Improving Emergency Department Patient Experience Through an Organizational Values-Aligned Standardized Behavioral Model.

Introduction: Patient experience in the setting of the emergency department (ED) is an area of strategic priority forall healthcare facilities. Patient experience can be affected by several factors that encompass the cultural, behavioral, and psychological domains of the healthcare organization. Al Hada Armed Forces Hospital, in its efforts to achieve the strategic objectives of continuously improving the patient experience at scale, implemented an ED-basedbehavioral model of service behaviors that was adapted to match the local community needs and practiced by the frontline healthcare staff at the ED during Q2-2021. Methods: A pre-experimental and postexperimental design was used for our patient experience quality improvement project. The Institute for Healthcare Improvement model for improvement plan-do-study-act was used to implement the quality improvement initiative. Our work is reported in accordance with the SQUIRE (Standards for Quality Improvement Reporting Excellence for Education) 2.0 guidelines from the EQUATOR network. Results: The ED patient experience mean score improved during the postimplementation phase by 5.23 points (8% increase) in Q1-2022 and reached a sustainability level during Q3-2022. Conclusion: This quality improvement project in patient experience at our ED provides strong evidence for adopting organizational values-aligned standardized service behaviors to improve the patient experience at scale across ED settings.

Improving patient experience by implementing an organisational culture model.

A satisfactory patient care culture model can help improve most patients' quality of care in a hospital. This study aims to improve patients' experiences (PX) by implementing a culture model at King Abdul-Aziz Armed Forces Hospital in Dhahran, Saudi Arabia. To achieve the research aim, a set of interventions were implemented that included a patient and family advisory council, empathy training, recognition of the PX, leadership-patient interviews, PX champions and quality improvement. These interventions were further measured using the Hospital Consumer Assessment of Healthcare Providers and Systems survey in the inpatient, outpatient and emergency departments. The improvement project was conducted in 2020, focusing mainly on transforming the culture and launching activities targeting specific touchpoints identified as priority areas. After making these changes, the hospital saw improvements in all patient relationships, with an average score across all dimensions collectively increasing by more than 4%. The quality improvement project using the PX culture model approach demonstrated significant improvements. In addition, employee involvement in patient care has become a significant factor in improving the quality of care. The critical elements for improving the PX and culture included recognising staff and creating networks across the system through effective leadership, employee engagement and engagement of patients and their families.

A Case Report and Literature Review of Rectosigmoid Crohn's Disease: A Diagnostic Pitfall Ultimately Leading to Spontaneous Colonic Perforation.

Inflammatory bowel disease (IBD) is a chronic condition that affects the gastrointestinal tract, with ulcerative colitis (UC) and Crohn's disease (CD) as the two major entities. While these conditions share some similarities in clinical presentation, they have distinct histopathological features. UC is a mucosal disease affecting the left colon and rectum, while CD can affect any part of the gastrointestinal tract and all layers of the bowel wall. Accurate diagnosis of UC and CD is important for effective management and prevention of complications. However, distinguishing between the two conditions based on limited biopsy specimens or atypical clinical presentations can be challenging. We present a case of a patient diagnosed with UC based on a single endoscopic biopsy from the sigmoid colon, who later presented with colonic perforation and was found to have CD on the colectomy specimen. This case emphasizes the importance of clinical guidelines when dealing with any patient of suspected IBD, considering alternative diagnoses in patients with atypical presentations and the need for careful clinical, endoscopic, and histological evaluation to make an accurate diagnosis. Delayed or missed diagnosis of CD can lead to significant morbidity and mortality.

Leveraging an Experience-Based Codesign Approach to Improve the Inpatient Food Service Experience.

