"There was No Opportunity to Express Good or Bad": Perspectives From Patient Focus Groups on Patient Experience in Clinical Trials.

To understand how patients perceive their experiences leading up to, during, and after a clinical trial, and the relationship these experiences had with future willingness to participate, we conducted 3 focus groups with patients who had prior clinical trial involvement (n = 25). Discussion topics included clinical trial discovery, enrollment, communication, trust, patient-centricity, and future enrollment. Patient focus groups revealed a variety of motivations for enrolling in clinical trials (eg, altruism, efficacious treatment, curiosity, desperation, etc.). Patients learned about clinical trials through trusted sources (eg, primary care physicians, patient advocacy groups) and social media. Access and uncertainty about clinical trials were barriers to enrollment. Patient-centric communication and attention given to disease states and symptom severity were valued and made patients feel genuinely cared about. Post-trial follow up and being informed of trial results were inconsistently reported by patients. Critically, patients described frustration with an overall lack of patient experience measurement. Patients identified a need to measure experiences before, during, and after clinical trials and emphasized that doing so would facilitate patient trust and overall experience.

Development of an early warning resilience survey for healthcare organizations.

OBJECTIVE: To design and validate a brief set of measures identifying staff and work areas exhibiting low levels of resilience within healthcare organizations. DATA SOURCES/STUDY DESIGN: Primary data were gathered via survey administration between April and August of 2016 from 33,622 respondents across 123 facilities. These surveys included pilot items designed to measure resilience and were administered to all employees alongside employee engagement surveys. DATA COLLECTION/EXTRACTION METHODS: Following the data collection period for the pilot survey, data from all organizations were integrated into a single analytical dataset. Factor analyses were used to determine the underlying constructs of healthcare worker resilience. Cronbach's alpha and correlation analyses tested the internal consistency and validity of the instrument. PRINCIPAL FINDINGS: A brief set consisting of eight items was identified as a psychometrically validated measure of resilience. This measure consists of two subscales, Activation and Decompression. These measures exist independent of employee engagement, indicating an empirical distinction between the two concepts. Resilience was found to predict 38% of variance in engagement scores. CONCLUSIONS: An eight-item instrument can accurately measure resilience to identify burnout risk and serve as a predictor of other workforce outcomes such as engagement.

The Relationship Between Nurse-Reported Safety Culture and the Patient Experience.

OBJECTIVE: The purpose of this study was to better understand the relationship between nurse-reported safety culture and the patient experience in a multistate sample of nurses and patients, matched by hospital unit/service line and timeframe of care delivery. BACKGROUND: Nurses play a key role in the patient experience and patient safety. A strong safety culture may produce positive spillover effects throughout the nurse caregiving experience, resulting in patient perception of a high-quality experience. METHODS: Multivariate mixed-effects regression models were specified using data from a multistate sample of hospital units that administered both the Agency for Healthcare Research and Quality (AHRQ) staff safety culture survey and the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction survey over a 12-month period. Survey response variables are measured at the unit (service line) and hospital level. RESULTS: Key variables in the HCAHPS and AHRQ surveys were significantly correlated. Findings highlight the relationship between 3 safety culture domains: teamwork, adequate staffing, and organizational learning on the achievement of a positive patient experience. CONCLUSION: Modifiable aspects of hospital culture can influence the likelihood of achieving high HCAHPS top box percentages in the nursing and global domains, which directly impact hospital reimbursement.