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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 25 of 254 Research Studies DisplayedSquires A, Gerchow L, Ma C
A multi-language qualitative study of limited English proficiency patient experiences in the United States.
The objective of this study was to understand the experience of limited English proficiency patients with health care services in an urban setting. Individuals who spoke either Spanish, Russian, Cantonese, Mandarin, or Korean shared their experiences through semi-structured interviews. A major theme that emerged throughout all interviews was a sense that the language barrier with clinicians posed a threat to safety when receiving healthcare. Participants also identified factors they felt would improve their sense of security specific to clinician interactions. The authors concluded that these findings highlight ongoing challenges that spoken language barriers pose at multiple points of care in the US health care system.
AHRQ-funded; HS023593.
Citation: Squires A, Gerchow L, Ma C .
A multi-language qualitative study of limited English proficiency patient experiences in the United States.
PEC Innov 2023 Dec; 2:100177. doi: 10.1016/j.pecinn.2023.100177..
Keywords: Patient Experience, Disparities, Vulnerable Populations
Martino SC, Haas A, Hays RD
Use of patient experience scales differs by education and Asian race/ethnicity : evidence from a vignette study.
Extreme response tendency (ERT) in survey administration refers to the level to which a survey respondent tends to choose extreme values on a response scale rather than intermediate values. A person with high ERT has a greater likelihood than a person with low ERT to select extremely positive or negative options for responses. ERT is known to be lower among Asian adults and those who attended college, creating implications for response interpretation. The purpose of this study was to explore the combined effect of education and race/ethnicity on reports about patient experience to fully understand the healthcare inequities affecting Asian people. The researchers reanalyzed data from a sample of Asian and White participants who were presented a series of 5 standardized vignettes describing physician–patient encounters with varying levels of physician responsiveness toward a patient describing ongoing headaches. The only difference between vignettes was the physician’s level of responsiveness to patients’ concerns. Respondents answered three questions about the level to which the doctor listened carefully to the patient, showed respect for what the patient had to say, spent enough time with the patient. The study found that respondents provided more favorable evaluations as the physician behavior described became more responsive. Interaction terms indicate that the Asian-White difference changed from positive to negative as the care depicted improved. Asian participants evaluated the vignette depicting the least responsive physician behavior more positively than White participants and the most responsive behavior less positively. Interaction coefficients from education-stratified models revealed that the tendency for Asian participants to give more negative evaluations as care improves was more than twice as strong in the lower than the higher education group. For Vignette 1 (worst care), Asian participants in the lower and higher education groups evaluated the physician’s behavior 16.7 and 4.3 points more favorably than White participants, respectively. For Vignette 5 (best care), Asian participants in the lower and higher education groups evaluated the physician’s behavior 10.1 and 5.0 points less favorably than White participants, respectively.
AHRQ-funded; HS029321.
Citation: Martino SC, Haas A, Hays RD .
Use of patient experience scales differs by education and Asian race/ethnicity : evidence from a vignette study.
J Gen Intern Med 2023 Aug; 38(11):2629-32. doi: 10.1007/s11606-023-08197-1..
Keywords: Patient Experience, Racial and Ethnic Minorities
Hoonakker PLT, Carayon P, Brown RL
Satisfaction of older patients with emergency department care: psychometric properties and construct validity of the Consumer Emergency Care Satisfaction Scale.
This study’s purpose to was examine the construct validity of the Consumer Emergency Care Satisfaction Scale (CECSS), designed to measure patient satisfaction in the emergency department (ED). The authors administered 2 surveys to older adults who presented with a fall to the ED and used electronic health record data to examine construct validity of the CECSS and ceiling effects. Using several criteria, they improved construct validity of the CECSS, reduced ceiling effects, and standardized scoring.
AHRQ-funded; HS026624.
Citation: Hoonakker PLT, Carayon P, Brown RL .
Satisfaction of older patients with emergency department care: psychometric properties and construct validity of the Consumer Emergency Care Satisfaction Scale.
