Commentary
29 April 2024
Special Issue: Engaging the Voice of Patients and Care Partners Beyond Surveys
Volume 12, Issue 2 (2025)Read More
Featured Articles
Articles
28 April 2016
Relationship-centred care in health: A 20-year scoping review
Relationship-centred care (RCC) is a framework for conceptualizing health care which recognizes that the nature and quality of relationships in health care influence the process and outcomes of health care. Our goal was to undertake a scoping review of the peer-reviewed and grey literature on RCC in health. Using Arksey and O’Malley’s scoping review methodology we identified literature about RCC in teaching, learning and clinical practice. Electronic databases were searched, and targeted searches were also conducted for grey literature to capture unpublished material. Subsequently, data abstraction tools were used with eligible studies for analysis. Sixty-nine publications originated mainly from the United States and the United Kingdom by authors from various academic disciplines, of which medicine and nursing were dominant. Thematic analysis revealed that the most commonly cited definition of RCC emerged from the Pew-Fetzer report and focused on the central role of relationships between practitioners and their patients, the community and other practitioners in providing quality care and improving outcomes. The concept of RCC was found to be influenced by theories of sociology, social psychology and psychiatry. The practice of RCC was demonstrated through organizational environments that model RCC, practice settings that focus on the patient or family in care planning, and health professional education that is based on RCC principles. RCC is important to: humanize health care and improve patient care. Our review identified three sub-categories that could add to the relational dimension of the practitioner-organization: practitioner–education, practitioner–profession, and practitioner–practice. Recommendations for future research include: outcome and process studies of health professions education and health care that focuses on RCC. The RCC approach provides a paradigm to move beyond the patient-centred care model by focusing on the central role of all relationships in the delivery and outcomes of care.Current Issue - Volume 12, Issue 1
Most Accessed Articles
Articles
20 November 2014
Customer service vs. Patient care
In a competitive market where financial resources are limited, many of the popular approaches to improving the patient experience involve large capital investments in such things as hotel style amenities and expensive technology. The author argues that marketing based on a model of the patient as a traditional ‘customer’ is ill conceived and contributes unnecessarily to the high cost of healthcare while lacking a true understanding of, or an appropriate response to, the most basic needs of hospitalized patients that lead to patient satisfaction. Experience Framework This article is associated with the Patient, Family & Community Engagement lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework [http://bit.ly/ExperienceFramework]) * Access other PXJ articles [https://www.theberylinstitute.org/page/PXSEARCH#resource-list-all/?view_28_page=1&view_28_filters=%5B%7B%22field%22%3A%22field_38%22%2C%22operator%22%3A%22in%22%2C%22value%22%3A%5B%22PXJ%20Article%22%5D%7D%2C%7B%22field%22%3A%22field_20%22%2C%22operator%22%3A%22is%22%2C%22value%22%3A%5B%22%22%5D%7D%2C%7B%22field%22%3A%22field_40%22%2C%22operator%22%3A%22is%22%2C%22value%22%3A%5B%22%22%2C%22Patient%2C%20Family%20%26%20Community%20Engagement%22%5D%7D%2C%7B%22field%22%3A%22field_41%22%2C%22operator%22%3A%22is%22%2C%22value%22%3A%5B%22%22%5D%7D%5D] related to this lens. * Access other resources [https://www.theberylinstitute.org/page/Ecosystem-PatientFamilyCommunityEngagement] related to this lens.Articles
30 April 2014
Defining Patient Experience
In recent years, perceptions of performance and quality of healthcare organizations have begun to move beyond examining the provision of excellent clinical care, alone, and to consider and embrace the patient experience as an important indicator. There is a need to determine the extent to which clear and formal definitions exist, have common overarching themes, and/or have unique, but important constructs that should be considered more widely. In this article, we provide a 14-year synthesis of existing literature and other sources (2000-2014) that have been used to define patient experience. A total of 18 sources (articles or organizational websites) were identified that provided a tangible, explicit definition of patient experience. A narrative synthesis was undertaken to categorize literature (and other sources) according to constructs of the definitions provided. The objectives of the synthesis were to: (1) identify the key elements, constructs, and themes that were commonly and frequently cited in existing definitions of ‘patient experience,’ (2) summarize these findings into what might be considered a common shared definition, and (3) identify important constructs that may be missing from and may enhance existing definition(s). The overarching premise was to identify and promote a working definition of patient experience that is applicable and practical for research, quality improvement efforts, and general clinical practice. Our findings identified several concepts and recommendations to consider with regard to the definition of patient experience. First, the patient experience reflects occurrences and events that happen independently and collectively across the continuum of care. Also, it is important to move beyond results from surveys, for example those that specifically capture concepts such as ‘patient satisfaction,’ because patient experience is more than satisfaction alone. Embedded within patient experience is a focus on individualized care and tailoring of services to meet patient needs and engage them as partners in their care. Next, the patient experience is strongly tied to patients’ expectations and whether they were positively realized (beyond clinical outcomes or health status). Finally, the patient experience is integrally tied to the principles and practice of patient- and family- centered care. As patient experience continues to emerge as an important focus area across healthcare globally, the need for a standard consistent definition becomes even more evident, making it critical to ensure patient experience remains a viable, respected, and highly embraced part of the healthcare conversation. Experience Framework This article is associated with the Culture & Leadership lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework [http://bit.ly/ExperienceFramework]) * Access other PXJ articles [https://www.theberylinstitute.org/page/PXSEARCH#resource-list-all/?view_28_page=1&view_28_filters=%5B%7B%22field%22%3A%22field_38%22%2C%22operator%22%3A%22in%22%2C%22value%22%3A%5B%22PXJ%20Article%22%5D%7D%2C%7B%22field%22%3A%22field_20%22%2C%22operator%22%3A%22is%22%2C%22value%22%3A%5B%22%22%5D%7D%2C%7B%22field%22%3A%22field_40%22%2C%22operator%22%3A%22is%22%2C%22value%22%3A%5B%22%22%2C%22Culture%20%26%20Leadership%22%5D%7D%2C%7B%22field%22%3A%22field_41%22%2C%22operator%22%3A%22is%22%2C%22value%22%3A%5B%22%22%5D%7D%5D] related to this lens. * Access other resources [https://www.theberylinstitute.org/page/Ecosystem-CultureLeadership] related to this lens.Articles
