Patient Experience Of Care Research Articles

Staff and patient experiences of crowding, corridor care and boarding: a rapid review.

The increasing use of healthcare services is leading to issues with hospital overcrowding and this is particularly apparent in emergency departments (EDs). Consequently, patients are being cared for in areas that were not designed for that purpose, such as waiting areas and corridors. This negatively affects nurses' and patients' experiences of care. This article provides a rapid review of the evidence on nurses' and patients' experiences of crowding, corridor care and boarding. The findings highlight three main elements experienced by staff and patients when caring or being cared for in such contexts: stress and frustration; dissatisfaction with care; and safety and coping mechanisms. Enhancing nurse autonomy and improving communication with patients could mitigate some of these negative experiences and thereby improve staff retention, reduce staff-patient conflict and reduce the likelihood of patients leaving the ED without being seen.

Patient and carer experiences of hospital-based hybrid virtual medical care: a qualitative study.

To understand patients' and carers' experiences of virtual medical care delivered into rural and remote hospitals. Qualitative study using semi-structured interviews. Interviews were conducted between 7 June 2022 and 21 February 2023. Participants were people who had received a virtual medical service from the Virtual Rural Generalist Service (VRGS), and their carers, in rural and remote hospitals within the Western NSW Local Health District. Acceptability of, access to, quality of and appropriateness of care provided by the VRGS. We interviewed 43 patients and carers about their experiences of VRGS services received in an emergency department or inpatient setting. About half of our participants thought that virtual medical care (supported by in-person nursing staff) was highly acceptable and equivalent to in-person care. For the remaining participants, virtual care was seen as being an acceptable alternative if in-person care was not available. Patients reported that the model met their immediate needs, even if the virtual delivery mode was not their preference. VRGS doctors were generally seen as skilled and personable, and acceptability of virtual care increased with more experience of it. A key perceived benefit of virtual care was increased access to medical care without the need to travel long distances. Hospital-based virtual care was not considered less appropriate for older adults or children. Virtual care in a rural hospital setting, such as that delivered by the VRGS, is broadly acceptable to patients and carers. While most would prefer to have a doctor physically present, patients and carers are accepting of the need for virtual care to supplement in-person care in rural and remote areas. Patients and carers who experience hospital-based virtual care perceive that it can provide good quality medical care and meet many of their needs.

Experience of patients and healthcare practitioners with interdisciplinary care in immune-mediated inflammatory diseases with skin manifestations: A systematic scoping review.

Immune-mediated inflammatory diseases with skin manifestations (skIMIDs) may affect multiple organs. Interdisciplinary care (IC) can overcome the fragmented knowledge used in the management of skIMIDs. In skIMIDs-care, patient and healthcare practitioner (HCP) satisfaction with IC is unknown. Yet, patient experience influences adherence and medical outcomes. Moreover, HCP experience influences professional satisfaction, perception of care quality and autonomy. Thus, measuring patient and HCP experience can identify areas for improvement in care delivery. The aim of this scoping review was to gather evidence on patient- and HCP perceptions on skIMID-IC and their measurement. We systematically searched on 30 August 2023 PubMed/EMBASE/Cinahl/Web of Science. Eligible studies had to address explicitly experience of IC by patients or HCPs. A conceptional synthesis appraised how experiences were measured and IC was perceived by patients and HCPs. The database search resulted in 21 eligible studies. Fourteen described positive patient and HCP experiences with a specific IC programme. These studies were heterogenous on the levels of IC models, medical conditions, measurement methods and outcomes. Despite that patients and HCPs rated such tailored IC models positively, seven studies on a geographically broader region reported less satisfaction with IC. A conceptual analysis identified domains deemed as important regarding IC: 'general satisfaction', 'patient-HCP interaction', 'information', 'functioning of IC', 'benefits of IC'. For patients, 'access to care' and 'disease management' were added. For HCPs 'illness perception' was deemed relevant. The heterogeneous way in how IC experience is captured hinders strong conclusions, which mandates the development of standardized analysis tools. Experience with IC in skIMIDs strongly depends on the context of the provided IC and patient experience seems to be better in local IC programmes than systems rolled out in larger geographical regions. Future need is to develop a core IC outcome set including medical outcomes, process indicators, financial indicators, plus patient and HCP care experience measures.

Moving Forward Together: Establishing an Actionable Pedagogical Approach to Ableism-Aware Medical Education.

