scholarly journals Striking a balance: Health care providers’ experiences with home-based, patient-centered care for older people—A meta-synthesis of qualitative studies

2019 ◽  
Vol 102 (11) ◽  
pp. 1991-2000 ◽  
Author(s):  
Cecilie Fromholt Olsen ◽  
Astrid Bergland ◽  
Jonas Debesay ◽  
Asta Bye ◽  
Anne G. Langaas
Keyword(s):  
Health Care ◽  
Older People ◽  
Health Care Providers ◽  
Patient Centered Care ◽  
Qualitative Studies ◽  
Care Providers ◽  
Patient Centered ◽  
Home Based ◽  
Centered Care ◽  
Care For Older People

Patient Flow or the Patient’s Journey? Exploring Health Care Providers’ Experiences and Understandings of Implementing a Care Pathway to Improve the Quality of Transitional Care for Older People

2021 ◽  
pp. 104973232110038
Author(s):  
Cecilie Fromholt Olsen ◽  
Astrid Bergland ◽  
Jonas Debesay ◽  
Asta Bye ◽  
Anne Gudrun Langaas
Keyword(s):  
Health Care ◽  
Older People ◽  
Health Care Providers ◽  
Transitional Care ◽  
Care Pathway ◽  
Patient Flow ◽  
Care Pathways ◽  
Care Providers ◽  
Patient Centered ◽  
Care For Older People

Internationally, the implementation of care pathways is a common strategy for making transitional care for older people more effective and patient-centered. Previous research highlights inherent tensions in care pathways, particularly in relation to their patient-centered aspects, which may cause dilemmas for health care providers. Health care providers’ understandings and experiences of this, however, remain unclear. Our aim was to explore health care providers’ experiences and understandings of implementing a care pathway to improve transitional care for older people. We conducted semistructured interviews with 20 health care providers and three key persons, along with participant observations of 22 meetings, in a Norwegian quality improvement collaborative. Through a thematic analysis, we identified an understanding of the care pathway as both patient flow and the patient’s journey and a dilemma between the two, and we discuss how the negotiation of conflicting institutional logics is a central part of care pathway implementation.

Psychometric Evaluation of the Korean Version of Patient-Centered Care Scale for Hospital Nurses

2018 ◽  
Vol 42 (3) ◽  
pp. 344-365 ◽  
Author(s):  
Yun Mi Lee ◽  
Ju-Eun Song ◽  
Chanhee Park ◽  
Youn-Jung Son
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Goodness Of Fit ◽  
Discriminant Validity ◽  
Patient Centered Care ◽  
Care Providers ◽  
University Hospitals ◽  
Patient Centered ◽  
Korean Version ◽  
Centered Care

Patient-centered care (PCC) encourages active collaboration and effective communication among patients, their family caregivers, and health-care providers to achieve high-quality care. Despite its importance, there is no validated and reliable Korean instrument for assessing PCC among health-care providers yet. This study aimed to establish a Korean version of the PCC (K-PCC) Scale using international translation guidelines and systematically evaluating its psychometric properties. The participants in this study were 424 nurses with a mean age of 28.07 years (±4.56) from two university hospitals in South Korea. Confirmatory factor analysis identified that the revised model, which included three factors (holistic, collaborative, and responsive care), had a satisfactory goodness of fit. The testing of item convergent and item-discriminant validity revealed a 100% scaling success. Criterion validity showed that nurses who had positive perceptions of K-PCC were more likely to practice PCC ( r = .692, p < .001). The internal consistency for 23 items as a whole was good, at .935. From these results, K-PCC is considered a valid and reliable instrument for measuring health-care providers’ perceptions of PCC among Korean populations. Scale brevity and simplicity, together with rigorous testing, indicate that validation of the PCC Scale may be helpful for ensuring quality improvement in hospital settings.

