Inpatient Experience Research Articles

Behavioral Health Unit Gratitude Intervention Study: Patient and Nurse Perceptions

Gratitude is the positive experience of feeling thankful and appreciative when receiving something beneficial and is linked to psychological well-being. More evidence about the impact of gratitude on physical well-being is needed. An inpatient, adult behavioral health, nurse-led gratitude intervention was studied based on research that has demonstrated its helpfulness in medical surgical patients and improved hospitalization experience. In this mixed-methods study, researchers evaluated patient (N=75) and RN (N=16) rankings and comments of a nurse-led, interprofessional gratitude intervention, incorporating resulting actions based on patient responses of what the patient is grateful/thankful for. Several findings were statistically significant. Patients ranked the intervention as helpful to improve the inpatient hospitalization experience, and recommended frequency on every shift basis. Most (84.0%) patients' grateful comments were hospital-related (e.g., compassionate care; condition-related resources); 16.0% were life-related (e.g., family; being alive). RN participants also ranked the intervention as significantly helpful and valuable to patient centered care. Behavioral health nurses or those aiming to provide more holistic healthcare for hospitalized patients can consider incorporating the gratitude intervention every shift.

"Because I couldn't understand and respond": A mixed-methodstudy examining the impact of language barriers on patient experiences of intensive care unit outreach team care.

"Because I couldn't understand and respond": A mixed-methodstudy examining the impact of language barriers on patient experiences of intensive care unit outreach team care.

At First, I Was Petrified – A Hospice's General Inpatient Audit Experience (TH 2)

At First, I Was Petrified – A Hospice's General Inpatient Audit Experience (TH 2)

U.S. Internal Medicine Residents’ Inpatient Learning Experience Variation Revealed Through Electronic Health Record Data

Phenomenon : Residents are assumed to be prepared for practice after completing required rotations, but there is little understanding of what clinical conditions they manage. Electronic health records (EHRs) capture resident clinical activities, but few studies have effectively used EHR data to characterize resident experiences. Approach : We extracted EHR data for all patients admitted July 1, 2018 to June 30, 2019 cared for by an internal medicine resident in the Johns Hopkins Hospital residency program. We examined individual residents’ encounters with specific clinical conditions, identified using the principal International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10 CM) discharge code and categorized according to the American Board of Internal Medicine (ABIM) Certification Exam Blueprint. We compared numbers and percentages of clinical conditions encountered across individuals and postgraduate years (PGYs). Findings : We included 19,129 admissions for 14,657 patients cared for by 135 residents. ABIM categories most commonly seen were cardiovascular (CV) (mean 20.4%, SD 4.7%), infectious diseases (ID) (mean 19.5%, SD 2.2%), and gastroenterology (GI) (mean 11.2%, SD 3.2%). The largest differences between clinical conditions encountered and ABIM Blueprint were excesses of 10.5% for ID and 6.4% for CV and deficits of 6.1% for rheumatology and orthopedics and 5.5% for endocrinology, diabetes, and metabolism. Total number of admissions per resident ranged 522-963 for PGY-1, 457-1268 for PGY-2, and 224-811 for PGY-3. Percentages of clinical conditions seen varied for individuals in the same postgraduate year: e.g., for CV, ranges were 16-23% for PGY-1, 15-40% for PGY-2, and 10-25% for PGY-3. Insights : Individual residents in the same program had varied inpatient experiences, suggesting a need to understand implications for variation. Linking residents to clinical conditions encountered using EHR data may generate insights that can be incorporated into precision medical education systems to improve learning and clinical outcomes.

Care Team Assistants as a Strategy to Reduce Physicians' Administrative Task Burden.

