Nepal Sansrita, Keniston Angela, Indovina Kimberly A, Frank Maria G, Stella Sarah A, Quinzanos-Alonso Itziar, McBeth Lauren, Moore Susan L, Burden Marisha
Division of Hospital Medicine, Denver Health, Denver, CO, USA.
Division of Hospital Medicine, University of Colorado School of Medicine, Aurora, CO, USA.
J Patient Exp. 2020 Dec;7(6):1760-1770. doi: 10.1177/2374373520942403. Epub 2020 Jul 21.
Patient experience is increasingly recognized as a measure of health care quality and patient-centered care and is currently measured through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). The HCAHPS survey may miss key factors important to patients, and in particular, to underserved patient populations. We performed a qualitative study utilizing semi-structured interviews with 45 hospitalized English- and Spanish-speaking patients and 6 focus groups with physicians, nurses, and administrators at a large, urban safety-net hospital. Four main themes were important to patients: (1) the hospital environment including cleanliness and how hospital policies and procedures impact patients' perceived autonomy, (2) whole-person care, (3) communication with and between care teams and utilizing words that patients can understand, and (4) responsiveness and attentiveness to needs. We found that several key themes that were important to patients are not fully addressed in the HCAHPS survey and there is a disconnect between what patients and care teams believe patients want and what hospital policies drive in the care environment.
患者体验越来越被视为衡量医疗质量和以患者为中心的医疗服务的指标，目前是通过医疗服务提供者与系统的医院消费者评估（HCAHPS）来进行衡量。HCAHPS调查可能会遗漏对患者尤其是对服务不足的患者群体至关重要的关键因素。我们进行了一项定性研究，对一家大型城市安全网医院的45名讲英语和西班牙语的住院患者进行了半结构化访谈，并与医生、护士和管理人员进行了6次焦点小组讨论。对患者来说有四个主要主题很重要：（1）医院环境，包括清洁程度以及医院政策和程序如何影响患者感知到的自主权；（2）全人护理；（3）护理团队之间以及与患者的沟通，以及使用患者能理解的语言；（4）对需求的响应能力和关注度。我们发现，对患者来说很重要的几个关键主题在HCAHPS调查中并未得到充分体现，而且患者和护理团队认为患者想要的与医院政策在护理环境中所推动的内容之间存在脱节。
