How teams impact patient satisfaction: A review of the empirical literature

Relationship between staff experience and patient outcomes in hospital settings: an overview of reviews

OBJECTIVES

This review aimed to investigate the relationship between staff experience and patient health and experience outcomes in hospital inpatient settings.

DESIGN

Systematic review of reviews.

METHODS

Searches were performed in Medline (OVID), CINAHL and Google Scholar using key terms from relevant review articles. The search was conducted on 28 August 2023. Inclusion criteria were systematic or narrative reviews in English from 2020 onwards, focusing on inpatients in hospital and related tertiary care facilities, examining the relationship between staff experience and patient outcomes. A review of reviews approach was used, with broad definitions for staff experience (eg, hospital culture, stress and burnout) and patient outcomes (eg, adverse events and patient experience). Independent screening and quality appraisal were conducted by two researchers. An evidence map of links between staff experience and patient outcomes was created. The methodological quality of systematic reviews was assessed using the AMSTAR 2 tool and narrative reviews with the SANRA tool.

RESULTS

From 2365 citations, 21 reviews (18 systematic, 3 narrative) were included. Review quality ranged from moderate to high. Mapping revealed 66 associations between staff experience and patient outcomes. Common associations included burnout, stress and fatigue with adverse events (six reviews); communication with patient satisfaction (four reviews) and teamwork with patient satisfaction (four reviews).

CONCLUSIONS

Staff burnout, teamwork and communication practices directly impact adverse events and patient satisfaction. These findings guide hospital managers and clinicians in improving health service policies and practices. Further research is needed to strengthen the evidence base.

What do cancer patients experience of the simultaneous care clinic? Results of a cross-sectional study on patient care satisfaction

BACKGROUND

Veneto Institute of Oncology has activated a simultaneous care outpatient clinic (SCOC) in which cancer patients with advanced-stage cancer are evaluated by oncologist and palliative care specialists. This cross-sectional study investigated patients' perceptions of the quality of this service.

MATERIALS AND METHODS

An ad-hoc self-administered questionnaire, developed by SCOC team, was used to assess the satisfaction of patients admitted at SCOC consultation. The questionnaire, in addition to the socio-demographic questions, contains eight questions with the Likert scale: time dedicated, feel listened to, feel understood, feel free to speak openly and to express doubts and concerns, feeling about information and indication received, level of empathy of health care and quality of the relationship, level of professional/quality of performance and utility of consultation, and one open-ended question. The questionnaire has been proposed to all 174 consecutively admitted patients at SCOC.

RESULTS

One hundred and sixty-two patients filled in the questionnaire: 66.7% were male, median age was 71 years, 88.3% had metastatic disease. The time dedicated to SCOC consultation was judged more than adequate (55%) or adequate (35%) by 90% of subjects. Patients completely satisfied about being listened to were 92.5%, with 80.9% being completely satisfied with understanding of their issues and 92% with the freedom to speak and express doubts. Usefulness of the SCOC was rated as excellent by 40% and good by 54.4% of patients. No statistically significant differences were observed in the responses to the questions by gender, age (< or ≥70 years old) and type of tumor.

CONCLUSION

Our study shows high levels of satisfactions after SCOC consultation in advanced cancer subjects. Patients' feedback confirmed that SCOC model was effective in helping them during their treatment journey and decision at the end of life. This study encouraged us to enhance our practice of SCOC consultation.

IMPLICATIONS FOR PRACTICE

A joint evaluation of patients living with cancer by oncologist and palliative care team (SCOC-embedded model), has shown to enhance patients' experience/satisfaction with care-such as listening, understanding, receiving information, symptom control, and decision about future, independently of age, gender, and kind of tumor.

Facilitators of palliative care quality improvement team cohesion: Lessons from a seven-site implementation project in India

BACKGROUND

The Palliative Care: Promoting Access and Improvement of the Cancer Experience (PC-PAICE) initiative is a team-based, palliative care (PC) quality improvement (QI) project working to promote high-quality PC in India. As a PC QI initiative, PC-PAICE implementation relied upon building interdisciplinary teams, providing the ideal context for understanding facilitators of team cohesion that compelled clinical, organizational, and administrative team members to work together. There is an opportunity to leverage the intersection between QI implementation and organizational theory to inform and improve implementation science.

PURPOSE

As a subaim of a larger implementation evaluation, we aimed to identify facilitators of team cohesion within QI implementation context.

METHODOLOGY

A quota sampling approach captured the perspectives of 44 stakeholders across three strata (organizational leaders, clinical leaders, and clinical team members) from all seven sites through a semistructured interview guide informed by the Consolidated Framework for Implementation Research (CFIR). We used a combination of inductive and deductive approaches informed by organizational theory to identify facilitators.

RESULT

We identified three facilitators of PC team cohesion: (a) balancing formalization and flexibility around team roles, (b) establishing widespread awareness of the QI project, and (c) prioritizing a nonhierarchical organizational culture.

PRACTICE IMPLICATIONS

Leveraging CFIR to analyze PC-PAICE stakeholder interviews created a data set conducive to understanding complex multisite implementation. Layering role and team theory to our implementation analysis helped us identify facilitators of team cohesion across levels within the team (bounded team), beyond the team (teaming), and surrounding the team (culture). These insights demonstrate the value of team and role theories in implementation evaluation efforts.

Data-driven clinical improvement: Oncology nurse leaders' perceptions and experiences of organisational data reports

AIM

To elicit oncology nurse leaders' perceptions and experiences of accessing, using and interpreting report data at the unit level, and their suggestions for future reports.

BACKGROUND

Nurse leaders are expected to use data reports for decisions about unit-level operations, yet data may be inaccessible, unavailable and lack relevance for improving patient care and unit-level outcomes.

METHODS

A purposeful sampling was used to recruit 12 unit-level nurse leaders. Qualitative data were collected through semi-structured interviews and analysed using thematic content analysis.

RESULTS

Consistent themes included the lack of accurate, useful and meaningful data specifically related to patient care. Accessibility Challenges, Limits to Applicability and Suggestions for Improvement were the main themes.

CONCLUSION

Nurse leaders require real-time data to effectively implement clinical interventions and practice changes for improving unit-level patient care.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse leaders emphasized that their insight into the development of customizable reports is crucial for obtaining meaningful data relevant to the varied unit-level health care setting. Reports targeting unit-level outcomes would provide meaningful data to facilitate clinical improvement where patient care is provided. Improved reports increase the likelihood of their use and the potential for enhancing the quality and safe care outcomes.