Exploring the Patient’s Experience of Receiving Clinical Care Which Incorporates the Use of Mobile Technology at the Bedside

Objective: Research-based insight into patient’s experiences of mobile technology at the bedside in the hospital setting remains limited. This research project aims to explore patient’s experience. Methods: This mixed method pre and post study aimed to explore the patient experience in relation to this and also test whether introducing further bedside technology (beyond the workstation on wheels) had an effect on the patient experience. Questionnaires and interviews were conducted among inpatient samples prior to and one year post introduction of a suite of new bedside technologies. Results: Pre and post patient survey results (pre: n=82; post: n=98) suggested that mixed views and perceptions existed and that some of these were associated with primary demographics such as age. At post-test, attitudes about bedside technology were found to be more positive, and feedback about care quality was found to be unchanged, Baseline patient interview findings (n=15) highlight the social ubiquity of technology as a driver of positive attitude in the digital health context. Conclusion: The addition of new bedside technology is very well received by patients and was not perceived to impact on care quality.

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Managing Multimorbidity: How Can the Patient Experience be Improved?

Journal of Comorbidity ◽

10.15256/joc.2016.6.75 ◽

2016 ◽

Vol 6 (1) ◽

pp. 28-32 ◽

Cited By ~ 5

Author(s):

Stanimir Hasardzhiev ◽

Luís Mendão ◽

Wolfram Nolte ◽

Bert Aben ◽

Karin Kadenbach

Keyword(s):

Patient Experience ◽

Healthcare Services ◽

Preliminary Evidence ◽

Care Quality ◽

Quality Healthcare ◽

Care Services ◽

Health And Social Care ◽

Patient’S Experience ◽

Physical Health Problems ◽

Mental And Physical Health

The patient's experience of their own healthcare is an important aspect of care quality that has been shown to improve clinical and other outcomes. Very little is currently known about patient experience in the management of multimorbidity, although preliminary evidence suggests that it may be poor. Individuals with multimorbidity report better experiences of care when they are knowledgeable and involved in the decision-making, when their care is well coordinated, and communication is good. A greater focus on disease prevention, stronger collaboration between health and social care services, and the provision of more integrated care for people with mental and physical health problems would also help to improve the patient experience. Advocacy groups can amplify the patient voice and improve access to care, as well as provide information and support to patients and their families. Patients have an important role in preventing multimorbidity and improving its management, and should be involved in the development of health policies and the delivery of healthcare services. Inequalities in access to quality healthcare must also be addressed.

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COVID-19 Management at IHU Méditerranée Infection: A One-Year Experience

Journal of Clinical Medicine ◽

10.3390/jcm10132881 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2881

Author(s):

Philippe Brouqui ◽

Michel Drancourt ◽

Didier Raoult ◽

Keyword(s):

Genetic Variants ◽

Quality Evaluation ◽

Low Dose ◽

Clinical Care ◽

Case Fatality ◽

Care Quality ◽

Ct Scanner ◽

High Quality ◽

Case Fatality Ratio ◽

One Year

Background: The Hospital-University Institute (IHU) Méditerranée Infection features a 27,000 square meter building hosting 700 employees and 75 hospitalized patients in the center of Marseille, France. Method: Previous preparedness in contagious disease management allowed the IHU to manage the COVID-19 outbreak by continuing adaptation for optimal diagnosis, care and outcome. We report here the output of this management. Results: From 5 March 2020, and 26 April 2021, 608,313 PCR tests were provided for 424,919 patients and 44,089 returned positive. A total of 23,390 patients with COVID-19 were followed at IHU with an overall case fatality ratio of 1.7%. Of them 20,270 were followed as outpatients with an overall CFR of 0.17%. We performed 24,807 EKG, 5759 low dose CT Scanner, and 18,344 serology. Of the 7643 nasopharyngeal samples inoculated in cell cultures 3317 (43.3%) yielded SARS-Cov-2 isolates. Finally, 7370 SARS-Cov-2 genomes were analyzed, allowing description of the first genetic variants and their implication in the epidemiologic curves. Continuous clinical care quality evaluation provided the opportunity for 155 publications allowing a better understanding of the disease and improvement of care and 132 videos posted on the IHU Facebook network, totaling 60 million views and 390,000 followers, and dealing with COVID-19, outbreaks, epistemology, and ethics in medicine. Conclusions: During this epidemic, IHU Méditerranée Infection played the role for which it has been created; useful clinical research to guarantee a high-quality diagnostic and care for patient and a recognized expertise.

