Abstract
User experience is key for measuring and improving the quality of services, especially in high personal and relation-intensive sectors, such as healthcare. However, evidence on whether and how the organizational model of healthcare service delivery can affect the patient experience is at an early stage. This study investigates the relationship between healthcare service provision models and patient experience by focusing on the nursing care delivery. 65 nurses' coordinators were involved to map the nursing models adopted in the healthcare organizations of in an Italian region, Tuscany. This dataset was merged with patient experience measures reported by 9,393 individuals discharged by the same organizations and collected through a Patient-Reported Experience Measures Observatory. The authors run a series of logistic regression models to test the relationships among variables. Patients appreciate those characteristics of care delivery related to a specific professional nurse. Having someone who is in charge of the patient, both the reference nurse and the supervisor, makes a real difference. Purely organizational features, for instance those referring to the team working, do not significantly predict an excellent experience with healthcare services. Different features referring to different nursing models make the difference in producing an excellent user experience with the service. These findings can support managers and practitioners in taking decisions on the service delivery models to adopt. Instead of applying monolithic pure models, mixing features of different models into a hybrid one seems more effective in meeting users' expectations. This is one of the first studies on the relationship between provision models of high-contact and relational-intensive services (the healthcare services) and users' experience. This research contributes to the literature on healthcare service management suggesting to acknowledge the importance of hybridization of features from different, purely theoretical service delivery models, in order to fit with providers' practice and users' expectations. This is one of the first studies on the relationship between provision models of nursing care and patient experience.Healthcare services' users appreciate service delivery characteristics identified with "be cared by," or in other words with having a reference nurse.Nursing models' features that relate to the organizations and that providers tend to judge as professionalizing and evolutive, such as team working, appear not key in relation to patient experience.Pure models of service delivery are theoretically useful, but hybrid models can better meet users' expectations.
Highlights
Services are, by their nature, always experienced (Carbone and Haeckel, 1994), including healthcare services delivered by public providers: “In no other service is managing the ‘customer experience’ more important than in healthcare” (Berry, 2019)
Nursing models: descriptive results The mapping of the nursing models shows that there is not a pure model put in practice in Tuscany, rather a hybridization between the three models described in the introduction (Table 1)
The distribution of the various characteristics of the nursing models are reported in Table A5 (Appendix), while the detailed results of the correlation analysis (1) among all features and (2) with the nursing models are reported in Appendix – Table A6
Summary
By their nature, always experienced (Carbone and Haeckel, 1994), including healthcare services delivered by public providers: “In no other service is managing the ‘customer experience’ more important than in healthcare” (Berry, 2019). How the patient experiences safety, respect, dignity and kindness is a key metric to determine the person-centeredness of healthcare systems, and a tool to innovate and co-produce the future developments of the same systems (Anderson et al, 2018; De Rosis et al, 2019). There is little evidence on whether and how the organizational model of healthcare service can affect the patient experience. This is true with regards to nursing care. The patient experience has been identified as a key aspect to consider in defining evidence-based practices and models of nursing care (Schaffer et al, 2013)
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