1
|
Neve O, van Buchem M, Kunneman M, van Benthem P, Boosman H, Hensen E. The added value of the artificial intelligence patient-reported experience measure (AI-PREM tool) in clinical practise: Deployment in a vestibular schwannoma care pathway. PEC INNOVATION 2023; 3:100204. [PMID: 37693727 PMCID: PMC10483065 DOI: 10.1016/j.pecinn.2023.100204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 06/06/2023] [Accepted: 08/28/2023] [Indexed: 09/12/2023]
Abstract
Objectives Patient-reported experience measures (PREMs) can be used for the improvement of quality of care. In this study, the outcome of an open-ended question PREM combined with computer-assisted analysis is compared to the outcome of a closed-ended PREM questionnaire. Methods This survey study assessed the outcome of the open-ended questionnaire PREM and a close-ended question PREM of patients with unilateral vestibular schwannoma in a tertiary vestibular schwannoma expert centre. Results The open-ended questions PREM, consisting of five questions, was completed by 507 participants and resulted in 1508 positive and 171 negative comments, categorised into 27 clusters. The close-ended questions PREM results were mainly positive (overall experience graded as 8/10), but did not identify specific action points. Patients who gave high overall scores (>8) on the close-ended question provided points for improvement in the open-ended question PREM, which would have been missed using the close-ended questions only. Conclusions Compared to the close-ended question PREM, the open-ended question PREM provides more detailed and specific information about the patient experience in the vestibular schwannoma care pathway. Innovation Automated analysis of feedback with the open-ended question PREM revealed relevant insights and identified topics for targeted quality improvement, whereas the close-ended PREM did not.
Collapse
Affiliation(s)
- O.M. Neve
- Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Centre, the Netherlands
| | - M.M. van Buchem
- Information Technology & Digital Innovation Department, Leiden University Medical Centre, the Netherlands
| | - M. Kunneman
- Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, United States of America
- Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, the Netherlands
| | - P.P.G. van Benthem
- Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Centre, the Netherlands
| | - H. Boosman
- Morgens consultancy, Leiden, the Netherlands
| | - E.F. Hensen
- Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Centre, the Netherlands
| |
Collapse
|
2
|
Waddell A, Goodwin D, Spassova G, Bragge P. "The Terminology Might Be Ahead of Practice": Embedding Shared Decision Making in Practice-Barriers and Facilitators to Implementation of SDM in the Context of Maternity Care. MDM Policy Pract 2023; 8:23814683231199943. [PMID: 37743932 PMCID: PMC10517621 DOI: 10.1177/23814683231199943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 07/20/2023] [Indexed: 09/26/2023] Open
Abstract
Background. It is a patient's right to be included in decisions about their health care. Implementing shared decision making (SDM) is important to enable active communication between clinicians and patients. Although health policy makers are increasingly mandating SDM implementation, SDM adoption has been slow. This study explored stakeholders' organizational- and system-level barriers and facilitators to implementing policy mandated SDM in maternity care in Victoria, Australia. Method. Twenty-four semi-structured interviews were conducted with participants including clinicians, health service administrators and decision makers, and government policy makers. Data were mapped to the Theoretical Domains Framework to identify barriers and facilitators to SDM implementation. Results. Factors identified as facilitating SDM implementation included using a whole-of-system approach, providing additional implementation resources, correct documentation facilitated by electronic medical records, and including patient outcomes in measurement. Barriers included health service lack of capacity, unclear policy definitions of SDM, and policy makers' lack of resources to track implementation. Conclusion. This is the first study to our knowledge to explore barriers and facilitators to SDM implementation from the perspective of multiple actors following policy mandating SDM in tertiary health services in Australia. The primary finding was that there are concerns that SDM implementation policy is outpacing practice. Nonclinical staff play a crucial role translating policy to practice. Addressing organizational- and system-level barriers and facilitators to SDM implementation should be a key concern of health policy makers, health services, and staff. Highlights New government policies require shared decision making (SDM) implementation in hospitals.There is limited evidence for how to implement SDM in hospital settings.There are concerns SDM implementation policy is outpacing practice.Understanding and capacity for SDM varies considerably among stakeholders.Whole of system approaches and electronic medical records are seen to facilitate SDM.
