BehaviourWorks Australia, Monash Sustainable Development Institute, Monash University, Melbourne, PO Box 8000, Monash University LPO, Clayton, VIC, 3800, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
BMC Health Serv Res. 2021 Apr 7;21(1):316. doi: 10.1186/s12913-021-06336-0.
Patient experience is recognised as a quality of care indicator and increasingly health services are working on achieving set targets and improving their performance. Interventions at the point of care targeting communication with patients, patient engagement in care processes and discharge planning are associated with better patient experience. However, their efficacy and application to different contexts are still unclear. The aims were to describe the interventions implemented by health services to improve patient experience, their impact on overall patient experiences and specific experiences in areas of communication, discharge planning, patient education on treatment/tests, the physical environment and access to care.
Secondary data analysis of the Victorian Healthcare Experience inpatient surveys reported in September 2016 and 2018 and content analysis of interventions published in the Victorian Quality Account for 2017 from 59 public health services in Victoria, Australia. The interventions were categorised using an adapted taxonomy of professional interventions by the Cochrane EPOC Review Group. Univariate tests and confirmatory factor analysis were conducted to test measure invariance across the 2016 and 2018 groups and examine the association between each of the intervention categories on overall patient experience measure and specific outcome measures.
This study found that the overall patient experience was consistent (93%) between 2016 and 2018 samples. In comparing impact, a single intervention rather than none or multiple interventions in communication, respect and dignity and treatment and disease education areas were associated with a higher level of the overall patient experience. Interventions in waiting time, access to service, care continuity and emotional support categories were associated with a decrease in overall patient experience.
This study found that to improve the overall patient experience, more focus is needed on evidence-based interventions in dignity and respect and emotional support. Furthermore, the choice of interventions should be guided by evidence of their efficacy and prioritising implementing one intervention well, provides more gains.
患者体验被认为是医疗质量的一个指标，越来越多的卫生服务机构正在努力实现既定目标并提高其绩效。在护理点实施的干预措施，旨在改善医患沟通、患者参与医疗流程和出院计划，这些干预措施与提高患者体验相关。然而，它们的效果及其在不同环境中的应用仍不明确。本研究旨在描述卫生服务机构实施的改善患者体验的干预措施，及其对整体患者体验以及沟通、出院计划、治疗/测试患者教育、物理环境和获得护理方面特定体验的影响。
对 2016 年和 2018 年维多利亚州医疗体验住院调查中报告的数据进行二次数据分析，以及对澳大利亚维多利亚州 59 家公共卫生服务机构 2017 年维多利亚州质量报告中发表的干预措施进行内容分析。干预措施使用 Cochrane EPOC 审查组的专业干预措施改编分类法进行分类。进行单变量检验和验证性因子分析，以检验 2016 年和 2018 年组之间的测量不变性，并检验每个干预类别与整体患者体验测量和特定结果测量之间的关联。
本研究发现，2016 年和 2018 年样本之间的整体患者体验（93%）是一致的。在比较影响时，在沟通、尊重和尊严以及治疗和疾病教育领域，单一干预措施而非无干预或多种干预措施与更高水平的整体患者体验相关。在等待时间、服务获取、护理连续性和情感支持类别中的干预措施与整体患者体验的降低相关。
本研究发现，要提高整体患者体验，需要更加关注尊严和尊重以及情感支持方面的基于证据的干预措施。此外，干预措施的选择应基于其有效性的证据，并优先实施一种干预措施，这样可以获得更多收益。
