Evaluation of Patient Satisfaction and Patient-physician Relationship in an Out- Patient Department Re-engineered through a Health Information Management System: A Descriptive Study Done at a Major Women’s Hospital in Sri Lanka

Introduction: Health information management is one of the major pillars in a health system that improves the effectiveness and efficiency of health services. It is essential to assess the patient perception towards re-engineered services provide through Hospital Information Management Systems (HIMSs) and how this implementation affects the doctor-patient relationship. The objective of the study was to describe the extent of patient satisfaction towards Out-Patient Department (OPD) services, pharmacy service and patient physician relationship in the OPD, re-engineered through a HIMS, at the Castle Street Hospital for Women (CSHW), Sri Lanka. Methods: A descriptive cross-sectional study was carried out among 362 out-patients aged over 18 years attending the OPD of the CSHW during 2018-2019. Consecutive sampling method, and an interviewer-administrated questionnaire were used to collect data. The quantitative analysis was done using the SPSS software version 23. The sentiment analysis was performed to analyze comments given by patients using the Rapid Miner software. Results: All participants were females with a mean age of 41years (±13.58). Almost all participants were satisfied with overall services provided by the OPD (99.7%) and the pharmacy (98.4%). The majority (65.3%) agreed that implementation of the HIMS had improved the doctor-patient relationship. All reported comments regarding the re-engineered services of the OPD were ‘positive’. The study also suggests considering providing information in all common languages while announcing the patient’s OPD number at the waiting area in future implementations. Conclusions: The majority of patients were satisfied with the overall OPD services provided through implementation of the HIMS at the CSHW, Sri Lanka. Keywords: Health information systems, Hospital information management system, Outpatientdepartment, Patient-physician relationship.

Patient-Physician Communication in Acute Myeloid Leukemia and Myelodysplastic Syndrome

Introduction: An effective communication is an integral part of the patient-physician relationship. Lack of a healthy patient-physician relationship leads to a lower level of patient satisfaction, scarce understanding of interventions and poor adherence to treatment regimes. Patients need to be involved in the therapeutic process and the assessment of risks and perspectives of the illness in order to better evaluate their options. Physicians, in turn, must convey and communicate information clearly in order to avoid misunderstandings and consequently poor medical care. The patient-physician relationship in cancer care is extremely delicate due to the complexity of the disease. In cancer diagnosis, the physician must adopt a communicative approach that considers the psychosocial factors, needs and patient’s preferences for information,which in turn all contribute to affect clinical outcomes. Search Strategy and Methods : This review was conducted using the Preferred Reporting Items for Systematic and Meta-analyses (PRISMA) statement. We included studies on the importance of physician-patient communication in Acute Myeloid Leukaemia and Myelodysplastic Syndrome care. We searched PubMed, Web of Sciences, Scopus, Google scholar for studies published from December 1 st , 2020 up to March 1 st , 2021. Using MeSH headings, we search for the terms “Physician and patient communication AND Acute Myeloid leukemia” or “Myelodysplastic syndrome” or “Doctor” or “Clinician”, as well as variations thereof . Purpose of the Review : This review examines the progress in communication research between patient and physician and focuses on the impact of communication styles on patient-physician relationshipin hematologic cancers, including Acute Myeloid Leukaemia and Myelodysplastic Syndromes.

Physician Rating Websites in the United States: A systematic review (Preprint)

BACKGROUND Physician rating websites are gaining popularity, however, data on their usability and influence on healthcare quality is limited. OBJECTIVE to provide an overview of physician rating websites in the US and find answers for the following questions: 1. What are the most commonly studied/rated physician rating websites in the US? 2. Which specialty of physicians/providers are most commonly studied/rated? 3. How many physicians were rated on the studied PRWs? 4. What is the average number of ratings on these websites and are they positive or negative? 5. How does the profile of providers influence their rating? 6. How are PRWs associated with healthcare quality? 7. How PRWs are associated with patient-physician relationship? METHODS A systematic literature search was conducted through Medline for peer-reviewed articles in the English language on studies conducted in the US. RESULTS 33 articles published in peer-reviewed journals were included in the final review. Most of the studies were conducted on surgeons. A significant number of studies observed no correlation of online ratings with gender, geographic location, and years of experience. Additionally, no significant correlation was found between PRWs and healthcare quality. CONCLUSIONS It has been observed that with the current structure of these websites, the reliability of information available on them is rather questionable, and hence more research is required to assess the credibility of these websites along with their cost-effectiveness, effect on the patient-physician relationship, and quality of healthcare delivery.

Dancers’ Perceptions of Accessibility and Quality of the Relationship with Healthcare Professionals in Quebec