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The changing role of GP clinicians working in community hospitals.

British Journal of General Practice ◽

10.3399/bjgp18x696713 ◽

2018 ◽

Vol 68 (suppl 1) ◽

pp. bjgp18X696713

Author(s):

David Seamark ◽

Deborah Davidson ◽

Helen Tucker ◽

Angela Ellis-Paine ◽

Jon Glasby

Keyword(s):

Medical Care ◽

Local Community ◽

Community Hospital ◽

Clinical Care ◽

Hospital Setting ◽

Community Hospitals ◽

Recruitment Challenges ◽

Acute Hospitals ◽

Changing Role

BackgroundIn 2000 20% of UK GPs had admitting rights to community hospitals. In subsequent years the number of GPs engaged in community hospital clinical care has decreased.AimWhat models of medical care exist in English community hospitals today and what factors are driving changes?MethodInterviews with community hospital clinical staff conducted as part of a multimethod study of the community value of community hospitals.ResultsSeventeen interviews were conducted and two different models of medical care observed: GP led and Trust employed doctors. Factors driving changes were GP workload and recruitment challenges; increased medical acuity of patients admitted; fewer local patients being admitted; frustration over the move from ‘step-up’ care from the local community to ‘step-down’ care from acute hospitals; increased burden of GP medical support; inadequate remuneration; and GP admission rights removed due to bed closures or GP practices withdrawing from community hospital work.ConclusionMultiple factors have driven changes in the role of GP community hospital clinicians with a consequent loss of GP generalist skills in the community hospital setting. The NHS needs to develop a focused strategy if GPs are to remain engaged with community hospital care.

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Patient Experience in Home Respiratory Therapies: Where We Are and Where to Go

Journal of Clinical Medicine ◽

10.3390/jcm8040555 ◽

2019 ◽

Vol 8 (4) ◽

pp. 555 ◽

Cited By ~ 5

Author(s):

Cátia Caneiras ◽

Cristina Jácome ◽

Sagrario Mayoralas-Alises ◽

José Ramon Calvo ◽

João Almeida Fonseca ◽

...

Keyword(s):

Clinical Research ◽

Patient Experience ◽

Clinical Care ◽

Research Priorities ◽

Specific Patient ◽

Quality Healthcare ◽

Body Of Knowledge ◽

Number Of Patients ◽

Patient Reported ◽

System Sustainability

The increasing number of patients receiving home respiratory therapy (HRT) is imposing a major impact on routine clinical care and healthcare system sustainability. The current challenge is to continue to guarantee access to HRT while maintaining the quality of care. The patient experience is a cornerstone of high-quality healthcare and an emergent area of clinical research. This review approaches the assessment of the patient experience in the context of HRT while highlighting the European contribution to this body of knowledge. This review demonstrates that research in this area is still limited, with no example of a prescription model that incorporates the patient experience as an outcome and no specific patient-reported experience measures (PREMs) available. This work also shows that Europe is leading the research on HRT provision. The development of a specific PREM and the integration of PREMs into the assessment of prescription models should be clinical research priorities in the next several years.

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Association of Emergency Department Waiting Times With Patient Experience in Admitted and Discharged Patients

Journal of Patient Experience ◽

10.1177/23743735211011404 ◽

2021 ◽

Vol 8 ◽

pp. 237437352110114

Author(s):

Andrew Nyce ◽

Snehal Gandhi ◽

Brian Freeze ◽

Joshua Bosire ◽

Terry Ricca ◽

...

