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Stelling H, Ueda M, Tilby-Jones F, Brown M, Burford B, Fisher J, Vance G, Bain R. From passive participants to proactive partners: How to engage students in the design, delivery and development of research using the principles of co-production. CLINICAL TEACHER 2024:e13804. [PMID: 39218616 DOI: 10.1111/tct.13804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 07/24/2024] [Indexed: 09/04/2024]
Affiliation(s)
- Heidi Stelling
- School of Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Muzuki Ueda
- School of Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Fred Tilby-Jones
- School of Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Megan Brown
- School of Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Bryan Burford
- School of Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - James Fisher
- School of Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Gillian Vance
- School of Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Robbie Bain
- School of Medicine, Newcastle University, Newcastle upon Tyne, UK
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Rathert C, Mittler JN, Vogus TJ, Lee YSH. What matters to you? An observational field study of patient and care provider expectations for health care relationships. PLoS One 2024; 19:e0304854. [PMID: 38954686 PMCID: PMC11218989 DOI: 10.1371/journal.pone.0304854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 05/21/2024] [Indexed: 07/04/2024] Open
Abstract
Therapeutic connections (TC) between patients and providers are foundational to patient-centered care, which is co-produced between patients and care providers. This necessitates that we understand what patients expect from TCs, the extent to which providers know what patients expect, and what providers expect. The purpose of this study was to examine nine TC dimensions and determine which are most important to patients, which dimensions providers believe are most important to patients, and which are most important to providers. An online survey of patients (n = 388) and care providers (n = 433) was conducted in the USA in March 2021. Respondents rated the extent to which the nine TC dimensions were important to them, followed by open-ended questions to expand upon what matters. The quantitative responses were rank-ordered and rankings were compared across groups. All groups ranked "having the patient's best interest in mind no matter what" as the top expectation. Patients also ranked "caring commitment" and being "on the same page" as highly important. Providers were relatively accurate in ranking what they believed was most important to patients. Respondents affirmed the TC dimensions in the qualitative results, adding nuance and context, such as patients feeling "heard" and noting providers that go "above and beyond." Providers ranked dimensions differently for themselves, prioritizing "full presence" and "emotional support" of patients. This study is among the first to examine expectations for TC. TC could play an explanatory role in understanding variation in patient experience ratings and other outcomes.
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Affiliation(s)
- Cheryl Rathert
- Department of Health Management and Policy, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, United States of America
| | - Jessica N. Mittler
- Department of Health Administration, College of Health Professions, Virginia Commonwealth University, Richmond, VA, United States of America
| | - Timothy J. Vogus
- Department of Organizational Studies, Owen Graduate School of Management, Vanderbilt University, Nashville, TN, United States of America
| | - Yuna S. H. Lee
- Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY, United States of America
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Vanhaecht K, Lachman P, Van der Auwera C, Seys D, Claessens F, Panella M, De Ridder D. The "House of Trust". A framework for quality healthcare and leadership. F1000Res 2024; 13:503. [PMID: 38881947 PMCID: PMC11179047 DOI: 10.12688/f1000research.149711.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/27/2024] [Indexed: 06/18/2024] Open
Abstract
In healthcare, improvement leaders have been inspired by the frameworks from industry which have been adapted into control systems and certifications to improve quality of care for people. To address the challenge to regain trust in healthcare design and delivery, we propose a conceptual framework, i.e. the "House of Trust". This House brings together the Juran Trilogy, the emerging concept of co-production in quality management and the multidimensional definition of quality, which describes core values as an integral part of the system to deliver person- and kin-centered care. In the "House of Trust" patients, their kin, healthcare providers, executives and managers feel at home, with a sense of belonging. If we want to build a care organization that inspires and radiates confidence to all stakeholders, highlighting the basic interactions between front- and back-office is required. An organization with both well-organized back- and front-offices can enable all to benefit from the trust each of them needs and deserves. A quality system does not depend on government inspection and regulations nor on external accreditation to develop itself into a House of Trust. Success will only be achieved if all involved continuously question themselves about the technical dimensions of quality and their core values during the "moment of truth".