OBJECTIVE: To understand dancers’ perception of accessibility to care and quality of the relationship with healthcare practitioners in Quebec; to identify the key elements of an optimal dancer–physician relationship; and to propose recommendations for improvement. METHODS: An online questionnaire consisting of multiple choice, “yes/no,” and short answer questions was sent to professional dance organizations, companies, agencies, and schools in Quebec, Canada. Information regarding the dance artists’ sociodemographics, dance background, dance-related injuries, and access to a primary care physician were collected. Experiences and expectations regarding the dancer–physician relationship were surveyed. One-way ANOVA analyses and Pearson correlations were performed to assess differences of perception between dancers’ demographic characteristics and associations between the variables. RESULTS: Out of 161 participants, 144 met inclusion criteria, consisting of largely French-speaking females, North American or European decent, self-employed contemporary dancers with an average age of 33.13 ± 10.81 yrs. Dance artists sought medical care from osteopaths (47.9%) and physiotherapists (36.1%) more frequently than from physicians (8.3%). Fully employed dancers had more favorable perceptions of the dancer–physician relationship compared to self-employed dancers and those who had mixed streams of income. The perception of most participants was that physicians do not comprehend the unique dance-associated impacts on health (81.8%). The most important aspect affecting perception of the relationship with the physician was diagnostic acumen (41.3%). Most participants (79.0%) selected “works with other health professionals [...] and gives expert advice” as an important expectation from physicians. CONCLUSION: This research is the first investigation of the dancer–physician relationship in Quebec. It reveals a desire amongst the dance artist community to improve the dancer–physician relationship and the overall quality of their unique healthcare requirements.

Medical Subspecialty Telehealth Consults

Health care reforms are advancing new care models that emphasize population-based outcomes. Emergency clinicians are challenged to provide coordinated care with limited resources. Emerging value-based models create the incentives for emergency clinicians to collaborate with specialists to provide high-quality care while lowering cost by reducing admissions when possible. Subspecialty consultation may be difficult to obtain in regions where the population does not support a subspecialist or where there is a workforce shortage. However, obtaining a telehealth subspecialist consult from a remote pool, local network, or established patient–physician relationship can provide such a service. Several use-cases are presented to illustrate how telehealth subspecialty consultation from the emergency department can change patient care and outcomes.

Does information structuring improve recall of discharge information? A cluster randomized clinical trial

Objectives The impact of the quality of discharge communication between physicians and their patients is critical on patients’ health outcomes. Nevertheless, low recall of information given to patients at discharge from emergency departments (EDs) is a well-documented problem. Therefore, we investigated the outcomes and related benefits of two different communication strategies: Physicians were instructed to either use empathy (E) or information structuring (S) skills hypothesizing superior recall by patients in the S group. Methods For the direct comparison of two communication strategies at discharge, physicians were cluster-randomized to an E or a S skills training. Feasibility was measured by training completion rates. Outcomes were measured in patients immediately after discharge, after 7, and 30 days. Primary outcome was patients’ immediate recall of discharge information. Secondary outcomes were feasibility of training implementation, patients’ adherence to recommendations and satisfaction, as well as the patient-physician relationship. Results Of 117 eligible physicians, 80 (68.4%) completed the training. Out of 256 patients randomized to one of the two training groups (E: 146 and S: 119) 196 completed the post-discharge assessment. Patients’ immediate recall of discharge information was superior in patients in the S-group vs. E-group. Patients in the S-group adhered to more recommendations within 30 days (p = .002), and were more likely to recommend the physician to family and friends (p = .021). No differences were found on other assessed outcome domains. Conclusions and practice Implications Immediate recall and subsequent adherence to recommendations were higher in the S group. Feasibility was shown by a 69.6% completion rate of trainings. Thus, trainings of discharge information structuring are feasible and improve patients’ recall, and may therefore improve quality of care in the ED.

Management strategy of healthcare organizations. PDRQ–9 method

The main source of success for a customer-centric organization is the ability to identify its customers, identify their needs, and use that information to develop a customer-centric strategy. In this regard, there is a widespread change in attitudes toward the construction of management in organizations. Whereas previously the competitiveness of an organization could be measured by its financial performance, now the intellectual potential of an organization is at the forefront. As the role of the patient in the health care system has intensified, the importance of patient participation has received increasing attention and has become central to health care research. In this regard, in today’s environment, the foundation of success in the treatment and delivery of professional care in medicine is primarily the degree of patient satisfaction. Patient-centered care acts as a new paradigm for the development of the health care system, which is characterized by a shift in the center of gravity to the patient. In this regard, in the field of health care, the relationship between the patient and the doctor, as perceived by the patient, is one of the main elements of the methodology of scientific research. The purpose of this article is to review and analyze the results of the PDRQ–9, which assesses the patient-physician relationship. The PDRQ–9 provides researchers with a brief assessment of the therapeutic aspects of the patient-physician relationship in the primary care setting. It is a valuable tool for research and practice purposes that includes monitoring the patient-doctor relationship.

Reinforcing Factors Influencing Patient-physician Relationships: A Content Analysis Study

Background: Building an effective patient-physician relationship is a vital component of a successful health care. Therefore, educating and preparing students to communicate effectively with patients has always been critical. Such a criticism needs to evaluate the current situation and the socio-cultural context in which the communications are built. The aim of this study was to analyze the status of patient-physician relationship and explore factors influencing communication in Tabriz University of Medical Sciences (TUoMS) from the perspective of patients, students and faculty members.Methods: In this content analysis study, data were gathered using focus groups, semi-structured interviews and observations in the field, based on purposive sampling until the data saturation was achieved.Findings: Content analysis resulted in emerging five categories, affecting patient-physician relationship. They included factors related to: physician, patient, environment, socio-cultural context and health care system. Participants related their stratifying experiences of the PPR to 36 factors in five different categories. Among them, the factors related to the physician played the most significant role. Most students stated that they did not receive any practical or theoretical training in a form of a predefined formal program to improve their communication skills.Conclusion: The findings of this study indicated that the current situation of patient-physician relationship at TUoMS is not satisfying and serious and comprehensive interventions are needed to improve the PPR.