Physicians increasingly perform administrative tasks that can lead to inefficiencies in care and reduced joy in work. Care Team Assistants (CTAs) are nonclinical team members who address inpatient administrative tasks. This report aims to quantify the task load performed by CTAs and measure CTA impact on inpatient experiences of residents and hospitalists as it relates to their administrative burden, job satisfaction, and delivery of care. To gather observational data on CTA activities, a CTA supervisor shadowed an embedded CTA on 15 shifts on a resident team in real time using a macros-enabled Microsoft Excel time and motion tracker. Assessment surveys through research electronic data capture were distributed to evaluate the impact of CTAs on the provider's experience. On average, CTAs devoted about 6 hours daily to rounding and care coordination, specifically spending an average of 173 minutes/day with family-centered rounding and an average of 196 minutes/day on care coordination. Survey results highlight that the percentage of respondents spending less than 1 hour on administrative tasks increased from 20% when a CTA is not present to 93% when a CTA is present. A total 99% of respondents reported that CTAs allow them to spend more time caring for patients, and 99% reported overall improved job satisfaction as a result of having a CTA on the care team. This report highlights that as embedded team members, CTAs have enough elasticity in daily activities to absorb multiple short-term tasks that reduce team task burden, ensuring physicians can practice at the top of their license.

My Week of Denial and Disorientation: A Lived Experience Narrative of a Stay in a Psychiatric Emergency Department.

Psychiatric emergency departments (EDs) are common settings in which patients receive crisis care, yet their experiences in these environments remain understudied. This lived experience narrative recounts the first author's week-long stay in a psychiatric ED, providing insight into the experiences and challenges of inpatient psychiatric care. The first author used a narrative approach to develop a series of vignettes that captured significant moments of her inpatient experience. Both authors reflected on these experiences, drawing on professional expertise and existing literature. The narrative reveals a lack of communication on the unit, power imbalances between patients and staff and the dismissal of patients' concerns, experiences and identities. It illustrates how patients' behaviours are often misinterpreted, contributing to further distress and disempowerment. The authors examine systemic problems in mental health care, such as epistemic injustice, the dominance of the biomedical model and restrictive control over patient autonomy. They argue for the need to shift to a more compassionate, pluralistic and trauma-informed approach to mental health care. This narrative highlights the need for reforms in emergency psychiatric care. By centring patients' voices, mental health services can foster a more respectful and healing environment for people in crisis.

Effect of SMS Ward Round Notifications on Inpatient Experience in Acute Medical Settings: Retrospective Cohort Study.

Ward rounds are an essential component of inpatient care. Patient participation in rounds is increasingly encouraged, despite the occasional complicated circumstances, especially in acute care settings. This study aimed to evaluate the effect of real-time ward round notifications using SMS text messaging on the satisfaction of inpatients in an acute medical ward. Since January 2021, a service implementing real-time ward round notifications via text messaging (WR-SMS) has been operational at a tertiary-care medical center in Korea. To assess its impact, we conducted a retrospective cohort study of patients admitted to the acute medical unit who participated in a patient experience survey. Patient satisfaction was compared between patients admitted in 2020 (pre-WR-SMS group) and 2021 (post-WR-SMS group). From January 2020 to December 2021, a total of 100 patients were enrolled (53 patients in the pre-WR-SMS group and 47 patients in the post-WR-SMS group). Compared with the pre-WR-SMS group, the post-WR-SMS group showed significantly greater satisfaction about being informed about round schedules (mean 3.43, SD 0.910 vs mean 3.89, SD 0.375; P<.001) and felt more emotionally supported during admission (mean 3.49, SD 0.800 vs mean 3.87, SD 0.397; P<.001). Regarding other questionnaire scores, the post-WR-SMS group showed an overall, although statistically insignificant, improvement compared with the pre-WR-SMS group. Real-time round notifications using a user-friendly SMS may improve inpatient satisfaction effectively.