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Affiliation(s)
- Kris Vanhaecht
- Leuven Institute for Healthcare Policy, KU Leuven, KU Leuven University of Leuven, Leuven, Flanders, Belgium
- Department of Quality, University Hospitals of Leuven, Leuven, 3000, Belgium
| | - Peter Lachman
- Royal College of Physicians of Ireland, Dublin, Leinster, Ireland
| | - Charlotte Van der Auwera
- Leuven Institute for Healthcare Policy, KU Leuven, KU Leuven University of Leuven, Leuven, Flanders, Belgium
| | - Deborah Seys
- Leuven Institute for Healthcare Policy, KU Leuven, KU Leuven University of Leuven, Leuven, Flanders, Belgium
| | - Fien Claessens
- Leuven Institute for Healthcare Policy, KU Leuven, KU Leuven University of Leuven, Leuven, Flanders, Belgium
| | - Massimiliano Panella
- Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Dirk De Ridder
- Leuven Institute for Healthcare Policy, KU Leuven, KU Leuven University of Leuven, Leuven, Flanders, Belgium
- Department of Quality, University Hospitals of Leuven, Leuven, 3000, Belgium
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Robertson C, Hibberd C, Shepherd A, Johnston G. How a National Organization Works in Partnership With People Who Have Lived Experience in Mental Health Improvement Programs: Protocol for an Exploratory Case Study. JMIR Res Protoc 2024; 13:e51779. [PMID: 38640479 PMCID: PMC11069100 DOI: 10.2196/51779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 03/13/2024] [Accepted: 03/14/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND This is a research proposal for a case study to explore how a national organization works in partnership with people with lived experience in national mental health improvement programs. Quality improvement is considered a key solution to addressing challenges within health care, and in Scotland, there are significant efforts to use quality improvement as a means of improving health and social care delivery. In 2016, Healthcare Improvement Scotland (HIS) established the improvement hub, whose purpose is to lead national improvement programs that use a range of approaches to support teams and services. Working in partnership with people with lived experience is recognized as a key component of such improvement work. There is, however, little understanding of how this is manifested in practice in national organizations. To address gaps in evidence and strengthen a consistent approach, a greater understanding is required to improve partnership working. OBJECTIVE The aim of this study is to better understand how a national organization works in partnership with people who have lived experience with improvement programs in mental health services, exploring people's experiences of partnership working in a national organization. An exploratory case study approach will be used to address the research questions in relation to the Personality Disorder (PD) Improvement Programme: (1) How is partnership working described in the PD Improvement Programme? (2) How is partnership working manifested in practice in the PD Improvement Programme? and (3) What factors influence partnership working in the PD Improvement Programme? METHODS An exploratory case study approach will be used in relation to the PD Improvement Programme, led by HIS. This research will explore how partnership working with people with lived experience is described and manifested in practice, outlining factors influencing partnership working. Data will be gathered from various qualitative sources, and analysis will deepen an understanding of partnership working. RESULTS This study is part of a clinical doctorate program at the University of Stirling and is unfunded. Data collection was completed in October 2023; analysis is expected to be completed and results will be published in January 2025. CONCLUSIONS This study will produce new knowledge on ways of working with people with lived experience and will have practical implications for all improvement-focused interventions. Although the main focus of the study is on national improvement programs, it is anticipated that this study will contribute to the understanding of how all national public service organizations work in partnership with people with lived experience of mental health care. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/51779.