As a form of discrimination, ableism impacts access to and the experience of clinical care for patients with disabilities as well as the daily experiences of learners and clinicians with disabilities. Ableist beliefs and practices conflict with physicians' professional responsibilities and legal obligations to provide care that is nondiscriminatory and accessible. An actionable pedagogical approach within medical education is needed to prepare a physician workforce that is able to meaningfully identify and mitigate ableism at all levels of the health care system.In this article, the authors propose a 3-pronged approach to ableism-aware medical education, building on frameworks that have been articulated for addressing other forms of discrimination to set forth a practical framework easily adopted by educators who may not be experts in ableism and its impact. The 3-pronged approach aligns with American Medical Association and Association of American Medical Colleges perspectives on advancing health equity and is inclusive of priority areas articulated by stakeholders, including those living with disability, those teaching about disability, and those advancing equity within medicine more broadly. The authors provide strategies relevant to medical students, faculty, and institutions, recognizing that ableism exists-and can be addressed-on multiple levels.

Phenomenological Studies: Experiences of Family Members Taking Care of Post-Stroke Patients

Most of the global stroke burden occurs in low- and lower-middle-income countries. The most common obstacles families face when caring for stroke patients appear to cause various tensions between patients and their families. This study examines family members' experiences of caring for patients after a stroke. This study uses a qualitative method with a descriptive phenomenological design. The research participants were 11 participants using purposive sampling techniques. Data were analyzed using NVivo 12 qualitative data analysis software, and interview results were analyzed using thematic analysis. This study identified five phenomena related to the experience of caring for patients after stroke: fulfillment of patient's daily activities, patient treatment, participant psychological response, participant support, and barriers to patient care. Most participants had a less pleasant experience caring for patients after a stroke. This is reflected in sad reactions, angry reactions, the need for help and support from the government, health workers, and other family members, and barriers to patient care. It is important to ensure good coordination between health services and patients and their families, as patients and participants do not have access to health services due to distance and physical disability.

Safety and Clinical Outcomes of a Complete "Minimalist" Left Atrial Appendage Occlusion Pathway.

The standard approach to catheter based left atrial appendage occlusion (LAAO) involves trans-esophageal echocardiography (TEE) guided screening and placement, and procedural general anesthesia requiring overnight stay. In pursuit of improved patient experience and reduced cost, streamlined approaches in each phase of care have been explored. However, the safety and clinical outcomes for a completely protocolized minimalist approach utilizing computed tomography angiogram (CTA), intracardiac echocardiography (ICE), conscious sedation, and same-day discharge are lacking. We retrospectively studied 179 patients undergoing LAAO for nonvalvular atrial fibrillation using a novel "Minimalist" pathway. Efficacy and safety endpoints included stroke, systemic embolism, major bleeding requiring transfusion, pericardial effusion, vascular complication, or death through 7 or 45 days post-procedure. The procedural success rate in Minimalist cases was 100%. A total of 159 patients (88.8%) were eligible for SDD. All patients survived to 45 days of follow up and there was a 0% incidence of stroke, systemic embolism, and vascular complications. There were low rates of DRT (1.3%) and peri-device flow (0.7%), yielding a high rate of safe OAC discontinuation. Using a pre-defined Minimalist pathway, eligible patients demonstrated excellent clinical outcomes comparable to those reported in national clinical registries, supporting use of our novel pathway to safely improve both patient experience and efficiency of care.

Nurses' and physicians’ experience of a new algorithm for tapering analgosedation in the paediatric intensive care unit: A focus-group investigation

Aim/objectiveIatrogenic withdrawal syndrome occurs frequently during the tapering phase of opioids and benzodiazepines in paediatric intensive care units. The aim of this study was to explore physicians' and nurses' experiences in patient care and staff collaboration during the tapering phase using a new “algorithm for tapering analgosedation” MethodsWe used a qualitative explorative design with focus groups. The framework method was followed including transcription, familiarisation, coding, developing a framework, applying the framework, charting data into the framework matrix, and interpreting the data. The study was conducted at two paediatric intensive care units at Oslo University Hospital in Norway. Nurses and physicians who had used the new algorithm participated in the study. FindingsThree focus-group interviews were conducted with a total of 15 informants. Three main themes were identified with relevant subthemes: “Caring for a child in withdrawal”, “Advantages of the algorithm”, and “Challenges of the algorithm”. The algorithm positively affected patient care and staff collaboration during tapering. The use of the Withdrawal Assessment Tool-1 integrated in the algorithm required experienced nurses due to the risk of false-positive patient assessments. ConclusionNurses and physicians in our study experienced that the new algorithm promoted staff collaboration and positively affected patient care. The use of the Withdrawal Assessment Tool-1 integrated in the algorithm required experienced staff and resources for continuous staff education.