Implementation suggestions for shared decision-making: results from a comparative study of inpatients and outpatients experience surveys

BackgroundShared decision-making (SDM) is crucial in patient-centered healthcare services, but its integration into routine medical care remains limited. This study aimed to investigate patients’ experience with SDM in both outpatient and inpatient settings, exploring how the quality of care provided by doctors and patient’s trust in doctors influence SDM across different contexts.MethodsThis study utilized data from the regional cross-sectional surveys, including the 2019 Inpatient Experience and the 2021 Specialist Outpatient Experience survey in Hong Kong. Multivariable logistic regression and path analysis were conducted.ResultsA total of 20,675 participants were included (inpatients: n = 8,275; outpatients: n = 12, 400) in this study. The results indicated that inpatients perceiving better quality of doctor’s care were significantly more likely to participate in SDM (OR = 1.29, 95%CI = 1.26–1.47, p < 0.001), with trust in doctors significantly moderating this association. Conversely, among outpatients, a higher quality of doctor’s care was significantly associated with decreased SDM involvement (OR = 0.91, 95% CI = 0.88-1.00, p = 0.04), with trust in doctors serving as a mediator in suppressing this association. Additionally, both subsets indicated that females, the elderly, individuals with good health status, less-educated people, and those living alone were less likely to engage in SDM.ConclusionThese findings underscore the importance of tailoring SDM implementation to specific contexts, acknowledging the different challenges within outpatient and inpatient settings. Building trust is key to promoting SDM, with added support for vulnerable groups to ensure their involvement in decision-making.

Using Creative Activities to Improve the Postoperative Experience of Adult Patients.

Unlike pediatric care that often benefits from child-life services, adult hospitals rarely offer structured engagement activities for postsurgical patients. To address this, we conducted a prospective, randomized survey-based study to evaluate the impact of creative engagement activities on adult inpatient experiences. Patients undergoing surgery between January and September 2023 were randomly assigned to either standard postoperative course or one that received an entertainment packet. Both cohorts completed a survey about their hospital experience. The intervention group reported significantly higher satisfaction: 95% agreed or strongly agreed with "I am satisfied with my hospital experience," compared to 65% in the control group (P = .045). Additionally, 65% of the intervention cohort reported a positive postoperative experience and 80% found their stay engaging versus 30% in the control cohort (P = .028 and P = .001, respectively). These findings suggest that creative entertainment can improve the postoperative experience for adult patients.

The Chinese version of the patients' experiences scale for older inpatients in the medical group: Instrument development and cross-sectional validation study.

The Chinese version of the patients' experiences scale for older inpatients in the medical group: Instrument development and cross-sectional validation study.

Virtual Reality Therapeutic Art for Adult Hospitalized Patients and Caregivers: A Mixed-Methods Project.

Increased stress, anxiety, and depression hinder recovery of hospitalized patients. Mindfulness therapies, which adopt a holistic approach to patient care, reduce anxiety, and depression. This quality improvement initiative evaluated the implementation of a virtual reality (VR) therapeutic art program at Stanford Health Care from February to June 2024, providing an innovative and scalable adjunct to traditional art and music mindfulness therapies. This mixed methods project piloted 84 cumulative hours with 105 participants. Outcomes investigated satisfaction and the impact on hospitalization experience via survey questions. Data were analyzed using descriptive statistics and thematic analysis. Results (n = 40) indicated substantial improvements in patient experience, with 85% recommending the program and 97.5% reporting positive impacts from VR engagement. Thematic analysis of open-ended survey responses identified 4 key themes: escape and distraction, therapeutic benefits, enjoyment of the interactive activity, and positive facilitator interactions. Participants also expressed interest in additional VR offerings, including virtual mindfulness, and meditation. The results suggest that VR can serve as an effective adjunct to conventional mindfulness therapies and improve the inpatient experience.

“You don't have to be a survivor of abuse to be worried about smears”: Cervical screening experience of forensic inpatients

“You don't have to be a survivor of abuse to be worried about smears”: Cervical screening experience of forensic inpatients

Identifying Patient-Reported Care Experiences in Free-Text Survey Comments: Topic Modeling Study.