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Affiliation(s)
- Ciara Robertson
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, United Kingdom
| | - Carina Hibberd
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, United Kingdom
| | - Ashley Shepherd
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, United Kingdom
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Chan A, Hickey L, Finucane K, Brennan J. Assessing care quality in general practice: a qualitative study of GPs in Ireland. BJGP Open 2024; 8:BJGPO.2023.0104. [PMID: 37813473 PMCID: PMC11169978 DOI: 10.3399/bjgpo.2023.0104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/15/2023] [Accepted: 09/21/2023] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND It is estimated that each year in Ireland, approximately 29 million consultations occur in general practice with a patient satisfaction level of 90%. To date, research has been lacking on how GPs assess the quality of care. AIM To examine how GPs assess care quality during routine practice with respect to the following pillars of quality improvement: effectiveness, safety, timeliness, equity, efficiency, sustainability, and person-centredness. DESIGN & SETTING Qualitative study of GPs in Ireland. METHOD In this qualitative study, semi-structured interviews were conducted with 10 GPs who were recruited via a snowball sampling strategy. Interviews were recorded, transcribed, and analysed. Quality 'assessment points' were identified and themes were synthesised to produce a theoretical framework. RESULTS Five female and five male GPs practising in a variety of settings were interviewed. The age range was 33-68 years. In total, 122 assessment points emerged from the data and were collated into the following eight themes: the GP as a professional person factors; the patient and coproduction factors; care team factors; direct care factors; outcome factors; practice environment and organisation factors; external environment factors; and improvement approach factors. CONCLUSION This is the first study to examine how GPs in Ireland assess care quality as a holistic construct during daily care. The qualitative approach applied yielded rich and diverse insights into the many assessment points that GPs use to inform their approach and actions as clinicians, managers, collaborators, and leaders to maximise patient care. The theory produced is likely useful and applicable for practising GPs, healthcare administration, policymakers, and funders in planning and executing changes for quality improvement.
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Affiliation(s)
- Aaron Chan
- University College Dublin School of Medicine, Dublin, Republic of Ireland
| | | | | | - John Brennan
- Quality Improvement Faculty, Royal College of Physicians of Ireland, Dublin, Republic of Ireland
- Gowran Medical Centre, Co. Kilkenny, Dublin, Republic of Ireland
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Figueroa J, McPherson ME, Henriks G, Mountford J, Barker P. Method to share learning in real time at scientific meetings: lessons from the IHI-BMJ International Conference on Quality and Safety. BMJ LEADER 2024; 8:74-78. [PMID: 37407066 DOI: 10.1136/leader-2023-000788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 06/08/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND Capturing and disseminating key learnings on emerging themes for conference participants is challenging, yet also presents a significant opportunity to distill, share and discuss learning in real time with conference organisers and attendees. The Institute for Healthcare Improvement (IHI) and British Medical Journal (BMJ) collaborate annually to convene a Health Quality and Safety conference attracting 1000 to 3000 attendees each year. AIM To test a learning system that harvested and synthesised the key lessons shared by conference participants at the 2022 IHI-BMJ Gothenburg Forum, and to disseminate this content. METHODS Twelve invited Forum attendees collected and shared their 'breakthrough learnings' via electronic survey. Three IHI team members synthesised the participants' responses into themes that were shared and refined in real time at an in-person Forum session including 35 additional participants. RESULTS Participants shared four learning themes: collaboration and co-production, trust, meaningful communication about data, and broadening the scope of the Science of Improvement field to multi-disciplinary and multi-system approaches. CONCLUSIONS Collection of key learning on emerging topics of interest to the health system improvement community is feasible and yielded information both for dissemination and real-time learning. While not representing the full scope of the conference learnings, the content resonated with an additional group of reviewers at the conclusion of the conference and has guided planning for the next annual meeting. This approach may be helpful in capturing key themes for discussion and planning by similar improvement communities.
