence. The combination of practical relevance and methodological rigor in our contributions will help to ensure a future in which patient experience is paramount in health service delivery conversations. In addition, gaps in the patient experience literature and emergent opportunities for theoretical and practical contributions are recommended

Whose party is it anyway? An invitation from a patient experience advocate

In this commentary, the associate editor of Patient Experience Journal (PXJ) discusses the need to center the human experience in health care by celebrating its essential human, the patient. We have a duty to honor and uphold the dignity of the importance of patient priorities, needs, and preferences, and those of their families. We honor, empower, and celebrate the patient experience at the Patient Experience Journal. We do this not only for the sake of patients, but for our sakes as well, so that we might all delight in patient-centered healthcare systems across the globe. Experience Framework This article is associated with the Culture & Leadership lens of The Beryl Institute Experience Framework (https://theberylinstitute.org/experience-framework/). Access other PXJ articles related to this lens. Access other resources related to this lens

Patient evaluations of the interpersonal care experience (ICE) in U.S. hospitals: A factor analysis of the HCAHPS survey

The Hospital Consumer Assessment of Healthcare Providers and Systems survey (HCAHPS) is widely used to evaluate patients’ perceptions of their inpatient healthcare experiences. The HCAHPS is organized into 10 measures: six composite measures, two individual measures, and two global measures.1 In prior research on the link between patients’ care experiences and hospital’s quality and cost outcomes, scholars have grouped these measures in a variety of ways. The evident lack of consistency in these groupings along with the persistent lack of empirical justification for these groupings suggests a need to empirically examine the relational structure of HCAHPS measures. Accordingly, the purpose of this study is to determine the degree to which patient care evaluations captured by HCAHPS reflect unmeasured aspects of the patient experience. We use two-step factor analytic process on a nationally representative split sample of HCAHPS performance from 2007-2011. The results of the analysis reveal a single latent factor consisting of five measures that correspond conceptually to patients’ evaluations of care provider behaviors during their interpersonal interactions with them. We label this factor Interpersonal Care Experience (I.C.E) and argue that it may prove useful in future practical and scholarly explorations of the link between patient experience and other performance outcomes

A commitment to hope

On April 1, we made the decision to reconfigure our scheduled special issue on Behavioral Health to the topic of this issue - Sustaining a Focus on Human Experience in the Face of COVID-19. In the midst of crisis, we were uncertain how people would respond to this call or even if they could in the face of the realities they were addressing each day. Yet, the research, cases and stories started to arrive. The contributions in this special issue represent a patchwork of powerful insights and a historic record to document this moment. What we have brought together includes the best of real-time insights and research, powerful stories and personal reflections that are so central to this time, one that has called on all of us to dig deeper, ask ourselves personal and essential questions and remind ourselves what really matters overall. We are deeply moved and inspired by the speed, thoughtfulness and comprehensive nature with which our contributors engaged, many of whom were tackling this crisis but still took time to contribute to a conversation beyond themselves. That may be the most powerful lesson of all: that in struggling with each of our own personal or individual organizational issues, we remained called to come together to share something beyond ourselves. As you review the pages that follow, we challenge you to uncover a new idea or practice; discover an inspiration or opportunity to reflect, release or breathe; find a seed of hope. For in the generous and both heartful and thoughtful words of our contributors, we not only capture this moment in our history, we also feed the roots of possibility from which we will all spring in the days ahead. Experience Framework This article is associated with the Culture & Leadership lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this len

Patient experience established: One year later

Scholars and administrators have long dedicated themselves to centering healthcare conversations and debates on the experiences of patients and their families. Patient experience advocates view these experiences as critical to evaluations of healthcare quality. There have been a great multitude of important contributions, yet, for decades, these calls for patient-centric care experiences and healthcare systems have been confined to the fringes of disparate health policy and reform debates. This bygone reality created a diaspora of scholars and administrators dedicated to understanding, evaluating, and improving the patient experience. This article begins to explore a coalescing around patient experience research efforts citing where people have turned to find leading research and reinforcing the value for an emerging research home for patient experience found on the pages of Patient Experience Journal itself

Technology about me without me: An examination of the relationship between patient-facing technology and patient experience

To appreciate the role of electronic health records (EHRs) in achieving the goals of patient-centered care, scholars have focused primarily on the influence of EHR capabilities on clinical providers’ behaviors. The objective of this study is to examine the degree to which patient-facing technology (P-Tech) in U.S. hospital EHRs are associated with patient evaluations of their care experience. A cross-sectional OLS regression is executed to examine the relationship between P-Tech and patient experience on a sample of U.S. hospitals (n=1,168) compiled via data from CMS, the American Hospital Association’s (AHA) Annual Survey (2014), and the AHA Health Information Technology supplement (2014). Findings confirm a positive relationship between P-Tech and overall ratings of patient experience. In addition, the results find that P-Tech capabilities correspond to various communication pathways (Exchanging Information, Self-Management, and Administrative Actions) outlined by Street et al.1 The findings show an association between hospitals offering patient-facing EHR technologies that enable exchange of information and better patient evaluations of their care experience. As care delivery continues to explore the advancement of telehealth and telecare services, highlighting patient perspectives and appreciating that patients perceive face-to-face interactions as a complement to digital interactions will be key to the digital transformation of healthcare. Experience Framework This article is associated with the Innovation & Technology 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 len

