Care Provider Satisfaction Research Articles

Job Satisfaction in the Health Care Sector: Empirical Evidence from Medical Care in Greece

It is extremely important for employees in every sector of an economy to be satisfied with their work since job satisfaction contributes significantly to improvements in their productiveness and performance. This paper deals with the very sensitive sector of health care in which medical staff provide citizens with health care services. The job satisfaction of these medical care providers is of particular importance when aiming to improve the quality of their services. Literature on job satisfaction among the providers of medical care is limited since researches have focused mainly on users’ satisfaction with the medical care services provided. In an era in which many countries worldwide are facing uncertainty and the social insurance systems are confronted with serious problems as they strive to respond to a number of changes, the Greek health care sector is no exception. With particular reference to the Greek reality, due to the heavy recession that the country has been facing for a number of years, health care expenditures have been cut dramatically and, as a result, the working conditions in public hospitals have been negatively influenced. Based on the above, the purpose of this paper is, through empirical investigation, to examine the levels of job satisfaction among Greek doctors who work in public hospitals and to determine the factors that may influence the satisfaction they gain from their work.

Do satisfied employees lead to satisfied patients? An empirical study in an Italian hospital

This study aimed to understand the relationship between care provider (employee) satisfaction and patient satisfaction and to identify key drivers of their satisfaction. The European Foundation for Quality Management-based 4P model and Picker’s Patient Experience quality dimension were used as the theoretical basis for understanding the satisfaction relationship along with the key drivers. A cross-sectional survey was conducted in two wards (maternity and cardiology) from June to August 2014. The partial least squares structural equation modelling method was used to analyse the data. For the 4P model, we found strong evidence for the influence of enablers on the results and eventually on employee satisfaction. Likewise, we found strong evidence for the effect of patients’ experience on their overall satisfaction and eventually on their loyalty. Concerning the relationship between employee and patient satisfaction, we found that a higher patient satisfaction level in one ward was associated with higher employee satisfaction in the same ward. Other findings include the identification of key drivers of patient and employee satisfaction along with improvement priorities for each ward. This study provides insights that can be useful for healthcare managers and policy-makers responsible for developing and planning strategies for more sustainable healthcare organisations.

A Randomised Controlled Trial of Consent Procedures for the Use of Residual Tissues for Medical Research: Preferences of and Implications for Patients, Research and Clinical Practice.

BackgroundDespite much debate, there is little evidence on consequences of consent procedures for residual tissue use. Here, we investigated these consequences for the availability of residual tissue for medical research, clinical practice, and patient informedness.MethodsWe conducted a randomised clinical trial with three arms in six hospitals. Participants, patients from whom tissue had been removed for diagnosis or treatment, were randomised to one of three arms: informed consent, an opt-out procedure with active information provision (opt-out plus), and an opt-out procedure without active information provision. Participants received a questionnaire six weeks post-intervention; a subsample of respondents was interviewed. Health care providers completed a pre- and post-intervention questionnaire. We assessed percentage of residual tissue samples available for medical research, and patient and health care provider satisfaction and preference. Health care providers and outcome assessors could not be blinded.ResultsWe randomised 1,319 patients, 440 in the informed consent, 434 in the opt-out plus, and 445 in the opt-out arm; respectively 60.7%, 100%, and 99.8% of patients’ tissue samples could be used for medical research. Of the questionnaire respondents (N = 224, 207, and 214 in the informed consent, opt-out plus, and opt-out arms), 71%, 69%, and 31%, respectively, indicated being (very) well informed. By questionnaire, the majority (53%) indicated a preference for informed consent, whereas by interview, most indicated a preference for opt-out plus (37%). Health care providers (N = 35) were more likely to be (very) satisfied with opt-out plus than with informed consent (p = 0.002) or opt-out (p = 0.039); the majority (66%) preferred opt-out plus.ConclusionWe conclude that opt-out with information (opt-out plus) is the best choice to balance the consequences for medical research, patients, and clinical practice, and is therefore the most optimal consent procedure for residual tissue use in Dutch hospitals.Trial RegistrationDutch Trial Register NTR2982

Attitude and satisfaction of health care providers towards clinical pharmacy services in Ethiopia: A post-deployment survey.

