scholarly journals The therapeutic needs of psychiatric in-patients with psychosis: A qualitative exploration of patient and staff perspectives

BJPsych Open ◽  
2019 ◽  
Vol 5 (3) ◽  
Author(s):  
Lisa Wood ◽  
Claire Williams ◽  
Jo Billings ◽  
Sonia Johnson
Keyword(s):  
Patient Care ◽  
Quality Care ◽  
Structured Interview ◽  
Care Provision ◽  
Patient Dissatisfaction ◽  
Patient Interviews ◽  
Lack Of Control ◽  
Therapeutic Needs ◽  
Qualitative Exploration ◽  
Admission Interviews

Background Concerns are recurrently expressed that the therapeutic content of in-patient care is limited and lacking clear guidance. The perspectives of patients and staff regarding therapeutic priorities for psychiatric in-patient care have been little explored and compared. Aims The aim of this study was to examine patient and staff perspectives on the care priorities of psychiatric in-patients with psychosis. Method We recruited 12 in-patients with psychosis and 12 multidisciplinary team staff. All participants undertook a semi-structured interview examining their perspectives on the therapeutic needs of people with psychosis during admission. Interviews were transcribed verbatim and thematic analysis conducted. Results Three superordinate themes arose from patient interviews: ‘the importance of considering social circumstances and trauma’, ‘managing the intra- and interpersonal impact of psychosis’ and ‘lack of control and collaboration in care’ and three from staff interviews: ‘multidisciplinary facilitators of care’, ‘treating complexity and incorporating social factors’ and ‘restrictive practices preventing quality care provision’. Comparison of patient and staff themes identified unmet needs in addressing social marginalisation, trauma and distress, and the importance of collaborative treatment process and inclusion of spirituality. Conclusions There are gaps between staff and patient perspectives on important priorities for in-patient care that may help explain persistent patient dissatisfaction with in-patient care. Findings suggest the need for coproduced work to develop and test interventions that address broader therapeutic priorities. Declaration of interest None.

The Critical Incident Technique: Method or Methodology?

2019 ◽  
Vol 29 (7) ◽  
pp. 1065-1079 ◽  
Author(s):  
Roderik F. Viergever
Keyword(s):  
Data Collection ◽  
Critical Incident ◽  
Quality Care ◽  
Critical Incident Technique ◽  
Satisfaction With Care ◽  
Care Provision ◽  
Services Research ◽  
Data Collection And Analysis ◽  
Or Methodology ◽  
Good Quality Care

The critical incident technique (CIT) is a qualitative research tool that is frequently used in health services research to explore what helps or hinders in providing good quality care or achieving satisfaction with care provision. However, confusion currently exists on the nature of the CIT: Is it a method for data collection and analysis or a methodology? In this article, I explain why this distinction is important and I argue that the CIT is a methodology (and not a method) for the following reasons: Key methodological dimensions are described for the CIT; it has a clear focus; studies that apply this technique make use of various methods for data collection and analysis; it describes, explains, evaluates, and justifies the use of a specific format for those methods; it implies philosophical and practical assumptions; and studies that use the CIT cannot easily make use of additional methodologies simultaneously.

PATIENT CARE AND STUDENT LEARNING IN A PEDIATRIC CLINIC

PEDIATRICS ◽  
1972 ◽  
Vol 50 (6) ◽  
pp. 847-848
Author(s):  
Robert J. Haggerty
Keyword(s):  
Patient Care ◽  
Student Teaching ◽  
Effective Management ◽  
Patient Dissatisfaction ◽  
Complex Problems ◽  
Teaching Objectives ◽  
Recruitment Procedure ◽  
Outpatient Departments ◽  
Selection For ◽  
Definition Of