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Affiliation(s)
- Johanna Figueroa
- Institute for Healthcare Improvement, Cambridge, Massachusetts, USA
| | | | | | - James Mountford
- Galileo Global Foundation, Paris, Paris, France
- Regent's University, London, UK
| | - Pierre Barker
- Institute for Healthcare Improvement, Cambridge, Massachusetts, USA
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Claessens F, Seys D, Van der Auwera C, Castro EM, Jans A, Schoenmakers B, De Ridder D, Bruyneel L, Van Wilder A, Vanhaecht K. The FlaQuM-Quickscan: A starting point to include primary care professionals' perspectives in the evaluation of hospital quality priorities. J Healthc Qual Res 2024; 39:89-99. [PMID: 38195377 DOI: 10.1016/j.jhqr.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 11/22/2023] [Accepted: 12/05/2023] [Indexed: 01/11/2024]
Abstract
INTRODUCTION Today, primary care professionals' (PCPs) perspectives on hospital quality are unknown when evaluating hospital quality priorities. The aims of the present study were to identify key healthcare quality attributes from PCPs' perspective, to validate an instrument that measures PCPs' experiences of healthcare quality multidimensionally and to define hospital quality priorities based on PCPs' experiences. MATERIAL AND METHODS Focus groups with PCPs were conducted to identify quality attributes through a qualitative in-depth analysis. A multicentre study of 18 hospitals was used to quantitatively assess construct, discriminant and criterion validity of the FlaQuM-Quickscan, an instrument that measures 'Healthcare quality for patients and kin' (part 1) and 'Healthcare quality for professionals' (part 2). To set quality priorities, scores on quality domains were analyzed descriptively and between-hospital variation was examined by evaluating differences in hospitals' mean scores on the quality domains using one-way Analysis of Variance (ANOVA). RESULTS Identified key attributes largely corresponded with Lachman's multidimensional quality model. Including 'Communication' as a new quality domain was recommended. The FlaQuM-Quickscan was completed by 550 PCPs. Confirmatory factor analyses showed reasonable to good fit, except for the Root Mean Square Error of Approximation (RMSEA) in part 2. The 'Equity' domain scored the highest in parts 1 and 2. Domains 'Kin-centred care' and 'Accessibility and timeliness' scored the lowest in part 1 and 'Resilience' and 'Partnership and co-production' in part 2. Significant variation in hospitals' mean scores was observed for eleven domains in part 1 and sixteen domains in part 2. CONCLUSIONS The results gained a better understanding of PCPs' perspective on quality. The FlaQuM-Quickscan is a valid instrument to measure PCPs' experiences of hospital quality. Identified priorities indicate that hospital management should focus on multifaceted quality strategies, including technical domains, person-and kin-centredness, core values and catalysts.
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Affiliation(s)
- F Claessens
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven, University of Leuven, Leuven, Belgium.
| | - D Seys
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven, University of Leuven, Leuven, Belgium
| | - C Van der Auwera
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven, University of Leuven, Leuven, Belgium
| | - E M Castro
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven, University of Leuven, Leuven, Belgium; Department of Quality Management, Regionaal Ziekenhuis Heilig Hart Tienen, Tienen, Belgium
| | - A Jans
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven, University of Leuven, Leuven, Belgium; Department of Quality Management, Sint-Trudo Ziekenhuis, Sint-Truiden, Belgium
| | - B Schoenmakers
- Academic Center for General Practice, Department of Public Health and Primary Care, KU Leuven, University of Leuven, Leuven, Belgium
| | - D De Ridder
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven, University of Leuven, Leuven, Belgium; Department of Quality Management, University Hospitals Leuven, Leuven, Belgium
| | - L Bruyneel
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven, University of Leuven, Leuven, Belgium
| | - A Van Wilder
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven, University of Leuven, Leuven, Belgium
| | - K Vanhaecht
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven, University of Leuven, Leuven, Belgium; Department of Quality Management, University Hospitals Leuven, Leuven, Belgium