scholarly journals Discussion of patient centered care in health organizations

2021 ◽  
Author(s):  
Suzanne Fredericks ◽  
Jennifer L. Lapum ◽  
Jasna Schwind ◽  
Heather Beanlands ◽  
Daria Romaniuk ◽  
...  
Keyword(s):  
Health Care ◽  
Social Theory ◽  
Health Care Providers ◽  
Health Care Organizations ◽  
Patient Centered Care ◽  
Critical Social Theory ◽  
Care Providers ◽  
Patient Centered ◽  
Health Organizations ◽  
Centered Care

The tradition of inherent knowledge and power of health care providers stands in stark contrast to the principles of self-determination and patient participation in patient centered care. At the organizational level, patient centered care is a merging of patient education, self-care, and evidence-based models of practice and consists of 4 broad domains of intervention including communication, partnerships, health promotion, and physical care. As a result of the unexamined discourse of knowledge and power in health care, the possibilities of patient centered care have not been fully achieved. In this article, we employ a critical social theory lens to examine the discursive influence of power upon the integration of patient centered care into health care organizations. We begin with an overview of patient centered care, followed by a discussion of the various ways that it has been introduced into health care organizations. We proceed by deconstructing the inherent power and knowledge of health care providers and shed light on how these long standing traditions have impeded the integration of patient centered care. We conclude with a discussion of viable solutions that can be used to implement patient centered care into health care organizations. This article presents a perspective through which the integration of patient centered care into health organizations can be examined. Keywords: patient centered care, critical social theory, biomedical knowledge, power, health care organization.

scholarly journals Understanding Patient Expectations of Health Care: A Qualitative Study

2020 ◽  
Vol 7 (6) ◽  
pp. 1724-1731 ◽  
Author(s):  
Carlos El-Haddad ◽  
Iman Hegazi ◽  
Wendy Hu
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Patient Centered Care ◽  
Patient Expectations ◽  
Care Providers ◽  
Structured Interviews ◽  
Patient Centered ◽  
Measurement Tools ◽  
Metropolitan Hospital ◽  
Centered Care

Understanding and measuring patient expectations of health care is central to improving patient satisfaction and delivering patient-centered care. However, most empiric research in this field has focused on measuring patient expectations for specific diseases only. Patient expectations common to a variety of settings and clinical contexts need to be better understood to design measures with wider utility. We aimed to understand how patients express and conceptualize their expectations of health care across a range of clinical contexts and conditions. Semi-structured interviews were conducted with patients presenting to a major metropolitan hospital, informed by interpretive phenomenological analysis. Sampling continued until thematic saturation. Interview topics explored the illness experience, interactions with clinicians, how patients communicated and conceptualized their expectations of health care, and the nature of these expectations. The 26 participants conceptualized and described their expectations in 3 distinct domains: (1) health outcomes, (2) individual clinicians, and (3) the health-care system. Importantly, these domains were consistent across a variety of clinical contexts, participant demographics, and medical conditions. Despite variation in expectations due to individual patient circumstances, we identified 3 conceptual domains within which expectations consistently lie. When designing measurement tools for patient expectations, we suggest incorporating questions specifically addressing the 3 domains we have identified. With such measures, clinicians and health-care providers can be empowered to provide and monitor patient-centered care with outcomes tailored to what patients desire.

scholarly journals Dissatisfaction between medical providers and patients in the Republic of Kazakhstan.