Keyword(s):

Emergency Department ◽

Length Of Stay ◽

Patient Experience ◽

Waiting Times ◽

Hospital Length ◽

Short Length ◽

Hospital Length Of Stay ◽

Patient’S Experience ◽

Discharged Patients ◽

The Impact

Prolonged waiting times are associated with worse patient experience in patients discharged from the emergency department (ED). However, it is unclear which component of the waiting times is most impactful to the patient experience and the impact on hospitalized patients. We performed a retrospective analysis of ED patients between July 2018 and March 30, 2020. In all, 3278 patients were included: 1477 patients were discharged from the ED, and 1680 were admitted. Discharged patients had a longer door-to-first provider and door-to-doctor time, but a shorter doctor-to-disposition, disposition-to-departure, and total ED time when compared to admitted patients. Some, but not all, components of waiting times were significantly higher in patients with suboptimal experience (<100th percentile). Prolonged door-to-doctor time was significantly associated with worse patient experience in discharged patients and in patients with hospital length of stay ≤4 days. Prolonged ED waiting times were significantly associated with worse patient experience in patients who were discharged from the ED and in inpatients with short length of stay. Door-to-doctor time seems to have the highest impact on the patient’s experience of these 2 groups.

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Evaluation of Patient Experience During Virtual and In-Person Urgent Care Visits: Time and Cost Analysis

Journal of Patient Experience ◽

10.1177/2374373520981487 ◽

2021 ◽

Vol 8 ◽

pp. 237437352098148

Author(s):

Saif Khairat ◽

Xi Lin ◽

Songzi Liu ◽

Zhaohui Man ◽

Tanzila Zaman ◽

...

Keyword(s):

Patient Experience ◽

Care Delivery ◽

Turnaround Time ◽

Cross Sectional Study ◽

Emergency Department Visits ◽

Urgent Care ◽

Cross Sectional ◽

Significant Difference ◽

Virtual Visits ◽

One Year

Urgent care (UC) is one of the fastest growing venues of health care delivery for nonemergent conditions. This study compared the patient experience during virtual and in-person urgent care visits. We conducted a cross-sectional study of patients with the same diagnosis during Virtual Urgent Care (VUC) and in-person UC visits with the same diagnosis with regard to time and cost over a period of one year. We recorded and analyzed 16 685 urgent care visits: In-person UC (n = 14 734), VUC (n = 1262). Significant differences were found in the average total time for a visit in an in-person UC (70.89 minutes), and VUC (9.38 minutes). The average total cost of VUC ($49) and in-person UC ($142.657) differed significantly. Significant difference was found between UC turnaround time and VC turnaround time (Dependent variable (DV): 53.77, P < .01). We found significant differences in cost and time between in favor of virtual visits. Our findings suggest additional policy reform to expand the use of virtual care among target populations to improve access, reduce costs, meet the needs of patients, and reduce emergency department visits.

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A Mental Health Drop-In Centre Offering Brief Transdiagnostic Psychological Assessment and Treatment in a Paediatric Hospital Setting: A One-Year Descriptive Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105369 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5369

Author(s):

Matteo Catanzano ◽

Sophie D Bennett ◽

Marc S Tibber ◽

Anna E Coughtrey ◽

Holan Liang ◽

...

