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Engstrom T, Shteiman M, Kelly K, Sullivan C, Pole JD. What is measured matters: A scoping review of analysis methods used for qualitative patient reported experience measure data. Int J Med Inform 2024; 190:105559. [PMID: 39032453 DOI: 10.1016/j.ijmedinf.2024.105559] [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: 11/26/2023] [Revised: 07/11/2024] [Accepted: 07/16/2024] [Indexed: 07/23/2024]
Abstract
INTRODUCTION Hospitals are increasingly turning to patients for valuable feedback regarding their care experience. A common method to collect this information is patient reported experience measures (PREMs) surveys. Health care workers report qualitative PREMs as more interesting, relevant, and informative than quantitative survey responses. However, a major barrier to utilising qualitative PREMs data to drive quality improvements is a lack of resources to analyse the data. This scoping review aimed to review the methods used to analyse qualitative PREMs survey data from routine hospital care. METHODS We utilised the JBI scoping review methodology, and searched four databases for articles from 2013 to 2023 which analysed qualitative PREMs survey data from routine care in hospitals. Study characteristics were extracted, as well as the analysis method - specifically, whether the study used traditional manual analysis methods in which the researcher reads the text and categorise the data, or automated methods utilising computers and algorithms to read and categorise the data. RESULTS From 960 unique articles, 123 went through full-text review and 54 were deemed eligible. 75.9 % used only manual content analysis methods to analyse the qualitative responses, 16.7 % of studies used a combination of manual and automated methods, and only 7.4 % used exclusively automated methods. Automated methods were used in 27.5 % of studies published 2019-2023, compared to 14.3 % of studies published 2013-2018. All bar one study using automated methods focused on investigating the validity of the automated methodology or used it to complement manual content analysis. CONCLUSION The studies included in this review show a transition from traditional time-consuming manual analyses to computerised methods enabling analysis at a larger scale. As the volume of PREMs data collected grows, efficient and effective ways to analyse qualitative PREMs data at scale are required to enable health services to capture the patient voice and drive consumer-centred improvements in care.
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Affiliation(s)
- Teyl Engstrom
- Queensland Digital Health Centre, Centre for Health Services Research, The University of Queensland, Herston, QLD, Australia.
| | - Max Shteiman
- The University of Queensland-Ochsner Clinical School, Brisbane, QLD, Australia
| | - Kim Kelly
- Qualitative Research Center of Excellence, IQVIA, Tucson, AZ, USA
| | - Clair Sullivan
- Queensland Digital Health Centre, Centre for Health Services Research, The University of Queensland, Herston, QLD, Australia; Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - Jason D Pole
- Queensland Digital Health Centre, Centre for Health Services Research, The University of Queensland, Herston, QLD, Australia; The University of Toronto, Dalla Lana School of Public Health, Toronto, ON, Canada
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Welch RJ, Fredricks K, Marek R, Asaithambi R, Masciale M. The Impact of Visitor Identification Policies on Hospitalized Children and Families. Hosp Pediatr 2024; 14:e406-e408. [PMID: 39118589 DOI: 10.1542/hpeds.2024-007909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/23/2024] [Accepted: 05/27/2024] [Indexed: 08/10/2024]
Affiliation(s)
- Rachel Jon Welch
- Department of Pediatrics, University of Washington, Seattle Children's Hospital, Seattle, Washington
| | - Karla Fredricks
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Rachel Marek
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Rathi Asaithambi
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Marina Masciale
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
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Moldovan F, Moldovan L. Evaluation of Community Involvement and Development in an Orthopedic Hospital. Healthcare (Basel) 2024; 12:1286. [PMID: 38998821 PMCID: PMC11241023 DOI: 10.3390/healthcare12131286] [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: 05/27/2024] [Revised: 06/20/2024] [Accepted: 06/25/2024] [Indexed: 07/14/2024] Open
Abstract
Improving healthcare requires appropriate community involvement supported by appropriate partner engagement methods. This research aims to develop a complex tool for evaluating the social responsibility of health facilities regarding community involvement and development. We developed areas of a new reference framework for the sustainability of healthcare organizations, which includes the area of community involvement and expansion. It is made up of nine indicators. These were designed using the most representative activities reported by hospitals around the world. Their testing was conducted in an orthopedic emergency hospital. The designed indicators are community engagement actions; the interventions' content adapted to the community; partnership and networking; the involvement of volunteers and training networks; the involvement and participation of professional associations; community-involved local opinion leaders; satisfaction with partnerships; initiatives together with the community; and educational visits. The testing and validation of health practices of the indicators highlighted their adequacy with the proposed purpose of the research and the promotion of sustainable development. We have also verified their compatibility with the requirements of national hospital accreditation legislation and the European framework for quality assurance in hospitals.