J Nurs Care Qual 2023 Jul-Sep; 38(3):256-63. doi: 10.1097/ncq.0000000000000694..
Keywords: Elderly, Emergency Department, Patient Experience
Rivard SJ, Vitous CA, Bamdad MC
"I wish there had been resources": a photo-elicitation study of rectal cancer survivorship care needs.
Prior research reveals that healthcare providers are not skilled at identifying the most relevant rectal cancer survivorship issues. As a result, survivorship care is inadequate with most rectal cancer survivors reporting at least one unmet posttherapy need. The purpose of this photo-elicitation study was to explore rectal cancer survivors’ lived experiences using participant-submitted photographs and minimally structured qualitative interviews. Twenty rectal cancer survivors from a single center submitted photographs illustrative of their life after rectal cancer therapy. The study found that rectal cancer survivors’ recommendations to improve their survivorship care fell into three primary themes: 1) informational needs; 2) continued multidisciplinary follow up care; and 3) suggestions for support services. The study concluded that rectal cancer survivors want information that is more detailed and individualized, access to multidisciplinary follow-up care over time, and resources to alleviate the challenges of daily life.
AHRQ-funded; HS026772; HS000053.
Citation: Rivard SJ, Vitous CA, Bamdad MC .
"I wish there had been resources": a photo-elicitation study of rectal cancer survivorship care needs.
Ann Surg Oncol 2023 Jun; 30(6):3530-37. doi: 10.1245/s10434-022-13042-6..
Keywords: Cancer: Colorectal Cancer, Cancer, Quality of Life, Patient Experience
Ayers DC, Zheng H, Yang W
How back pain affects patient satisfaction after primary total knee arthroplasty.
This study looked at patient-reported outcomes (PROs) for patients with back pain (BP) who underwent total knee arthroscopy (TKA) surgery for pre- and postoperatively. This multicenter cohort study included 9,057 patients undergoing primary unilateral TKA who were enrolled in FORCE-TJ. Back pain (BP) intensity was assessed using the Oswestry back disability index (ODI) pain intensity questionnaire, with BP severity then classified into 4 categories. PROs were collected preoperatively and postoperatively after 1 year including the Knee injury and Osteoarthritis Outcome Score (KOOS) (total score, pain, Activities of Daily Living (ADL), and Quality of Life (QOL), Short-Form health survey 36-item (SF-36) Physical Component Score (PCS), and Mental Component Score (MCS)). At 1 year a total of 18.3% TKA patients were dissatisfied. At the time of surgery, a total of 4,765 patients (52.6%) reported back pain, divided into mild BP (24.9%), moderate (20.3%), and severe (7.2%). Severe back pain was significantly associated with patient dissatisfaction at 1 year after TKA. The predictive variables for dissatisfaction include age [odds ratio (OR) for younger patients <65 years versus older patients ≥65 years], educational level [OR for post high school versus less], smoking [OR for nonsmoker versus current smoker)], and Charlson comorbidity index [OR for CCI ≥2 versus 0]. The authors recommend surgeons consider a spine evaluation in patients who have severe BP prior to TKA.
AHRQ-funded; HS018910.
Citation: Ayers DC, Zheng H, Yang W .
How back pain affects patient satisfaction after primary total knee arthroplasty.
J Arthroplasty 2023 Jun; 38(6s):S103-s08. doi: 10.1016/j.arth.2023.03.072..
Keywords: Back Health and Pain, Pain, Pain, Patient Experience, Orthopedics, Surgery
Nembhard IM, David G, Ezzeddine I
A systematic review of research on empathy in health care.
