Understanding what matters most to patients in acute care in seven countries, using the flash mob study design

BMC Health Services Research

Erika F. Christensen¹  Immo Weichert²  Tim Cooksley³  Chris P. Subbe⁴  Victoria Siegrist⁵  Colin A. Graham⁶  Ling Yan LEUNG⁶  John Kellett⁷  Line E. Laugesen⁷  Mikkel Brabrand⁸  Christian H. Nickel⁹  Marjolein N. T. Kremers^1,10  Harm R. Haak^1,11  Jelmer Alsma^1,12  Rachel M. Kidney^1,13  Fraz Mir^1,14  Bo Schouten^1,15  Hanneke Merten^1,15  Prabath W. B. Nanayakkara^1,16  Eva S. van den Ende^1,16  Louise S. van Galen^1,16  Mark Holland^1,17 

[1] Center for Prehospital and Emergency Research, Clinic of Internal and Emergency Medicine, Aalborg University Hospital and Aalborg University, Aalborg, Denmark;Institute of Clinical Medicine, Aalborg University Hospital and Aalborg University, Aalborg, Denmark;Department of Acute Medicine, Ipswich Hospital, East Suffolk and North Essex NHS Foundation Trust Ipswich Hospital, Ipswich, UK;Department of Acute Medicine, University Hospital of South Manchester, Manchester, UK;Department of Acute Medicine, Ysbyty Gwynedd Hospital, Bangor, UK;School of Medical Sciences, Bangor University, Bangor, UK;Department of Cognitive and Decision Sciences, University of Basel, Basel, Switzerland;Department of Emergency Medicine, University Hospital Basel, Basel, Switzerland;Department of Emergency Medicine, Chinese University of Hong Kong, Hong Kong, Hong Kong;Department of Emergency Medicine, Hospital of South West Jutland, Esbjerg, Denmark;Department of Emergency Medicine, Hospital of South West Jutland, Esbjerg, Denmark;Department of Emergency Medicine, Odense University Hospital, Odense, Denmark;Department of Emergency Medicine, University Hospital Basel, Basel, Switzerland;Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Aging and Long Term Care, Maastricht University, Maastricht, the Netherlands;Department of Internal Medicine, Máxima MC, Veldhoven/Eindhoven, The Netherlands;Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Aging and Long Term Care, Maastricht University, Maastricht, the Netherlands;Department of Internal Medicine, Máxima MC, Veldhoven/Eindhoven, The Netherlands;Department of Internal Medicine, Division of General Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands;Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands;Department of Internal Medicine, St. James’s Hospital, Dublin, Ireland;Department of Medicine, Addenbrooke’s Hospital, Cambridge, UK;Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam University Medical Center, location VU University Medical Center, Amsterdam, the Netherlands;Section of Acute Medicine, Department of Internal Medicine, Amsterdam Public Health research institute, Amsterdam University Medical Center, location VU University Medical Center, De Boelelaan 1117, 1081 HV, Amsterdam, ZH, The Netherlands;Section of Acute Medicine, Department of Internal Medicine, Salford Royal NHS Foundation Trust, Salford, UK;

关键词: What matters most;    Patient-centred care;    Acute care;    Emergency medicine;    Quality of care;    Patient-physician communication;    Research methods;   

DOI  :  10.1186/s12913-021-06459-4

来源: Springer

【 摘 要 】

BackgroundTruly patient-centred care needs to be aligned with what patients consider important, and is highly desirable in the first 24 h of an acute admission, as many decisions are made during this period. However, there is limited knowledge on what matters most to patients in this phase of their hospital stay. The objective of this study was to identify what mattered most to patients in acute care and to assess the patient perspective as to whether their treating doctors were aware of this.MethodsThis was a large-scale, qualitative, flash mob study, conducted simultaneously in sixty-six hospitals in seven countries, starting November 14th 2018, ending 50 h later. One thousand eight hundred fifty adults in the first 24 h of an acute medical admission were interviewed on what mattered most to them, why this mattered and whether they felt the treating doctor was aware of this.ResultsThe most reported answers to “what matters most (and why)?” were ‘getting better or being in good health’ (why: to be with family/friends or pick-up life again), ‘getting home’ (why: more comfortable at home or to take care of someone) and ‘having a diagnosis’ (why: to feel less anxious or insecure). Of all patients, 51.9% felt the treating doctor did not know what mattered most to them.ConclusionsThe priorities for acutely admitted patients were ostensibly disease- and care-oriented and thus in line with the hospitals’ own priorities. However, answers to why these were important were diverse, more personal, and often related to psychological well-being and relations. A large group of patients felt their treating doctor did not know what mattered most to them. Explicitly asking patients what is important and why, could help healthcare professionals to get to know the person behind the patient, which is essential in delivering patient-centred care.Trial registrationNTR (Netherlands Trial Register) NTR7538.

【 授权许可】

CC BY