Collapse
Affiliation(s)
- Alex Waddell
- Monash Sustainable Development Institute, Monash University, Clayton, VIC, Australia
- Safer Care Victoria, Victorian Department of Health, Melbourne, VIC, Australia
| | - Denise Goodwin
- Behaviour Works Australia Health Programs, Monash Sustainable Development Institute, Monash University, Clayton, VIC, Australia
| | - Gerri Spassova
- Department of Marketing, Monash Business School, Caulfield East, VIC, Australia
| | - Peter Bragge
- Monash Sustainable Evidence Review Service, Monash Sustainable Development Institute, Monash University, Clayton, VIC, Australia
| |
Collapse
|
3
|
Furness K, Harris M, Lassemillante A, Keenan S, Smith N, Desneves KJ, King S. Patient Mealtime Experience: Capturing Patient Perceptions Using a Novel Patient Mealtime Experience Tool. Nutrients 2023; 15:2747. [PMID: 37375651 DOI: 10.3390/nu15122747] [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: 05/10/2023] [Revised: 05/23/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
INTRODUCTION The aim of this study is to describe the mealtime experience using the qualitative components of the Austin Health Patient Mealtime Experience Tool (AHPMET) to complement the quantitative findings of this tool. METHODS A multiphase, cross-sectional study was undertaken across all sites of Austin Health (Victoria, Australia) between March 2020 and November 2021. Patient mealtime experience was measured using the AHPMET. Descriptive statistics and a deductive thematic analysis approach described the patients' mealtime experiences. RESULTS Questionnaire data were collected from 149 participants. Patients were most satisfied with staff interactions, and least satisfied with dimensions of food quality, specifically, flavour, presentation, and menu variety. Clinical symptoms, nutrition impact symptoms and the patient's position were barriers to consumption. DISCUSSION Food quality was perceived as the poorest aspect of patient satisfaction with the hospital foodservice, particularly flavour, presentation, and menu variety. Future foodservice quality improvements must prioritise improving food quality to have the greatest impact on patient satisfaction. While clinical and organisational systems have a role in improving mealtime experience and oral intake, communicating patient perceptions of the mealtime experience is critical for responding to current perceptions of hospital food quality. CONCLUSION Mealtime experience in the hospital has a significant impact on oral intake and patients' wider perception of hospital services. Questionnaires have been used to capture patient satisfaction with foodservice in the hospital; however, no comprehensive questionnaires including qualitative questions that capture the broader mealtime experience have been validated across different hospital settings. The tool developed through this study can be implemented in any acute and subacute health service to provide feedback and improve the mealtime experience of patients. This has the capacity to improve mealtime intake, mitigate malnutrition, and improve quality of life and patient outcomes.
Collapse
Affiliation(s)
- Kate Furness
- Department Sport, Exercise and Nutrition Sciences, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC 3086, Australia
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
| | - Melina Harris
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
| | - Annie Lassemillante
- Department Sport, Exercise and Nutrition Sciences, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, VIC 3086, Australia
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
| | - Stephen Keenan
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
| | - Natasha Smith
- School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
- Austin Health, Nutrition and Dietetics Department, Division of Allied Health, Heidelberg, VIC 3084, Australia
| | - Katherine J Desneves
- Austin Health, Nutrition and Dietetics Department, Division of Allied Health, Heidelberg, VIC 3084, Australia
| | - Sam King
- Austin Health, Nutrition and Dietetics Department, Division of Allied Health, Heidelberg, VIC 3084, Australia
| |
Collapse
|
4
|
Ó Coimín D, Rohde D, Foley C, O’Carroll T, Murphy R. Dying, death and bereavement: developing a national survey of bereaved relatives. BMC Palliat Care 2023; 22:14. [PMID: 36823584 PMCID: PMC9947439 DOI: 10.1186/s12904-023-01135-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 02/08/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Assessing and measuring the experience and quality of care provided is central to the improvement of care delivery of all healthcare systems. This paper reports on the development of a survey instrument to capture the experiences of care at end of life from the perspective of bereaved relatives in the Republic of Ireland. METHODS A multi-method, multi-stakeholder, sequential approach was adopted for this study. Items for inclusion in the survey instrument bank were identified through (1) a feasibility study and scoping literature review, (2) expert panel programme board review, (3) focus groups and (4) gap analysis. The following steps were undertaken to prioritise the items for inclusion in the final survey instrument: (1) a Delphi study (2) technical expert panel review (3) cognitive interviews with bereaved relatives and an (4) expert panel programme board review. RESULTS Following an iterative process with key stakeholders, a survey instrument was developed with sections focusing on the provision of care at home, in the last nursing home / residential care facility, hospice and hospital, as well as care experience in the last 2 days of life, the relative's experiences of care and support, the circumstances of care surrounding death and demographic information. In total, a bank of 123 questions were prioritised to be included in the National End of Life Survey instrument. CONCLUSION The survey will provide a standardised national approach to capturing the experience of care of those who have died, from the perspective of bereaved relatives in the Republic of Ireland. This will allow health service providers, policy makers and regulators to gather important insights into the experiences of care at end of life and will help fulfil the requirement of healthcare services to ensure they are providing high-quality care.