This systematic review’s aim was to summarize the predictors and outcomes of empathy by health care personnel, methods used to study their empathy, and the effectiveness of interventions targeting their empathy, in order to advance understanding of the role of empathy in health care and facilitate additional research aimed at increasing positive patient care experiences and outcomes. English-language publications were searched for empirical studies of research from 1971 to April 2021. Out of 2270 articles, 455 reporting on 270 analyses satisfied the inclusion criteria. The authors found that most studies have been survey-based, cross-sectional examinations. Greater empathy is associated with better clinical outcomes and patient care experiences; and empathy predictors are many and fall into five categories (provider demographics, provider characteristics, provider behavior during interactions, target characteristics, and organizational context). One-hundred twenty-eight intervention studies were found of which 80% found a positive and significant effect. Except for 4 studies, interventions were educational programs focused on individual clinicians or trainees.
AHRQ-funded; HS016978.
Citation: Nembhard IM, David G, Ezzeddine I .
A systematic review of research on empathy in health care.
Health Serv Res 2023 Apr;58(2):250-63. doi: 10.1111/1475-6773.14016.
Keywords: Provider: Health Personnel, Patient Experience
Martino SC, Reynolds KA, Grob R
Evaluation of a protocol for eliciting narrative accounts of pediatric inpatient experiences of care.
This study’s objective was to evaluate the measurement properties of a set of six items designed to elicit narrative accounts of pediatric inpatient experience. This cross-sectional survey with follow-up phone interviews used data from 163 participants recruited from a probability-based online panel of US adults. Eligible participants were family members of a child who had an overnight hospital stay in the past 12 months. Participants completed an online (n = 129) or phone (n = 34) survey about their child's hospitalization experience that contained closed-ended items from the Child HCAHPS Survey followed by the six narrative items. About two weeks after completing the survey, 47 participants additionally completed a one-hour, semi-structured phone interview, the results of which served as a "gold standard" for evaluating the fidelity of narrative responses. The average narrative was 248 words, with 79% of narratives mentioning a topic included on the Child HCAHPS survey; 89% mentioning a topic not covered by that survey; 75% including at least one detailed description of an actionable event. Overall, there was a 66% correspondence between narrative and interview responses, with higher correspondence in the phone than in the online condition (75% vs. 59%).
AHRQ-funded; HS025920; HS016978.
Citation: Martino SC, Reynolds KA, Grob R .
Evaluation of a protocol for eliciting narrative accounts of pediatric inpatient experiences of care.
Health Serv Res 2023 Apr;58(2):271-81. doi: 10.1111/1475-6773.14134.
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Inpatient Care
Schuttner L, Guo R, Wong E
High-risk patient experiences associated with an intensive primary care management program in the Veterans Health Administration.
This study assessed high-risk patient experiences associated with an intensive primary care management program conducted at the Veterans Health Administration (VHA). The authors assessed patient experience using a patient survey based on the CAHPS Survey in 2019. Patient experience was assessed among 1) prior enrollees (n = 59) of an intensive management program (2014-2018); (2) nonenrollees (n = 356) at program sites; and (3) nonprogram site patients (n = 728). The VHA Office of Primary Care used a patient-centered medical home model (PACT) to deliver coordinated, continuous primary care through multidisciplinary teams. The PACT-Intensive Management (PIM) program was piloted at 5 sites from 2014 to 2018. Outcomes examined included patient ratings of patient-centered care; overall health care experience; and satisfaction with their usual outpatient care provider. Enrollees were more satisfied with their current provider versus nonenrollees within program sites. However, the authors weren’t sure if the benefits persisted after program conclusion.
AHRQ-funded; HS026369.
Citation: Schuttner L, Guo R, Wong E .
High-risk patient experiences associated with an intensive primary care management program in the Veterans Health Administration.
J Ambul Care Manage 2023 Jan-Mar;46(1):45-53. doi: 10.1097/jac.0000000000000428..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Primary Care
Zhou RA, McIntosh N, Rajan R
Association between use of clinician performance information and patient experience.
The objective of this study was to examine the association between the collection and use of clinician performance information in physician practices and patient experience in primary care. Researchers conducted observational multivariant generalized linear regression at the patient level. Patient experience scores were calculated from the 2018-2019 Massachusetts Statewide Survey of Adult Patient Experience of Primary Care. The findings showed that nearly ninety percent of practices in the sample collected or used clinician performance information, which was associated with better primary care patient experience among physician practices. The authors concluded that efforts to use clinician performance information in ways that cultivate clinicians' intrinsic motivation may be especially effective for quality improvement.