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Affiliation(s)
- Flaviu Moldovan
- Orthopedics—Traumatology Department, Faculty of Medicine, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Liviu Moldovan
- Faculty of Engineering and Information Technology, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania;
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Dasso N, Catania G, Zanini M, Rossi S, Aleo G, Signori A, Scelsi S, Petralia P, Watson R, Hayter M, Sasso L, Bagnasco A. Informal carers' experiences with their children's care during hospitalization in Italy: Child HCAHPS results from RN4CAST@IT-Ped cross-sectional study. J Pediatr Nurs 2024; 74:10-16. [PMID: 37980795 DOI: 10.1016/j.pedn.2023.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 11/01/2023] [Accepted: 11/04/2023] [Indexed: 11/21/2023]
Abstract
PURPOSE To examine informal carers' experiences during their child's hospitalization and evaluate the associations with care received and care context. DESIGN AND METHODS What is described in this article is only a part of the larger study, RN4CAST@IT-Ped, a multicenter cross-sectional study, with multi-level data collection through convenience sampling, the Child Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey was used to collect data from informal carers of pediatric patients, applying the "top box" approach. RESULTS Nine hospitals, 1472 nurses, and 635 children's parents were involved. A correlation was found between patient safety and satisfaction outcomes and nursing staff characteristics. Adequate workloads for nurses improved carers' assessment of their experience in the hospital. CONCLUSION Adequate staffing management could significantly improve informal carers' satisfaction with the care provided to their children during hospitalization. PRACTICE IMPLICATIONS Children's informal carers greatly value the care they receive in pediatric hospitals. Adequate workloads for nurses improve carers' overall evaluation of the care their children receive during hospitalization. Nursing management should consider improving these aspects to ensure high-quality care in children's hospitals.
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Affiliation(s)
- Nicoletta Dasso
- Health Professional Direction, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini 5, 16147 Genoa, Italy.
| | - Gianluca Catania
- Department of Health Sciences, University of Genoa, Via Pastore, 1, 16132 Genoa, Italy.
| | - Milko Zanini
- Department of Health Sciences, University of Genoa, Via Pastore, 1, 16132 Genoa, Italy.
| | - Silvia Rossi
- Health Professional Direction, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini 5, 16147 Genoa, Italy.
| | - Giuseppe Aleo
- Department of Health Sciences, University of Genoa, Via A. Pastore, 1, 16132 Genoa, Italy; Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin, Ireland..
| | - Alessio Signori
- Department of Health Sciences, Biostatistics, Via A. Pastore 1, I-16132 Genoa, Italy.
| | - Silvia Scelsi
- Health Professional Direction, IRCCS Istituto Giannina Gaslini, Via Gerolamo Gaslini 5, 16147 Genoa, Italy.
| | - Paolo Petralia
- Italian Association of Paediatric Hospitals (AOPI), General Director, ASL 4 S.S.R. Ligure, Via G. Gaslini 5, 16147 Genoa, Italy
| | | | - Mark Hayter
- Faculty of Health and Education, Manchester Metropolitan University, Manchester, United Kingdom.
| | - Loredana Sasso
- Department of Health Sciences, University of Genoa, Via Pastore, 1, 16132 Genoa, Italy.
| | - Annamaria Bagnasco
- Department of Health Sciences, University of Genoa, Via Pastore, 1, 16132 Genoa, Italy.
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Inhestern L, Herrmann J, Schürmann J, Meister RL, Nawka MT, Mynarek M, Linhart D, Bergelt C. Child-centredness in paediatric magnetic resonance imaging: Information needs and experiences of children requiring magnetic resonance imaging and their parents. Child Care Health Dev 2024; 50:e13157. [PMID: 37581953 DOI: 10.1111/cch.13157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 06/30/2023] [Accepted: 07/03/2023] [Indexed: 08/17/2023]
Abstract
BACKGROUND Assessing patient experiences is essential to provide high quality health-care. The objectives of this study were to examine (1) child- and parent-reported information status before magnetic resonance imaging (MRI), (2) experiences during an MRI and (3) needs and suggestions for improvement. METHODS Children (≥8 years) and parents answered questionnaires (before and after planned MRI examination) covering mental condition, information status/needs, preparation for MRI, and potential stressors. Before MRI n = 132 accompanying parents and n = 91 children provided data (after MRI: n = 93 parents; n = 71 children). The mean age of the children undergoing MRI was 10.5 years (SD = 4.9). Children had on average seven previous MRIs before our survey (Range: 1-33). Twenty-three percent of the children were to be sedated during the examination. RESULTS Parents and children reported low to medium levels of burden, high knowledge and high information status. For the children, most stressful factors during the MRI were boredom and noise. Main information resources were the radiologists or self-searches. Parents of children with their first MRI reported higher anxiety levels in their children and stated a worse information status (main information source: self-searches/internet). Parents reported needs regarding organization of the MRI (e.g., reduction of waiting times), age-appropriate information and communication during the MRI. Children wished to visit the MRI room prior the examination (44%) and to get more information (44%). Children suggested improvements such as better sound quality of films/music, more transparency about the procedure, being in contact with a parent and shorter examinations. CONCLUSION Results suggest that preparation, information provision and care is perceived positively by families. Needs and suggestions for improvement were, for example, higher transparency of procedures, better communication and reduction of stress. Findings indicate that preparation in routine-care should follow an individualized child-focused approach, should focus on families without previous MRIs and should address children with high anxiety levels.