Patient-reported experience surveys allow administrators, clinicians, and researchers to quantify and improve health care by receiving feedback directly from patients. Existing research has focused primarily on quantitative analysis of survey items, but these measures may collect optional free-text comments. These comments can provide insights for health systems but may not be analyzed due to limited resources and the complexity of traditional textual analysis. However, advances in machine learning-based natural language processing provide opportunities to learn from this traditionally underused data source. This study aimed to apply natural language processing to model topics found in free-text comments of patient-reported experience surveys. Consumer Assessment of Healthcare Providers and Systems-derived patient experience surveys were collected and linked to administrative inpatient records by the provincial health services organization responsible for inpatient care. Unsupervised topic modeling with automated labeling was performed with BERTopic. Sentiment analysis was performed to further assist in topic description. Between April 2016 and February 2020, 43.4% (43,522/100,272) adult patients and 46.9% (3501/7464) pediatric caregivers included free-text responses on completed patient experience surveys. Topic models identified 86 topics among adult survey responses and 35 topics among pediatric responses that included elements of care not currently surveyed by existing questionnaires. Frequent topics were generally positive. We found that with limited tuning, BERTopic identified care experience topics with interpretable automated labeling. Results are discussed in the context of person-centered care, patient safety, and health care quality improvement. Furthermore, we note the opportunity for the identification of temporal and site-specific trends as a method to identify patient care and safety concerns. As the use of patient experience measurement increases in health care, we discuss how machine learning can be leveraged to provide additional insight on patient experiences.

The Forgotten Voices: Enabling Children and Young People With Intellectual Disability to Express Their Views on Their Inpatient Hospital Experience.

The importance of enabling patients to provide feedback on their experience of healthcare is widely accepted but there are few appropriate measures to enable children and young people to directly provide feedback, particularly those with intellectual disability or younger children. Our primary aim was to develop and test patient-reported experience measures for children and young people with intellectual disability who use inpatient hospital services. A secondary aim was to test these measures with younger children aged 4-7 years without intellectual disability. A hospital inpatient patient-reported experience measure previously developed for children aged 8-11 years was revised iteratively in conjunction with a parent advisory group (comprising five parents of children and young people with and without intellectual disability) and children and young people with intellectual disability. The final patient-reported experience measure was tested in children's inpatient wards at seven hospitals in England over a 3-month period. Parents suggested a need for a single patient-reported experience measure for all children with intellectual disability which contained simpler language, fewer questions and response options, and images to illustrate each question. The final patient-reported experience measure had 22 questions, each with a corresponding image, and a free text box in which children could add anything further. Questions addressed environment, people, care and treatment and safety. During testing at seven children's hospitals, 52 children and young people with intellectual disability (4-18 years) and 76 children without intellectual disability (4-7 years), all of whom received inpatient care, completed the patient-reported experience measure. Two percent of data were missing; in 16 instances respondents either ticked two responses or placed a tick between two response categories. Half the respondents added comments and/or drew a picture. The development of a patient-reported experience measure for children and young people with intellectual disability provides a previously unavailable opportunity for them to report on their experiences of inpatient care and have their voices heard. Future work to extend testing to a wider group is underway and will enable us to clarify whether one patient-reported experience measure is valid and reliable for all children and young people with intellectual disability. A parent advisory group, comprising parents/carers of young people with or without a learning disability, advised on all aspects of the wider study design and specifically on revisions to the measure reported in this manuscript. The parent advisory group met twice a year during the study with email contact between meetings for specific requests and study updates. Representatives of the advisory group also attended the study steering group.

Promoting Personal Recovery Within Psychiatric Inpatient Care-Nurses' Experiences.

To meet the aim of synthesising research on nurses' experiences of promoting personal recovery within psychiatric inpatient care, meta ethnography according to Noblit and Hare has been chosen as the method, which is a qualitative review of scientific literature that results in a synthesis. The focus is on interpretation and is expressed to be able to reduce a story, but at the same time keep what is unique using metaphors. Nine articles formed the basis of the synthesis. The analysis resulted in two levels of synthesis. The first level involved the translation of metaphors into one another, which proceeded in two directions, described as two principal headings. The second level produced five overarching metaphors. The first principal heading is that 'erected walls in psychiatric inpatient care impedes personal recovery.' It encompasses the overarching metaphors 'cultivating in exhausted soil' and 'nurses are gatekeeping watchdogs'. The second principal heading is 'torn-down walls in psychiatric inpatient care enable personal recovery'. It encompasses the overarching metaphors 'disarming and de-escalating', 'facing suffering together reveals treasures' and 'elevating the competent partner promotes recovery'. Conclusively, if the nurse is to be able to promote personal recovery in psychiatric inpatient care, bridges of cooperation and consensus need to be built to other professions in care. Otherwise, the obstacles to promoting personal recovery will be far too hard to overcome.