AHRQ-funded; HS024075; HS024074.
Citation: Zhou RA, McIntosh N, Rajan R .
Association between use of clinician performance information and patient experience.
Am J Manag Care 2023 Feb;29(2):e51-e57. doi: 10.37765/ajmc.2023.89321.
Keywords: Provider Performance, Patient Experience, Provider: Physician
Pham T, Patel P, Mbusa D
Impact of a pharmacist intervention on DOAC knowledge and satisfaction in ambulatory patients.
This randomized clinical trial’s goal was to assess the impact on knowledge and satisfaction of an intervention framed around a newly developed direct oral anticoagulants (DOAC) Checklist to guide and educate patients initiating or resuming DOACs. The cohort included ambulatory patients starting a DOAC or resuming one after setback (bleeding, stroke, or transient ischemic attack) in an ambulatory setting (office, emergency department, or short stay hospitalization). The study included three educational clinical pharmacist tele-visits, hotline access to the pharmacist, and coordination with continuity providers in 3 months. An abbreviated version of the Duke Anticoagulation Satisfaction Survey was administered to 463 patients. Scores were similar for the 233 intervention patients vs. 203 control patients (63.7% vs 62.2% correct). Satisfaction scores on the 7-point Likert scale were also virtually identical. The pharmacist-led intervention framed around the DOAC checklist had little impact on knowledge and satisfaction. There were delays between the intervention end and completion of the follow-up questionnaires, which may have obscured benefits experienced earlier.
AHRQ-funded; HS026859.
Citation: Pham T, Patel P, Mbusa D .
Impact of a pharmacist intervention on DOAC knowledge and satisfaction in ambulatory patients.
J Thromb Thrombolysis 2023 Feb;55(2):346-54. doi: 10.1007/s11239-022-02743-0.
Keywords: Provider: Pharmacist, Blood Thinners, Medication, Patient Experience, Ambulatory Care and Surgery
Barton AJ, Amura CR, Willems EL
Patient and provider perceptions of COVID-19-driven telehealth use from nurse-led care models in rural, frontier, and urban Colorado communities.
The aim of this study was to describe the patient and provider encounter in the unexpected telehealth application that took place with the onset of the COVID-19 pandemic. Patients and providers from 3 nurse-led models of care (federally qualified health centers, nurse midwifery practices, and the Nurse-Family partnership program) in Colorado were surveyed. Data from the Patient Attitude toward Telehealth survey and Provider Perceptions about Telehealth were collected. Patients who resided in urban areas utilized telehealth with greater frequency than in rural or frontier areas. Across each of the 5 domains assessed, rural/frontier patients had significantly lower attitude scores than urban patients. The mode of Telehealth employed differed across location, with video calls utilized more frequently by urban providers, and phone calls utilized by rural/frontier providers.
AHRQ-funded; HS028085.
Citation: Barton AJ, Amura CR, Willems EL .
Patient and provider perceptions of COVID-19-driven telehealth use from nurse-led care models in rural, frontier, and urban Colorado communities.
J Patient Exp 2023 Jan 25; 10:23743735231151546. doi: 10.1177/23743735231151546..
Keywords: COVID-19, Telehealth, Primary Care, Patient Experience, Rural Health, Urban Health, Vulnerable Populations, Provider: Nurse
Quigley DD, Elliott MN, Slaughter ME
Follow-up shadow coaching improves primary care provider-patient interactions and maintains improvements when conducted regularly: a spline model analysis.
The purpose of this study was to explore whether a second shadow coaching session (re-coaching) improves the patient experience and maintains it over time. The researchers observed a statistically significant increase of 3.7 points among re-coached providers after re-coaching on overall provider rating (OPR) and 3.5 points on provider communication (PC) (differences of 1, 3, and 5 points or more are considered small, medium, and large, respectively). Improvements from the re-coaching endured for 12 months for OPR and 8 months for PC.
