Mapping the Patient Journey Across the Continuum: Lessons Learned From One Patient’s Experience

Abstract

Patient-centered care is essential for achieving high-quality and cost-effective health care. This is particularly important for patients with chronic or complex conditions who utilize more health-care services and require comprehensive care coordination. This case report draws on a longitudinal journey map—a valuable tool to capture patient experience and inform the care process—for a patient with multiple chronic conditions who needed a hip replacement. An analysis of the patient journey revealed 3 critical needs for a more patient-centered process: (1) making the patient health goal visible; (2) instigating transparent, shared decision-making; and (3) using a closed-loop communication process. Although key challenges exist, systems can facilitate more patient-centered care enabling health-care organizations to improve the patient experience across the continuum and provide higher quality care.

Definition and conceptualization of the patient-centered care pathway, a proposed integrative framework for consensus: a Concept analysis and systematic review

“… NR Low De Belvis et al, 2019 [ 55 ] Italy Descriptive cross-sectional stud Clinical pathway Ischemic stroke Systemic Italian teaching hospital 483 stroke patients Electronic records ( n = 483) High Gualandi et al, 2019 [ 14 ] Italy Qualitative Patient journey Hip and knee replacement surgery Organizational 250-bed Italian teaching hospital Patients and professionals Interviews (n = 20), patient shadowing (n = 8) High Louis et al, 2019 [ 56 ] United States of America Qualitative Patient-centered care Breast cancer Systemic Three health systems Physician, inpatient and outpatient nursing, patient navigation, clinical trials, genetics, and care coordination. Interviews ( n = 30) High Meyer, 2019 [ 57 ] United States of America Mixed-method Patient journey Multiple chronic conditions Systemic Large health system and its care partners NR NR Low Schildmeijer et al, 2019 [ 15 ] Sweden Qualitative Standardized care pathway Prostate Cancer Systemic Midsized hospital in southeast Sweden Professionals and patients Interviews ( n = 14) Medium Fung-Kee-Fung et al, 2018 [ 4 ] Canada Mixed-method Care process Lung Cancer Care Systemic A regional Community of Practice, Ottawa Professionals, patients and caregivers. Interviews ( n = 68), Quantitative data (NR) Low Kelly et al, 2018 [ 1 ...…”

“…Beyond the simple satisfaction, the provision of information, at an appropriate health literacy level, increases patient awareness [ 36 , 51 ] and thus increases patient education. This results in a better detection of the symptoms at an early stage by the patient [ 3 , 36 ], the development of the “expert patient” [ 51 , 57 , 58 , 71 ], which aids adherence to treatment, supports shared decision-making [ 57 ] and improves self-management [ 51 , 58 ]. However, many empirical studies showed there to be a lack of patient information throughout patient journeys [ 5 , 14 , 15 , 42 , 51 , 53 , 64 ].…”

Post‐acute health care needs of people with head and neck cancer: Mapping health care services, experiences, and the impact of rurality

“…32 Previous use of journey mapping in the evaluation of rural renal health care found the process beneficial for structuring and organizing case study data when planning the transfer of care from a metropolitan facility to local services. 33 In this study, we adapted and modified a longitudinal patient journey map published by Meyer 34 as this framework allowed for the presentation of a large number of separate touch points. Details of each appointment were recorded as a separate touch point and listed consecutively by date.…”

The role of evaluation in iterative learning and implementation of quality of care interventions

“…A key role for evaluations is thus to more clearly map the continuum as well as the gaps in such a continuum. One important purpose of evaluations will involve following women longitudinally across their journeys 46 through the continuum of care of the maternal health system. In fulfilling these functions, evaluations should consider some of the following questions What are critical gaps in the continuum of care?…”