Exploring empathy of nursing students and the extent of their clinical experiences: a cross-case analysis

Introduction: Empathy is the ability of a nurse to understand the circumstances, experiences, and feelings of the patients. It is a vital component of a nurse as this enables the nurse to respond therapeutically to the needs of the clients, thereby providing quality nursing care. This study explored the development of empathy among nursing students based on their hospital exposure and other factors that provide a more in-depth understanding of the phenomenon investigated. Methods: Using the intrinsic case study method, the study interviewed six nursing students as informants, selected based on their extent of clinical exposure through purposive sampling. A standardized Jefferson Scale of Empathy (JSE) was also used to provide information on empathy. A cross-case analysis was used to generate the findings of this study. Results: Findings generated five themes: maintaining empathy level across different conditions, prior clinical experiences affect empathy levels, empathy increases with knowledge, expression of empathy is hindered by academic workload and mismatch between perceived and objectively measured empathy levels. Conclusions: Empathy was more developed by nursing students when they were exposed to patient care experiences. The extent of knowledge and the continued experience in the clinical field are major factors that contribute to their increased empathy levels of nursing students.

Primary care experience in people with mental health conditions: results from a national patient experience survey.

The study explored whether the reported experience of primary healthcare differs for survey respondents in Aotearoa New Zealand who self-report having a mental health (MH) condition in comparison with those who do not. Responses to the New Zealand Health Quality & Safety Commission's adult primary care patient experience survey received from August 2020 to May 2022 were analysed. Comparative analysis of patient-reported experience measures were completed to contrast experiences reported by those with and without a MH condition, with results stratified by ethnicity (Māori/non-Māori), age group and gender. Age/gender-standardised estimates for proportions of positive responses to each question were developed for each group alongside standardised risk differences. Our sample comprised 201,650 responses, with 21% reporting a current diagnosed MH condition. While most respondents reported positive experiences of primary healthcare, we found a consistent pattern of fewer positive experiences for those with MH conditions across dimensions of care quality, age and gender groups. When responses were separated by ethnicity, this difference was amplified among Māori. This analysis adds to the increasing body of evidence that experience of MH conditions is associated with worse healthcare experiences. It demonstrates that data are available in Aotearoa New Zealand to routinely monitor and report on primary care experiences for this group. Interventions to improve healthcare should focus on care for Māori with MH conditions as a priority.

Posttraumatic Stress Symptoms among Obstetricians with Personal Experience of Birth Trauma.

Psychological birth trauma (BT), defined as an event that occurs during labor and delivery involving actual or threatened harm or death to the pregnant person and/or their baby, has been reported in up to one-third of births. Obstetrician-Gynecologists (OBGYNs) who personally experience BT are at a unique risk of re-traumatization upon return to work. We aimed to investigate the prevalence of personal BT among obstetricians and their perceptions of how personal BT impacts their experience of caring for obstetric patients. We performed a web-based survey of OBGYNs who had given birth. Participants were recruited from the "OMG (OBGYN Mom Group)" on Facebook. The questionnaire assessed individuals' personal experience of childbirth using items adapted from the "City Birth Trauma Scale" to assess posttraumatic symptoms related to their childbirth and patient interactions following the personal experience of BT. Responses were categorized by whether or not the participant considered one or more of their own births to be traumatic. Posttraumatic stress symptoms (PTSSs) and symptoms of occupational re-traumatization were compared by reported BT. Bivariable analyses were used. Of the 591 OBGYNs who completed the survey, 180 (30.5%) reported experiencing BT. Ninety-two percent of OBs cared for birthing patients after giving birth. There were no differences in demographic or clinical practice characteristics between those with and without BT. OBGYNs with BT experienced PTSSs including flashbacks (60.6% vs. 14.4%), amnesia (36.7% vs. 20.9%), and insomnia (24.4% vs. 1.2%) at higher rates than those without BT (p < 0.001). Almost one-third of OBGYNs in this sample reported personally experiencing BT, mirroring data from reported BT rates in the general population. Given that OBGYNs are at high risk for occupational re-traumatization, initiatives focused on improving support for birthing OBGYNs upon returning to work should be studied to assess the impact on emotional wellness among practicing OBGYNs. · Birthing OBGYNs experience psychological BT at similar rates to the general population.. · OBGYNs who experience personal BT may experience PTSSs at work.. · Further research on the prevalence of personal BT among OBGYNs is needed..