AHRQ-funded; HS025920.
Citation: Quigley DD, Elliott MN, Slaughter ME .
Follow-up shadow coaching improves primary care provider-patient interactions and maintains improvements when conducted regularly: a spline model analysis.
J Gen Intern Med 2023 Jan; 38(1):221-27. doi: 10.1007/s11606-022-07881-y..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Primary Care, Clinician-Patient Communication, Patient Experience, Provider Performance
Anhang Price R, Quigley DD DD, Hargraves JL
A systematic review of strategies to enhance response rates and representativeness of patient experience surveys.
The purpose of this systematic review study was to explore evidence on survey administration strategies to increase response rates and representativeness of patient surveys. The researchers examined 40 peer-reviewed randomized experiments of administration protocols for patient experience surveys. The study found that when compared to mail-only or telephone-only administration of surveys, mail administration with telephone follow-up provides a median response rate benefit of 13%. Researchers also discovered that while surveys administered only by web usually result in lower response rates than those administered by mail or telephone, the limited evidence for a web-mail-telephone process suggests a potential response rate benefit over a mail-telephone process. Monetary incentives are related with substantial improvements in response rates. The study concluded that mixed-mode survey administration results in increased patient survey response rates than a single mode.
AHRQ-funded; HS025920.
Citation: Anhang Price R, Quigley DD DD, Hargraves JL .
A systematic review of strategies to enhance response rates and representativeness of patient experience surveys.
Med Care 2022 Dec;60(12):910-18. doi: 10.1097/mlr.0000000000001784..
Keywords: Patient Experience, Research Methodologies, Health Services Research (HSR)
Fry BT, Howard RA, Gunaseelan V
Association of postoperative opioid prescription size and patient satisfaction.
The purpose of this prospective cohort study was to assess the relationship between postoperative opioid prescription size and patient-reported satisfaction among surgical patients. The researchers included 1,520 opioid-naive adult patients undergoing laparoscopic cholecystectomy, laparoscopic appendectomy, and minor hernia repair between January 1 and May 31, 2018. The main outcome was patient satisfaction measured on a scale of 0 to 10 and dichotomized into "highly satisfied" (9-10) and "not highly satisfied" (0-8). The explanatory variable of interest was size of opioid prescription at discharge from surgery, converted into milligrams of oral morphine equivalents (OME). The study found that 84.1% of patients were highly satisfied and 15.9% were not highly satisfied. There was no significant association between opioid prescription size and satisfaction. The researchers concluded that in a large cohort of patients undergoing common surgical procedures, there was no association between opioid prescription size at discharge after surgery and patient satisfaction.
AHRQ-funded; HS023313.
Citation: Fry BT, Howard RA, Gunaseelan V .
Association of postoperative opioid prescription size and patient satisfaction.
Ann Surg 2022 Dec 1;276(6):e1064-e69. doi: 10.1097/sla.0000000000004784..
Keywords: Opioids, Surgery, Medication, Patient Experience
Steeves-Reece AL, Nicolaidis C, Richardson DM
"It made me feel like things are starting to change in society:" a qualitative study to foster positive patient experiences during phone-based social needs interventions.
Investigators conducted a pragmatic qualitative study with patients who had participated in a health-related social needs (HRSN) intervention. They found that patients were likely to have initial skepticism or reservations about the intervention; they identified 4 positive intervention components regarding patient experience; and they found that patients could be left with feelings of appreciation or hope, regardless of whether they connected with HRSN resources.
AHRQ-funded; HS027707.
Citation: Steeves-Reece AL, Nicolaidis C, Richardson DM .
"It made me feel like things are starting to change in society:" a qualitative study to foster positive patient experiences during phone-based social needs interventions.
Int J Environ Res Public Health 2022 Oct 3;19(19). doi: 10.3390/ijerph191912668..
