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Hospital-level care coordination strategies associated with better patient experience

Quality and Safety in Health Care Journal -

Background

Patient experience is a key measure of hospital quality and is increasingly contained in value-based payment programmes. Understanding whether strategies aimed at improving care transitions are associated with better patient experience could help clinical leaders and policymakers seeking to improve care across multiple dimensions.

Objective

To determine the association of specific hospital care coordination and transition strategies with patient experience.

Design

We surveyed leadership at 1600 acute care hospitals and categorised respondents into three groups based on the strategies used: low-strategy (bottom quartile of number of strategies), mid-strategy (quartiles 2 and 3) and high-strategy (highest quartile). We used linear regression models to examine the association between use of these strategies and performance on measures of patient experience from the Hospital Consumer Assessment of Healthcare Providers and Systems survey.

Results

We achieved a 62% response rate. High-strategy hospitals reported using 7.7 strategies on average usually or always on their patient populations, while mid-strategy and low-strategy hospitals reported using 5.0 and 2.3 strategies, respectively. Compared with low-strategy hospitals, high-strategy hospitals had a higher overall rating (+2.23 percentage points (pp), P<0.001), higher recommendation score (+2.5 pp, P<0.001), and higher satisfaction with discharge process (+1.35 pp, P=0.01) and medication communication (+1.44 pp, P=0.002). Mid-strategy hospitals had higher scores than low-strategy hospitals except for discharge satisfaction. Patient-facing strategies, like sharing discharge summaries with patients prior to discharge, using discharge coordinators and calling patients 48 hours after discharge, were each individually associated with a higher overall hospital rating, and higher satisfaction with discharge process and medication communication.

Conclusions

Hospitals with greater reported use of care coordination and transition strategies have better patient experience than hospitals with fewer reported strategies. Strategies that most directly involve patients have the strongest association with better experience.

Implementing electronic patient-reported outcomes measurements: challenges and success factors

Quality and Safety in Health Care Journal -

Determining how to collect and use patient-reported outcome measures (PROMs) continues to be an area of discussion, and in some cases frustration.1–5 Gaining a greater depth of knowledge concerning a patient’s initial health status as well as improvement after a medical or surgical intervention, would provide a clearer understanding of needed care paths and outcomes of treatments, oftentimes missing from our current healthcare processes.6 7 While PROMs are not a new idea, the ability to electronically collect, report and use the data has become more relevant in recent years. As such, this work focuses on the challenges and lessons learnt from implementing electronic PROMs (ePROMs) within a destination medical centre which provides team-based comprehensive care for patients.

Implementations in multiple departments and disease specific areas of care throughout the organisation took place between January 2016...

Role of patient and public involvement in implementation research: a consensus study

Quality and Safety in Health Care Journal -

Background

Patient and public involvement (PPI) is often an essential requirement for research funding. Distinctions can be drawn between clinical research, which generally focuses on patients, and implementation research, which generally focuses on health professional behaviour. There is uncertainty about the role of PPI in this latter field. We explored and defined the roles of PPI in implementation research to inform relevant good practice guidance.

Methods

We used a structured consensus process using a convenience sample panel of nine experienced PPI and two researcher members. We drew on available literature to identify 21 PPI research roles. The panel rated their agreement with roles independently online in relation to both implementation and clinical research. Disagreements were discussed at a face-to-face meeting prior to a second online rating of all roles. Median scores were calculated and a final meeting held to review findings and consider recommendations.

Results

Ten panellists completed the consensus process. For clinical research, there was strong support and consensus for the role of PPI throughout most of the research process. For implementation research, there were eight roles with consensus and strong support, seven roles with consensus but weaker support and six roles with no consensus. There were more disagreements relating to PPI roles in implementation research compared with clinical research. PPI was rated as contributing less to the design and management of implementation research than for clinical research.

Conclusions

The roles of PPI need to be tailored according to the nature of research to ensure authentic and appropriate involvement. We provide a framework to guide the planning, conduct and reporting of PPI in implementation research, and encourage further research to evaluate its use.

Visual Management Board

Institute for Healthcare Improvement -

A visual management board is used as a key communication tool that provides at-a-glance information about current process performance, both quantitative and qualitative data, to help clinical unit staff coordinate and guide their daily work and monitor ongoing improvement projects.

Visual Management Board

Institute for Healthcare Improvement -

A visual management board is used as a key communication tool that provides at-a-glance information about current process performance, both quantitative and qualitative data, to help clinical unit staff coordinate and guide their daily work and monitor ongoing improvement projects.

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