Collapse
Affiliation(s)
- Diarmuid Ó Coimín
- Hospice Friendly Hospitals Programme, Quality and Patient Safety Directorate, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland.
| | - Daniela Rohde
- National Care Experience Programme, Health Information and Quality Authority, George’s Court, George’s Lane, Smithfield, Dublin 7, D07 E98Y Ireland
| | - Conor Foley
- National Care Experience Programme, Health Information and Quality Authority, George’s Court, George’s Lane, Smithfield, Dublin 7, D07 E98Y Ireland
| | - Tracy O’Carroll
- National Care Experience Programme, Health Information and Quality Authority, George’s Court, George’s Lane, Smithfield, Dublin 7, D07 E98Y Ireland
| | - Róisín Murphy
- National Care Experience Programme, Health Information and Quality Authority, George’s Court, George’s Lane, Smithfield, Dublin 7, D07 E98Y Ireland
| |
Collapse
|
5
|
Wong E, Mavondo F, Horvat L, McKinlay L, Fisher J. Healthcare professionals' perspective on delivering personalised and holistic care: using the Theoretical Domains Framework. BMC Health Serv Res 2022; 22:281. [PMID: 35232432 PMCID: PMC8887936 DOI: 10.1186/s12913-022-07630-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 02/14/2022] [Indexed: 11/30/2022] Open
Abstract
Background Interventions to improve personalised and holistic care delivery by healthcare professionals are more likely to be effective if they target the factors influencing specific behaviours. This study reports on the development and testing of a questionnaire to identify perspectives of healthcare professionals’ personalised and holistic care behaviours based on the Theoretical Domains Framework. Methods The study was conducted in public health services in Victoria, Australia. The questionnaire was developed and pilot-tested with behaviour change researchers and healthcare professionals. Doctors, nurses and midwives were recruited via notices and email invitations from Safer Care Victoria's website and mailing lists of healthcare professionals and invited to completed the questionnaire online (hosted on Qualtrics). Health services administrators and allied health professionals were excluded from the study. Confirmatory factor analysis was undertaken to generate the model of best fit and group differences were tested using univariate tests. Results One hundred and four healthcare professionals from public health services in Victoria, Australia, completed the 39-item questionnaire focusing on specific personalised and holistic care behaviours. The final model consisted of 13 factors and 39 items, and CFA produced an acceptable fit, as well as adequate levels of discriminant validity and internal consistency (α = 0.60 to 0.84). Seven domains, “social influence”, “motivation & goals”, “environmental context and resources’, “skills”, ‘beliefs about consequences”, “behaviour regulation” and “nature of behaviour” were identified. Significant differences in the factors influencing these behaviours were found in groups with different years of experience and role seniority. These findings suggest that future interventions need to be targeted to specific groups. Conclusion This study identified the specific behaviours and the factors associated with performance of personalised and holistic care among healthcare professionals. The findings suggest several interventions and policy functions may be taken to improve personalised and holistic care. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07630-1.
Collapse
Affiliation(s)
- Eunice Wong
- Monash Sustainable Development Institute, BehaviourWorks Australia, Monash University, Melbourne, Australia. .,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Felix Mavondo
- Department of Marketing, Monash University, Melbourne, Australia
| | - Lidia Horvat
- Safer Care Victoria, Department of Health Victoria, Melbourne, Australia
| | - Louise McKinlay
- Safer Care Victoria, Department of Health Victoria, Melbourne, Australia
| | - Jane Fisher
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| |
Collapse
|