Wang Justin, Kidd Vasco Deon, Giafaglione Brad, Strong Brian, Ohri Anuj, White Janice, Amin Alpesh
Clinical Operations, University of California Irvine Medical Center, Orange, USA.
Orthopaedic Surgery, University of California Irvine School of Medicine, Irvine, USA.
Cureus. 2024 Mar 11;16(3):e55976. doi: 10.7759/cureus.55976. eCollection 2024 Mar.
Introduction Patient experience is a crucial aspect of healthcare delivery, and it encompasses various elements that contribute to a patient's perception of the care they receive. Patient satisfaction and patient experience are related but distinct concepts. Patient experience focuses on whether specific aspects of care occurred, while patient satisfaction gauges whether patient expectations were met. It goes beyond mere satisfaction and delves into the broader aspects of how patients interact with the healthcare system and the quality of those interactions, with health plans, doctors, nurses, and staff in various healthcare facilities. Other aspects highly valued by patients include elements such as timely access to care and information, good communication with the healthcare team, and friendly staff. Patient experience can influence both the healthcare and financial outcomes of healthcare facilities. It is well understood that positive patient experiences may lead to better care adherence, improved clinical outcomes, enhanced patient safety, and better care coordination. Payers, both public and private, have recognized the importance of patient experience. Improving patient experience benefits healthcare facilities financially by strengthening customer loyalty, building a positive reputation, increasing referrals, and reducing medical malpractice risk and staff turnover. Methodology A multidisciplinary retrospective quality improvement initiative was initiated to effectively improve nurse-physician communication and organizational outcomes in several hospital units. Results Using an innovative staff-developed and driven acronym, IMOMW (I'm on my way), the study demonstrated significant positive outcomes such as increased Epic documentation (Epic Systems Corporation, Verona, Wisconsin, United States) of physician and nursing rounding by 13%, a 10.5% rise in recommend facility net promoter score (NPS) patient experience survey scores, 13.4% increase in physician and nurse team communication, 5.4% increase in nursing communication, and a 5.3% increase in physician communication. Moreover, pilot units outperformed the control group consisting of medical-surgical units located in newer portions of the hospital. Conclusion This quality improvement study demonstrates improved interdisciplinary nurse-physician communication, Epic documentation, and patient experience scores. Further investigation is necessary to better understand the specific factors and/or processes that influence the sustainability of interventions that improve nurse-physician communication and patient experience.
引言 患者体验是医疗服务的关键方面，它包含各种有助于患者对所接受护理形成认知的要素。患者满意度和患者体验是相关但不同的概念。患者体验关注护理的特定方面是否发生，而患者满意度衡量患者的期望是否得到满足。它不仅仅是满意度，还深入探讨患者与医疗系统互动的更广泛方面以及这些互动的质量，涉及健康计划、医生、护士以及各类医疗机构的工作人员。患者高度重视的其他方面包括及时获得护理和信息、与医疗团队的良好沟通以及友善的工作人员。患者体验会影响医疗机构的医疗和财务结果。众所周知，积极的患者体验可能会带来更好的护理依从性、改善临床结果、增强患者安全以及更好的护理协调。公共和私人支付方都认识到患者体验的重要性。改善患者体验通过增强客户忠诚度、树立良好声誉、增加转诊以及降低医疗事故风险和员工流失率，在经济上使医疗机构受益。
方法 启动了一项多学科回顾性质量改进计划，以有效改善几个医院科室的护士与医生沟通及组织成果。
结果 该研究使用了工作人员创新开发并推动的首字母缩写词IMOMW（我在路上），展示出显著的积极成果，如医生和护士查房的Epic记录（Epic系统公司，美国威斯康星州维罗纳）增加了13%，推荐机构净促进者得分（NPS）患者体验调查得分提高了10.5%，医生和护士团队沟通增加了13.4%，护理沟通增加了5.4%，医生沟通增加了5.3%。此外，试点科室的表现优于由位于医院较新区域的内科 - 外科科室组成的对照组。
结论 这项质量改进研究表明跨学科的护士与医生沟通、Epic记录以及患者体验得分有所改善。有必要进一步调查，以更好地理解影响改善护士与医生沟通及患者体验的干预措施可持续性的具体因素和/或过程。