BackgroundClinical pharmacy service has evolved steadily over the past few decades and is contributing to the ‘patient care journey’ at all stages. The service improves safety and effectiveness of medicines, thereby avoiding medication errors. As part of this global shift in pharmacy education and practice, Ethiopian Universities revamped the undergraduate pharmacy curriculum and the first graduates came out in July 2013. These graduates were immediately deployed in public hospital settings, with the ultimate aim of providing clinical pharmacy services. As such an initiative is new to the Ethiopian pharmacy sector, there is a need to do assessment of the health care providers’ perception and satisfaction towards the service.MethodsA cross-sectional survey using self-administered questionnaire was conducted in six regions and one-city administration of the country. Physicians, Health officers and Nurses working along with the new pharmacy graduates formed the study population. A total of 650 healthcare professionals participated in the study. Data were entered, cleaned and analyzed using appropriate statistical tools.ResultsMajority of the health care providers agreed that clinical pharmacy service could have a significant contribution to the patient care. A large proportion of them (70–90 %) had a positive attitude, although there appeared to be some differences across professions. About 50 % of the professionals were of the opinion that patient care should be left to the health care providers and pharmacists should concentrate on drug products. In addition, the same proportion of respondents said that the setup in their respective hospital was appropriate for provision of clinical pharmacy service. Multivariable analysis indicated that attitude of the health care providers was significantly associated with year of experience.ConclusionsA large proportion of the health care providers had positive attitude towards the service, although the extent of the service was below their expectation. Hence, efforts should be in place to organize continuous professional training for pharmacists and awareness creation forums for other healthcare professionals.

English

Assessing patients’ perception of satisfaction, professionalism, competence and skill of health care providers helps health institutions and providers respond to the needs and expectations of the patients. Little work is known to have taken place to understand this phenomenon especially in radiological services in Nigerian hospitals. This study is therefore aimed at investigating the perception of patients’ satisfaction, professionalism, competence and skill of radiographers during routine radiological examination in two Nigerian hospitals. Materials and Methods: Three hundred patients were interviewed from two hospitals on their perception of satisfaction, professionalism, competence and skill of radiographers during routine radiological examination. The data was analyzed in terms of descriptive statistics using 95% confidence interval. ANOVA, Chi-Square and multivariate (intercept) statistical tools were applied. Results: The result of Test of Equality of Covariance Matrices giving a Box’s M result of 47.745 and F-value of 1.787 >Fcritical of 1.52 (p < 0.05), indicates that respondents’ perception of level of satisfaction, radiographers’ professionalism, skill and competence are dependent on the combined factors of the respondents age, type of hospital where service is received, gender, level of education and patient length of experience of radiological services. Key-words: Satisfaction, professionalism, skill and competence, Nigeria, patient perception of care, radiological examination.

