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Patient centeredness

Kendra E Brett, Lindsay J Ritchie, Emily Ertel, Alexandria Bennett, Greg A Knoll
BACKGROUND: The best approach for determining whether a transplant program is delivering high-quality care is unknown. This review aims to identify and characterize quality metrics in solid organ transplantation. METHODS: Medline, Embase, and Cochrane Central Register of Controlled Trials were searched from inception until February 1 2017. Relevant full text reports and conference abstracts that examined quality metrics in organ transplantation were included. Two reviewers independently extracted study characteristics and quality metrics from 52 full text reports and 24 abstracts...
March 20, 2018: Transplantation
Rebecca Lewthwaite, Carolee J Winstein, Christianne J Lane, Sarah Blanton, Burl R Wagenheim, Monica A Nelsen, Alexander W Dromerick, Steven L Wolf
BACKGROUND: Task-oriented therapies have been developed to address significant upper extremity disability that persists after stroke. Yet, the extent of and approach to rehabilitation and recovery remains unsatisfactory to many. OBJECTIVE: To compare a skill-directed investigational intervention with usual care treatment for body functions and structures, activities, participation, and quality of life outcomes. METHODS: On average, 46 days poststroke, 361 patients were randomized to 1 of 3 outpatient therapy groups: a patient-centered Accelerated Skill Acquisition Program (ASAP), dose-equivalent usual occupational therapy (DEUCC), or usual therapy (UCC)...
February 2018: Neurorehabilitation and Neural Repair
Nicholas Golda, Stephen Beeson, Nita Kohli, Brandon Merrill
Assessing the patient experience has been a component of national health care policy for years in various forms, and it is now incorporated into many areas affecting physician practice. This review will focus on the origin and importance of this measure and address its critiques. The evolution of the measure as it progressed from patient satisfaction to patient experience and the rationale behind this shift will be detailed, the thought process behind the measure as an indicator of a culture of patient-centeredness and quality rather than as strictly a score will be reviewed, and the various motivators for physicians to improve patient experience will be divided into extrinsic and intrinsic and discussed...
April 2018: Journal of the American Academy of Dermatology
Stewart W Mercer, Yuefang Zhou, Gerry M Humphris, Alex McConnachie, Andisheh Bakhshi, Annemieke Bikker, Maria Higgins, Paul Little, Bridie Fitzpatrick, Graham C M Watt
PURPOSE: The influence of multimorbidity on the clinical encounter is poorly understood, especially in areas of high socioeconomic deprivation where burdensome multimorbidity is concentrated. The aim of the current study was to examine the effect of multimorbidity on general practice consultations, in areas of high and low deprivation. METHODS: We conducted secondary analyses of 659 video-recorded routine consultations involving 25 general practitioners (GPs) in deprived areas and 22 in affluent areas of Scotland...
March 2018: Annals of Family Medicine
Alex D Federman, Lina Jandorf, Joseph DeLuca, Mary Gover, Angela Sanchez Munoz, Li Chen, Michael S Wolf, Joseph Kannry
OBJECTIVE: To test the impact of a redesigned, patient-centered after visit summary (AVS) on patients' and clinicians' ratings of and experience with the document. METHODS: We conducted a difference-in-differences (DiD) evaluation of the impact of the redesigned AVS before and after its introduction in an academic primary care practice compared to a concurrent control practice. Outcomes included ratings of the features of the AVS. RESULTS: The intervention site had 118 and 98 patients in the pre- and post-intervention periods and the control site had 99 and 105, respectively...
March 6, 2018: Patient Education and Counseling
Timothy P Hogan, Tana M Luger, Julie E Volkman, Mary Rocheleau, Nora Mueller, Anna M Barker, Kim M Nazi, Thomas K Houston, Barbara G Bokhour
BACKGROUND: As information and communication technology is becoming more widely implemented across health care organizations, patient-provider email or asynchronous electronic secure messaging has the potential to support patient-centered communication. Within the medical home model of the Veterans Health Administration (VA), secure messaging is envisioned as a means to enhance access and strengthen the relationships between veterans and their health care team members. However, despite previous studies that have examined the content of electronic messages exchanged between patients and health care providers, less research has focused on the socioemotional aspects of the communication enacted through those messages...
