A qualitative analysis of patients' experience with hospitalist service handovers

Wray, Charlie M; Farnan, Jeanne M.; Arora, Vineet M.; Meltzer, David O.

doi:10.1002/jhm.2608

Cited by 10 publications

(11 citation statements)

References 32 publications

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“…Whilst research has indicated that professional's expectations and experiences often are likely to influence quality of handover, results have also indicated that communication, in particular a lack of active listening, has been an issue in handovers . In a qualitative study analysing patients' experiences of handover, communication and bedside manner were also found to impact on patient satisfaction levels during the handover experience, and that patients desired improved communication during their hospital handovers . However, consistent with other studies, these issues can be averted and continuity of care can be assured if paramedics clearly communicate a client's situation and story to emergency staff as well as updating the patient about what is and will be happening.…”

Section: Discussionmentioning

confidence: 56%

“I was worried if I don’t have a broken leg they might not take it seriously”: Experiences of men accessing ambulance services for mental health and/or alcohol and other drug problems

Ferguson

Savic

McCann

et al. 2019

Health Expectations

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Background A large proportion of ambulance callouts are for men with mental health and/or alcohol and other drug (AOD) problems, but little is known about their experiences of care. This study aimed to describe men's experiences of ambulance care for mental health and/or AOD problems, and factors that influence their care. Methods Interviews were undertaken with 30 men who used an ambulance service for mental health and/or AOD problems in Australia. Interviews were analysed using the Framework approach to thematic analysis. Results Three interconnected themes were abstracted from the data: (a) professionalism and compassion, (b) communication and (c) handover to emergency department staff. Positive experiences often involved paramedics communicating effectively and conveying compassion throughout the episode of care. Conversely, negative experiences often involved a perceived lack of professionalism, and poor communication, especially at handover to emergency department staff. Conclusion Increased training and organizational measures may be needed to enhance paramedics' communication when providing care to men with mental health and/or AOD problems.

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Section: Discussionmentioning

confidence: 56%

“I was worried if I don’t have a broken leg they might not take it seriously”: Experiences of men accessing ambulance services for mental health and/or alcohol and other drug problems

Ferguson

Savic

McCann

et al. 2019

Health Expectations

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“…Our study suggests that Boyd’s findings (which excluded current inpatients) were not unduly affected by recall bias. Nonetheless, hospitalised patients remain relatively indifferent to service-level performance and change 14. We suggest an explanation for this: current inpatients are unable to exercise informed choices about their ward, nor are they able to directly use information to improve performance.…”

Section: Discussionmentioning

confidence: 87%

What matters to medical ward patients, and do we measure it? A qualitative comparison of patient priorities and current practice in quality measurement, on UK NHS medical wards

et al. 2019

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ObjectivesTo compare the quality metrics selected for public display on medical wards to patients’ and carers’ expressed quality priorities.MethodsMultimodal qualitative evaluation of general medical wards and semi-structured interviews.SettingUK tertiary National Health Service (public) hospital.ParticipantsFourteen patients and carers on acute medical wards and geriatric wards.ResultsQuality metrics on public display evaluated hand hygiene, hospital-acquired infections, nurse staffing, pressure ulcers, falls and patient feedback. The intended audience for these metrics was unclear, and the displays gave no indication as to whether performance was improving or worsening. Interviews identified three perceived key components of high-quality ward care: communication, staff attitudes and hygiene. These aligned poorly with the priorities on display. Suboptimal performance reporting had the potential to reduce patients’ trust in their medical teams. More philosophically, patients’ and carers’ ongoing experiences of care would override any other evaluation, and they felt little need for measures relating to previous performance. The display of performance reports only served to emphasise patients’ and carers’ lack of control in this inpatient setting.ConclusionsThere is a gap between general medical inpatients’ care priorities and the aspects of care that are publicly reported. Patients and carers do not act as ‘informed choosers’ of healthcare in the inpatient setting, and tokenistic quality measurement may have unintended consequences.

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“…As medical professionals, we can speculate on what patients may want improved about hospitalization. Some studies have been conducted about particular areas, such as service handovers and food quality ( 16 – 18 ). However, this focused approach does not allow for new themes to emerge and instead assumes that the focus area is one which patients would like improved.…”

Section: Introductionmentioning

confidence: 99%

The Hospital Experience Through the Patients’ Eyes

Snyder

Fletcher

2019

Journal of Patient Experience

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Background: Posthospital syndrome is associated with a decrease in physical and cognitive function and can contribute to overall patient decline. We can speculate on contributors to this decline (eg, poor sleep and nutrition), but other factors may also contribute. This study seeks to explain how patients experience hospitalization with particular attention on what makes the hospital stay difficult. Design: Qualitative interview study using grounded theory methodology. Setting: Single-site academic medical center. Patients: Hospitalized general medicine patients. Measurements: Interviews using a semistructured interview guide. Results: We recruited 20 general medicine inpatients from an academic medical center. Of the participants, 12 were women and the mean age was 55 years (range = 22-82 years). We found 4 major themes contributing to the hospital experience: (1) hospital environment (eg, food quality and entertainment), (2) patient factors (eg, indifference and expectations), (3) hospital personnel (eg, care team size and level of helpfulness), and (4) patient feelings (eg, level of control and feeling like an object). We discovered that these emotions arising from hospital experiences, together with the other 3 major themes, led to the patients’ perception of their hospital experience overall. We also explore the role that patient tolerance may play in the reporting of patient satisfaction. Conclusions: This article demonstrates the factors affecting how patients experience hospitalization. It provides insight into possible contributors to posthospital syndrome and offers a blueprint for specific quality improvement initiatives. Lastly, it briefly explores how patient tolerance may prove a challenge to the current system of quality reporting.

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A qualitative analysis of patients' experience with hospitalist service handovers

Cited by 10 publications

References 32 publications

“I was worried if I don’t have a broken leg they might not take it seriously”: Experiences of men accessing ambulance services for mental health and/or alcohol and other drug problems

“I was worried if I don’t have a broken leg they might not take it seriously”: Experiences of men accessing ambulance services for mental health and/or alcohol and other drug problems

What matters to medical ward patients, and do we measure it? A qualitative comparison of patient priorities and current practice in quality measurement, on UK NHS medical wards

The Hospital Experience Through the Patients’ Eyes

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