Patient experience

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Patient experience describes the range of interactions that patients have with the healthcare system, including care from health plans, doctors, nurses, and staff in hospitals, physician practices, and other healthcare facilities. [1] [2] Understanding patient experience is a key step in moving toward patient-centered care. [3] [4] Evaluating patient experience provides a complete picture of healthcare quality. It reflects whether patients are receiving care that is respectful of and responsive to their preferences, needs, and values.

Contents

Key Aspects

Patient experience can be categorized into eight key aspects: [5]

These aspects collectively contribute to a patient-centered approach, emphasizing the importance of responsiveness and respect in healthcare delivery.

Patient experience vs. patient satisfaction

The terms patient experience and patient satisfaction are often used interchangeably but have distinct meanings: [6]

Patient experience is often reported in health research as also encompassing people's experiences of illness and injury outside of their experiences with health services, such as those experiences with family and friends, the influence of illness/injury over their capacity to engage in social activities or previously imagined futures, [7] and even their engagement with the development of the guidelines that will inform their treatment. [8] For example, researchers might report of the patient experience of living with heart failure [9] or other chronic illnesses. [10]

Measurement

Using a combination of objective and subjective interactions, perceptions, affect, and outcome metrics helps capture the complex and dynamic nature of patient experience. Patient Experience Metrics (Godovykh & Pizam, 2023).png
Using a combination of objective and subjective interactions, perceptions, affect, and outcome metrics helps capture the complex and dynamic nature of patient experience.

Patient experience has become a key quality outcome for healthcare; measuring it is seen to support improvement in healthcare quality, governance, public accountability and patient choice. [11] Measures of patient experience arose from work in the 1980s and is now there use is now widescale. However, their effectiveness has been questioned [12] and clinicians and managers may disagree about their use. [13] There is a general agreement in the literature that measuring patient experience can be accomplished using a quantitative, qualitative, or mixed-methods approach.

Effective measurement of patient experience is essential for improving healthcare quality. Key methods include:

CAHPS Surveys

CAHPS (Consumer Assessment of Healthcare Providers and Systems) surveys are critical tools for assessing patient-centered care. [14] These standardized instruments ask patients about their experiences, such as communication with providers, staff responsiveness, and ease of accessing information. CAHPS surveys do not measure satisfaction but focus on reporting patient experiences to ensure consistency and reliability across healthcare systems.

Other Surveys

Other tools, such as the Picker Patient Experience Questionnaire and NHS Patient Surveys, gather standardized feedback on aspects like cleanliness, courtesy, and timeliness. [15] Surveys provide large datasets for benchmarking and comparative analysis but are limited by memory bias and predefined topics.

Patient Interviews

Interviews provide qualitative insights, uncovering emotional and interpersonal factors influencing patient perceptions. They are valuable for exploring sensitive issues, though they require significant time and resources.

Focus Groups

These sessions bring together patients with shared experiences to explore common themes. [16] They are effective for testing new healthcare initiatives but require skilled facilitation to ensure all voices are heard.

Experience Sampling

This method captures real-time data on patients’ emotions and reactions during their care journey, reducing recall bias. [17] Mobile apps and text prompts facilitate this approach, though frequent prompts may feel intrusive.

Psychophysiological Techniques

Tools such as heart rate variability monitoring, facial expression analysis, and eye-tracking provide objective data on stress, comfort, and engagement. Though resource-intensive, these techniques offer unique insights into patient experiences. [18]

Sentiment Analysis

Using natural language processing (NLP), this method analyzes patient reviews and open-ended feedback to identify trends and priorities for improvement. It is particularly valuable for capturing insights from patients who do not participate in traditional surveys.

Experimental Design

By testing specific interventions (e.g., empathy training for staff), experimental designs evaluate the impact of targeted strategies on patient experience. This approach supports evidence-based decision-making but requires careful planning and ethical considerations.

By utilizing a combination of objective and subjective interactions, perceptions, affect, and outcome metrics, healthcare providers can effectively capture the complex and dynamic nature of patient experience. [1] This multifaceted approach leverages the strengths of various measurement methods, resulting in more comprehensive insights and enabling targeted improvements in patient-centered care.

See also

Related Research Articles

Palliative care is an interdisciplinary medical caregiving approach aimed at optimizing quality of life and mitigating suffering among people with serious, complex, and often terminal illnesses. Within the published literature, many definitions of palliative care exist. The World Health Organization (WHO) describes palliative care as

"an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual".

