Abstract
To examine trends in patient experiences in the period 2014-2019, describe improvement strategies implemented by hospitals in the same period, and study associations between patient experiences and implemented strategies. Multi-center retrospective region-wide observational design. Flanders, Belgium. 44 out of 46 Flemish acute-care hospitals publicly reporting patient experiences via the Flemish Patient Survey (FPS). Primary outcomes were the two global FPS ratings: percentage of patients rating the hospital 9 or 10 and percentage of patients definitely recommending the hospital. Secondary outcomes were the average top-box score percentages for each of the 8 remaining dimensions of the FPS. Between 2014 and 2019, there was a significant improvement in patients scoring the hospital 9 or 10 (56% to 61%) and patients definitely recommending (67% to 70%) the hospital. Significant increases in patient experiences over time were also observed in other dimensions, except for the dimension discharge. Hospital key informants reported various improvement strategies related to patient experiences with care and the FPS. Feedback to nursing wards (n = 44, 100%) and clinicians (n = 39, 89%) were most common. Overall, most improvement strategies were not or only weakly associated with patient experience ratings in 2019 and changes in ratings over time. Still, positive associations were discovered between the strategies 'nursing ward interventions' and 'hospital wide education' and recommendation of the hospital. Patient experiences have improved modestly in Flemish acute-care hospitals. Hospitals report to have invested in patient experience improvement strategies but positive associations between such strategies and FPS scores are weak, although there is potential in further exploring nursing ward interventions and hospital wide education. Hospitals should continue their efforts to improve the patient's experience, but with a more targeted approach, taking the lessons learned on the efficacy of strategies into consideration.
Highlights
Hospitals are increasingly integrating patient-centeredness within their policy statements
Hospitals report to have invested in patient experience improvement strategies but positive associations between such strategies and Flemish Patient Survey (FPS) scores are weak, there is potential in further exploring nursing ward interventions and hospital wide education
Many health systems have developed survey instruments aimed at measuring patient experiences, like the Hospital Consumer Assessment of Healthcare Providers and Systems (USA) [6] and the NHS Patient Survey (UK) [7] for acute-care hospitals
Summary
Hospitals are increasingly integrating patient-centeredness within their policy statements. Patient-centered care is associated with improved clinical outcomes and reduced costs [1,2,3,4]. Assessing the patient’s perspective of quality has long been described as a valuable quality indicator [5] and the foundation of patient-centeredness. Many health systems have developed survey instruments aimed at measuring patient experiences, like the Hospital Consumer Assessment of Healthcare Providers and Systems (USA) [6] and the NHS Patient Survey (UK) [7] for acute-care hospitals. The stakeholder-initiated Flemish Hospital Indicator Initiative (VIP2) aimed to increase insight into the quality of its hospitals by using clinical process and outcome indicators. Patient experiences with care, are voluntarily gathered hospital-wide via FPS by most Flemish hospitals. The top-box scores of two global patient experience measures, i.e. patients definitely recommending the hospital and patients rating the hospital 9 or 10, are publicly reported once a year since July 2015
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