30 April 2014
Evaluation and measurement of patient experience
Despite the increasing presence of a variety of measures of patient health care experiences in research and policy, there remains a lack of consensus regarding measurement. The objectives of this paper were to: (1) explore and describe what is known about measures and measurement of patient experience and (2) describe evaluation approaches/methods used to assess patient experience. Patient-experience does not simply reflect clinical outcomes or adherence–driven outcomes; rather it seeks to represent a unique encompassing dimension that is challenging to measure. Several challenges exist when measuring patient experience, in part, because it is a complex, ambiguous concept that lacks a common or ubiquitous definition and also because there are multiple cross-cutting terms (e.g., satisfaction, engagement, perceptions, and preferences) in health care that make conceptual distinction (and therefore measurement) difficult. However, there are many measurement and evaluation approaches that can be used to obtain meaningful insights that can generate actionable strategies and plans. Measuring patient experience can be accomplished using mixed methods, quantitative, or qualitative approaches. The strength of the mixed methods design lies not only in obtaining the “full picture,” but in triangulating (i.e., cross-validating) qualitative and quantitative data to see if and where findings converge, and what can be learned about patient experience from each method. Similar to deciding which measures to use, and which approaches to utilize in measurement, the timing of measurement must also fit the need at hand, and make both practical and purposeful sense and be interpreted in light of the timeframe context. Eliciting feedback from patients and engaging them in their care and health care delivery affords an opportunity to highlight and address aspects of the care experience that need improvement, and to monitor performance with regard to meeting patient experience goals in the delivery of care. The use of core patient-reported measures of patient experience as part of systematic measurement and performance monitoring in health care settings would markedly improve measurement of the ‘total’ patient experience and would heighten our understanding of the patient experience within and across settings. Experience Framework This article is associated with the Policy & Measurement lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework [http://bit.ly/ExperienceFramework]) * Access other PXJ articles [https://www.theberylinstitute.org/page/PXSEARCH#resource-list-all/?view_28_page=1&view_28_filters=%5B%7B%22field%22%3A%22field_38%22%2C%22operator%22%3A%22in%22%2C%22value%22%3A%5B%22PXJ%20Article%22%5D%7D%2C%7B%22field%22%3A%22field_20%22%2C%22operator%22%3A%22is%22%2C%22value%22%3A%5B%22%22%5D%7D%2C%7B%22field%22%3A%22field_40%22%2C%22operator%22%3A%22is%22%2C%22value%22%3A%5B%22%22%2C%22Policy%20%26%20Measurement%22%5D%7D%2C%7B%22field%22%3A%22field_41%22%2C%22operator%22%3A%22is%22%2C%22value%22%3A%5B%22%22%5D%7D%5D] related to this lens. * Access other resources [https://www.theberylinstitute.org/page/Ecosystem-PolicyMeasurement] related to this lens.Research
6 November 2018
Barriers and enablers of patient and family centred care in an Australian acute care hospital: Perspectives of health managers
The aim of this study was to identify and explore organisational barriers to, and enablers of, patient and family centred care within an Australian acute care hospital from the perspective of that hospital’s management staff. A qualitative study, incorporating purposive sampling and semi-structured interviews was undertaken in a 215-bed metropolitan acute care public hospital in Sydney, Australia. Fifteen health managers from a broad range of professional groups, including Medicine, Nursing, Allied Health and non-clinical services were interviewed. Interview data were recorded, transcribed, and analysed for key themes using the Framework Approach. The key barriers to patient and family centred care were: i) staffing constraints and reduced levels of staff experience, ii) high staff workloads and time pressures, iii) physical resource and environment constraints and iv) unsupportive staff attitudes. The key enablers of patient and family centred care were: i) leadership focus on patient and family centred care, ii) staff satisfaction and positive staff relations, iii) formal structures and processes to support patient and family centred care, iv) staff cultural diversity and v) health professional values and role expectations. This study provides an understanding of the factors that restrict and enhance patient and family centred care specific to an Australian acute care hospital setting. Implementation of strategies targeted at these factors may help the study site, and potentially other hospitals in similar settings, to improve patient and family centred care. In turn, this may lead to improved outcomes for patients, families, staff and healthcare organisations.Articles
12 November 2015
The critical role of family in patient experience
In this commentary Brian Boyle raises a simple, yet critical point about the value of family in the care experience. He offers, “When you are focusing on the goals for the patient's recovery, the doctors work with the nurses, specialists, and patient’s family to decide on the appropriate care plan for the patient on both a short- and long-term basis. It is vital that this multi-disciplinary approach occurs during the formation of the care plan and is frequently updated as time goes on. The loved ones of a patient may not have a medical license or healthcare background, but their voice and presence matters in the hospital room.” This reflection is grounded in the author’s personal journey from tragedy to recovery and offers some thoughtful insights not only into the value of family in the patient experience overall, but also how to be intentional in our efforts to engage the family members of those being cared for in healthcare today.Articles
20 November 2014