Establishing a Gynecology Student-Run Free Clinic: A Joint Medical Student and Resident Physician Initiative

Dedicated women’s health services are rarely mentioned in the student-run free clinic literature. As society grappled with repeated waves of coronavirus-2019, the number of healthcare professionals decreased across the country and impacted all healthcare settings, including student-run free clinics. In response, a collaboration between medical students and Obstetrics &amp; Gynecology resident physicians at Oakland University William Beaumont School of Medicine and the Gary Burnstein Community Health Clinic established a new gynecology free clinic. This program, under the joint oversight of medical students and resident physicians in addition to attending physician support, provided uninsured women across Southeast Michigan with critical access to healthcare services at a time demand for services was similarly rising. Our clinic emphasized excellence in screening, contraception, and vaccination and, in doing so, provided our patients with evidence-based care and a medical home. Our experience demonstrates student-run free clinics are uniquely positioned to critically expand access to women’s health services. Additionally, the establishment of a joint medical student and resident physician endeavor can further enrich both the educational and patient-care experience.

Nepenthes-inspired saliva-amassing low-dosed risk-factor alerted detecting (SALAD) mouthguard for forewarning of the intraoral cancer

Oral cancers pose a significant challenge to global public health with devastating incidence and poor prognosis, highlighting the urgent need for early detection and intervention. Herein, inspired by the unique water-collecting structure (peristome) of the Nepenthes pitcher plant, an innovative saliva-amassing low-dosed risk-factor alerted detecting (SALAD) system was integrated into the wearable mouthguard for in situ, specific, and sensitive detection of tumor necrosis factor-alpha (TNF-α) in saliva, serving as a potential early indicator for oral cancers. This system employed an efficient liquid amassing (LA) module to collect and immobilize intraoral biomarkers in dynamic and complex saliva environments. Moreover, the Aggregation-Induced Emission (AIE)-related fluorescent signal was activated directly in the center of the mouthguard in conjunction with a household UV lamp, simplifying the detection process and amplifying the visibility of the diagnostic readings. Encouragingly, the SALAD mouthguard demonstrated exceptional capability in detecting target biomarkers in simulated intraoral environments. Promisingly, it received highly positive support from the volunteers who underwent preliminary testing with the SALAD mouthguard. Overall, validated by numerous simulated and realistic in vitro and in vivo tests, the SALAD mouthguard was demonstrated to act as a promising candidate for forewarning of oral cancer, highlighting potential for clinical translation and improving patient care experiences.

Abstract 4138609: Patient Care Experience Worsens After Private Equity Acquisition of US Hospitals: Implications for Cardiovascular Outcomes

Background: Patient care experience is strongly associated with outcomes among individuals with cardiovascular disease. There is growing concern that the recent and precipitous rise in private equity acquisitions of US hospitals may worsen patient-centered care, and ultimately, cardiovascular outcomes. However, little is known about how private equity acquisitions of hospitals impact patient care experience. Research Question: To evaluate whether the acquisition of US hospitals by private equity firms was associated with changes in measures of patient-reported experience compared with matched control hospitals (not acquired by private equity) between 2007-2019. Methods: This cohort study identified 74 US acute care hospitals newly acquired by private equity firms and 298 matched control (non-acquired) hospitals from 2007 to 2019. CMS Hospital Compare files were used to obtain patient experience measure scores for each hospital from Hospital Consumer Assessment of Healthcare Providers and Systems (HCAPHS) survey results. A quasi-experimental difference-in-differences design was used to evaluate changes in patient experience measures at private-equity acquired hospitals compared with matched control hospitals 3 years before vs 3 years after acquisition. Results: The percentage of patients rating hospitals as a 9 or 10 out of 10 at private equity acquired hospitals and control hospitals is shown in the Figure. There was a differential decrease in patient ratings (of 9 or 10 out of 10) at hospitals acquired by private equity firms compared with control hospitals (-2.4 percentage points [95% CI -3.9, -0.9]). A similar trend was seen in the percentage of patients that would definitely recommend the hospital, with a differential decrease at private equity-acquired hospitals relative to control hospitals (-2.2 percentage points [95% CI -3.6, -0.7]). For both measures, the relative decrease in patient care experience at private equity hospitals compared with control hospitals steadily grew with each subsequent year after acquisition. Conclusion: In this national study, patient-reported care experience worsened after private equity acquisition of US hospitals, which has important implications for cardiovascular care and outcomes.

The Experience of Reflexive Hospice Care for Patients With Advanced Cancer: A Qualitative Study.