2020 ◽  
Author(s):  
Anara Zhumadilova ◽  
Aizhan Kozhakhmetova ◽  
Gaukhar Kuanyshbayeva ◽  
Madina Kazhen ◽  
Amina Akhmadiyeva ◽  
...  
Keyword(s):  
Health Care ◽  
Life Satisfaction ◽  
Health Care Providers ◽  
Patient Centered Care ◽  
Care Providers ◽  
Patient Centered ◽  
Patient Dissatisfaction ◽  
Centered Care ◽  
The Republic ◽  
The City

Abstract Background: Dissatisfaction among patients towards health care providers remains a serious concern in the Republic of Kazakhstan that requires further attention [1,2,3,4,5]. Patient-centered care, trust between patients and medical providers, the involvement of patients in their own treatment process, and effective communication are major areas in need of strengthening in order to improve outcomes of medical care [6-10]. The objective of this study was to broaden the investigation of patient dissatisfaction to various departments from different medical facilities in the city of Nur-Sultan and examine additional factors that may be influencing provider-patient communication and contributing to patient dissatisfaction. Methods: This cross-sectional study of 500 patients (response rate, 85.4%) and 500 health care providers (response rate, 86.4%) from one private and one state hospitals and two state policlinics in the city of Nur-Sultan, Kazakhstan, used questionnaires containing the Patient-Practitioner Orientation Scale (PPOS) and scales assessing life and job satisfaction, job effort-job reward balance, and patient evaluation of communication. Results: Our study showed that the majority of health care providers and even patients were doctor-centered as opposed to patient-centered in their expectations of the doctor visit. The patient-centered orientation of health care providers was negatively correlated with age (P=0.000218) and life satisfaction (P=0.000001). In patients, contrarily, patient-centeredness was enhanced by higher life satisfaction (P=0.040), although negatively correlated with age (P=2.659E-21). Conclusions: The results of this study demonstrate that younger health care providers and those with lower life satisfaction expect a more patient-centered approach to the doctor visit. Older respondents and those with higher life satisfaction, in contrast, reported doctor-centered attitudes. The majority of younger patients have a stronger belief in good health associated with patient centered care whereas the older population preferred a more doctor-centered approach to care. In all patients, the preference for patient-centered care was associated with higher satisfaction in life.

scholarly journals Discussion of patient centered care in health organizations

2021 ◽  
Author(s):  
Suzanne Fredericks ◽  
Jennifer L. Lapum ◽  
Jasna Schwind ◽  
Heather Beanlands ◽  
Daria Romaniuk ◽  
...  
Keyword(s):  
Health Care ◽  
Social Theory ◽  
Health Care Providers ◽  
Health Care Organizations ◽  
Patient Centered Care ◽  
Critical Social Theory ◽  
Care Providers ◽  
Patient Centered ◽  
Health Organizations ◽  
Centered Care

The tradition of inherent knowledge and power of health care providers stands in stark contrast to the principles of self-determination and patient participation in patient centered care. At the organizational level, patient centered care is a merging of patient education, self-care, and evidence-based models of practice and consists of 4 broad domains of intervention including communication, partnerships, health promotion, and physical care. As a result of the unexamined discourse of knowledge and power in health care, the possibilities of patient centered care have not been fully achieved. In this article, we employ a critical social theory lens to examine the discursive influence of power upon the integration of patient centered care into health care organizations. We begin with an overview of patient centered care, followed by a discussion of the various ways that it has been introduced into health care organizations. We proceed by deconstructing the inherent power and knowledge of health care providers and shed light on how these long standing traditions have impeded the integration of patient centered care. We conclude with a discussion of viable solutions that can be used to implement patient centered care into health care organizations. This article presents a perspective through which the integration of patient centered care into health organizations can be examined. Keywords: patient centered care, critical social theory, biomedical knowledge, power, health care organization.

scholarly journals Dissatisfaction between medical providers and patients in the Republic of Kazakhstan.