Telemedicine: Underutilized Tool of Global Health

Challenges bring an opportunity for success and each success is followed by a new challenge. Challenges and successes witnessed in the discipline of medicine are numerous. When world was preparing to enter the new millennium twenty years ago many great challenges were faced by medical professionals in-order to implement plans of quality health provision to every human globally. Health for all strategy, Millennium Development Goals (MDGs) and many other similar plans are the examples of such great vision to provide health care with equitable distribution, appropriate technology, community participation and acceptance among masses. Telemedicine is the use of telecommunication and information technologies in order to provide clinical health care at far flung areas with connections through networking. In absence of telemedicine, the equitable access to deliver better health care is difficult especially in remote communities as some health standards could not be implemented on providers and recipients in different places at the same time. Recent advances in telemedicine have created opportunities for health care providers and recipients to overcome the barriers of lack of awareness and deficiency of standard approach towards prevention and management. The experts could extend their teaching and evidence based medical practices in order to increase standards of health care globally. Information technology helps to eliminate distance and communication barriers and can improve access to medical services that are deficient or in distant rural communities. The communities in far-flung areas and isolated populations can receive health care from specialist residing at a distance without patient to the need of travel to visit them. Telemedicine can also be used to train health workers in field, providing evidence based medical practices, facilitation in standard operating procedures, delivery of medical education, sharing best practices and experiences. Recent advances in mobile techno-logy and the potential for global health elevated telemedicine as a popular force in health care. The special-ties that can be focused during implementation of telemedicine practices include preventive medicine, radiology, pathology, cardiology, mental health services, primary care, emergency care, physical rehabilitation, pediatrics, obstetrics, immunization, nutrition, mother and child health, disaster management, epidemic control, health system monitoring and management and many others. Telemedicine in developing countries like Pakis-tan is a tool of global health. Pakistan is an over populated country where people are, by the large, deprived of proper medical facilities especially those living in far flung areas. The implementation of telemedicine can facilitate the patients and educate the health care providers for the purpose of improving patient care. In Pakistan, biometric verficationby Pakistan Telecommunication Authority (PTA) has declared mobile phone users in the country; according to which the figure for mobile phone users is estimated to be near 114.7 million. Thus big resource is available that can be channelized to improve health and prevent disease through telemedicine across the country and beyond geographical boundaries.According to World Health Organization (WHO), the use of telemedicine in provision of health care is not simply about technology, but a means to reach an out-come, such as better decisions for provision of prevention and management, vulnerable populations received high quality and safer care, more awareness about health making people to have better choices for their health, better surveillance of communicable and non-communicable disease, government become more responsible and aware of health needs of populations. More-over equitable, appropriate, acceptable, effective and efficient monitoring of resources at Healthcare Centers. The satisfaction of patients and health care provi-ders were found positive over time. According to Care Hill more than 80% of consumers find their health care to be satisfactory. Telemedicine is occasionally blamed of being driven by commercial rather than public health interests. However in spite of this criticism, telemedicine is linking the rich communities with poors globally. Nevertheless, telemedicine is an effective tool for surveillance, monitoring, standardization, research, and implementation. There is no alternative to telemedicine. There are several telemedicine networks linking the industrialized and developing world, this is an area that is likely to grow in the future. Global health strategies have to focus on underutilized tool for better access to health care.

Strategies for Primary Care Stakeholders to Improve Electronic Health Records (EHRs).

The use of electronic health records (EHRs) and the vendors that develop them have increased exponentially in recent years. While there continues to emerge literature on the challenges EHRs have created related to primary care provider satisfaction and workflow, there is sparse literature on the perspective of the EHR vendors themselves. We examined the role of EHR vendors in optimizing primary care practice through a qualitative study of vendor leadership and developers representing 8 companies. We found that EHR vendors apply a range of strategies to elicit feedback from their clinical users and to engage selected users in their development and design process, but priorities are heavily influenced by the macroenvironment and government regulations. To improve the "marriage" between primary care and the EHR vendor community, we propose 6 strategies that may be most impactful for primary care stakeholders seeking to influence EHR development processes.

The Limited English Proficiency Patient Family Advocate Role: Fostering Respectful and Effective Care Across Language and Culture in a Pediatric Oncology Setting.

Patients and families with limited English proficiency (LEP) face a multitude of barriers both inside and outside the hospital walls. These barriers can contribute to difficulty accessing care and understanding/adhering to treatment recommendations, ultimately placing them at higher risk for poorer outcomes than their English-speaking counterparts. The LEP Patient Family Advocate role was created with the aim of improving access, promoting effective communication, and equalizing care for children with cancer from families with LEP. The goal of this mixed methods study was to describe the level of satisfaction and experiences of parents and health care providers who used the LEP Patient Family Advocate while receiving or providing care. Twelve parents and 15 health care providers completed quantitative surveys and an open-ended question about their experiences. High levels of satisfaction were reported. Themes about the role from qualitative responses included its positive effect on communication, trust, and connectedness between parents and staff. Continuity of care and safety were improved, and parents thought the role helped decrease their stress. The LEP Patient Family Advocate has a positive influence on family-centered cultural care.

Communicating with mismatch and tension: treatment provision experiences of primary care doctors treating patients with overactive bladder in Hong Kong.