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Khan A, Patel SJ, Anderson M, Baird JD, Johnson TM, Liss I, Graham DA, Calaman S, Fegley AE, Goldstein J, O'Toole JK, Rosenbluth G, Alminde C, Bass EJ, Bismilla Z, Caruth M, Coghlan-McDonald S, Cray S, Destino LA, Dreyer BP, Everhart JL, Good BP, Guiot AB, Haskell H, Hepps JH, Knighton AJ, Kocolas I, Kuzma NC, Lewis K, Litterer KP, Kruvand E, Markle P, Micalizzi DA, Patel A, Rogers JE, Subramony A, Vara T, Yin HS, Sectish TC, Srivastava R, Starmer AJ, West DC, Spector ND, Landrigan CP. Implementing a Family-Centered Rounds Intervention Using Novel Mentor-Trios. Pediatrics 2024; 153:e2023062666. [PMID: 38164122 DOI: 10.1542/peds.2023-062666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Patient and Family Centered I-PASS (PFC I-PASS) emphasizes family and nurse engagement, health literacy, and structured communication on family-centered rounds organized around the I-PASS framework (Illness severity-Patient summary-Action items-Situational awareness-Synthesis by receiver). We assessed adherence, safety, and experience after implementing PFC I-PASS using a novel "Mentor-Trio" implementation approach with multidisciplinary parent-nurse-physician teams coaching sites. METHODS Hybrid Type II effectiveness-implementation study from 2/29/19-3/13/22 with ≥3 months of baseline and 12 months of postimplementation data collection/site across 21 US community and tertiary pediatric teaching hospitals. We conducted rounds observations and surveyed nurses, physicians, and Arabic/Chinese/English/Spanish-speaking patients/parents. RESULTS We conducted 4557 rounds observations and received 2285 patient/family, 1240 resident, 819 nurse, and 378 attending surveys. Adherence to all I-PASS components, bedside rounding, written rounds summaries, family and nurse engagement, and plain language improved post-implementation (13.0%-60.8% absolute increase by item), all P < .05. Except for written summary, improvements sustained 12 months post-implementation. Resident-reported harms/1000-resident-days were unchanged overall but decreased in larger hospitals (116.9 to 86.3 to 72.3 pre versus early- versus late-implementation, P = .006), hospitals with greater nurse engagement on rounds (110.6 to 73.3 to 65.3, P < .001), and greater adherence to I-PASS structure (95.3 to 73.6 to 72.3, P < .05). Twelve of 12 measures of staff safety climate improved (eg, "excellent"/"very good" safety grade improved from 80.4% to 86.3% to 88.0%), all P < .05. Patient/family experience and teaching were unchanged. CONCLUSIONS Hospitals successfully used Mentor-Trios to implement PFC I-PASS. Family/nurse engagement, safety climate, and harms improved in larger hospitals and hospitals with better nurse engagement and intervention adherence. Patient/family experience and teaching were not affected.
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Affiliation(s)
- Alisa Khan
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Shilpa J Patel
- Department of Pediatrics, University of Hawaii John A. Burns School of Medicine, Honolulu, Hawaii
- Kapi'olani Medical Center for Women and Children, Hawaii Pacific Health, Honolulu, Hawaii
| | - Michele Anderson
- Family Centered Care Department, Lucile Packard Children's Hospital Stanford, Palo Alto, California
- Patient and Family Centered I-PASS SCORE Family Advisory Council, Boston, Massachusetts
| | - Jennifer D Baird
- Institute for Nursing and Interprofessional Research, Children's Hospital Los Angeles, Los Angeles, California
| | - Tyler M Johnson
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts
| | - Isabella Liss
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts
| | - Dionne A Graham
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
- Program for Patient Safety and Quality, Boston Children's Hospital, Boston, Massachusetts
| | - Sharon Calaman
- Division of Pediatric Critical Care, NYU Langone Health/Hassenfeld Children's Hospital, NYU Grossman School of Medicine; New York City, New York
| | - April E Fegley
- Center for Quality Improvement, Society of Hospital Medicine, Philadelphia, Pennsylvania
| | - Jenna Goldstein
- Center for Quality Improvement, Society of Hospital Medicine, Philadelphia, Pennsylvania
| | - Jennifer K O'Toole
- Departments of Pediatrics and Internal Medicine, Cincinnati Children's Hospital Medical Center/University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Glenn Rosenbluth
- Department of Pediatrics, University of California San Francisco School of Medicine, San Francisco, California
- Benioff Children's Hospital, San Francisco, University of California San Francisco School of Medicine, San Francisco, California
| | - Claire Alminde
- Department of Nursing, St Christopher's Hospital for Children, Philadelphia, Pennsylvania
| | - Ellen J Bass