March 8, 2018: Journal of Medical Internet Research
Mikkel Bek Clausen, Thomas Bandholm, Michael Skovdal Rathleff, Karl Bang Christensen, Mette Kreutzfeldt Zebis, Thomas Graven-Nielsen, Per Hölmich, Kristian Thorborg
BACKGROUND: Subacromial impingement syndrome (SIS) is a painful, and often long lasting, shoulder condition affecting patient function and quality of life. In a recent study, we observed major strength impairments in shoulder external rotation and abduction (~30%) in a population of patients with pronounced and long-lasting SIS. However, the current rehabilitation of such strength impairments may be inadequate, with novel rehabilitation programmes including exercise therapy only improving external rotation strength by 4-13%...
March 2, 2018: Trials
Inga Hege, Andrzej A Kononowicz, Norman B Berman, Benedikt Lenzer, Jan Kiesewetter
Background: Clinical reasoning is a complex skill students have to acquire during their education. For educators it is difficult to explain their reasoning to students, because it is partly an automatic and unconscious process. Virtual Patients (VPs) are used to support the acquisition of clinical reasoning skills in healthcare education. However, until now it remains unclear which features or settings of VPs optimally foster clinical reasoning. Therefore, our aims were to identify key concepts of the clinical reasoning process in a qualitative approach and draw conclusions on how each concept can be enhanced to advance the learning of clinical reasoning with virtual patients...
2018: GMS Journal for Medical Education
Heba H Hijazi, Heather L Harvey, Mohammad S Alyahya, Hussam A Alshraideh, Rabah M Al Abdi, Sanjai K Parahoo
Targeting the patient's needs and preferences has become an important contributor for improving care delivery, enhancing patient satisfaction, and achieving better clinical outcomes. This study aimed to examine the impact of applying quality management practices on patient centeredness within the context of health care accreditation and to explore the differences in the views of various health care workers regarding the attributes affecting patient-centered care. Our study followed a cross-sectional survey design wherein 4 Jordanian public hospitals were investigated several months after accreditation was obtained...
January 2018: Inquiry: a Journal of Medical Care Organization, Provision and Financing
Suan Ee Ong, Shilpa Tyagi, Jane Mingjie Lim, Kee Seng Chia, Helena Legido-Quigley
In response to a growing chronic disease burden and ageing population, Singapore implemented Regional Health Systems (RHS) in 2008. In January 2017, the MOH announced that the six RHS clusters would be reorganised into three in 2018. This qualitative study sought to identify the health system challenges, opportunities, and ways forward for the implementation of the RHS. We conducted semi-structured interviews with 35 key informants from RHS clusters, government, academia, and private and voluntary sectors. Integration, innovation, and people-centeredness were identified as the key principles of the RHS...
February 19, 2018: Health Policy
Laura L Machin, Dawn Goodwin, David Warriner
In this article, we present the experiences of discharging against medical advice from the perspectives of 17 hospital and community-based health care practitioners, and 16 patients, and relatives from a range of medical and surgical wards. Semistructured, in-depth interviews were conducted and thematically analyzed. We identified that practitioners, patients, and relatives frequently expressed empathy for each other during the interviews, and discharge against medical advice was presented as a way for patients to have control over their health...
February 1, 2018: Qualitative Health Research
Sarina R Isenberg, Rebecca A Aslakson, James N Dionne-Odom, Katherine Clegg Smith, Sarabdeep Singh, Susan Larson, John F P Bridges, Thomas J Smith, Jennifer L Wolff, Debra L Roter
OBJECTIVE: To examine the association between family companion presence during pre-surgical visits to discuss major cancer surgery and patient-provider communication and satisfaction. METHODS: Secondary analysis of 61 pre-surgical visit recordings with eight surgical oncologists at an academic tertiary care hospital using the Roter Interaction Analysis System (RIAS). Surgeons, patients, and companions completed post-visit satisfaction questionnaires. Poisson and logistic regression models assessed differences in communication and satisfaction when companions were present vs...
February 2, 2018: Patient Education and Counseling
Melissa K Afable, Gouri Gupte, Steven R Simon, Jessica Shanahan, Varsha Vimalananda, Eun Ji Kim, Judith Strymish, Jay D Orlander
Electronic consultations (e-consults) improve access to specialty care without requiring face-to-face patient visits. We conducted a mixed-methods descriptive study to understand the variability in e-consult use across anesthesiology departments in the Veterans Affairs New England Healthcare System (VANEHS). In the period 2012-15, the system experienced a rapid increase in the use of anesthesiology e-consults: 5,023 were sent in 2015, compared with 103 in 2012. Uptake across sites varied from near-universal use of e-consults for preoperative assessment to use for only selected low-risk patients or no use...