2020 ◽  
Author(s):  
Anara Zhumadilova ◽  
Aizhan Kozhakhmetova ◽  
Gaukhar Kuanyshbayeva ◽  
Madina Kazhen ◽  
Amina Akhmadiyeva ◽  
...  
Keyword(s):  
Health Care ◽  
Life Satisfaction ◽  
Health Care Providers ◽  
Response Rate ◽  
Patient Centered Care ◽  
Care Providers ◽  
Patient Centered ◽  
Continuous Increase ◽  
Centered Care ◽  
The Republic

Abstract The continuous increase in dissatisfaction among patients toward health care providers remains high in the Republic of Kazakhstan. To confirm the researcher’s previous results and see any other possible outcomes in the present study, we decided to investigate randomly selected patients and health care providers from both private and state medical hospitals. We investigated the possible factors in miscommunication between health care providers and patients to understand and discuss this demand and to develop recommendations for further improvement. The cross-sectional study of 500 patients (response rate, 85.4%) and 500 health care providers (response rate, 86.4%) from some private and state hospitals in the city of Nur-Sultan, Kazakhstan, was carried out based on their answers from a questionnaire containing the Patient-Practitioner Orientation Scale (PPOS) and scales assessing life and job satisfaction, job effort-job reward balance, and patient evaluation of communication. Our study showed that the majority of health care providers and even patients were doctor-centered. The patient-centered orientation of health care providers was negatively correlated with age (P=0.000218) and life satisfaction (P=0.000001). In patients, contrarily, patient-centeredness was enhanced by higher life satisfaction (P=0.040), although negatively correlated with age (P=2.659E-21). This study has demonstrated that younger health care providers and those with lower life satisfaction are more patient-centered. Older respondents and those with higher life satisfaction, in contrast, reported doctor-centered attitudes. The majority of younger patients have a stronger belief in good health associated with patient-centered care whereas the older population preferred a more doctor-centered care. In all patients, the preference of patient-centered care was associated with higher satisfaction in life.

Abstract 002: Patient Provider Communication and Patient-centered Outcomes Among Patients With Atherosclerotic Cardiovascular Disease in United States: Medical Expenditure Panel Survey 2010-2013

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Victor Okunrintemi ◽  
Erica Spatz ◽  
Joseph Salami ◽  
Haider Warraich ◽  
Salim Virani ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Medical Expenditure Panel Survey ◽  
Medical Expenditure ◽  
Atherosclerotic Cardiovascular Disease ◽  
Care Providers ◽  
Patient Centered ◽  
Patient Reported ◽  
Centered Care ◽  
Nationally Representative

Background: With recent enactment of Accountable Care Act, consumer reported patient-provider communication (PPC) assessed by Consumer Assessment of Health Plans Survey (CAHPS) in ambulatory settings is incorporated as a complementary value metric for patient-centered care of chronic conditions in pay-for-performance programs. In this study, we examine the relationship of PPC with select indicators of patient-centered care in a nationally representative adult US population with established atherosclerotic cardiovascular disease (ASCVD). Methods: The study population consisted of a nationally representative sample of 8223 individuals (age ≥ 18 years) representing 21.6 million with established ASCVD (self-reported or ICD-9 diagnosis) reporting a usual source of care in the 2010-2013 pooled Medical Expenditure Panel Survey (MEPS) cohort. Participants responded to questions from CAHPS that assess satisfaction with PPC (four-point response scale: never, sometimes, usually, always ) :(1) “How often providers show respect for what you had to say” (2) “How often health care providers listened carefully to you” (3) “How often health care providers explained things so you understood” (4) “How often health providers spent enough time with you” We developed a weighted PPC composite score, categorized as 1 ( never / sometimes ), 2 ( usually ), and 3 ( always ). Outcomes of interest were 1) patient reported outcomes (PRO): SF-12 physical/mental health status, 2) quality of care measures: statin and ASA use, 3) health-care resource utilization (HRU): Emergency room visits & hospital stays, 4) total annual and out of pocket healthcare expenditures (HCE). Results: As shown in the table, those with ASCVD reporting ineffective (never/sometimes) vs. effective PCC (always) were over 2-fold more likely to report poor PRO, 34% & 22% less likely to report statin and ASA use respectively, had a significantly greater HRU (OR≥ 2 ER visit: 1.40 [95% CI:1.09-1.80], OR≥ 2 hospitalization: 1.35 [95% CI:1.02-1.77], as well as an estimated $1,294 ($121-2468) higher annual HCE. Conclusion: This study reveals a strong relationship between patient-physician communication among those with established ASCVD with patient-reported outcomes, utilization of evidence based therapies, healthcare resource utilization and expenditures.