BackgroundOveractive bladder (OAB) is a common chronic bladder dysfunction worldwide. As the first contact point of health care, primary health care providers are often consulted by patients seeking initial consultation for OAB. The relatively short history of the existence of OAB in medicine and low public awareness of OAB in Hong Kong, however, often serve as a challenge to primary health care providers in treating patients with OAB. The experiences of patients and health care providers are often influenced by the interaction between these two groups, hence both health care providers and patients are key determinants of the entire treatment experience, and the perspectives of health care providers should not be overlooked. However, patient experiences have been the main focus of related studies, few of which have examined the treatment provision experiences and perspectives of health care providers. This research gap is notable considering that the satisfaction and morale of health care providers can influence treatment outcome.MethodsThis study adopted a qualitative research approach by conducting semistructured individual interviews with 30 private practice primary care doctors in Hong Kong between November 2013 and May 2014.ResultsLacking confidence in treating OAB patients, encountering mismatch with patients in treatment expectations and communication style, and feeling embarrassed when communicating with OAB patients were the experiences reported by the sampled doctors.ConclusionThe sampled doctors’ treatment provision experiences revealed a general lack of knowledge about OAB among primary care doctors in Hong Kong. Furthermore, the negative stereotype of and lack of trust in private practice doctors created tension between the doctors and patients. This lack of mutual trust was particularly unfavourable for the doctors to provide long-term treatment and support to patients with OAB. The embedded distrust of private practice doctors also affected the prescribing behaviour of the doctors, who prescribed medication only to satisfy patient demands, which may lead to antibiotic abuse and resistance. Finally, the expectations of doctor professionalism and behaviour in Chinese cultures and the cultural perceptions of urinary diseases caused challenging treatment provision experiences for the sampled doctors.

Role of the Obstetric Clinical Nurse Coordinator

<h2>Poster Presentation</h2><h3>Purpose for the Program</h3> The scheduling of procedures on the unit was formally an ad hoc process. This resulted in no true clinical oversight of the procedures being scheduled. The American College of Obstetricians and Gynecologists, The Joint Commission, and Centers for Medicare & Medicaid Services call for regulation surrounding the elective induction of labor of pregnancies before 39 weeks gestation. There also are controlled criteria for exclusions to these guidelines. Gaps in adhering to the guidelines as well as patient and physician dissatisfaction resulted in the vision of a single point of contact for all women entering the obstetric unit for planned procedures. <h3>Proposed Change</h3> To have the obstetric clinical nurse coordinator play the role of the clinical nurse expert to shepherd women through the final stages of their pregnancies, help guide their transition from outpatient to inpatient setting, and ensure adherence to guidelines of scheduled procedures. <h3>Implementation, Outcomes, and Evaluation</h3> Before initiation of the role, the hospital had a high nulliparous elective induction rate. This translated to a failed induction rate of 25%. This number proved to be staggering and bolstered support of a clinical expert to monitor scheduled procedures. Six‐months postimplementation of the role, the rate of failed inductions decreased dramatically to 2% with enforcement of cervical Bishop scoring and adherence to the guidelines related to medical versus elective inductions. This remarkable change in the model of care also resulted in fewer elective inductions scheduled overall from 15% to 8%. The clinical nurse coordinator also is a driver of family‐centered care. Women come to the unit already having established a relationship and point of contact in the inpatient units. This has resulted in high patient satisfaction scores with year‐to‐date overall inpatient satisfaction at 90.4% via Press Ganey. The number of delayed or cancelled inductions has decreased dramatically as well, and health care provider satisfaction has increased. <h3>Implications for Nursing Practice</h3> The role was not easily understood when first presented and resistance of the idea was met initially. The need for this change and desire to have a clinical nurse expert in the role, once occupied by a unit clerk, was met with skepticism. However, this model is now regarded as an exemplar of patient‐focused, quality care. The quantitative and qualitative positive results affirm the vision of this role.