Keywords: Patient Experience, Patient and Family Engagement, Patient-Centered Healthcare, Telehealth, Health Information Technology (HIT)
Hoonakker PLT, Carayon P, Brown RL
A systematic review of the Consumer Emergency Care Satisfaction Scale (CECSS).
In this study, researchers systematically reviewed the literature on the Consumer Emergency Care Satisfaction Scale (CECSS) and examined its psychometric properties. Their systematic literature search resulted in 28 articles in which the CECSS was used, demonstrating that, from a psychometric perspective, the CECSS is a valid and reliable instrument. However, their study also showed that the CECSS has several weaknesses, and they made recommendations for its improvement.
AHRQ-funded; HS026624.
Citation: Hoonakker PLT, Carayon P, Brown RL .
A systematic review of the Consumer Emergency Care Satisfaction Scale (CECSS).
J Nurs Care Qual 2022 Oct-Dec;37(4):349-55. doi: 10.1097/ncq.0000000000000636..
Keywords: Emergency Department, Patient Experience
Quigley DD, Qureshi N, Palimaru A
Content and actionability of recommendations to providers after shadow coaching.
This paper examined the content of the recommendations given to shadow-coached providers aimed at improving provider-patient interactions, to characterize these recommendations, and to examine their actionability. Using CAHPS data, the study’s findings showed that patient experience surveys were effective at identifying where improvement is needed but are not always informative enough to instruct providers on how to modify and improve their interactions with patients. Analyzing the feedback given to coached providers as part of an effective shadow-coaching program provides details about implementation on shadow-coaching feedback.
AHRQ-funded; HS025920.
Citation: Quigley DD, Qureshi N, Palimaru A .
Content and actionability of recommendations to providers after shadow coaching.
Qual Manag Health Care 2022 Oct-Dec;31(4):199-209. doi: 10.1097/qmh.0000000000000354..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Patient Experience, Quality Improvement, Quality of Care, Practice Improvement, Clinician-Patient Communication, Communication
Brooks EM, Tong ST, Krist AH
Emergence of gun violence as a patient priority.
The purpose of this study was to explore how community-level factors influence patient engagement in primary care, as part of a larger study on cardiovascular health. In this study, exposure to gun violence was the community factor and a total of 19 patients from underserved and minority communities. The study concludes that gun violence has a profound impact on cardiovascular health, and all of aspects of health as well.
AHRQ-funded; HS023913.
Citation: Brooks EM, Tong ST, Krist AH .
Emergence of gun violence as a patient priority.
J Am Board Fam Med 2022 Oct; 35(5):961-67. doi: 10.3122/jabfm.2022.05.210283..
Keywords: Patient Experience
Khullar D, Prasad K, Neprash H
Factors associated with patient trust in their clinicians: results from the healthy work place study.
The goal of this study was to determine workplace, clinician, and patient correlates of patient trust in their clinician. The sample used baseline data from the Healthy Work Place trial, a randomized trial of Midwest and East Coast primary care practices. Trust was found to relate mainly to several aspects of care variables (including satisfaction with explanations, overall satisfaction with provider, learning about medical conditions, and the clinician's personal manner), with lesser association with patient characteristics and clinician work conditions. Findings showed that trust was primarily related to what happens between clinicians and patients in the examination room.
AHRQ-funded; HS018160.
Citation: Khullar D, Prasad K, Neprash H .
Factors associated with patient trust in their clinicians: results from the healthy work place study.
Health Care Manage Rev 2022 Oct-Dec;47(4):289-96. doi: 10.1097/hmr.0000000000000336..
Keywords: Patient-Centered Healthcare, Patient Experience, Clinician-Patient Communication
Shah SC, Bonnet K, Schulte R
Helicobacter pylori management is associated with predominantly negative patient experiences: results from a focused qualitative analysis.