A clinical decision support system (CDSS) is a health information technology that provides clinicians, staff, patients, and other individuals with knowledge and person-specific information to help health and health care. CDSS encompasses a variety of tools to enhance decision-making in the clinical workflow. These tools include computerized alerts and reminders to care providers and patients, clinical guidelines, condition-specific order sets, focused patient data reports and summaries, documentation templates, diagnostic support, and contextually relevant reference information, among other tools. CDSSs constitute a major topic in artificial intelligence in medicine.

In the healthcare industry, pay for performance (P4P), also known as "value-based purchasing", is a payment model that offers financial incentives to physicians, hospitals, medical groups, and other healthcare providers for meeting certain performance measures. Clinical outcomes, such as longer survival, are difficult to measure, so pay for performance systems usually evaluate process quality and efficiency, such as measuring blood pressure, lowering blood pressure, or counseling patients to stop smoking. This model also penalizes health care providers for poor outcomes, medical errors, or increased costs. Integrated delivery systems where insurers and providers share in the cost are intended to help align incentives for value-based care.

<span class="mw-page-title-main">Self-care</span> Taking care of ones own health

Self-care has been defined as the process of establishing behaviors to ensure holistic well-being of oneself, to promote health, and actively manage illness when it occurs. Individuals engage in some form of self-care daily with food choices, exercise, sleep, and hygiene. Self-care is not only a solo activity, as the community—a group that supports the person performing self-care—overall plays a role in access to, implementation of, and success of self-care activities.

Transitional care refers to the coordination and continuity of health care during a movement from one healthcare setting to either another or to home, called care transition, between health care practitioners and settings as their condition and care needs change during the course of a chronic or acute illness. Older adults who suffer from a variety of health conditions often need health care services in different settings to meet their many needs. For young people the focus is on moving successfully from child to adult health services.

Chronic care management encompasses the oversight and education activities conducted by health care professionals to help patients with chronic diseases and health conditions such as diabetes, high blood pressure, systemic lupus erythematosus, multiple sclerosis, and sleep apnea learn to understand their condition and live successfully with it. This term is equivalent to disease management for chronic conditions. The work involves motivating patients to persist in necessary therapies and interventions and helping them to achieve an ongoing, reasonable quality of life.

Evidence-based nursing (EBN) is an approach to making quality decisions and providing nursing care based upon personal clinical expertise in combination with the most current, relevant research available on the topic. This approach is using evidence-based practice (EBP) as a foundation. EBN implements the most up to date methods of providing care, which have been proven through appraisal of high quality studies and statistically significant research findings. The goal of EBN is to improve the health and safety of patients while also providing care in a cost-effective manner to improve the outcomes for both the patient and the healthcare system. EBN is a process founded on the collection, interpretation, appraisal, and integration of valid, clinically significant, and applicable research. The evidence used to change practice or make a clinical decision can be separated into seven levels of evidence that differ in type of study and level of quality. To properly implement EBN, the knowledge of the nurse, the patient's preferences, and multiple studies of evidence must all be collaborated and utilized in order to produce an appropriate solution to the task at hand. These skills are taught in modern nursing education and also as a part of professional training.

Outcomes research is a branch of public health research which studies the end results of the structure and processes of the health care system on the health and well-being of patients and populations. According to one medical outcomes and guidelines source book - 1996, Outcomes research includes health services research that focuses on identifying variations in medical procedures and associated health outcomes. Though listed as a synonym for the National Library of Medicine MeSH term "Outcome Assessment ", outcomes research may refer to both health services research and healthcare outcomes assessment, which aims at health technology assessment, decision making, and policy analysis through systematic evaluation of quality of care, access, and effectiveness.

<span class="mw-page-title-main">Quality of life (healthcare)</span> Notion in healthcare

In general, quality of life is the perceived quality of an individual's daily life, that is, an assessment of their well-being or lack thereof. This includes all emotional, social and physical aspects of the individual's life. In health care, health-related quality of life (HRQoL) is an assessment of how the individual's well-being may be affected over time by a disease, disability or disorder.

Patient participation is a trend that arose in answer to medical paternalism. Informed consent is a process where patients make decisions informed by the advice of medical professionals.

Minimally disruptive medicine is an approach to patient care in chronic illness proposed by Carl R May, Victor Montori, and Frances Mair. In a 2009 article in the British Medical Journal they argued that the burden of illness has its counterpart in the burden of treatment. As medical responses to illness have become more sophisticated, the burden of treatment has grown, and includes increasingly complex techniques and health technologies that must be routinely incorporated in everyday life by their users. minimally disruptive medicine is an approach to designing patient care that seeks to consider the effects of treatment work, and in particular to prevent overburdening patients. Overburdening leads, May, Montori and Mair argued, to structurally induced non-compliance with treatment, in which it becomes progressively more difficult for patients – especially older patients with multiple long-term conditions – to meet the demands that therapeutic regimens place upon them. minimally disruptive medicine has a theoretical basis in Normalization Process Theory, which explains the processes by which treatment regimens and other ensembles of cognitive, behavioural and technical practices are routinely incorporated in everyday life.

