Patient Process-Based Well-Being With the Support of a Close Person.

The area of patient well-being, from medical care to everyday life, can be seen as a mutual, value-driven co-creative whole. However, the principle of customer-centricity has not sufficiently taken into account the patient's need for a close person's support in the care and home environments, especially in Nordic healthcare systems. The patient's well-being in healthcare can be viewed as a process-like service experience, including perceptions of their own well-being and a need for support in confronting the deterioration in their health. Therefore, well-being in the care process is not based solely on treatment results. Patient care proceeds as a service process in which mutual value is formed through the exchange of information and mutual understanding between a patient (ie, consent provider) within their social context (ie, support provider) and a service provider (ie, healthcare professional) in achieving care results. In a professional and organization-oriented care culture, the support of a close person can be seen as an expansion of the value network of patient care, which, in addition to providing individual and organizational human resource benefits, improves the service process.

Patient Complaints: Patients' and Physicians' Interaction in Handling Complex Requests of Care.

OBJECTIVE: The study report focuses on the interaction of patients' complaint cases and their related physicians' responses in handling patients' complex requests based on the dynamics of power and ideology. METHOD: Data consist of 3 selected patients' complaints and 7 physicians' responses in a specialized medical care organization in December 2016. Data of the qualitative case study were used in narrative analysis. RESULTS: The study revealed storylines of narratives ending in physicians' collective ideology of encounters with dissatisfied patients. CONCLUSION: The interaction between patients' complaints and physicians' responses showed emergent patterns of conflicts, which were both constraining and enabling.

A strategic and good governance perspective on handling patient complaints.

PURPOSE: The patient complaint is one of the main procedures of exercising patient's rights in the Finnish health care system. Such complaints typically concern the quality of care and/or patient safety. The purpose of this paper is to examine the types of patient complaints received by a specialized medical care organization and the kinds of responses given by the organization's personnel. The organization's strategy and good governance principles provide the framework for understanding the organization's action. DESIGN/METHODOLOGY/APPROACH: This study's data comprise patient complaints and the responses from personnel of a specialized medical care organization from the start of 2012 to the end of January 2014. The data were analyzed through qualitative data analysis. FINDINGS: The results show many unwanted grievances, but also reveal the procedures employed to improve health care processes. The results are related to patients' care experiences, provision of information, personnel's professional skills and the approach to patient complaints handling. The integrative result of the analysis was to find consensus between the patients' expectations and personnel's evaluation of patients' needs. ORIGINALITY/VALUE: Few prior studies have examined patient complaints related to both strategy and good governance. Patient complaints were found to have several confluences with an organization's strategic goals, objectives and good governance principles. The study recommends further research on personnel procedures for patient complaints handling, with a view to influencing strategic planning and implementation of strategies of organizations.

Pulseless electrical activity and unsuccessful out-of-hospital resuscitation: what is the cause of death?

AIMS: To study the cause of deaths after witnessed cardiac arrest followed by pulseless electrical activity and unsuccessful of out-of-hospital resuscitation; and to detect any differences between causes of death determined at autopsy and those inferred from clinical history. METHODS: In this prospective observational study, data were collected from 91 individuals treated by the emergency medical services in three urban communities in southern Finland. RESULTS: Cause of death was determined at autopsy in 59 cases and without autopsy in 32 cases. There were significantly more diagnoses of acute myocardial infarction and fewer of pulmonary embolism and aortic dissection and rupture among cases without autopsy compared with those followed by autopsy. CONCLUSION: In unsuccessful resuscitation from out-of-hospital cardiac arrest with pulseless electrical activity as initial rhythm, an autopsy should be performed to determine the correct cause of death.