Every pediatrician who has taught or worked in university pediatric outpatient departments recognizes the syndrome presented by Duff et al. in this issue of Pediatrics. The diagnosis is clear: effective student teaching is not occurring. The etiology of this problem is complex and not so clear. Some of the causes are inappropriate patient selection for beginning students, lack of effective administrative organization to achieve even limited teaching objectives, and lack of appropriate techniques to diagnose and manage the complex sociomedical problems presented. As a result, student, faculty, and patient dissatisfaction is very high. Effective management of the syndrome is even less clear. As with most complex problems, a clearer definition of the goals is the first step to a solution. What do we want the student to learn? How to gather information from families with such complex social and medical difficulties? Skills in diagnosis and management of common or rare health problems? Change of attitudes? Until each ambulatory program defines its teaching objectives more clearly in behaviorally measurable terms, effective management of the disease "poor patient care and teaching" will continue to elude us. I would, however, suggest the following considerations: 1. The first direct patient experiences which students have in ambulatory settings should be with patients who present considerably less complex problems than those available in most of our outpatient departments, and there should be a wider social class selection for the student's initial experience. To achieve this will require either a different patient recruitment procedure or the use of different settings for such education.

scholarly journals The dog that failed to bark

2010 ◽  
Vol 34 (9) ◽  
pp. 361-363 ◽  
Author(s):  
Tom Burns
Keyword(s):  
Mental Health ◽  
Patient Care ◽  
Continuity Of Care ◽  
International Comparisons ◽  
Patient Dissatisfaction ◽  
Significant Potential ◽  
Mental Health Act ◽  
The Poor ◽  
Structural Discontinuity ◽  
Careful Thought

SummaryUK mental healh services have been distinguished by their continuity of care but recently there has been a move to separating consultant responsibility for in-patient and out-patient care. Local examples of the success of this approach have been published but there has been remarkably little careful thought about its longer-term impacts. International comparisons would suggest that there are significant potential disadvantages, including increased bed pressures. Some disadvantages, such as the poor fit with the Mental Health Act and patient dissatisfaction with structural discontinuity are already obvious. A more considered debate is called for.

P035: Development of a province-wide audit program for return visits to the emergency department

CJEM ◽  
2017 ◽  
Vol 19 (S1) ◽  
pp. S89-S90
Author(s):  
L.B. Chartier ◽  
O. Ostrow ◽  
I. Yuen ◽  
S. Kutty ◽  
B. Davis ◽  
...  
Keyword(s):  
Emergency Department ◽  
Patient Care ◽  
Quality Care ◽  
Improve Patient Care ◽  
Lessons Learned ◽  
Quality And Safety ◽  
Term Care ◽  
Clinical Observations ◽  
Quality Program ◽  
Physician Leaders

Introduction: Routine auditing of charts of patients with an emergency department (ED) return visit (RV) resulting in hospital admission can uncover quality and safety gaps in care. This feedback can be helpful to clinicians, administrators, and leaders working to improve clinical outcomes, increase patient satisfaction, and promote high-value care. Health Quality Ontario (HQO) has been tasked by Ontario’s Ministry of Health and Long-Term Care (MOHLTC) to manage the newly created ED RV Quality Program (RVQP), which mandates EDs participating in the Pay-for-Results (P4R) program to audit a minimum of 25-50 RVs/year. The goal of the first-ever ED-specific province-wide Quality Improvement (QI) initiative of this kind is to promote a culture of QI that will lead to improved patient care. Methods: Participating hospitals receive quarterly confidential reports from Access to Care (ATC) that show their and other hospitals’ rates of RVs, as well as identifying information for patients meeting RV inclusion criteria at their ED (within 72 hrs of index visit, or within 7 days with specific diagnoses). HQO has partnered with QI experts and ED physician-leaders to develop various guidance materials. These materials have been disseminated through various media. Hospitals are conducting audits to identify underlying quality issues, take steps to address the underlying causes, and submit reports to HQO. A taskforce will then analyze clinical observations, summarize key findings and lessons learned, and share improvements at a provincial level through an annual report. Results: Since its launch in April 2016, 73 P4R and 16 voluntarily enrolled non-P4R hospitals (which collectively receive approximately 90% of ED visits in the province) are participating in the RVQP. ED leaders have engaged their hospital’s leadership to leverage interest and resources to improve patient care in the ED. To date, hospitals have conducted thousands of audits and have identified quality and safety gaps to address, which will be analyzed in February 2017 for reporting shortly thereafter. These will inform QI endeavours locally and provincially, and be the largest source of such data ever created in Ontario. Conclusion: The ED RVQP aims to create a culture of continuous QI in the Ontario health care system, which provides care to over 13.8 million people. Other jurisdictions can replicate this model to promote high-quality care.

