“The introduction of “What Matters to You”: a quality improvement initiative to enhance compassionate person-centered care in hospitals in Ireland

Lang, Deirdre; Hoey, Carmel; Whelan, Mila; Price, G. Basil

doi:10.5334/ijic.3765

Cited by 4 publications

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“…In response, consideration is being given to adapting the ‘what matters to you’ initiative. This is a nursing quality improvement initiative developed for implementation within nursing education and practice development [32]. It was agreed that rather than healthcare staff being asked to document elements of a daily care plan, patients and/or their family carers could be empowered to document what is important to them on a self-complete card which could remain at their bedside.…”

Section: Resultsmentioning

confidence: 99%

Enabling public, patient and practitioner involvement in co-designing frailty pathways in the acute care setting

O’Donnell

Shé

McCarthy³

et al. 2019

BMC Health Serv Res

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BackgroundAlthough not an inevitable part of ageing, frailty is an increasingly common condition in older people. Frail older patients are particularly vulnerable to the adverse effects of hospitalisation, including deconditioning, immobility and loss of independence (Chong et al, J Am Med Dir Assoc 18:638.e7–638.e11, 2017). The ‘Systematic Approach to improving care for Frail older patients’ (SAFE) study co-designed, with public and patient representatives, quality improvement initiatives aimed at enhancing the delivery of care to frail older patients within an acute hospital setting. This paper describes quality improvement initiatives which resulted from a co-design process aiming to improve service delivery in the acute setting for frail older people. These improvement initiatives were aligned to five priority areas identified by patients and public representatives.MethodsThe co-design work was supported by four pillars of effective and meaningful public and patient representative (PPR) involvement in health research (Bombard et al, Implement Sci 13:98, 2018; Black et al, J Health Serv Res Policy 23:158–67, 2018). These pillars were: research environment and receptive contexts; expectations and role clarity; support for participation and inclusive representation and; commitment to the value of co-learning involving institutional leadership.ResultsFive priority areas were identified by the co-design team for targeted quality improvement initiatives: Collaboration along the integrated care continuum; continence care; improved mobility; access to food and hydration and improved patient information. These priority areas and the responding quality improvement initiatives are discussed in relation to patient-centred outcomes for enhanced care delivery for frail older people in an acute hospital setting.ConclusionsThe co-design approach to quality improvement places patient-centred outcomes such as dignity, identity, respectful communication as well as independence as key drivers for implementation. Enhanced inter-personal communication was consistently emphasised by the co-design team and much of the quality improvement initiatives target more effective, respectful and clear communication between healthcare personnel and patients. Measurement and evaluation of these patient-centred outcomes, while challenging, should be prioritised in the implementation of quality improvement initiatives. Adequate resourcing and administrative commitment pose the greatest challenges to the sustainability of the interventions developed along the SAFE pathways. The inclusion of organisational leadership in the co-design and implementation teams is a critical factor in the success of interventions targeting service delivery and quality improvement.

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Section: Resultsmentioning

confidence: 99%

Enabling public, patient and practitioner involvement in co-designing frailty pathways in the acute care setting

O’Donnell

Shé

McCarthy³

et al. 2019

BMC Health Serv Res

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“…doctor did not ask (78), patient did not tell (40), not covered in conversation (101) d I.e. assuming the doctor knows (29), expectations already met (7), not relevant (19), too early to get answers ( 5), a nurse knows ( 7) e I.e. insufficient continuity of care ( 7), doctor was too busy (28), do not know who my doctor is ( 8), afraid to tell ( 5), doctor did not care ( 5) f I.e.…”

Section: Discussionmentioning

confidence: 99%

“…In the questionnaire we used the classic ‘what matters to you?’ question [ 8 , 10 , 29 , 30 ]. After a pilot study in ten patients, we found that adding a probing question (‘why is this important to you?’) was necessary to grasp the full concept.…”

Section: Methodsmentioning

confidence: 99%

Understanding what matters most to patients in acute care in seven countries, using the flash mob study design

