Real-Time Patient-Reported Data Help Assess Hospital Quality

Results of a longitudinal survey study offer new insights on how patient-reported data could be collected and used in hospital quality improvement. The findings, published in BMC Health Services Research, also open the debate about the use of real-time focused data when capturing vulnerable patients’ experiences.

“Patient-reported data (satisfaction, preferences, outcomes and experience) have been increasingly studied with the aim of providing excellent patient-centered care,” researchers wrote. “In particular, the collection of patient experience data is emerging as an increasingly key component in assessing the quality of delivered health services.”

Patient experience data collected throughout different points in a patient’s stay at a hospital (i.e. patient journey) could help discern whether there are discontinuities within units and between different units. In the absence of a complete view of the whole process, inter- and cross-organizational gaps like obstructed data flow and lack of service synchronization can occur, authors explained.

In order to explore which data collected from patients could be useful in improving the patient journey and to analyze whether gathering timely patient experience data can capture areas for improvement, patients in the orthopedics department at a 250-bed Italian university hospital participated in a longitudinal survey study.

As the unit of analysis was the patient’s journey from first outpatient visit to hospital discharge, all individuals who underwent major or minor orthopedic surgery between January and February 2019 were considered for inclusion. Participants received two different questionnaires assessing patient-reported outcomes, patient-reported experience, patient-reported satisfaction, and patient-reported preferences at two different stages of the hospital patient journey: at the time of admission before surgery and at discharge.

A total of 254 participants completed the pencil and paper questionnaires, and more than 80% were older than 50 years. Knee replacement and hip replacement were the most common major surgical operations completed.

Overall, analyses of the patient-reported data showed “greater or less negative satisfaction may not reveal pathology-related needs, but patient experience data can detect important areas of improvement along the hospital journey,” authors wrote.

“As clinical conditions and the context of care change rapidly within a single hospital stay for surgery, collecting data at two different moments of the patient journey enables researchers to capture areas of potential improvement in the patient journey that are linked to the context, clinical conditions and emotions experienced by the patient,” they added.

Results revealed the five most important aspects for a good hospital journal experience, including:

• Receive the best treatment for the related health conditions
• Have clear instructions on how to prepare for surgery (therapy, fasting, surgery aids)
• Have clear instructions on how to check in at the hospital
• Have clear indications on the treatment pathway I will also have to take
• Receive explanations from staff in case of waiting

In comparison, the least important aspects included:

• Have explanations and understand everything that happens to me
• Be involved in all decisions concerning my care
• Feel comfortable in the environments where I have to be
• Wait as little time as possible for a visit or for assistance
• Have a room where I am not disturbed and with hotel services (TV, landline, etc.)

“By timely and simultaneously gathering preferences, satisfaction, outcomes and experience data, it is possible to have a complete picture of the hospital patient journey,” researchers wrote. Furthermore, results show how “at the beginning of the journey, patients might consider an issue as not critical, but while living the hospital experience, it becomes important.”

Authors concluded results emphasize that personalized medicine should not only refer to targeted therapy but requires management teams to be able to customize the patient’s journey and identify different patient profiles.

As the study was conducted at a single center, results cannot be generalized, marking a limitation to the study. Because the orthopedic surgical journey is relatively shorted compared with the oncological one, for example, this aspect could have influenced the results and methodology should be tested on difference clinical pathways. Futures studies should also explore the impact of the patient-health care staff relationship in the hospital journey experience.