- Department of Information Science in the College of Computing and Informatics, Drexel University, Philadelphia, Pennsylvania
| | - Zia Bismilla
- Departments of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Monique Caruth
- Patient and Family Centered I-PASS SCORE Family Advisory Council, Boston, Massachusetts
| | - Sally Coghlan-McDonald
- Patient and Family Centered I-PASS SCORE Family Advisory Council, Boston, Massachusetts
- Benioff Children's Hospital, San Francisco, University of California San Francisco School of Medicine, San Francisco, California
| | - Sharon Cray
- Patient and Family Centered I-PASS SCORE Family Advisory Council, Boston, Massachusetts
- Patient Safety and Quality Improvement Committee, St Christopher's Hospital for Children, Philadelphia, Pennsylvania
| | - Lauren A Destino
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California
- Lucile Packard Children's Hospital Stanford, Palo Alto, California
| | - Benard P Dreyer
- Department of Pediatrics, New York University Grossman School of Medicine, New York, New York
| | - Jennifer L Everhart
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California
- Lucile Packard Children's Hospital Stanford, Palo Alto, California
| | - Brian P Good
- Department of Pediatrics, Primary Children's Hospital, University of Utah School of Medicine, Salt Lake City, Utah
| | - Amy B Guiot
- Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Helen Haskell
- Patient and Family Centered I-PASS SCORE Family Advisory Council, Boston, Massachusetts
- Mothers Against Medical Error, Columbia, South Carolina
| | - Jennifer H Hepps
- Department of Pediatrics, Walter Reed National Military Medical Center, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | | | - Irene Kocolas
- Department of Pediatrics, Primary Children's Hospital, University of Utah School of Medicine, Salt Lake City, Utah
| | - Nicholas C Kuzma
- Department of Pediatrics, St Christopher's Hospital for Children, Philadelphia, Pennsylvania
- Department of Pediatrics, Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Kheyandra Lewis
- Department of Pediatrics, St Christopher's Hospital for Children, Philadelphia, Pennsylvania
- Department of Pediatrics, Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Katherine P Litterer
- Patient and Family Centered I-PASS SCORE Family Advisory Council, Boston, Massachusetts
- Office of Experience, Boston Children's Hospital, Boston, Massachusetts
| | - Elizabeth Kruvand
- Patient and Family Centered I-PASS SCORE Family Advisory Council, Boston, Massachusetts
- SSM Health Cardinal Glennon Children's Hospital, St Louis, Missouri
| | - Peggy Markle
- Patient and Family Centered I-PASS SCORE Family Advisory Council, Boston, Massachusetts
- Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Dale A Micalizzi
- Patient and Family Centered I-PASS SCORE Family Advisory Council, Boston, Massachusetts
| | - Aarti Patel
- Department of Pediatrics, University of California San Diego, Rady Children's Hospital, San Diego, California
| | - Jayne E Rogers
- Department of Nursing, Boston Children's Hospital, Boston, Massachusetts
| | - Anupama Subramony
- Department of Pediatrics, Cohen Children's Medical Center, Hofstra Northwell School of Medicine, New Hyde Park, New York
| | - Tiffany Vara
- Kapi'olani Medical Center for Women and Children, Hawaii Pacific Health, Honolulu, Hawaii
- Patient and Family Centered I-PASS SCORE Family Advisory Council, Boston, Massachusetts
| | - H Shonna Yin
- Departments of Pediatrics and Population Health, New York University Grossman School of Medicine, New York, New York
| | - Theodore C Sectish
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Rajendu Srivastava
- Department of Pediatrics, Primary Children's Hospital, University of Utah School of Medicine, Salt Lake City, Utah
- Healthcare Delivery Institute, Intermountain Health, Murray, Utah
| | - Amy J Starmer
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Daniel C West
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Nancy D Spector
- Department of Pediatrics, St Christopher's Hospital for Children, Philadelphia, Pennsylvania
- Department of Pediatrics, Drexel University College of Medicine, Philadelphia, Pennsylvania
- The Hedwig van Ameringen Executive Leadership in Academic Medicine (ELAM) Program, Philadelphia, Pennsylvania
| | - Christopher P Landrigan
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
