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Healthcare
Special Issues
Innovations in Measuring and Improving Patient Care Experiences
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Innovations in Measuring and Improving Patient Care Experiences

A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: closed (30 April 2015) | Viewed by 52979

Special Issue Editor

Prof. Hector P. Rodriguez

E-Mail Website
Guest Editor
Division of Health Policy and Management, School of Public Health, University of California, Berkeley, CA 94720, USA
Interests: organizational influences on patient care experiences; interprofessional primary care team approaches and continuity of care; implementation and dissemination research; performance measurement and improvement

Special Issue Information

Dear Colleagues,

Delivery system innovations can have both positive and negative impacts on patients’ experiences of care, depending on how they are implemented. Although many innovations, such as interprofessional care team approaches, can offer patients and health care systems many advantages, including improved patient self-management and health outcomes, they can be poorly implemented, uncoordinated, and distracting to primary care physician-patient relationships. This special issue of Healthcare will focus on clarifying the benefits, limitations, and tradeoffs of implementing delivery system innovations on patient care experiences, including but not limited to: interprofessional care team approaches, patient activation and engagement tools and interventions, shared decision-making with decision aids, group visits, and health coaching by lay health workers. Research aimed at improving the valid and reliable measurement of patient care experiences is also encouraged, as are studies examining the implementation and impact of patient experience performance feedback to individual clinicians, teams, and/or practices.

Prof. Hector P. Rodriguez
Guest Editor

Submission

The journal publishes immediately upon acceptance and the special issue will stop considering new papers on 30 April 2015. Papers to this special issue submitted after 30 April 2015 will be included into the regular issue for processing.

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. Papers will be published continuously (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are refereed through a peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed Open Access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. For the first couple of issues the Article Processing Charge (APC) will be waived for well-prepared manuscripts. English correction and/or formatting fees of 250 CHF (Swiss Francs) will be charged in certain cases for those articles accepted for publication that require extensive additional formatting and/or English corrections.

Keywords

  • patient care experiences
  • patient-reported outcome measures
  • patient activation and engagement
  • shared decision-making
  • interprofessional care teams
  • patients’ preferences
  • primary care practice redesign
  • Clinician Group CAHPS Survey
  • mixed methods research

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (5 papers)

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Research

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16 pages, 504 KiB  
Article
Shortening a Patient Experiences Survey for Medical Homes
by Judy H. Ng, Erika Henry, Tyler Oberlander, Peichang Shi and Sarah Hudson Scholle
Healthcare 2016, 4(1), 1; https://doi.org/10.3390/healthcare4010001 - 23 Dec 2015
Cited by 5 | Viewed by 4660
Abstract
The Consumer Assessment of Healthcare Providers and Systems—Patient-Centered Medical Home (CAHPS PCMH) Survey assesses patient experiences reflecting domains of care related to general patient experience (access to care, communication with providers, office staff interaction, provider rating) and PCMH-specific aspects of patient care (comprehensiveness [...] Read more.
The Consumer Assessment of Healthcare Providers and Systems—Patient-Centered Medical Home (CAHPS PCMH) Survey assesses patient experiences reflecting domains of care related to general patient experience (access to care, communication with providers, office staff interaction, provider rating) and PCMH-specific aspects of patient care (comprehensiveness of care, self-management support, shared decision making). The current work compares psychometric properties of the current survey and a proposed shortened version of the survey (from 52 to 26 adult survey items, from 66 to 31 child survey items). The revisions were based on initial psychometric analysis and stakeholder input regarding survey length concerns. A total of 268 practices voluntarily submitted adult surveys and 58 submitted child survey data to the National Committee for Quality Assurance in 2013. Mean unadjusted scores, practice-level item and composite reliability, and item-to-scale correlations were calculated. Results show that the shorter adult survey has lower reliability, but still it still meets general definitions of a sound survey for the adult version, and resulted in few changes to mean scores. The impact was more problematic for the pediatric version. Further testing is needed to investigate approaches to improving survey response and the relevance of survey items in informing quality improvement. Full article
(This article belongs to the Special Issue Innovations in Measuring and Improving Patient Care Experiences)
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16 pages, 2543 KiB  
Article
Creating the Evidence through Comparative Effectiveness Research for Interprofessional Education and Collaborative Practice by Deploying a National Intervention Network and a National Data Repository
by Judith Pechacek, Frank Cerra, Barbara Brandt, May Nawal Lutfiyya and Connie Delaney
Healthcare 2015, 3(1), 146-161; https://doi.org/10.3390/healthcare3010146 - 18 Mar 2015
Cited by 16 | Viewed by 9503
Abstract
Background: There is currently a resurgence of interest in interprofessional education and collaborative practice (IPECP) and its potential to positively impact health outcomes at both the patient level and population level, healthcare delivery, and health professions education. This resurgence of interest led [...] Read more.
Background: There is currently a resurgence of interest in interprofessional education and collaborative practice (IPECP) and its potential to positively impact health outcomes at both the patient level and population level, healthcare delivery, and health professions education. This resurgence of interest led to the creation of the National Center on Interprofessional Collaborative Practice and Education in October 2012. Methods: This paper describes three intertwined knowledge generation strategies of the National Center on Interprofessional Practice and Education: (1) the development of a Nexus Incubator Network, (2) the undertaking of comparative effectiveness research, and (3) the creation of a National Center Data Repository. Results: As these strategies are implemented over time they will result in the production of empirically grounded knowledge regarding the direction and scope of the impact, if any, of IPECP on well-defined health and healthcare outcomes including the possible improvement of the patient experience of care. Conclusions: Among the motivating factors for the National Center and the three strategies adopted and addressed herein is the need for rigorously produced, scientifically sound evidence regarding IPECP and whether or not it has the capacity to positively affect the patient experience of care, the health of populations, and the per capita cost of healthcare. Full article
(This article belongs to the Special Issue Innovations in Measuring and Improving Patient Care Experiences)
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16 pages, 609 KiB  
Article
Variation in Anticoagulant Recommendations by the Guidelines and Decision Tools among Patients with Atrial Fibrillation
by Anand Shewale, Jill Johnson, Chenghui Li, David Nelsen and Bradley Martin
Healthcare 2015, 3(1), 130-145; https://doi.org/10.3390/healthcare3010130 - 5 Mar 2015
Cited by 10 | Viewed by 5738
Abstract
Published atrial fibrillation (AF) guidelines and decision tools offer oral anticoagulant (OAC) recommendations; however, they consider stroke and bleeding risk differently. The aims of our study are: (i) to compare the variation in OAC recommendations by the 2012 American College of Chest Physicians [...] Read more.
Published atrial fibrillation (AF) guidelines and decision tools offer oral anticoagulant (OAC) recommendations; however, they consider stroke and bleeding risk differently. The aims of our study are: (i) to compare the variation in OAC recommendations by the 2012 American College of Chest Physicians guidelines, the 2012 European Society of Cardiology (ESC) guidelines, the 2014 American Heart Association (AHA) guidelines and two published decision tools by Casciano and LaHaye; (ii) to compare the concordance with actual OAC use in the overall study population and the population stratified by stroke/bleed risk. A cross-sectional study using the 2001–2013 Lifelink claims data was used to contrast the treatment recommendations by these decision aids. CHA2DS2-VASc and HAS-BLED algorithms were used to stratify 15,129 AF patients into nine stroke/bleed risk groups to study the variation in treatment recommendations and concordance with actual OAC use/non-use. The AHA guidelines which were set to recommend OAC when CHA2DS2-VASc = 1 recommended OAC most often (86.30%) and the LaHaye tool recommended OAC the least often (14.91%). OAC treatment recommendations varied considerably when stroke risk was moderate or high (CHA2DS2-VASc > 0). Actual OAC use/non-use was highly discordant (>40%) with all of the guidelines or decision tools reflecting substantial opportunities to improve AF OAC decisions. Full article
(This article belongs to the Special Issue Innovations in Measuring and Improving Patient Care Experiences)
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Review

