Patient experiences and predictors in an acute geriatric ward: A cross‐sectional study

Leonardsen, Ann‐Chatrin Linqvist; Jelsness-Jørgensen, Lars-Petter

doi:10.1111/jocn.13796

Cited by 8 publications

(12 citation statements)

References 52 publications

(49 reference statements)

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“…There were 21 publications that generally took the angle of how a specific implementation (or aspect such as physician spending or doctor-patient communication) of generalist care affects outcomes or quality of care ( 3 , 17 , 18 , 20 , 21 , 23 , 27 – 29 , 31 , 32 , 34 , 36 – 40 , 42 – 45 ). Eleven were focused on elderly patients ( 17 , 20 , 21 , 23 , 27 , 28 , 31 , 32 , 34 , 43 , 45 ).…”

Section: Resultsmentioning

confidence: 99%

Performance management of generalist care for hospitalised multimorbid patients—a scoping review for value-based care

Khoo,

Lim,

Lai

2024

Front. Health Serv.

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ObjectivesGiven the shift towards value-based healthcare and the increasing recognition of generalist care, enacting value-based healthcare for generalist care is critical. This work aims to shed light on how to conduct performance management of generalist care to facilitate value-based care, with a focus on medical care of hospitalised patients.Design and settingA scoping review of published literature was conducted. 30 publications which were relevant to performance management of generalist medical inpatient care were included in the review.Outcome measuresThe performance measures used across the studies were analysed and other qualitative findings were also obtained.ResultsWe report an overall lack of research on performance management methods for generalist inpatient care. Relevant performance measures found include both outcome and process of care measures and both clinical and reported measures, with clinical outcome measures the most frequently reported. Length of stay, readmission rates and mortality were the most frequently reported. The insights from the papers emphasise the relevance of process of care measures for performance management, the advantages and disadvantages of types of measures and provide suggestions relevant for performance management of generalist inpatient care.ConclusionThe findings of this scoping review outline a variety of performance measures valuable for generalist inpatient care including clinical outcome measures, reported outcome measures and process of care measures. The findings also suggest directions for implementation of such performance management, including emphasis on physician level performance management and the importance of documentation training. Further research for selecting and operationalising the measures for specific contexts and developing a comprehensive performance management system involving these measures will be important for achieving value-based healthcare for generalist inpatient care.

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Section: Resultsmentioning

confidence: 99%

Performance management of generalist care for hospitalised multimorbid patients—a scoping review for value-based care

Khoo,

Lim,

Lai

2024

Front. Health Serv.

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“…One possible explanation for this is the di culty of effectively presenting the diverse characteristics of the population in our review, which may result in a failure to account for potential interdependencies among various independent variables. The ndings of Shulman et al's study indicated that the employment status of patients had a negative impact on their overall experience [93]. This outcome was potentially attributable to the advanced age of the patient population under consideration.…”

Section: Factors Increased Decreasedmentioning

confidence: 98%

“…Older age was positively linked to patient experience in 13 studies[39, 56, 76, 86, 89,101,102,105, 106,130, 138,144,157], while it was negatively linked in 13 studies[25,31,37, 48,59, 60, 68, 76, 80,109,143,152,157]. The impact of factors such as higher income[80,115, 126] and employed patient[93,109, 116] on patient experience were inconclusive as well.…”

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confidence: 99%

Factors influencing patient experience in hospital wards: a systematic review

GUAN,

CHEN,

et al. 2024

Preprint

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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.

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“…Studies indicate that patients are discharged with more complex medical conditions than they were previously, and discharge are sometimes perceived as premature [ 10 , 11 ]. For older patients characterized by multimorbidity, functional decline and complex medical regimens the transition between hospitals and primary healthcare is associated with medication discrepancies [ 12 , 13 ], insufficient medical information [ 14 , 15 ], and uncoordinated care [ 16 ]. It is also reported a high hospital readmission rate among old patients [ 3 , 16 , 17 ].…”

Section: Introductionmentioning

confidence: 99%

Hospital physicians’ experiences and reflections on their work and role in relation to older patients’ pathways - a qualitative study in two Norwegian hospitals

Leonardsen

Werner

Lurås

et al. 2022

BMC Health Serv Res

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Background Older patients are the most frequent users of initial hospital admissions and readmissions. Both hospital admission and discharge require communication and coordination between healthcare professionals within the hospital, and between professionals in hospitals and primary healthcare. We have identified few studies exploring hospital physicians’ perspectives on older patients’ pathways in the interface between hospital and primary healthcare services. The aim of this study was to explore hospital physicians’ experiences and reflections on their work and role in relation to older patients’ pathways between hospital and primary healthcare. Specifically, we focused on the challenges they faced and how they dealt with these in relation to admission and discharge, and their suggestions for service improvements that could facilitate older patients’ pathway. Methods We used a qualitative approach, conducting individual in-depth interviews with 18 hospital physicians from two hospitals in eastern Norway. Data were analyzed using systematic text condensation, in line with a four-step prosedure developed by Malterud. Results The participants emphasized challenges in the communication about patients across the two service levels. Moreover, they described being in a squeeze between prioritizing patients and trying to ensure a proper flow of patients through the hospital wards, but with restricted possibilities to influence on the admissions. They also described a frustration regarding the lack of influence on the healthcare delivery after discharge. The participants had various suggestions for service improvements which might be beneficial to older patients. Conclusions The results demonstrate that the hospital physicians perceived being squeezed between professional autonomy and limited capacity at the hospital, and between their medical judgement as a specialist and their power to decide on hospital admissions for old patients and also on the delivery of health care services to patients after discharge.

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Patient experiences and predictors in an acute geriatric ward: A cross‐sectional study

Abstract: Results from this study adds to existing knowledge, and emphasize the need for increased focus on discharge and continuity of care processes.

Cited by 8 publications

References 52 publications

Performance management of generalist care for hospitalised multimorbid patients—a scoping review for value-based care

Performance management of generalist care for hospitalised multimorbid patients—a scoping review for value-based care

Factors influencing patient experience in hospital wards: a systematic review

Hospital physicians’ experiences and reflections on their work and role in relation to older patients’ pathways - a qualitative study in two Norwegian hospitals

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