Prescribing an App? Oncology Providers’ Views on Mobile Health Apps for Cancer Care

2017 ◽  
pp. 1-7 ◽  
Author(s):  
Callie M. Berkowitz ◽  
Leah L. Zullig ◽  
Bridget F. Koontz ◽  
Sophia K. Smith
Keyword(s):  
Patient Care ◽  
Health Care Providers ◽  
Mobile Health ◽  
Cancer Care ◽  
Structured Interview ◽  
Mobile App ◽  
Care Providers ◽  
Supportive Services ◽  
Wide Range ◽  
Oncology Providers

Introduction Although there are over 500 mobile health (mHealth) applications (apps) available for download in the field of oncology, little research has addressed their acceptability among health care providers. In addition, the providers’ perspectives regarding patient app use has been largely unexamined. We conducted a qualitative study to explore opportunities and barriers for mHealth app use for oncology care. Methods We developed a structured interview guide focusing on acceptability, appropriateness, feasibility, and sustainability of the use of apps in cancer care. We interviewed 15 oncology providers about their attitudes and preferences. De-identified audio recordings were transcribed and coded for emerging themes. Results Providers interviewed included physicians (n = 8) and advanced practice (n = 3) and supportive services (n = 4) providers who care for a wide range of cancer types; ages ranged from 32 to 68 years. Interviews lasted approximately 30 minutes. Oncology providers reported limited exposure to mHealth apps in patient care, but were generally open to recommending or prescribing apps in the future. Key themes included opportunities for mobile app use (including general health promotion, tracking symptoms, and engaging patients) and barriers to implementation (including access to technology, responsibility, workflow, and the source of the app itself). Conclusion Our results show openness among oncology providers to using mHealth technology as part of patient care, but concerns regarding implementation. Designing acceptable apps may be challenging and require involvement of key stakeholders, partnering with trustworthy institutions, and outcome-based research.

scholarly journals The Use of Electronic Health Record Systems During COVID-19 at a Local Community Hospital on the West Coast

2021 ◽  
pp. 53-58
Author(s):  
Malini Krishnamurthi, Ph.D.
Keyword(s):  
Health Care ◽  
Electronic Health Record ◽  
Patient Care ◽  
Data Privacy ◽  
Local Community ◽  
Quality Care ◽  
The United States ◽  
Health Record ◽  
Privacy And Security ◽  
Electronic Health

The United States Federal government looks toward information technology to curtail health care costs while increasing the quality of patient care through the adoption of electronic health record (EHR)systems. This paper examined the experience of a hospital with its EHR system in the context of the pandemic. Results showed that the hospital maintains a state-of-the-art health care system to provide quality care to its community and was responsive to the recent crisis. The results were consistent with other comparable hospitals examined in this study. The hospitals were successful in adopting EHR systems. They were able to identify gaps that could be filled with technology add-ons from different software vendors to improve their functionality and thereby provide better & timely patient care. Managing large volumes of data generated in the normal process of EHR operation and ensuring data privacy and security were the significant challenges faced and are likely to continue in the future.

scholarly journals Hospital accreditation and patient care, a dilemma?