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Affiliation(s)
- Laura Inhestern
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jochen Herrmann
- Section of Pediatric Radiology, Department of Diagnostic and Interventional Radiology and Nuclear medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jana Schürmann
- Faculty of Educational Science, University of Education Freiburg, Breisgau, Germany
| | - Rieke Lisa Meister
- Section of Pediatric Radiology, Department of Diagnostic and Interventional Radiology and Nuclear medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marie Teresa Nawka
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Mynarek
- Department for Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Mildred Scheel Cancer Career Center HaTriCS4, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dieter Linhart
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department for Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Corinna Bergelt
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Medical Psychology, University Medicine Greifswald, Greifswald, Germany
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Quigley DD, Slaughter ME, Hays RD. Pediatric Inpatient Leaders, Views Changed with COVID-19: A Call to Re-engage in Quality Improvement. Pediatr Qual Saf 2023; 8:e648. [PMID: 38571733 PMCID: PMC10990334 DOI: 10.1097/pq9.0000000000000648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 04/01/2023] [Indexed: 04/05/2024] Open
Affiliation(s)
| | | | - Ron D. Hays
- University of California Los Angeles, David Geffen School of Medicine
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Vaz LE, Jungbauer RM, Jenisch C, Austin JP, Wagner DV, Everest SJ, Libak AJ, Harris MA, Zuckerman KE. Caregiver Experiences in Pediatric Hospitalizations: Challenges and Opportunities for Improvement. Hosp Pediatr 2022; 12:1073-1080. [PMID: 36412061 DOI: 10.1542/hpeds.2022-006645] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND There are limited qualitative data describing general pediatric hospitalizations through the caregivers' lens, and most focus on one particular challenge or time during the hospitalization. This qualitative study aimed to address a gap in the description of the breadth and depth of personal challenges caregivers may face during the entire hospitalization, irrespective of severity of patient illness or diagnosis, and explored caregiver-suggested interventions. METHODS Caregivers of pediatric patients on the hospitalist service at a Pacific Northwest children's hospital were interviewed to explore their hospitalization experience and solicit feedback for potential interventions. Content was coded iteratively using a framework analysis until thematic saturation was met. Findings were triangulated through 2 focus groups, 1 with parent advisors and the other with hospital physicians and nurses. RESULTS Among 14 caregivers (7 each of readmitted and newly admitted patients) and focus group participants, emergent domains on difficulties faced with their child's hospitalization were anchored on physiologic (sleep, personal hygiene, and food), psychosocial (feelings of isolation, mental stress), and communication challenges (information flow between families and the medical teams). Caregivers recognized that addressing physiologic and psychosocial needs better enabled them to advocate for their child and suggested interventions to ameliorate hospital challenges. CONCLUSIONS Addressing physiologic and psychosocial needs may reduce barriers to caregivers optimally caring and advocating for their child. Downstream consequences of unaddressed caregiver challenges should be explored in relation to participation in hospital care and confidence in shared decision-making, both vital components for optimization of family-centered care.