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12 pages, 100 KiB  
Review
Student Continuity with Patients: A System Delivery Innovation to Benefit Patient Care and Learning (Continuity Patient Benefit)
by Ann N. Poncelet and J. Nicky Hudson
Healthcare 2015, 3(3), 607-618; https://doi.org/10.3390/healthcare3030607 - 22 Jul 2015
Cited by 14 | Viewed by 5221
Abstract
Medical education is continuing to evolve to meet the healthcare needs of the future. The longitudinal integrated clerkship (LIC) model is an important innovation in medical education. It has in its vision and structure “patient- and learner-centered education”, using longitudinal relationships between patients [...] Read more.
Medical education is continuing to evolve to meet the healthcare needs of the future. The longitudinal integrated clerkship (LIC) model is an important innovation in medical education. It has in its vision and structure “patient- and learner-centered education”, using longitudinal relationships between patients and students as a foundational element in its design. LIC students have shown more patient-centered attitudes and behaviors that persist after medical school. They remain connected with the patient experience of care, which supports empathy and student moral development. The time that LIC students spend acting independently with patients also supports the development of higher order clinical and cognitive skills and professional identity formation. Student participation in a more meaningful way in the care of their patients promotes patient wellbeing, and helps patients with transitions of care, communication and preventative care. Patients report feeling empowered to be more active agents in their own care and feel an accountability and pleasure in the training of new physicians. Focusing on the patient/student relationship as a foundational element of clinical education has meaningful benefits to the patient and student with the potential to improve patient care directly and in the future, as these students become physicians. Full article
(This article belongs to the Special Issue Innovations in Measuring and Improving Patient Care Experiences)
14 pages, 477 KiB  
Review
Minimally Disruptive Medicine: A Pragmatically Comprehensive Model for Delivering Care to Patients with Multiple Chronic Conditions
by Aaron L. Leppin, Victor M. Montori and Michael R. Gionfriddo
Healthcare 2015, 3(1), 50-63; https://doi.org/10.3390/healthcare3010050 - 29 Jan 2015
Cited by 119 | Viewed by 27135
Abstract
An increasing proportion of healthcare resources in the United States are directed toward an expanding group of complex and multimorbid patients. Federal stakeholders have called for new models of care to meet the needs of these patients. Minimally Disruptive Medicine (MDM) is a [...] Read more.
An increasing proportion of healthcare resources in the United States are directed toward an expanding group of complex and multimorbid patients. Federal stakeholders have called for new models of care to meet the needs of these patients. Minimally Disruptive Medicine (MDM) is a theory-based, patient-centered, and context-sensitive approach to care that focuses on achieving patient goals for life and health while imposing the smallest possible treatment burden on patients’ lives. The MDM Care Model is designed to be pragmatically comprehensive, meaning that it aims to address any and all factors that impact the implementation and effectiveness of care for patients with multiple chronic conditions. It comprises core activities that map to an underlying and testable theoretical framework. This encourages refinement and future study. Here, we present the conceptual rationale for and a practical approach to minimally disruptive care for patients with multiple chronic conditions. We introduce some of the specific tools and strategies that can be used to identify the right care for these patients and to put it into practice. Full article
(This article belongs to the Special Issue Innovations in Measuring and Improving Patient Care Experiences)
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