This paper is a qualitative analysis of the patient experience of H. pylori management using a focus group and one-on-one telephone interviews. A total of 13 participants were included (mean age 50.4 years; 62% female; 38% non-Hispanic white). A total of 987 codes were yielded that five major themes related to the patient H. pylori experience: context of decision-making; health beliefs; barriers experienced; cues to action; and impact of new knowledge. The perceived patient-provider interaction contributed most prominently to the negative patient experience along with treatment-related side effects. Knowledge that lack of treatment can lead to gastric cancer along with symptoms modified participants’ perceptions and motivation to accept treatment.
AHRQ-funded; HS026395.
Citation: Shah SC, Bonnet K, Schulte R .
Helicobacter pylori management is associated with predominantly negative patient experiences: results from a focused qualitative analysis.
Dig Dis Sci 2022 Sep;67(9):4387-94. doi: 10.1007/s10620-021-07320-8..
Keywords: Digestive Disease and Health, Patient Experience
White VanGompel E, Lai JS, Davis DA
Psychometric validation of a patient-reported experience measure of obstetric racism© (The PREM-OB Scale™ suite).
This study sought to develop a valid patient-reported experience measure (PREM) of Obstetric Racism(©) in hospital-based intrapartum care designed for, by, and with Black women as patient, community, and content experts. The study was conducted using PROMIS© instrument development standards adapted with cultural rigor methodology. The study had 2 phases: Phase 1 included item pool generation, modified Delphi method, and cognitive interviews and Phase 2 evaluated the item pool using factor analysis and item response theory. Items were identified or written to cover 7 previously identified theoretical domains with 806 Black mothers and birthing people completing the pilot test. Good fit indices were indicated with factor analysis. Factor 1 was “Humanity” which had 31 items measuring experiences of safety and accountability, autonomy, communication, and empathy; Factor 2 “Racism” which had 12 items measuring experiences of neglect and mistreatment; and Factor 3 “Kinship” which had 7 items measuring hospital denial and disruption of relationships between Black mothers and their child or support system.
AHRQ-funded; HS028028.
Citation: White VanGompel E, Lai JS, Davis DA .
Psychometric validation of a patient-reported experience measure of obstetric racism© (The PREM-OB Scale™ suite).
Birth 2022 Sep;49(3):514-25. doi: 10.1111/birt.12622..
Keywords: Racial and Ethnic Minorities, Women, Patient Experience
Quigley D, Qureshi N, Rybowski L
Summary of the 2020 AHRQ research meeting on 'Advancing Methods of Implementing and Evaluating Patient experience improvement using consumer assessment of Healthcare Providers and Systems (CAHPS®) Surveys'.
The purpose of this AHRQ authored paper was to discuss the Agency for Healthcare Research and Quality research meeting on using Consumer Assessment of Healthcare Providers and Systems (CAHPS®) data for quality improvement (QI). The author reports on 3 topics addressed, including: lessons learned about organizational factors/environment for improving patient experience; 2) organizational use of data to improve patient experience; and 3) information provided by evaluations utilizing CAHPS data and their use in implementing successful programs to improve patient experience. The author further identified key themes, including: Early and frequent engagement of providers and stakeholders, QI process standardization, complementing CAHPS data with other data, and compiling dashboards of CAHPS scores to identify and track improvement. The author concluded that much can be learned and achieved from organization-level studies.
AHRQ-authored; AHRQ-funded; HS025920; HS016978.
Citation: Quigley D, Qureshi N, Rybowski L .
Summary of the 2020 AHRQ research meeting on 'Advancing Methods of Implementing and Evaluating Patient experience improvement using consumer assessment of Healthcare Providers and Systems (CAHPS®) Surveys'.
Expert Rev Pharmacoecon Outcomes Res 2022 Sep;22(6):883-90. doi: 10.1080/14737167.2022.2064848..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Quality Improvement, Quality of Care, Patient Experience
Fowler FJ, Brenner PS, Cosenza C
How responding in Spanish affects CAHPS results.