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Affiliation(s)
- Louise E Vaz
- Department of Pediatrics, Doernbecher Children's Hospital
| | - Rebecca M Jungbauer
- Pacific Northwest Evidence-Based Practice Center, Oregon Health and Science University, Portland, Oregon
| | - Celeste Jenisch
- Department of Pediatrics, Doernbecher Children's Hospital.,Build Exito Program, Portland State University, Portland, Oregon
| | - Jared P Austin
- Department of Pediatrics, Doernbecher Children's Hospital
| | - David V Wagner
- Department of Pediatrics, Doernbecher Children's Hospital
| | - Steven J Everest
- Build Exito Program, Portland State University, Portland, Oregon
| | - Alyssa J Libak
- Build Exito Program, Portland State University, Portland, Oregon
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Quigley D, Qureshi N, Rybowski L, Shaller D, Edgman-Levitan S, Cleary PD, Ginsberg C, Hays RD. Summary of the 2020 AHRQ research meeting on 'advancing methods of implementing and evaluating patient experience improvement using consumer assessment of healthcare providers and systems (CAHPS®) surveys'. Expert Rev Pharmacoecon Outcomes Res 2022; 22:883-890. [PMID: 35510496 PMCID: PMC11141132 DOI: 10.1080/14737167.2022.2064848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 04/07/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND The Agency for Healthcare Research and Quality held a research meeting on using Consumer Assessment of Healthcare Providers and Systems (CAHPS®) data for quality improvement (QI) and evaluating such efforts. TOPICS COVERED. Meeting addressed: 1)What has been learned about organizational factors/environment needed to improve patient experience? 2)How have organizations used data to improve patient experience? 3)What can evaluations using CAHPS data teach us about implementing successful programs to improve patient experience? KEY THEMES Providers and stakeholders need to be engaged early and often, standardize QI processes, complement CAHPS data with other data, and compile dashboards of CAHPS scores to identify and track improvement. Rigorous study designs are valuable, but much can be learned and accomplished through practical organization-level studies.
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Affiliation(s)
- Denise Quigley
- RAND Corporation, Santa Monica, California, United States
| | - Nabeel Qureshi
- RAND Corporation, Santa Monica, California, United States
| | | | | | - Susan Edgman-Levitan
- John D. Stoeckle Center for Primary Care Innovation Massachusetts General Hospital
| | | | - Caren Ginsberg
- Agency for Healthcare Research and Quality, Rockville, Maryland, United States
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Quigley DD, Slaughter ME, Gidengil C, Palimaru A, Lerner C, Hays RD. Usefulness of Child HCAHPS Survey Data for Improving Inpatient Pediatric Care Experiences. Hosp Pediatr 2021; 11:e199-e214. [PMID: 34548390 PMCID: PMC11111155 DOI: 10.1542/hpeds.2020-004283] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Quality improvement (QI) requires data, indicators, and national benchmarks. Knowledge about the usefulness of Child Hospital Consumer Assessment of Healthcare Providers and Systems (Child HCAHPS) data are lacking. We examined quality leader and frontline staff perceptions about patient experience measurement and use of Child HCAHPS data for QI. METHODS We surveyed children's hospital leaders and staff about their use of Child HCAHPS for QI, including measures from other studies. We compared scale and item means for leaders and staff and compared means to other studies. RESULTS Almost all leaders, but only one-third of staff, received reports with Child HCAHPS data. Leaders found the data more useful for comparisons to other hospitals than did staff. Both agreed on the validity of Child HCAHPS scores and used these data for improving pediatric care experiences. They agreed the data accurately reflect their hospital's quality of care, provide specific information for QI, and can be used to improve pediatric care experiences. They also agreed on approaches to improve Child HCAHPS scores. Among staff, QI was reported as essential to their daily work and that Child HCAHPS data were integral to QI. CONCLUSIONS As uptake of the Child HCAHPS survey increases, our study of one medium-sized, urban children's hospital revealed that leaders and staff believe Child HCAHPS provides actionable metrics for improvement. Our study fills a gap in research about the use of Child HCAHPS for pediatric QI. A multisite evaluation would provide further information about how the Child HCAHPS survey can improve care.
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Affiliation(s)
| | | | | | | | - Carlos Lerner
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
- University of California Los Angeles Mattel Children's Hospital, Los Angeles, California
| | - Ron D Hays
- RAND Corporation, Santa Monica, California
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
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Abstract
BACKGROUND Patient surveys are the primary tool to measure patient experiences of care. Caution must be taken when analyzing these data, as responses can be influenced by factors that do not reflect the quality of care received. OBJECTIVES To provide a practical overview of adjusting patient experience survey results to address bias related to patient case-mix, extreme response tendency, and mode of survey administration. RESEARCH DESIGN We discuss options for adjustment for biases in how people respond to patient experience surveys. RESULTS Case-mix adjustment (CMA) aims to compare provider performance that would have been observed if all providers had treated the same set of patients by removing the effects of patient characteristics that vary across providers. Extreme response tendency can bias the measurement of the disparities in patient experiences even after typical CMAs, since differences in patients' use of extreme response options may affect patient experience scores when they have a skewed distribution. Survey mode may affect scores for the provider entity being evaluated (eg, hospital) more than CMA if survey mode differs at the provider level. CONCLUSIONS It is best practice to evaluate known source of bias when analyzing patient experience surveys. Failure to adjust for patient case-mix, extreme response tendency, and survey mode in patient experience surveys may lead to erroneous comparisons of providers.
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Affiliation(s)
| | | | - Ron D Hays
- Division of General Internal Medicine & Health Services Research, University of California, Los Angeles, Los Angeles, CA
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