Keyword(s):

Mental Health ◽

Young People ◽

Psychological Assessment ◽

Mental Health Problems ◽

Hospital Setting ◽

Considerable Proportion ◽

Paediatric Hospital ◽

Cognitive Behaviour ◽

Assessment And Treatment ◽

One Year

Aim: This study was part of a broader project to examine the acceptability, feasibility and impact of a transdiagnostic mental health drop-in centre offering brief psychological assessment and treatment for children and young people and/or their families with mental health needs in the context of long-term physical health conditions (LTCs). The aims of this investigation were to characterise: (i) the use of such a centre, (ii) the demographics and symptoms of those presenting to the centre, and (iii) the types of support that are requested and/or indicated. Methods: A mental health “booth” was located in reception of a national paediatric hospital over one year. Characteristics of young people with LTCs and their siblings/parents attending the booth were defined. Emotional/behavioural symptoms were measured using standardised questionnaires including the Strengths and Difficulties Questionnaire (SDQ). Participants subsequently received one of four categories of intervention: brief transdiagnostic cognitive behaviour therapy (CBT), referral to other services, neurodevelopmental assessment or signposting to resources. Results: One hundred and twenty-eight participants were recruited. The mean age of young people was 9.14 years (standard deviation: 4.28); 61% identified as white and 45% were male. Over half of young people recruited scored in the clinical range with respect to the SDQ. Presenting problems included: anxiety (49%), challenging behaviour (35%), low mood (22%) and other (15%). Conclusions: A considerable proportion of young people with LTC in a paediatric hospital scored in the clinical range for common mental health problems, indicating a potential for psychological interventions.

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2054. Hospital-initiated Antibiotics in Nursing Homes

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1734 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S692-S692

Author(s):

Jon P Furuno ◽

Brie N Noble ◽

Vicki Nordby ◽

Bo Weber ◽

Jessina C McGregor ◽

...

Keyword(s):

Nursing Homes ◽

Hospital Setting ◽

Antibiotic Prescribing ◽

Administration Route ◽

Electronic Health Record Data ◽

For Profit ◽

Duration Of Therapy ◽

Record Data ◽

One Year ◽

The One

Abstract Background Nursing homes (NHs) are required by the Centers for Medicare and Medicaid Services to maintain antimicrobial stewardship programs. Hospital-initiated antibiotics may pose a barrier to optimizing antibiotic prescribing in this setting. Our objective was to characterize hospital-initiated antibiotic prescriptions among NH residents. Methods We collected electronic health record data on antibiotic prescribing events within 60 days of residents’ admission to 17 for-profit NHs in Oregon, California, and Nevada between January 1, and December 31, 2017. We characterized antibiotics prescribed, administration route, and proportion initiated in a hospital setting. Results Over the one-year study period, there were 4350 antibiotic prescribing events among 1633 NH residents. Mean (standard deviation) age was 77 (12) years and 58% were female. Approximately 45% (1,973/4,350) of antibiotics prescribed within 60 days of NH admission were hospital-initiated. The most frequently prescribed hospital-initiated antibiotics were cephalosporins (27%; 1st gen: 54%, 2nd gen: 6%, 3rd gen: 34%, 4th gen: 5%, 5th gen: 1%), fluoroquinolones (20%), and penicillins (14%; natural penicilins: 4%, semisynthetic penicillins: 3%, aminopenicillans: 57%, β-lactam/β-lactamase inhibitors: 21%, and antipseudomonal penicillins: 15%). Additionally, 24% of antibiotics were parenteral and the median (interquartile range) duration of therapy was 6 (3–10) days. Over 15% of residents with hospital-initiated antibiotics were readmitted to the hospital within 30 days. Conclusion Approximately 45% of antibiotic prescribing in a multistate sample of NHs were hospital-initiated, of which roughly 40% was broad-spectrum. Interventions specifically targeting antibiotic prescribing during and following the transition from hospitals to NHs are needed. Disclosures All authors: No reported disclosures.

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Patient’s experience of psoriatic arthritis: a conceptual model based on qualitative interviews

RMD Open ◽

10.1136/rmdopen-2020-001321 ◽

2020 ◽

Vol 6 (3) ◽

pp. e001321

Author(s):

Alexis Ogdie ◽

Kaleb Michaud ◽

Miroslawa Nowak ◽

Rachel Bruce ◽

Sarah Cantor ◽

...

