Exploring the hospital patient journey: What does the patient experience?

Abstract

PurposeTo understand how different methodologies of qualitative research are able to capture patient experience of the hospital journey.MethodsA qualitative study of orthopaedic patients admitted for hip and knee replacement surgery in a 250-bed university hospital was performed. Eight patients were shadowed from the time they entered the hospital to the time of transfer to rehabilitation. Four patients and sixteen professionals, including orthopaedists, head nurses, nurses and administrative staff, were interviewed.ResultsThrough analysis of the data collected four main themes emerged: the information gap; the covering patient-professionals relationship; the effectiveness of family closeness; and the micro-integration of hospital services. The three different standpoints (patient shadowing, health professionals’ interviews and patients’ interviews) allowed different issues to be captured in the various phases of the journey.ConclusionsHospitals can significantly improve the quality of the service provided by exploring and understanding the individual patient journey. When dealing with a key cross-functional business process, the time-space dynamics of the activities performed have to be considered. Further research in the academic field can explore practical, methodological and ethical challenges more deeply in capturing the whole patient journey experience by using multiple methods and integrated tools.

What does the patient have to say? Valuing the patient experience to improve the patient journey

“…Moreover, one patient may reveal the important needs made impossible by circumstances (e.g., need of having a family member being close to the patient before surgery made impossible by hospital organisation). For example, when redesigning fast-track recovery from major orthopaedic surgery, significant touchpoints for the patient should be treated with respect to his or her need for interaction with professionals, his or her emotional state and social conditions and by considering the changing circumstances he or she will face along the journey [ 19 , 32 , 33 ]. In particular, the emotional state should be better explored to understand how this variable affects patient experience along the journey and to improve ways of interacting with the patient: by giving more information, by offering support or simply by accompanying him or her in critical moments of the presurgery period.…”

“…The type of surgery and stage of the patient journey formed the analysis groups. The study was part of a larger hospital project to redesign the orthopaedic patient journey for hip or knee replacement surgery, here starting with the patient experience [ 19 , 21 ]. In particular, the data collected by the hospital management to assess the quality of the service and that are presented in this work were integrated with interviews and the shadowing of patients, whose results are reported in other papers.…”

“…Consistent with the need to capture patient-reported data during a relatively rapid surgical pathway, the researchers chose to develop a questionnaire focused on the key themes that emerged from the results of the qualitative study previously conducted [ 19 ]. The questionnaire was developed by the first three authors to capture data on the following patient journey touchpoints: preadmission, admission to hospital, preparation for surgery, the postsurgery period and discharge.…”

“…Furthermore, it is not yet clear what the best method is for collecting patient experience data throughout the patient journey [ 19 ]. A recent study analysed the hospital stay experience through the use of unstructured diaries completed in a patient’s own words.…”

The Impact of Comorbidities on Calgary Hospital Utilization in Patients With Chronic Obstructive Pulmonary Disease and Heart Failure

“…An additional limitation is our assumption that each patient-day in hospital is valued in a consistent manner between conditions, patients, providers, and hospitals and constant regardless of length of admission. In reality, it is likely that individuals would attribute value to days in hospital differently depending on length of admission, severity of disease, and personal preferences [ 27 ]. Disease factors such as the type of HF or severity of disease affect hospitalization costs [ 28 ] and the fact that hospitals are often reimbursed for initial days in hospital at a higher rate than for subsequent days suggests that our assumption may not be true.…”