English

The objective of this study was to assess health care providers&rsquo; satisfaction with the service provided by the clinical laboratory personnel at Nekemte Referral Hospital, Western Ethiopia to determine the level of satisfaction of health care providers on clinical laboratory services. A cross sectional study was conducted from March to April, 2014 at Nekemte Referral Hospital. The data was collected from 105 randomly selected health professionals. The collected data was analysed using Statistical Package for Social Sciences (SPSS) version 20 statistical software. Bivariate and multivariate logistic regression analyses were used to assess the association between treatment outcomes and predictor variables. The overall satisfaction for all health care professionals on clinical laboratory services was 62.86%, while specific professional level of satisfaction was 51.2% for nurses, 65.0% for physicians, 75.0% for health officer (Assistant physician) and 85.7% for midwifes. Lack of adequacy of laboratory materials, absence of a timely report of critical values, lack of getting urgent results on time, and inadequacy of test menu on laboratory request forms were areas mentioned as sources of dissatisfaction. The overall degree of customers&rsquo; satisfaction with laboratory services was good. But the study showed room for improvement. In addition to taking intervention, the root causes of dissatisfaction need to be investigated and means of improving the satisfaction level should be designed and implemented. &nbsp; Key words: Satisfaction, health care providers, clinical laboratory services, Nekemte Referral Hospital.

Dermatology in an age of fully transparent electronic medical records.

More than 4 decades have passed since the call for “giving patients their medical records” was first proposed to increase patient engagement in health care delivery.1Today, this vision—once considered radical—is quickly becoming reality, with millions of Americans routinely accessing their medical records through web-based patient portals.1 The electronic health record content that patients can access online is expanding to include physicians’ documentation of patient visits. Recent studies evaluating OpenNotes, a patient-centered initiative enabling online access to providers’ clinical notes, have demonstrated high levels of patient utilization and improved self-reported understanding of care planning and medication adherence, resulting in patients “feeling more in control of their health care.”1 One year after implementation of OpenNotes in 3 diverse health care environments in 2010 (Beth Israel Deaconess Medical Center in Boston, Massachusetts; Geisinger Health System in northeastern and central Pennsylvania; and Harborview Medical Center in Seattle, Washington), more than 99% of patients wished to have ongoing online access to clinicians’ notes, paralleled by similar rates of primary care provider satisfaction.1 Open-access notes have since become standard of care at several large health care systems,2 including the Veterans Health Administration; as of January 2014, more than 1.4 million veterans have registered for full online access to their clinical notes.3 However, medical specialties may face distinct challenges consequent to adoption of open-access medical records. As more patients seek—and demand—comprehensive online availability of open-access notes, what will this mean for the field of dermatology? We believe the following issues merit particular attention among dermatologists in the era of medical record transparency.

Association Between Perceived Health Care Provider Support and Satisfaction with Insulin Pumps in Children with Type 1 Diabetes Mellitus: Opportunities for Pharmacists

Purpose: The purpose of this pilot study was to describe parents’ perceived healthcare provider support for integrating technology, satisfaction with insulin pump use in their child with T1DM, and the relationship between parents’ perceived healthcare provider support and satisfaction with insulin pump use.&#x0D; Methods: A cross-sectional, correlational design was used to collect data for the present study. The study was conducted through an Internet survey among Mid-South parents who have a child with T1DM, 18 years old or younger using an insulin pump and/or continuous glucose monitoring (CGM). Frequencies, descriptive statistics, and correlation coefficients were calculated.&#x0D; Results: Most of the parents surveyed used an endocrinologist/pediatric endocrinologist as their primary diabetes healthcare provider and considered three to four healthcare professionals as part of the diabetes healthcare team who helped them utilize insulin pumps and advanced technologies. Parents (23.4%) indicated a pharmacist was part of the healthcare team who helped them utilize technology. Parents appeared to perceive support for using insulin pumps; however, there is room for improvement. The more perceived support for integrating technology, the more satisfied the parents were with using insulin pumps (r=0.431, p=0.005).&#x0D; Conclusions: Results from this study suggest that parents and children need continued education, support and training to integrate insulin pumps into diabetes self-management. As more patients attempt to adopt insulin pumps and other advanced technologies, it will be important for pharmacists to support the adoption and integration of these technologies and be knowledgeable and helpful if asked about technology-related challenges.&#x0D; &#x0D; Type: Student Project

Continuous Improvements of a Clinical Pathway Increased Its Feasibility and Improved Care Providers' Perception in TKA.