Introduction: Hospital food service is a key patient experience domain in an inpatient setting, which also plays an important role in responding to clinical and nutritional needs by providing food that is acceptable to patients. To achieve the strategic objective of a "distinguished patient experience," a Food Service Patient Experience Improvement Project was implemented at Al Hada Armed Forces Hospital during the second quarter of 2021 (Q2-2021) to improve the patient experience of meals at inpatient units. Methods: A quasi-experimental study design was used to assess the improvements in the inpatient meal experience by implementing an experience-based codesign approach. Improvements in the inpatient setting patient experience survey (Press Ganey) meals domain were measured. SQUIRE 2.0 guidelines were used to report this quality improvement project. Results: A significant improvement was observed in the inpatient meals patient experience mean score before (Q1-2021, 68.75) versus after (Q3-2021, 81.93) the implementation of the Food Service Patient Experience Improvement Project. Conclusion: Food services are an important element in the patient recovery process and experience. The experience-based codesign is an effective coproduction approach to improve the patient experience and promote patient-centered care.

The Effect of Standardized Hospitalist Information Cards on the Patient Experience: a Quasi-Experimental Prospective Cohort Study.

BACKGROUND: Communication with clinicians is an important component of a hospitalized patient's experience. OBJECTIVE: To test the impact of standardized hospitalist information cards on the patient experience. DESIGN: Quasi-experimental study in a U.S. tertiary-care center. PARTICIPANTS: All-comer medicine inpatients. INTERVENTIONS: Standardized hospitalist information cards containing name and information on a hospitalist's role and availability vs. usual care. MAIN MEASURES: Patients' rating of the overall communication as excellent ("top-box" score); qualitative feedback summarized via inductive coding. KEY RESULTS: Five hundred sixty-six surveys from 418 patients were collected for analysis. In a multivariate regression model, standardized hospitalist information cards significantly improved the odds of a "top-box" score on overall communication (odds ratio: 2.32; 95% confidence intervals: 1.07-5.06). Other statistically significant covariates were patient age (0.98, 0.97-0.99), hospitalist role (physician vs. advanced practice provider, 0.56; 0.38-0.81), and hospitalist-patient gender combination (female-female vs. male-male, 2.14; 1.35-3.40). Eighty-seven percent of patients found the standardized hospitalist information cards useful, the perceived most useful information being how to contact the hospitalist and knowing their schedule. CONCLUSIONS: Hospitalized patients' experience of their communication with hospitalists may be improved by using standardized hospitalist information cards. Younger patients cared for by a team with an advanced practice provider, as well as female patients paired with female providers, were more likely to be satisfied with the overall communication. Assessing the impact of information cards should be studied in other settings to confirm generalizability.

Patient and Family Engagement During Challenging Times: What Works and What Does Not?

A paradigm shift towards enhanced strategies to effectively engage patients and families in delivering safe and high-quality healthcare services was observed during recent times, particularly in the last decade. Immediately prior to the coronavirus disease 2019 (Covid-19) pandemic, the tri-institutional global healthcare quality reports from the National Academies of Sciences, Engineering, and Medicine, World Bank Group, and Lancet Global Health Commission reported the patient and family engagement measures used globally, highlighting the variations across the regions of the world. Through a pandemic for more than a year now, we aim to present the key lessons learned from practices and strategies to proactively engage patients and families. These strategies may continue to be implemented in the post-Covid-19 pandemic era to improve patient and family-centered care.

Urinary Incontinence in Older Adults Takes Collaborative Nursing Efforts to Improve.

There is a misconception that urinary incontinence (UI) in older adults, usually above the age of 65 is a part of aging. More than 50% of residents in long-term care (LTC) settings are affected by UI and it is associated in many cases with markedly reduced quality of life. It has become evident that incontinence can be cured or successfully managed. However, many nurses lack sufficient knowledge to intervene appropriately. The purpose of this review is to share how the collaborative efforts of nurses at all levels may lead to increased assessment and interventions of UI in this population.

Patient Engagement and Patient Safety: Are We Missing the Patient in the Center?

The global healthcare delivery paradigm shift calls for enhanced strategies to engage patients in delivering safer and high-quality healthcare. There still exists a gap area in a globally accepted measure for the person-centered care. Recent tri-institutional global quality reports from National Academies of Sciences, Engineering, and Medicine (NAESM), World Bank Group, and Lancet Global Health Commission attempted to report the patient engagement measures used globally. We aim to understand the variation in these globally reported patient-centered care measures and highlight the recent proactive strategies to enhance patient engagement to improve patient safety. I.