In United States healthcare, service excellence is the ability of the provider to consistently meet and manage patient expectations. Clinical excellence must be the priority for any health care system. However, the best healthcare systems combine professional (clinical) service excellence with outstanding personal service. Although health care in the United States is touted as the “world’s largest service industry,” the quality of the service is infrequently discussed in medical literature. Thus, many questions regarding service excellence in healthcare largely remain unanswered.

Consumer Assessment of Healthcare Providers and Systems (CAHPS) refers to a set of surveys that ask patients to report on their health care experiences. The surveys are free to anyone who wants to use them. They focus on aspects of healthcare quality that patients find important and are well-equipped to assess, such as the communication skills of providers and ease of access to healthcare services. To customize a standardized CAHPS survey, users can add questions on a variety of topics.

The Patient-Reported Outcomes Measurement Information System (PROMIS) provides clinicians and researchers access to reliable, valid, and flexible measures of health status that assess physical, mental, and social well–being from the patient perspective. PROMIS measures are standardized, allowing for assessment of many patient-reported outcome domains—including pain, fatigue, emotional distress, physical functioning and social role participation—based on common metrics that allow for comparisons across domains, across chronic diseases, and with the general population. Further, PROMIS tools allow for computer adaptive testing, efficiently achieving precise measurement of health status domains with few items. There are PROMIS measures for both adults and children. PROMIS was established in 2004 with funding from the National Institutes of Health (NIH) as one of the initiatives of the NIH Roadmap for Medical Research.

Health care quality is a level of value provided by any health care resource, as determined by some measurement. As with quality in other fields, it is an assessment of whether something is good enough and whether it is suitable for its purpose. The goal of health care is to provide medical resources of high quality to all who need them; that is, to ensure good quality of life, cure illnesses when possible, to extend life expectancy, and so on. Researchers use a variety of quality measures to attempt to determine health care quality, including counts of a therapy's reduction or lessening of diseases identified by medical diagnosis, a decrease in the number of risk factors which people have following preventive care, or a survey of health indicators in a population who are accessing certain kinds of care.

<span class="mw-page-title-main">National Research Corporation</span> US healthcare consumer data mining company

National Research Corporation, doing business as NRC Health, is a company which provides healthcare products and subscription-based solutions in United States and Canada. It was founded in 1981 and is currently based in Lincoln, Nebraska.

Patient satisfaction is a measure of the extent to which a patient is content with the health care which they received from their health care provider.

<span class="mw-page-title-main">Cultural competence in healthcare</span> Health care services that are sensitive and responsive to the needs of diverse cultures

Cultural competence in healthcare refers to the ability for healthcare professionals to demonstrate cultural competence toward patients with diverse values, beliefs, and feelings. This process includes consideration of the individual social, cultural, and psychological needs of patients for effective cross-cultural communication with their health care providers. The goal of cultural competence in health care is to reduce health disparities and to provide optimal care to patients regardless of their race, gender, ethnic background, native languages spoken, and religious or cultural beliefs. Cultural competency training is important in health care fields where human interaction is common, including medicine, nursing, allied health, mental health, social work, pharmacy, oral health, and public health fields.

Press Ganey Associates is a South Bend, Indiana-based health care company known for developing and distributing patient satisfaction surveys. As of January 2017, its Medical Practice Survey was the most widely used outpatient satisfaction survey in the United States.

Value-based health care (VBHC) is a framework for restructuring health care systems with the overarching goal of value for patients, with value defined as health outcomes per unit of costs. The concept was introduced in 2006 by Michael Porter and Elizabeth Olmsted Teisberg, though implementation efforts on aspects of value-based care began long before them in the 1990s. VBHC emphasizes systematic measurement of outcomes and costs, restructuring provider organizations, and transitioning toward bundled payments.