P-970. Impressions of the Pediatric Infectious Diseases Subspecialty by Pediatric Resident Physicians and Medical Students Following a Peds ID Elective Rotation

Abstract Background The subspecialty of Pediatric Infectious Diseases continues to struggle with a low number of applicants seeking training relative to the number of fellowship programs and open training positions. We explored the impressions that medical students and pediatric residents gathered about the subspecialty after completion of a Peds ID elective as a Quality Improvement initiative. Methods Resident physicians and medical students at the University of Michigan, from July 2022 to present, were surveyed after their Peds ID elective experience. Participation was voluntary and only anonymous responses in aggregate form were reported. Results The survey response rate was 56.3% (27 of 48 learners invited; 79% resident physicians and 21% medical students). 100% of learners reported a high educational value in participating in a Peds ID elective. Despite only 7.4% of learners considering Peds ID as a career before the elective, 18.5% of learners reported considering Peds ID fellowship training after their elective experience. Respondents indicated that 1) expertise in the subject matter of infectious diseases, 2) a mixture of inpatient and outpatient clinical experiences, and 3) opportunities to participate in Infection Prevention and Public/Global Health, were the top three most attractive aspects of the Peds ID subspecialty. In contrast, respondents indicated that 1) salary and compensation, 2) antimicrobial stewardship responsibilities, and 3) patient volume and workload, were the three least attractive aspects of the Peds ID subspecialty. Conclusion Peds ID remains a popular elective among learners who praise the educational content and teaching. Relatively low compensation, a heavy workload, and displeasure with antimicrobial stewardship duties were some of the main negative impressions by learners. Despite these impressions, participation in a Peds ID elective did lead to over twice as many learners considering Peds ID for their future careers. A mandatory Peds ID experience should be considered for the educational benefit of all learners and may improve fellowship recruitment. We identified issues for our subspecialty to address through advocacy to improve working conditions and compensation, thereby helping train and sustain an appropriate Peds ID workforce for the future. Disclosures All Authors: No reported disclosures

The treatment drop-out experiences of inpatients treated in an addiction clinic: a mixed method study

ABSTRACT Background The issue of low adherence, persistence, and continuation rates, coupled with high dropout rates, represents a significant challenge in the field of addiction treatment. It is therefore of paramount importance to gain an understanding of the underlying causes of treatment discontinuation. The objective of this study was to examine the experiences of individuals who were treated in an inpatient clinic for addiction in Türkiye and subsequently discontinued their treatment. Method In order to ascertain the reasons behind the decision to terminate 21-day inpatient treatment, face-to-face interviews were conducted with six participants who had voluntarily discontinued their treatment between March and June 2022. A parallel mixed-methods approach was used to collect both qualitative and quantitative data. Results Findings revealed a prevalence of amphetamine derivative use among participants. Factors such as individual characteristics, environment, treatment protocols, and operational aspects influenced treatment outcomes. Participants exhibited high levels of addiction, which played a significant role in their decision to discontinue treatment. Conclusions These findings can inform the development of more effective treatment protocols and support strategies to improve adherence and reduce dropout rates.

Physical function and perceived pain following inpatient intensive interdisciplinary pain treatment for children and adolescents.