scholarly journals Instilling the core concept of inter professional education

1970 ◽  
Vol 9 (3) ◽  
pp. 201-206
Author(s):  
S Bhattacharya ◽  
SK Bhattacharya ◽  
AP Gautam
Keyword(s):  
Health Care ◽  
Health Professional ◽  
Health Care Providers ◽  
Professional Education ◽  
Care Delivery ◽  
Care Providers ◽  
Patient Centered ◽  
Innovative Teaching ◽  
Centered Care ◽  
Teaching Learning

The Inter Professional Education (IPE) is an innovative teaching learning intervention in Health Professions’ Education during which members of more than one health profession learn interactively together to improve collaborative practice and/health of the patients. Thus this approach provides positive outcomes for students enhancing their awareness towards other professional groups, improving knowledge and understanding of how to work in an inter professional team and strengthening their communication and collaboration skills. Within the hierarchical nature of many clinical settings, the aims of IPE courses intersect with socialization of health professional (HP) students into roles of responsibility and authority. The IPE in HP courses emphasizes the practice of frequent high quality communication, strong relationships and partnerships among health care providers to maximize the quality of care thus improving the efficiency of care thereby improving clinical outcomes. Health Professional Schools are this motivated to opt for inter professional education to improve the learning of the students, health care delivery and patient outcomes. Keywords: Inter professional relations; patient centered care; education DOI: http://dx.doi.org/10.3126/hren.v9i3.5591   HR 2011; 9(3): 201-206

scholarly journals Patients’ Perceptions of Portal Use Across Care Settings: Qualitative Study (Preprint)

2018 ◽  
Author(s):  
Ann Scheck McAlearney ◽  
Cynthia J Sieck ◽  
Alice Gaughan ◽  
Naleef Fareed ◽  
Jaclyn Volney ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Medical Center ◽  
Academic Medical Center ◽  
Patient Centered Care ◽  
Theory Approach ◽  
Access To Information ◽  
Engagement In Care ◽  
Care Providers ◽  
Patient Centered ◽  
Centered Care

BACKGROUND Patient portals are a promising instrument to improve patient-centered care, as they provide patients information and tools that can help them better manage their health. The implementation of portals in both the inpatient and outpatient setting gives health care providers an opportunity to support patients both during hospitalization and after discharge. Thus, there is a need to better understand how inpatient and outpatient portals are used across care contexts. OBJECTIVE This study aimed to examine patients’ perceptions of using inpatient and outpatient portals across the care settings, including how they used the portals and the benefits and concerns associated with portal use. METHODS This study was conducted in a large Midwestern academic medical center consisting of seven hospitals. We interviewed 120 patients who had used an inpatient portal during their hospitalization, at 15 days and 6 months postdischarge, to determine their perspectives of portal use in both hospital and outpatient settings. Interview transcripts were analyzed inductively and deductively by using team coding processes consistent with a grounded theory approach. RESULTS Interviews focused on three main areas of portal use: experience with the portal features, perceived benefits, and concerns. Responses at 15 days (n=60) and 6 months (n=60) postdischarge were consistent with respect to perceptions about portal use. Patients identified viewing their health information, managing their schedule, and communicating with providers as notable activities. Convenience, access to information, and better engagement in care were indicated as benefits. Concerns were related to technology issues and privacy/security risks. CONCLUSIONS Implementation of inpatient portals as a complement to outpatient portals is increasing and can enable patients to better manage aspects of their care. Although care processes vary substantively across settings, the benefits of convenience, improved access to information, and better engagement in care provide opportunities for portal use across care settings to support patient-centered care.

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