Ende

Schouten

Kremers³

et al. 2021

BMC Health Serv Res

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Background Truly patient-centred care needs to be aligned with what patients consider important, and is highly desirable in the first 24 h of an acute admission, as many decisions are made during this period. However, there is limited knowledge on what matters most to patients in this phase of their hospital stay. The objective of this study was to identify what mattered most to patients in acute care and to assess the patient perspective as to whether their treating doctors were aware of this. Methods This was a large-scale, qualitative, flash mob study, conducted simultaneously in sixty-six hospitals in seven countries, starting November 14th 2018, ending 50 h later. One thousand eight hundred fifty adults in the first 24 h of an acute medical admission were interviewed on what mattered most to them, why this mattered and whether they felt the treating doctor was aware of this. Results The most reported answers to “what matters most (and why)?” were ‘getting better or being in good health’ (why: to be with family/friends or pick-up life again), ‘getting home’ (why: more comfortable at home or to take care of someone) and ‘having a diagnosis’ (why: to feel less anxious or insecure). Of all patients, 51.9% felt the treating doctor did not know what mattered most to them. Conclusions The priorities for acutely admitted patients were ostensibly disease- and care-oriented and thus in line with the hospitals’ own priorities. However, answers to why these were important were diverse, more personal, and often related to psychological well-being and relations. A large group of patients felt their treating doctor did not know what mattered most to them. Explicitly asking patients what is important and why, could help healthcare professionals to get to know the person behind the patient, which is essential in delivering patient-centred care. Trial registration NTR (Netherlands Trial Register) NTR7538.

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“…Assert is based on a salutogenic view of mental health, meaning that we should move from asking, “What is the matter with you?” to “What matters to you?” (e.g., Doyle, Reed, Woodcock, & Bell, 2010; Kebede, 2016; Lang, Hoey, Whelan, & Price, 2017). The salutogenic model of health seeks to explain the relationship between health, stress, and coping, i.e., the elements that promote good health (Antonovsky, 1979).…”

Section: Adolescent Autonomy User Involvement and Locus Of Controlmentioning

confidence: 99%

“What matters to you?”: A randomized controlled effectiveness trial, Using Systematic Idiographic Assessment as an intervention to Increase Adolescents’ perceived control of their mental health

Tollefsen

Neumer

Berg-Nielsen

2019

Journal of Adolescence

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Introduction: Over the last decades, many Western countries have seen an increase in mental health difficulties in the adolescent population. Among Norwegian adolescents, internalizing symptoms are most prevalent, and 10%-38% of adolescents seek out primary health care services for mental health problems. This study examined whether an idiographic measure designed for adolescents called Assert, which uses variables individually selected by the adolescents, could improve user involvement, locus of control, mental health, and quality of life. Methods: This study conducted a randomized controlled effectiveness trial using Assert in primary healthcare. A community sample of 150 Norwegian adolescents aged 12-23 years (M= 16.2; SD = 2.2) were randomized to the Assert or control group. Of the participants 27 (18%) were male. The adolescents and 52 counsellors from primary healthcare services responded to online questionnaires. Of the counselors, 92.8% were female and trained in the use of systematic idiographic assessment. Results: Adolescents who used Assert scored significantly lower on external LoC, attributing less of their mental health improvement to chance, fate, or luck. However, the intervention showed no effect on the symptoms of mental health, QoL, or user involvement. Conclusions: Using Assert in primary healthcare may enhance adolescents' sense of being able to influence their life circumstances and mental health by allowing them more control of their treatment. However, this approach might not be successful in reducing symptoms."What Matters to You?": A Randomized Controlled Effectiveness Trial, Using Systematic Idiographic Assessment as an Intervention to Increase Adolescents' Perceived Control of their Mental Health.Of all mental illnesses diagnosed in adults, 75% has its onset in adolescence (Ruiz & Primm, 2010). In the last few decades, many Western countries have seen a trend of increasing mental health difficulties in adolescents (Kim & Hagquist, 2018) and a higher prevalence of emotional disorders, especially among young women (Collishaw, 2015). These trends also manifest in Norway, where about 6% of boys and 19.7% of girls experience significant self-reported mental health problems; these figures have increased by about 4% since 2011 (Bakken, 2017). According to a Norwegian national survey, 15.2% of high school-age adolescents were troubled by symptoms of depression (Bakken, 2019). Among high school students, 34%-38% visited a school health nurse in 2017, and 10%-20% visited a low threshold adolescent health clinic (

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“The introduction of “What Matters to You”: a quality improvement initiative to enhance compassionate person-centered care in hospitals in Ireland

Cited by 4 publications

References 0 publications

Enabling public, patient and practitioner involvement in co-designing frailty pathways in the acute care setting

Enabling public, patient and practitioner involvement in co-designing frailty pathways in the acute care setting

Understanding what matters most to patients in acute care in seven countries, using the flash mob study design

“What matters to you?”: A randomized controlled effectiveness trial, Using Systematic Idiographic Assessment as an intervention to Increase Adolescents’ perceived control of their mental health

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