Chronic pain among children and adolescents negatively impacts overall functioning and quality of life. Although Intensive Interdisciplinary Pain Treatment (IIPT) programs aim to reduce functional impairment and perceived pain, overall evidence is limited and restricted by small sample sizes and limited diversity in pain diagnoses. To determine whether children and adolescents with chronic pain participating in an inpatient IIPT program experience improvements in their physical function and perceived pain. Cross-sectional, secondary analysis. Inpatient acute rehabilitation. Children and adolescents with chronic pain (n = 258; females/males = 204/54; age = 16.5 ± 2.6) admitted to a 4-week inpatient IIPT program from November 2011 to January 2023. Participants attended individual and group sessions involving physical therapy, occupational therapy, aquatic therapy, cognitive behavioral therapy, school-related tasks, and meditation. The sessions focused on improving strength, endurance, and function, while helping participants modify physical sensations, catastrophic thinking, and maladaptive behaviors. Collected at admission and discharge: pain intensity (Numerical Pain Rating Scale; scale: 0-10), lower extremity function (Lower Extremity Functional Scale [LEFS]; scale: 0-80), upper extremity function (Upper Extremity Functional Index [UEFI]; scale: 0-80), motor proficiency (Bruininks-Oseretsky Test of Motor Proficiency, Second Edition short form [BOT-2 SF]; scale: 0-70), and occupational performance and satisfaction (Canadian Occupational Performance Measure [COPM]; scale: 0-10 for both). Overall, participants reported significant improvements (p < .05) in median LEFS (median change [MC] = +30.5; 25th, 75th percentile range [PR] = 19, 42), UEFI (MC = +21; PR = 12.8, 31), BOT-2 SF (MC = +9; PR = 5, 15), COPM performance (MC = +4; PR = 2.8, 5.4), and COPM satisfaction (MC = +5.6; PR = 3.8, 7.2). Moreover, participants reported significant reduction (p < .05) in median pain intensity (MC = -3; PR = 1, 5). For a majority of participants, MC surpassed previously reported minimally clinical important difference thresholds. Findings highlight the relevance of inpatient IIPT programs in enhancing physical function and reducing perceived pain in children and adolescents with chronic pain.

Views and Experiences of Nurses Receiving Care as Inpatients: An Empirical Qualitative Study From Ankara.

To determine the views and experiences of inpatient nurses receiving care. Switching from the care provider role to being a patient allows nurses to realise patients' real care expectations and to test their colleagues' care practices. Nurses' experience as inpatients is essential for understanding patients' care-related expectations and improving care quality by reflecting on their practices. This qualitative study used a descriptive phenomenological design. Data were collected from nine volunteer nurses between July 2018 and June 2020 in Ankara, Türkiye, through face-to-face interviews using semi-structured questionnaires and audio recordings. The research data were analysed by following the descriptive phenomenological data analysis steps. The Consolidated Criteria for Reporting Qualitative Research [COREQ] checklist was used to report study findings. Three themes emerged from the views and experiences of nurses receiving inpatient care: care-receiving experiences, components of good nursing care and change in perception of care. It is important to reveal the opinions and experiences of hospitalised nurses regarding care to understand the expectations of the care recipients and to increase the quality of the care provided. The study revealed that the experiences of nurses receiving inpatient care improved their professional sensitivity and this was reflected in the quality of the nursing care they provided. Nurses can provide higher quality and humanistic care by combining their professional knowledge and skills with the increased awareness of the inpatient experience of nurses. No patient or public contribution.

General Hospitals with High-Tech Medical Equipment and Patient Experience.

This study investigates the relationship between the retention of high-tech medical equipment in medical institutions in South Korea and patient experience evaluation outcomes. Data were sourced from the third Patient Experience Assessment conducted by the Health Insurance Review and Assessment Service (HIRA), a South Korean agency, and HIRA's 2021 data on medical equipment. A total of 320 institutions equipped with CT, MRI, and PET scans or only CT and MRI were analyzed. The dependent variable was the average score across six patient experience dimensions: overall, nurses, doctors, medication and treatment, hospital environment, and guarantee of patient rights. Multiple regression analysis revealed that institutions with CT, MRI, and PET scans scored higher in-patient experience, particularly in the overall dimension (2.15 points), hospital environment (2.22 points), patient rights (1.77 points), and doctors (1.54 points). These findings suggest that high-tech medical equipment positively influences patient satisfaction with care quality. Medical institutions should consider these factors when aiming to enhance patient experience.