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Claessens F, Seys D, Van der Auwera C, Jans A, Castro EM, Jacobs L, De Ridder D, Bruyneel L, Leenaerts Z, Van Wilder A, Brouwers J, Lachman P, Vanhaecht K. Measuring in-hospital quality multidimensionally by integrating patients', kin's and healthcare professionals' perspectives: development and validation of the FlaQuM-Quickscan. BMC Health Serv Res 2023; 23:1426. [PMID: 38104060 PMCID: PMC10725024 DOI: 10.1186/s12913-023-10349-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 11/20/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Measuring quality is essential to drive improvement initiatives in hospitals. An instrument that measures healthcare quality multidimensionally and integrates patients', kin's and professionals' perspectives is lacking. We aimed to develop and validate an instrument to measure healthcare quality multidimensionally from a multistakeholder perspective. METHODS A multi-method approach started by establishing content and face validity, followed by a multi-centre study in 17 Flemish (Belgian) hospitals to assess construct validity through confirmatory factor analysis, criterion validity through determining Pearson's correlations and reliability through Cronbach's alpha measurement. The instrument FlaQuM-Quickscan measures 'Healthcare quality for patients and kin' (part 1) and 'Healthcare quality for professionals' (part 2). This bipartite instrument mirrors 15 quality items and 3 general items (the overall quality score, recommendation score and intention-to-stay score). A process evaluation was organised to identify effective strategies in instrument distribution by conducting semi-structured interviews with quality managers. RESULTS By involving experts in the development of quality items and through pilot testing by a multi-stakeholder group, the content and face validity of instrument items was ensured. In total, 13,615 respondents (5,891 Patients/kin and 7,724 Professionals) completed the FlaQuM-Quickscan. Confirmatory factor analyses showed good to very good fit and correlations supported the associations between the quality items and general items for both instrument parts. Cronbach's alphas supported the internal consistency. The process evaluation revealed that supportive technical structures and approaching respondents individually were effective strategies to distribute the instrument. CONCLUSIONS The FlaQuM-Quickscan is a valid instrument to measure healthcare quality experiences multidimensionally from an integrated multistakeholder perspective. This new instrument offers unique and detailed data to design sustainable quality management systems in hospitals. Based on these data, hospital management and policymakers can set quality priorities for patients', kin's and professionals' care. Future research should investigate the transferability to other healthcare systems and examine between-stakeholders and between-hospitals variation.
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Affiliation(s)
- Fien Claessens
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven - University of Leuven, Leuven, Belgium.
| | - Deborah Seys
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven - University of Leuven, Leuven, Belgium
| | - Charlotte Van der Auwera
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven - University of Leuven, Leuven, Belgium
| | - Anneke Jans
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven - University of Leuven, Leuven, Belgium
- Department of Quality Management, Sint-Trudo Ziekenhuis, Sint-Truiden, Belgium
| | - Eva Marie Castro
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven - University of Leuven, Leuven, Belgium
- Department of Quality Management, Regionaal Ziekenhuis Heilig Hart Tienen, Tienen, Belgium
| | - Laura Jacobs
- Department of Quality Management, University Hospitals Leuven, Leuven, Belgium
| | - Dirk De Ridder
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven - University of Leuven, Leuven, Belgium
- Department of Quality Management, University Hospitals Leuven, Leuven, Belgium
| | - Luk Bruyneel
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven - University of Leuven, Leuven, Belgium
| | - Zita Leenaerts
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven - University of Leuven, Leuven, Belgium
| | - Astrid Van Wilder
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven - University of Leuven, Leuven, Belgium
| | - Jonas Brouwers
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven - University of Leuven, Leuven, Belgium
- Department of Orthopaedics, University Hospitals Leuven, Leuven, Belgium
| | - Peter Lachman
- Lead Faculty Quality Improvement Programme- Royal College of Physicians of Ireland, Dublin, Ireland
| | - Kris Vanhaecht
- Leuven Institute for Healthcare Policy, Department of Public Health and Primary Care, KU Leuven - University of Leuven, Leuven, Belgium
- Department of Quality Management, University Hospitals Leuven, Leuven, Belgium