PurposeWe aimed to determine 1) whether dropout rate decreased and 2) whether health care providers' perceptions were changed with continued improvements of contents of clinical pathway (CP) for total knee arthroplasty (TKA).Materials and MethodsThis retrospective study included two separate analyses of patients and health care providers. In the analysis of patients, dropout rates and reasons were evaluated in two cohorts of patients who underwent TKA with CP applied at two different time periods (384 patients from 2009 to 2010 and 242 patients from 2012 to 2013). Contents of CP were continuously improved during the 3-year interval. Self-administered questionnaire surveys targeted to health care providers were carried out twice (2010 and 2013) and compared.ResultsDropout rate decreased from 19.1% in the first time period to 10.4% in the second time period. Although overall satisfaction of care providers was high at both time-points, doctors had more favorable perceptions than nurses; most positive changes of perception were noted in nurses. The health care providers' perceptions for potential concerns of CP were improved while the perceptions for potential benefits and satisfaction were maintained.ConclusionsContinuously improved CP has increased feasibility for TKA patients and reduced health care providers' concern about its value. We propose that CP can be implemented and actively used to improve the outcomes and efficacy of patient care for TKA, regardless of the rotation of care providers.

Identifying palliative care beds to contribute to the integration of early palliative care (EPC) into the inpatient, private practice oncology setting in Brittany (France).

71 Background: In France, since 2002, Identified Palliative Care Beds (LISP) has contributed to the diversification and development of Palliative Care. They are identified in acute unit with significant PC activity and estimated at 5000 in 2011. In our Brittany private hospital, since fall 2008, 8 Beds are dedicated to PC in the solid tumour oncology unit (47 beds) and allowed EPC integrated to oncologic care for inpatients. Our model incorporated a PC physician as a second attending on service alongside the rounding oncologist. Time for discussions with oncologists is optimized and warranted decisions about providing adequate information to the patient and the continuation of treatments, specific or not. We thought to better define the added value of Identified PC Beds. Methods: Because more financial and educational resources are attributed to Identified Beds by health authorities to offer a true interdisciplinary approach, a specific annual evaluation is required. We analysed 7 quantitative components and the number of claimed letters about the unit between 2008 and 2013. Results: The table show an increased PC activity no reduced to terminal care (increase Home Hospice Care, decrease death) and better provider satisfaction with oncology care. Conclusions: The French concept of Identified PC Beds, in our experience, may improve early integrated PC into the inpatients and quality of care. The co management of patients with advanced cancer by oncologists and palliative care physicians is the key. Formal study of our Identified PC Beds model is warranted. [Table: see text]

The availability of and satisfaction with palliative care services among VHA-based radiation oncologists.

55 Background: Palliative care services enhance quality of life in patients with advanced malignancies and are an integral component of multidisciplinary cancer care. They provide symptom control and psychosocial support for patients and family members. A survey in non-VHA cancer centers showed that despite availability of palliative care programs, there was wide variability in the use of these services (Hui et al, JAMA 2010). Palliative care services are a component of the VHA medical benefits package. We sought to determine the ease of access to palliative care services and provider satisfaction among VHA Radiation Oncologists. Methods: VHA-based Radiation Oncologists were identified using the National VHA Radiation Oncology list serve group. All practicing Radiation Oncologists were surveyed to determine the extent of Palliative Care Services available to them and to measure their level of satisfaction with these services. Eighty two surveys were electronically mailed to practitioners at the 38 active VHA Radiation Oncology sites, followed by a reminder phone call.This survey was conducted over a four week period in May of 2014. Results: Sixty four of the 82 surveys distributed over the 4 week period, or 78% were completed. They represent 89% (34/38) of VHA Radiation Oncology Services. All respondents had Palliative Care Services available to them and 98% were happy with the services rendered by the Palliative Care teams. Conclusions: All VHA-based Radiation Oncologists who responded to this survey have access to local VHA based Palliative Care Services. This represented 82% of VHA Radiation Oncology practitioners and 98% were satisfied with the services rendered. Further studies should explore the scope and extent of palliative care involvement including when these services are integrated into the management of patients with advanced malignancies, availability of outpatient palliative care services and variations in care delivery. Radiation therapy is utilized in over 50% of patients with malignancy, often in advanced disease for symptom management and standard guidelines integrating radiotherapy and palliative care should be developed.