2021 ◽  
Vol 87 (2) ◽  
pp. 205-210
Author(s):  
Yves Fortems ◽  
Elke Van Eynde ◽  
Charlotte Fortems
Keyword(s):  
Patient Care ◽  
Quality Care ◽  
Improve Patient Care ◽  
Conclusive Evidence ◽  
Medical Professionals ◽  
End User ◽  
Safety Issues ◽  
Hospital Patients ◽  
Quality Programs ◽  
Improve Patient

Despite the massive financial and human efforts of hospitals in the Flemish part of Belgium to increase quality through the path of external accreditation, so far this has not convinced the end user, in casu the patient. In this study of 307 hospital patients we conclude that the knowledge about accreditation is very limited to none existent (2%) in a sample of Belgian patients not working in medical practice and that patients do not choose their hospital care in accordance to the accreditation status of the hospital. We remain convinced that improving quality is a continuous concern for medical professionals and hospital management. However, we believe that patients, medical professionals and hospital managers might define quality care in a somewhat different way and we question the methodology of imposing a 2 vast amount of strict protocols as a way to improve quality in patient care. There is no conclusive evidence to support that these uniformly imposed “quality programs” improve patient care, except on safety issues.

scholarly journals Maternal mortality in Ghana: an exploration of partners’ perception about factors that contributed to their wife’s death

2017 ◽  
Vol 4 (11) ◽  
pp. 4018 ◽  
Author(s):  
Diana Mawuko Adika ◽  
Muhammad Chutiyami ◽  
Hamina Dathini ◽  
Haruna Adamu
Keyword(s):  
Maternal Mortality ◽  
Health Facility ◽  
Health Care Services ◽  
Quality Care ◽  
Structured Interview ◽  
Sub Saharan Africa ◽  
Phone Call ◽  
Physical Factors ◽  
Quality Health Care ◽  
Published Evidence

Background: Many programmes were put in place internationally and locally to curtail the menace of maternal mortality, but little achievement has been made in certain parts of the world, particularly in sub-Saharan Africa. A number of literatures exist, which investigate into the predisposing factors of maternal mortality in Ghana, however, no published evidence as the time of conducting this study explore the perception of men with respect to maternal mortality. This study aims to explore the perceptions of men who have lost their wives about the factors that contributed to their wife’s death in Accra, Ghana.Methods: A qualitative phenomenological approach was adopted, using an in-depth semi-structured interview conducted via a phone call, which was recorded and transcribed. Ten men participated in the study. The data was analysed using narrative synthesis through identification of themes/sub-themes. Results: It was identified that physical, cultural and socio-economic factors were responsible for the death of men’s wives on the course of pregnancy. The major physical factors include direct causes of maternal mortality notably haemorrhage, delay in reaching health facility and delay from the health facility. The cultural factors mainly include seeking care from unskilled attendants and use of traditional preparations to aid delivery. Lastly, poor socio-economic status was blamed by majority of the participants, which impedes them from accessing quality care within shortest period of time. Conclusions: Men perceived factors predisposing to maternal mortality in Accra, Ghana were avoidable with quality health care services and improved access to the health facilities. 

scholarly journals Knowledge, Attitude And Health Belief (KAHB) On Cancer And Its Treatment: Qualitative Exploration Of Cancer Patients in Penang, Malaysia

2021 ◽  
Vol 6 (16) ◽  
Author(s):  
Che Noriah Othman ◽  
Syed Azhar Syed Sulaiman ◽  
Maryam Farooqui ◽  
Wan Ismahaniza Ismail
Keyword(s):  
Cancer Patients ◽  
Treatment Effectiveness ◽  
Publishing House ◽  
Health Belief ◽  
Structured Interview ◽  
Positive Health ◽  
Related Quality ◽  
Health Related ◽  
International Publishing ◽  
Qualitative Exploration

Knowledge, attitude, and health belief (KAHB) on cancer and treatment among cancer patients are essential for better clinical outcomes. This study measured KAHB among cancer patients in Penang, Malaysia. Using a semi-structured interview guide, we recorded the information. After transcribing the data, we analyzed them and reached saturation at patients no 18. Results revealed that knowledge on cancer was moderate, the attitude toward cancer was positive. Health belief on cancer was various; however, most believe that the treatment they received would heal their cancer. The correct information is crucial to ensure treatment effectiveness, thus better health-related quality of life. Keywords: Knowledge, Attitude, Health Belief, Cancer. eISSN: 2398-4287© 2021. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians/Africans/Arabians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI:

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