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Rathert C, Mittler JN, Vogus TJ, Lee YSH. Better outcomes through patient - Provider therapeutic connections? An exploratory study of proposed mediating variables. Soc Sci Med 2023; 338:116290. [PMID: 37866174 DOI: 10.1016/j.socscimed.2023.116290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND Patient-provider therapeutic connections (TCs) have been theorized to enhance patient outcomes as well as care provider job satisfaction and to reduce burnout. High-quality TCs may result in better matching of health care to patient needs, and thus, better care quality and patient outcomes. For care providers, work environments that enable high-quality TCs may make the work more motivating and facilitate resilience. METHOD We surveyed patients (n = 346) and care providers (n = 341) about their experiences of TCs, and how TCs related to outcomes. We tested parallel mediation models to examine relations. RESULTS TCs predicted better patient health status, mental health status, and satisfaction, and predicted greater care provider job satisfaction and lower burnout. TCs were theorized to operate through two sets of mechanisms (health self-efficacy and activation for patients; meaningfulness of work and psychological safety for providers). Results revealed significant indirect associations between TCs and outcomes for both groups. CONCLUSIONS TCs are associated with patient and provider outcomes; however, these relations appear to be explained by several mediating variables. It appears that TCs are associated with better outcomes for patients through health self-efficacy and activation, and TCs are associated with better outcomes for care providers through meaningfulness of work and psychological safety.
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Affiliation(s)
- Cheryl Rathert
- Department of Health Management and Policy, College for Public Health and Social Justice, Saint Louis University, 3545 Lafayette Ave, St. Louis, MO, 63104, USA.
| | - Jessica N Mittler
- Department of Health Administration, College of Health Professions, Virginia Commonwealth University, Box 980203 900 E Leigh St., Richmond, VA, 23298-0203, USA.
| | - Timothy J Vogus
- Vanderbilt University | Owen Graduate School of Management, 401 21st Avenue South, Nashville, TN, 37203-2422, USA.
| | - Yuna S H Lee
- Department of Health Policy and Management, Mailman School of Public Health, Columbia University, 722 West 168th Street, New York, NY, 10032, USA.
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Ponsignon F, Mathieu L, Durrieu F. Understanding the drivers of patient satisfaction with home health care services: An empirical study of two care pathways. Int J Health Plann Manage 2023; 38:1644-1656. [PMID: 37491716 DOI: 10.1002/hpm.3687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 06/08/2023] [Accepted: 07/09/2023] [Indexed: 07/27/2023] Open
Abstract
This research aims to empirically determine the drivers of patient satisfaction with home health care services and to develop an instrument for measuring patient satisfaction in this context. The empirical study focuses on insulin and respiratory assistance therapies. Two large patient samples of a private home care provider in France are surveyed. Two distinct, yet complementary, analytical procedures are performed to maximize the validity and reliability of the results. We identify four core concepts (interpersonal relationship, support and guidance, delivery of consumables, and equipment use) that play a key role in influencing patient satisfaction across the two therapies studied. The results also reveal that the relative role of each factor in driving overall patient satisfaction varies across these therapies, possibly due to differences in the characteristics of the therapies and related care services. Our empirical results enrich the existing literature, largely focused on hospital and primary care settings, by providing evidence to capture patient satisfaction drivers at the level of specificity required to account for the unique context of home care services. The article's main theoretical contribution is to establish, from the patient's perspective, a core set of drivers that determine patient satisfaction in the context of home health care services. The instrument provides practitioners and policy makers with a practical tool that supports them in achieving patient satisfaction and in understanding why and how such satisfaction is achieved. The suitability of the patient satisfaction instrument to other forms of home care services needs examining.
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