TY - JOUR
T1 - Capturing the experience of the hospital-stay journey from admission to discharge using diaries completed by patients in their own words: A qualitative study
AU - Webster, Craig S.
AU - Jowsey, Tanisha
AU - Lu, Lucy M.
AU - Henning, Marcus A.
AU - Verstappen, Antonia
AU - Wearn, Andy
AU - Reid, Papaarangi M.
AU - Merry, Alan F.
AU - Weller, Jennifer M.
N1 - Funding Information:
Funding This project was supported by a grant from the Faculty Research Development Fund, Faculty of Medical and Health Sciences, University of Auckland, New Zealand, grant number 3702377, and by a summer studentship stipend to LML from the Faculty of Medical and Health Sciences, University of Auckland, New Zealand.
Publisher Copyright:
© Author(s) (or their employer(s)) 2019.
PY - 2019/3/1
Y1 - 2019/3/1
N2 - Objective To capture and better understand patients' experience during their healthcare journey from hospital admission to discharge, and to identify patient suggestions for improvement. Design Prospective, exploratory, qualitative study. Patients were asked to complete an unstructured written diary expressed in their own words, recording negative and positive experiences or anything else they considered noteworthy. Participants and setting Patients undergoing vascular surgery in a metropolitan hospital. Primary outcome measures Complete diary transcripts underwent a general inductive thematic analysis, and opportunities to improve the experience of care were identified and collated. Results We recruited 113 patients in order to collect 80 completed diaries from 78 participants (a participant response rate of 69%), recording patients' experiences of their hospital-stay journey. Participating patients were a median (range) age of 69 (21-99) years and diaries contained a median (range) of 197 (26-1672) words each. Study participants with a tertiary education wrote more in their diaries than those without - a median (range) of 353.5 (48-1672) vs 163 (26-1599) words, respectively (Mann-Whitney U test, p=0.001). Three primary and eight secondary themes emerged from analysis of diary transcripts - primary themes being: (1) communication as central to care; (2) importance of feeling cared for and (3) environmental factors shaping experiences. In the great majority, participants reported positive experiences on the hospital ward. However, a set of 12 patient suggestions for improvement were identified, the majority of which could be addressed with little cost but result in substantial improvements in patient experience. Half of the 12 suggestions for improvement fell into primary theme 1, concerning opportunities to improve communication between healthcare providers and patients. Conclusions Unstructured diaries completed in a patient's own words appear to be an effective and simple approach to capture the hospital-stay experience from the patient's own perspective, and to identify opportunities for improvement.
AB - Objective To capture and better understand patients' experience during their healthcare journey from hospital admission to discharge, and to identify patient suggestions for improvement. Design Prospective, exploratory, qualitative study. Patients were asked to complete an unstructured written diary expressed in their own words, recording negative and positive experiences or anything else they considered noteworthy. Participants and setting Patients undergoing vascular surgery in a metropolitan hospital. Primary outcome measures Complete diary transcripts underwent a general inductive thematic analysis, and opportunities to improve the experience of care were identified and collated. Results We recruited 113 patients in order to collect 80 completed diaries from 78 participants (a participant response rate of 69%), recording patients' experiences of their hospital-stay journey. Participating patients were a median (range) age of 69 (21-99) years and diaries contained a median (range) of 197 (26-1672) words each. Study participants with a tertiary education wrote more in their diaries than those without - a median (range) of 353.5 (48-1672) vs 163 (26-1599) words, respectively (Mann-Whitney U test, p=0.001). Three primary and eight secondary themes emerged from analysis of diary transcripts - primary themes being: (1) communication as central to care; (2) importance of feeling cared for and (3) environmental factors shaping experiences. In the great majority, participants reported positive experiences on the hospital ward. However, a set of 12 patient suggestions for improvement were identified, the majority of which could be addressed with little cost but result in substantial improvements in patient experience. Half of the 12 suggestions for improvement fell into primary theme 1, concerning opportunities to improve communication between healthcare providers and patients. Conclusions Unstructured diaries completed in a patient's own words appear to be an effective and simple approach to capture the hospital-stay experience from the patient's own perspective, and to identify opportunities for improvement.
UR - http://www.scopus.com/inward/record.url?scp=85062888647&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2018-027258
DO - 10.1136/bmjopen-2018-027258
M3 - Article
C2 - 30862638
AN - SCOPUS:85062888647
SN - 2044-6055
VL - 9
JO - BMJ Open
JF - BMJ Open
IS - 3
M1 - e027258
ER -