February 2018: Health Affairs
Marianna D LaNoue, Debra L Roter
OBJECTIVE: To explore the relationships between self-reported Empathy and the patient-centered communication patterns of physician trainees. METHODS: "Eighty-four 3rd year medical students completed the Jefferson Scale of Empathy (JSE - student version) and had recordings of a single OSCE analyzed using the Roter Interactional Analysis System (RIAS). Correlation and regression were employed to explore the relationships among JSE total score, 3 JSE subscales, 10 composite codes of provider communication, and a summary 'patient centered communication' ratio, reflecting the balance of psychosocial and emotional to biomedical communication of the simulated patient and student...
January 29, 2018: Patient Education and Counseling
Mu'taman Jarrar, Hamzah Abdul Rahman, Mohd Sobri Minai, Mahdi S AbuMadini, Mercy Larbi
BACKGROUND: The shortage of nursing staff is a national and international issue. Inadequate number of hospital nurse staff leads to poor health care services. Yet the effects of patient-centeredness between the relationships of nursing shortage on the quality of care (QC) and patient safety (PS) have not been explored. The aim of this study was to examine the mediating effects of patient-centeredness on the relationship of nursing shortage on the QC and PS in the Medical and Surgical Wards, in Malaysian private hospitals...
January 30, 2018: International Journal of Health Planning and Management
Lisa Bailey-Davis, Samantha M R Kling, William J Cochran, Sandra Hassink, Lindsey Hess, Jennifer Franceschelli Hosterman, Shawnee Lutcher, Michele Marini, Jacob Mowery, Ian M Paul, Jennifer S Savage
New care delivery models call for integrating health services to coordinate care and improve patient-centeredness. Such models have been embraced to coordinate care with evidence-based strategies to prevent obesity. Both the Special Supplemental Program for Women, Infants and Children (WIC) Program and pediatricians are considered credible sources of preventive guidance, and coordinating these independent siloes would benefit a vulnerable population. Using semistructured focus groups and interviews, we evaluated practices, messaging, and the prospect of integrating and coordinating care...
January 23, 2018: Translational Behavioral Medicine
Jeanette Melin, Lars-Olof Persson, Charles Taft, Margareta Kreuter
STUDY DESIGN: Qualitative method, semi-structured interviews. OBJECTIVES: The aims of this study were to explore the meaning of patient participation from the perspective of staff members working with spinal cord injury (SCI) rehabilitation, and what they saw as requisites for and constraints to patient participation. SETTING: Swedish spinal injury unit. METHODS: Interviews with 13 staff members at a spinal unit were conducted individually and analyzed by means of content analysis...
January 24, 2018: Spinal Cord
Elizabeth Gaufberg, Lisette Dunham, Edward Krupat, Brent Stansfield, Charles Christianson, Susan Skochelak
Construct: Induction into the Gold Humanism Honor Society (GHHS) during medical school is recognized as an indicator of humanistic orientation and behavior. Various attitudes and interpersonal orientations including empathy and patient-centeredness have been posited to translate into behaviors constituting humanistic care. BACKGROUND: To our knowledge there has never been a longitudinal, multi-institutional empirical study of the attitudinal and interpersonal orientations correlated with GHHS membership status...
January 24, 2018: Teaching and Learning in Medicine
Karen Ford, Leigh Tesch, Jacqueline Dawborn, Helen Courtney-Pratt
AIMS AND OBJECTIVES: To evaluate the impact of an arts in health programme delivered by a specialised artist within an acute older person's unit. BACKGROUND: Acute hospitals must meet the increasingly complex needs of older people who experience multiple comorbidities, often including cognitive impairment, either directly related to their admission or longer term conditions, including dementia. A focus on physical illness, efficiency and tasks within an acute care environment can all divert attention from the psychosocial well-being of patients...
January 24, 2018: International Journal of Older People Nursing
Hanna Dubois, Peter T Schmidt, Johan Creutzfeldt, Mia Bergenmar
AIM: To describe the development and implementation of a person-centered endoscopy safety checklist and to evaluate the effects of a "checklist intervention". METHODS: The checklist, based on previously published safety checklists, was developed and locally adapted, taking patient safety aspects into consideration and using a person-centered approach. This novel checklist was introduced to the staff of an endoscopy unit at a Stockholm University Hospital during half-day seminars and team training sessions...
December 28, 2017: World Journal of Gastroenterology: WJG
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