English

English

Robotic Surgery in Cancer Care: Opportunities and Challenges

Malignancy-associated mortality, decreased productivity, and spiritual, social and physical burden in cancer patients and their families impose heavy costs on communities. Therefore cancer prevention, early detection, rapid diagnosis and timely treatment are very important. Use of modern methods based on information technology in cancer can improve patient survival and increase patient and health care provider satisfaction. Robot technology is used in different areas of health care and applications in surgery have emerged affecting the cancer treatment domain. Computerized and robotic devices can offer enhanced dexterity by tremor abolition, motion scaling, high quality 3D vision for surgeons and decreased blood loss, significant reduction in narcotic use, and reduced hospital stay for patients. However, there are many challenges like lack of surgical community support, large size, high costs and absence of tactile and haptic feedback. A comprehensive view to identify all factors in different aspects such as technical, legal and ethical items that prevent robotic surgery adoption is thus very necessary. Also evidence must be presented to surgeons to achieve appropriate support from physicians. The aim of this review article is to survey applications, opportunities and barriers to this advanced technology in patients and surgeons as an approach to improve cancer care.

Patients’ Stories of Interprofessional Whole-Person Care

Objectives: Interprofessional whole-person care has been depicted as being able to enhance patient health outcomes, increase health care provider satisfaction with care delivery, lower health care spending and decrease wait times for receiving care. Limited research has been conducted into exploring patients’ experiences of being recipients of this type of care. The objective of this oral presentation is to disseminate findings of a Master of Nursing study through patients’ stories of experience receiving care on aunit where inter professional care is practiced.Methods: Three participants underwent a two step data collection process: a one hour semi-structured interview and a 30 minute symbolic image artistic exercise, as adapted from Schwind’s Narrative Reflective Process. Participants were invited to describe how they experienced receivingcare from an interprofessional team and whether or not they believed whole-person care was delivered to them. Collected data are being analyzed using Clandinin and Connelly’s Narrative Inquiry approach of three dimensionalspace, temporality, sociality and place.Results: The emerging results suggest that participants express satisfaction with the care they received from the interprofessional team on their unit. Their stories indicate that strong interprofessional team-work can contribute to patient satisfaction in care received. For these teams to be successful, from the patients’ point of view, there needs to be: better communication between care providers, greater involvement of the patient in decision making, proper identification of who comprises the teams, andconsistency in team composition.Conclusion: By acknowledging experiences and feelings ofpatients who have received care from an interprofessional team, there is potential to increase sustainability of these teams. The data generated through this study can potentially help health care providers, who are members of interprofessional teams, to deliver more effective, comprehensive whole-personcare within health care institutions.

Profiles About Practice Settings of American College of Obstetricians and Gynecologists Fellows

Selection of a practice setting affects duty hours, practice autonomy, institutional relationships, administrative responsibilities, personal finances, and professional satisfaction. To identify national trends in practice settings reported by the College, we evaluated responses by Fellows (and Junior Fellows) in active practice from six College surveys on professional liability issues between 1992 and 2012. Although half of Fellows remained in an independent private practice, a decline was observed among solo health care practitioners (from 32% in 1992 to 19% in 2012). Direct employment increased either in hospital systems (from 5% to 15%) or as academic faculty (from 9% to 12%). The proportion of Fellows employed by either health maintenance organizations (from 4% to 2%) or the government (2%) remained low. We anticipate that practice settings will be increasingly influenced by health care reform, team-based care with use of nonphysician clinicians, physician age, and increasing subspecialization. Future surveys of Fellows about their practice settings, preferably required at the time of Maintenance of Certification, will aid in evaluating practice settings and their influence on quality of care, cost containment, and health care provider satisfaction.