The patient experience movement moment

For years, the patient experience movement has continued to gain momentum. From a novel concept, there is an emerging consensus that the patient experience is a fundamental aspect of provider quality; one that complements established clinical process and outcome measures but is neither subsumed nor secondary to them. An increasing volume of research as encouraged by publications such as Patient Experience Journal show this to be true. As the expectation of a high-quality patient experience becomes the norm, these developments have brought us to what we call the patient experience movement moment and there is little doubt that the patient experience has become, and is poised to remain, a central concern in healthcare for many years to come

Patient Experience: The field and future

In an effort to understand the progress and evolution of the field, a self-examination study has been administered to assess contributions to the core knowledge base in the field and to assess the degree to which articles published in Patient Experience Journal (PXJ) addressed the core elements of patient experience outlined in the definition of patient experience as offered by The Beryl Institute. The purpose of this examination is to understand PXJ’s position as a central voice for patient experience scholarship, practice, and knowledge exchange. The findings suggest that the operating definition of the field continues to be suitable and appropriate to the scope of practice and to the knowledge base in patient experience and reinforce that patient experience scholars and practitioners share a common understanding of the patient experience field. The article offers a call to action for patient experience practitioners, scholars, and educators and acknowledges that for as much as we have explored, we still do not know all that we can about patient experience. While reinforcing its core ideas, the results suggest that new themes germane to the patient experience await beyond the horizon

The influence of COVID-19 visitation restrictions on patient experience and safety outcomes: A critical role for subjective advocates

With the emergence of the coronavirus (COVID-19) pandemic in the United States in early 2020, hospitals across the country made the difficult decision to alter visitation policies, by either limiting visitations or restricting visitations altogether by closing access to family, friends and care partners in an effort to reduce further spread of the virus. While there is foundational research on the impact of family and care partner presence on the experience of patients and patient safety outcomes, the actions driven by the pandemic allowed for a real-time comparison of the impact of family or care partner presence or lack thereof. Patient and family engagement has long been a part of patient experience scholarship where the role of family members and care partners as patient advocates and a presence of support has been reinforced. Scholarship and practice have also encouraged movement from restricted visiting hours to having open visitation based on findings that, in addition to better patient outcomes, there is a benefit in nurse job satisfaction and communication when visitations are unrestricted. The purpose of this study is to examine the degree to which hospital visitation restrictions in U.S. hospitals during the COVID-19 pandemic help to explain changes in patient experience and patient safety outcomes. To examine this relationship, patient experience and safety outcomes of a national sample of hospitals (n=32) during the pandemic is compared to previous corresponding performance. The results indicate that hospital performance was negatively impacted on average during the pandemic for hospitals in the sample. However, differences in hospital performance during the pandemic were driven by hospitals that disallowed patient visitations. Hospitals with closed visitations saw most pronounced deficits in their performance with regard to patient ratings of medical staff responsiveness, fall rates and sepsis rates. Performance in hospitals that either remained unrestricted or partially limited their visitations was not appreciably different from pre-pandemic performance, and in some cases performance even improved marginally. The findings of this study indicate that the policy to allow for visitors, or subjective advocates, individuals with a vested interest in the well-being of the patient, is beneficial not only for the patient, but also in sustaining high quality of care. Recommendations are given for how hospitals might achieve improved quality and safety outcomes even in instances when organizations believe visitation needs to be disallowed or restricted. The results of this study suggest those decisions should be made with great care and in only the most extreme circumstances. Experience Framework This article is associated with the Patient, Family & Community Engagement 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

Transforming the American experience of death: What dreams may come?

There is no means to evaluate the death experience in the US healthcare system. Other countries have established population-wide measures to evaluate and improve the dying experience for patients and their families. With an increasing population of advanced-age persons, changes in sites of death, and a continually fractured healthcare delivery system, there is a need to establish a universal assessment of the quality of death in the US. In this commentary, we outline the need for such an assessment and build off of previous literature on the various existing assessments of the quality of death that have typically been reserved for end-of-life care specialties. Based on the aforementioned reasons and poor performance relative to other nations, there is a need for political attention to assessing the quality of American death experiences for patients and for their families. Absent such a measure, there will never be an incentive to improve the quality of death for patients and their families and the US healthcare system will continue to neglect this important aspect of American life. Experience Framework This article is associated with the Policy & Measurement lens of The Beryl Institute Experience Framework (https://theberylinstitute.org/experience-framework/). Access other PXJ articles related to this lens. Access other resources related to this lens