The purpose of this study was to examine the associations of language and ethnicity with responses to CAHPS surveys and assess the effect of responding to CAHPS surveys in Spanish. The researchers surveyed patients who had received care at a Connecticut community health center within 6 or 12 months of being sent a CAHPS survey that asks about care experiences. Three hypotheses were tested: 1. Spanish speakers are more likely to choose extreme response options. 2. The meaning of the Spanish translation is different than the English version of the questions, with Spanish speakers providing different answers because of meaning differences. 3. Spanish speakers have different expectations regarding their health care than those who answer in English. Researchers evaluated any differences by ethnicity and language. The study found that those answering in Spanish gave significantly more positive reports than the other two groups on three of the five measures, and higher than the non-Hispanic respondents on a fourth. The study concluded that subjects answering in Spanish gave more positive reports of their medical experiences than Hispanics and non-Hispanics answering in English.
AHRQ-funded; HS016978.
Citation: Fowler FJ, Brenner PS, Cosenza C .
How responding in Spanish affects CAHPS results.
BMC Health Serv Res 2022 Jul 8;22(1):884. doi: 10.1186/s12913-022-08262-1..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Cultural Competence, Patient Experience, Quality of Care, Racial and Ethnic Minorities
Womack DM, Kennedy R, Chamberlin SR
Patients' lived experiences and recommendations for enhanced awareness and use of integrative oncology services in cancer care.
The purpose of this study was to involve patients in understanding improved clinic processes and digital health tools to support patient awareness and use of integrative oncology services. The patients were engaged in participatory design to explore their lived experiences as related to the utilization of integrative oncology services during and after conventional cancer treatment. The researchers held 10 design sessions with individual participants, which began with patient story telling regarding their path to and use of integrative oncology services. Feedback was then requested on the functionality of prototypes of mobile app screens intended to support patient symptom alleviation. The study found that oncology patients are active participants in the management of their symptoms and treatment side effects. Patients who used massage, yoga, and acupuncture reported a need for earlier patient education about those services. The study concluded that clinics can collaborate with patients to identify high priority needs, unmet needs and challenges, guide development of clinic process, and co-produce wellbeing in conventional cancer care.
AHRQ-funded; HS000046.
Citation: Womack DM, Kennedy R, Chamberlin SR .
Patients' lived experiences and recommendations for enhanced awareness and use of integrative oncology services in cancer care.
Patient Educ Couns 2022 Jul;105(7):2557-61. doi: 10.1016/j.pec.2021.11.018..
Keywords: Cancer, Patient Experience, Patient and Family Engagement, Education: Patient and Caregiver
Ayers DC, Yousef M, Zheng H
The prevalence and predictors of patient dissatisfaction 5-years following primary total knee arthroplasty.
This retrospective cohort study’s purpose was to determine dissatisfaction among total knee arthroplasty (TKA) patients 5 years after the procedure and to determine patient factors predictive of dissatisfaction. Demographic and clinical data on 4402 patients who underwent primary unilateral TKA between 2012 and 2015 were collected prospectively through the Function and Outcomes Research for Comparative Effectiveness in Total Joint Replacement (FORCE-TJR) comparative effectiveness consortium including diverse community and academic practices distributed across 23 states in the United States. Several different satisfaction scales were used to collect data at 1 year preoperatively and 5 years postoperatively including patient satisfaction (using a 5-point Likert satisfaction scale) and patient-reported outcome measures (PROMs) including the Knee injury and Osteoarthritis Outcome Score (KOOS) and Short-Form health survey (36-item). A total of 12.7% (5549) patients expressed dissatisfaction 5 years postoperatively. Higher dissatisfaction rates were present in young patients, patients with less education, and non-White patients. It was also significantly associated with poor preoperative and 5-year postoperative PROMs scores and less score improvement from baseline to 5 years.
AHRQ-funded; HS018910.
Citation: Ayers DC, Yousef M, Zheng H .
The prevalence and predictors of patient dissatisfaction 5-years following primary total knee arthroplasty.
J Arthroplasty 2022 Jun;37(6s):S121-s28. doi: 10.1016/j.arth.2022.02.077..
Keywords: Orthopedics, Surgery, Patient Experience
