Factors influencing patient experience in hospital wards: a systematic review

Abstract

Background:Patient experience plays an essential role in improving clinical effectiveness and patient safety. It's important to identify factors influencing patient experience and to improve quality of healthcare. Objective:To identify factors that influence patient experience in hospital wards. Methods: We conducted a systematic review including six databases; they were PubMed, CINAHL, Embase, PsycInfo, ProQuest, and Cochrane. Studies were included if they met the inclusion criteria. The JBI checklist was used to perform quality appraisal. We used 5 domains of the ecological model to organize and synthesize our findings. Result: A total of 138 studies(133 cross-sectional, 3 longitudinal, 2 cohort studies) were included, and 164 factors were identified. These factors were integrated into 6 domains. All domains but one (survey-related factors) could be mapped onto the attributes of the social ecological framework: intrapersonal level, interpersonal level, institutional level, community level, and public policy level factors. These factors had mixture effect on patient experience. The intrapersonal level refers to individual characteristics of patients such as knowledge, attitudes and behavior. The interpersonal level refers to interactions between patients and nurses, such as the caring time spent by nurse. The institutional level refers to organizational characteristics, rules and regulations for operations, such as hospital size and accreditation. The community level refers to relationships among organizations, institutions, and informational networks within defined boundaries, such as a hospital located in a larger population area. Public policy refers to local, state, national, and global laws and policies, including health insurance policies. The sixth domain was added to the framework, survey related factors, and included factors such as survey response rate and survey response time. Conclusion: The factors influencing patient experience are comprehensive, ranging from intrapersonal to public policy. Providers should adopt a holistic and integrated perspective to assess patient experience and develop context-specific interventions to improve the quality of care. PROSPERO registration number CRD42023401066.