Keyword(s):

Psoriatic Arthritis ◽

Conceptual Model ◽

Patient Experience ◽

Qualitative Interviews ◽

Signs And Symptoms ◽

Structured Interviews ◽

Skin Symptoms ◽

Patient’S Experience ◽

Significant Burden

IntroductionPsoriatic arthritis (PsA) is a heterogeneous chronic inflammatory musculoskeletal disorder that manifests as peripheral arthritis, dactylitis, enthesitis and spondylitis. PsA results in significant burden that impacts quality of life of patients. We examined the signs, symptoms and impacts reported by patients with PsA, to characterise the patient experience of PsA and develop a conceptual model representing this patient experience.MethodsSemi-structured interviews were conducted with patients with PsA recruited through the FORWARD databank. Spontaneous and probed signs, symptoms and impacts of PsA were assessed. Patients rated the disturbance of these concepts on their lives using a scale from 0 (‘does not disturb’) to 10 (‘greatly disturbs’). Signs, symptoms and impacts reported by >80% of patients with a disturbance rating of ≥5 were defined as salient concepts. Recruitment continued until concept saturation was achieved.Results19 patients with PsA were interviewed. The interviews elicited 42 symptoms of which 8 had not been identified in a previous literature review encompassing 15 relevant articles. The most salient signs and symptoms elicited in the interviews were joint pain, skin symptoms, stiffness, swollen/inflamed joints and fatigue all with moderate to high disturbance ratings (range: 5.5–7.8). The most salient impacts were sleep disturbance, physical disability, effects on daily activities and feelings of frustration with also moderate to high disturbance ratings (range: 6.1–7.4).ConclusionsThe interviews highlighted the adverse impact PsA has on the patient’s life and may inform on outcome variables or areas suitable to be assessed in PsA studies.

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Managing the Digital Disruption Associated with COVID-19-Driven Rapid Digital Transformation in Brisbane, Australia

Applied Clinical Informatics ◽

10.1055/s-0041-1740190 ◽

2021 ◽

Vol 12 (05) ◽

pp. 1135-1143

Author(s):

Amalie Dyda ◽

Magid Fahim ◽

Jon Fraser ◽

Marianne Kirrane ◽

Ides Wong ◽

...

Keyword(s):

Care Delivery ◽

Digital Health ◽

Clinical Care ◽

Models Of Care ◽

Digital Transformation ◽

Lessons Learned ◽

Digital Data ◽

Routine Practice ◽

Action Research Project ◽

Digital Disruption

Abstract Background The COVID-19 pandemic has forced rapid digital transformation of many health systems. These innovations are now entering the literature, but there is little focus on the resulting disruption. Objective We describe the implementation of digital innovations during the COVID-19 response of Australia's largest health service, Metro North (in Brisbane, Queensland), the challenges of the subsequent digital disruption, how these were managed, and lessons learned. Methods Prior to the COVID-19 pandemic, the Australian state of Queensland created the Queensland Digital Clinical Charter, which provides guidance for the development of digital health programs. The guidelines utilize three horizons: digitizing workflows, leveraging digital data to transform clinical care, and reimagining new and innovative models of care. The technical response to COVID-19 in Metro North is described across these horizons. The rapid digital response caused significant disruption to health care delivery; management of the disruption and the outcomes are detailed. This is a participatory action research project, with members of the research team assisting with leading the implementation project informing the case report content. Results Several digital innovations were introduced across Metro North during the COVID-19 response. This resulted in significant disruption creating digital hypervigilance, digital deceleration, data discordance, and postdigital “depression.” Successful management of the digital disruption minimized the negative effects of rapid digital transformation, and contributed to the effective management of the pandemic in Queensland. Conclusion The rapid digital transformation in Metro North during COVID-19 was successful in several aspects; however, ongoing challenges remain. These include the need to improve data sharing and increase interoperability. Importantly, the innovations need to be evaluated to ensure that Metro North can capitalize on these changes and incorporate them into long-term routine practice. Moving forward, it will be essential to manage not only the pandemic, but increasingly, the resultant digital disruption.

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