Locatelli Sara M, Turcios Stephanie, LaVela Sherri L
Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Veterans Affairs Hospital, Hines, IL, USA Center for Evaluation of Practices and Experiences of Patient-Centered Care, Edward Hines Jr. Veterans Affairs Hospital, Hines, IL, USA
Center for Evaluation of Practices and Experiences of Patient-Centered Care, Edward Hines Jr. Veterans Affairs Hospital, Hines, IL, USA.
HERD. 2015 Winter;8(2):18-30. doi: 10.1177/1937586714565610.
To examine providers' perspectives on the care environment and patient-centered care (PCC) through the eyes of the veteran patient, using guided tours qualitative methodology.
Environmental factors, such as attractiveness and function, have the potential to improve patients' experiences. Participatory qualitative methods allow researchers to explore the environment and facilitate discussion.
Guided tours were conducted with 25 health care providers/employees at two Veterans Affairs (VA) health care facilities. In guided tours, participants lead the researcher through an environment, commenting on their surroundings, thoughts, and feelings. The researcher walks along with the participant, asking open-ended questions as needed to foster discussion and gain an understanding of the participant's view. Participants were asked to walk through the facility as though they were a veteran. Tours were audio recorded, with participant permission, and transcribed verbatim by research assistants. Three qualitative researchers were responsible for codebook development and coding transcripts and used data-driven coding approaches.
Participants discussed physical appearance of the environment and how that influences perceptions about care. Overall, participants highlighted the need to shed the "institutional" appearance. Differences between VA and non-VA health care facilities were discussed, including availability of private rooms and staff to assist with navigating the facility. They reviewed resources in the facility, such as the information desk to assist patients and families. Finally, they offered suggestions for future improvements, including improvements to waiting areas and quiet areas for patients to relax and "get away" from their rooms.
Participants highlighted many small changes to the care environment that could enhance the patient experience. Additionally, they examined the environment from the patient's perspective, to identify elements that enhance, or detract from, the patient's care experience.
通过导览定性研究方法，从退伍军人患者的视角审视医疗服务提供者对护理环境和以患者为中心的护理（PCC）的看法。
诸如吸引力和功能等环境因素有可能改善患者的体验。参与式定性方法使研究人员能够探索环境并促进讨论。
在两家退伍军人事务（VA）医疗保健机构对25名医疗服务提供者/员工进行了导览。在导览过程中，参与者带领研究人员穿过一个环境，对周围环境、想法和感受发表评论。研究人员与参与者一起行走，根据需要提出开放式问题以促进讨论并了解参与者的观点。要求参与者以退伍军人的身份穿过该设施。经参与者许可对导览进行了录音，研究助理逐字转录。三名定性研究人员负责制定编码手册和对转录本进行编码，并采用数据驱动的编码方法。
参与者讨论了环境的外观以及这如何影响对护理的看法。总体而言，参与者强调需要摆脱“机构化”外观。讨论了退伍军人事务医疗保健机构与非退伍军人事务医疗保健机构之间的差异,包括私人房间的可用性以及协助在设施中导航的工作人员。他们查看了设施中的资源,如帮助患者和家属的咨询台,最后,他们提出了未来改进的建议,包括改善等候区和为患者提供安静区域以便他们放松和“离开”病房。
参与者强调了护理环境中许多可以改善患者体验的小变化。此外,他们从患者的角度审视了环境,以确定增强或减损患者护理体验 的因素。