References

  1. 1 2 Godovykh, Maksim; Pizam, Abraham (2023-07-01). "Measuring patient experience in healthcare". International Journal of Hospitality Management. Hospitality in Healthcare. 112: 103405. doi:10.1016/j.ijhm.2022.103405. ISSN   0278-4319.
  2. ↑ "Home". The Beryl Institute. Retrieved 2024-12-15.
  3. ↑ Ahmed F, Burt J, Rowland M: Measuring patient experience: concepts and methods. In The Patient - Patient-Centered Outcomes Research. doi:10.1007/s40271-014-0060-5.
  4. ↑ Mirzaei, M., Aspin, C., Essue, B., Jeon, Y. H., Dugdale, P., Usherwood, T., & Leeder, S. (2013). A patient-centred approach to health service delivery: improving health outcomes for people with chronic illness. BMC health services research, 13(1), 251.
  5. ↑ "What Is Patient Experience?". www.ahrq.gov. Retrieved 2024-12-15.
  6. ↑ Friedel, Anna Lena; Siegel, Sonja; Kirstein, Cedric Fabian; Gerigk, Monja; Bingel, Ulrike; Diehl, Anke; Steidle, Oliver; Haupeltshofer, Steffen; Andermahr, Bernhard; Chmielewski, Witold; Kreitschmann-Andermahr, Ilonka (2023-03-08). "Measuring Patient Experience and Patient Satisfaction—How Are We Doing It and Why Does It Matter? A Comparison of European and U.S. American Approaches". Healthcare. 11 (6): 797. doi: 10.3390/healthcare11060797 . ISSN   2227-9032. PMID   36981454.
  7. ↑ Bury, M. (1982). Chronic illness as biographical disruption. Sociology of health & illness, 4(2), 167-182.
  8. ↑ Khodyakov, Dmitry; Denger, Brian; Sean Grant DPhil; Armstrong, Courtney; Ann Martin; Peay, Holly; Coulter, Ian; Hazlewood, Glen (2019). "The RAND/PPMD Patient-Centeredness Method: a novel online approach to engaging patients and their representatives in guideline development". European Journal for Person Centered Healthcare. 7 (3): 470–475. doi:10.5750/ejpch.v7i3.1750 (inactive 1 November 2024). PMC   8281319 . PMID   34277012.{{cite journal}}: CS1 maint: DOI inactive as of November 2024 (link)
  9. ↑ Jeon, Y. H., Kraus, S. G., Jowsey, T., & Glasgow, N. J. (2010). The experience of living with chronic heart failure: a narrative review of qualitative studies. BMC health services research, 10(1), 77.
  10. ↑ Jeon, Y. H., Jowsey, T., Yen, L., Glasgow, N. J., Essue, B., Kljakovic, M., ... & Kraus, S. G. (2010). Achieving a balanced life in the face of chronic illness. Australian Journal of Primary Health, 16(1), 66-74.
  11. ↑ Benson T, Potts HWW (2014). A short generic patient experience measure: howRwe development and validation. BMC Health Services Research, 14, 499. doi:10.1186/s12913-014-0499-z
  12. ↑ Haugum M, Danielsen K, Iversen HH, Bjertnaes O: The use of data from national and other large-scale user experience surveys in local quality work: a systematic review.International J Qual Health Care 2014:1;14. doi:10.1093/intqhc/mzu077
  13. ↑ Rozenblum R, Lisby M, Hockey P, Levtzion-Korach O, Salzberg C, Efrati N, Lipsitz S, Bates D: The patient satisfaction chasm: the gap between hospital management and frontline clinicians. BMJ Qual Saf 2013, 22:242-250
  14. ↑ Holt, Jeana M (2018-08-12). "Patient Experience in Primary Care: A Systematic Review of CG-CAHPS Surveys". Journal of Patient Experience. 6 (2): 93–102. doi:10.1177/2374373518793143. ISSN   2374-3735. PMC   6558944 . PMID   31218253.
  15. ↑ Reeves, R; Seccombe, I (2008-12-01). "Do patient surveys work? The influence of a national survey programme on local quality-improvement initiatives". Quality and Safety in Health Care. 17 (6): 437–441. doi:10.1136/qshc.2007.022749. ISSN   1475-3898.
  16. ↑ Lehoux, Pascale; Poland, Blake; Daudelin, Genevieve (October 2006). "Focus group research and "the patient's view"". Social Science & Medicine. 63 (8): 2091–2104. doi:10.1016/j.socscimed.2006.05.016. ISSN   0277-9536. PMID   16797811.
  17. ↑ Larson, Reed; Csikszentmihalyi, Mihaly (2014), "The Experience Sampling Method", Flow and the Foundations of Positive Psychology, Dordrecht: Springer Netherlands, pp. 21–34, doi:10.1007/978-94-017-9088-8_2, ISBN   978-94-017-9087-1 , retrieved 2024-12-15
  18. ↑ Yang, Michelle; Mady, Noor; Linnaranta, Outi (September 2021). "Utility of Psychophysiological Metrics in Guiding Treatment of Trauma Symptoms: A Systematic Review". Journal of Behavioral and Cognitive Therapy. 31 (3): 249–266. doi:10.1016/j.jbct.2021.01.004. ISSN   2589-9791.
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