Hospice care for patients with advanced cancer mainly takes the family members and healthcare professionals as the main body and the patients as the object. There is a lack of relevant research on reflexive hospice care that considers patients as subjects. To explore the experience of reflexive hospice care for patients with advanced cancer. An empirical phenomenological approach to research was conducted. Data were collected using face-to-face semi-structured interviews between April 3, 2024 and May 27, 2024 in the oncology wards of two comprehensive hospitals. Purposive sampling was used to recruit 18 patients with advanced cancer receiving hospice care. Colaizzi's phenomenological analysis method was used to analyse the data. We followed the consolidated criteria for reporting qualitative research (COREQ). Four themes were identified as being relevant to the experience of reflexive hospice care for patients with advanced cancer: the absence of prior awareness, reconciling with self and others, care and concern for others, and pursuing the meaning of life. This study provides new insights into hospice care for patients with advanced cancer. It emphasises the importance of patients' participation as subjects in hospice care. In reflexive hospice care, patients can actively participate and express their care for others and their understanding of life, thus gaining more respect and care in the end-of-life stage. Therefore, placing patients as the subjects of hospice care and fully respecting and listening to their wishes and needs is one of the most important ways to promote the development of hospice care quality. No patient or public contribution.

“I Know You'Re a Nurse or a Doctor but I'm the Expert on Hemophilia”: Insights into Healthcare Professional Knowledge and Patient Care Experiences in Hemophilia

“I Know You'Re a Nurse or a Doctor but I'm the Expert on Hemophilia”: Insights into Healthcare Professional Knowledge and Patient Care Experiences in Hemophilia

Resident physician burnout and association with working conditions, psychiatric determinants, and medical errors: A cross-sectional study.

Burnout has become a significant occupational concern for resident physicians, primarily attributed to chronic workplace stressors, inadequate work-life balance, high expectation from attending staffs, steep learning curve, and limited patient care experience. The study aimed to investigate the prevalence and associated factors of burnout in medical residents. This cross-sectional study was conducted online questionnaire of all specialists in a university hospital from September to October 2022. Burnout was assessed using the Maslach Burnout Inventory-Human Services Survey for Medical Personnel. The data collection encompassed information on socio-demographics, working conditions, psychiatric issues, and medical errors as potential predictive variables. To analyze the association between these factors and burnout, a confounder summary score model was employed in four separate models utilizing multivariable logistic regression. A total of 238 participants, the average age of participants was 28.1 years (SD 2.7), and 56.2% of them were female. Weekly working hours averaged 75 (SD 21.8). Burnout prevalence was 46.3%. This prevalence was characterized by high levels of emotional exhaustion (57.1%) and depersonalization (36.1%), along with low levels of personal accomplishment (52.4%). Summary of association in each domain with burnout were as follow: demographic determinants, (adjusted odds ratio (aOR) 2.80, 95% CI 1.68-4.64), working conditions (aOR 2.97, 95% CI 1.54-5.71), psychiatric determinants (aOR 2.47, 95% CI 1.77-3.45) medical errors (aOR 2.14, 95% CI 1.05-4.34). Medical residency training programs should provide a supportive system that actively monitors and addresses depressive symptoms. Implementing preventive measures, such as increasing pay rates, can play a role in mitigating burnout.

The Supportive Care Needs of Individuals Living With Advanced or Metastatic Lung Cancer Receiving Targeted or Immunotherapies.

Lung cancer is associated with the highest incidence and mortality of all cancers. New treatments, called targeted therapies (TT) and immunotherapies (IO), offer higher treatment efficacy and fewer side effects compared to traditional treatments but are accompanied by uncertainty and an unpredictable treatment course. There is a paucity of research on the experiences of individuals living with advanced or metastatic lung cancer receiving TT/IO, and even less is known about the supportive care needs of this population. Twenty four participants from across Canada participated in semi-structured interviews regarding their supportive care needs. Thematic analysis was utilized to identify their supportive care needs. Qualitative coding identified unmet needs and challenges. All participants indicated difficulties with unmet supportive care needs, including psychological, informational, and practical needs. The exploration of supportive care experiences of patients receiving TT/IO exposes high distress and unmet needs. Results indicate the need for timely and accessible supportive cancer care. Results can inform patient advocacy efforts and the development of new services.

Assessing the impact of implantable loop recorder placement on anxiety level

Abstract Background Anxiety is a prolonged state of apprehension or worry that can be an independent predictor of cardiovascular events, associated with a 48% increased risk of cardiac death. About one-third of patients with arrhythmias present with high anxiety levels, and subsequently worse quality of life. In our experience of patient care, many patients feel anxious about the possibility of an arrhythmia that could lead to their demise, especially if their symptoms are undiagnosed. Purpose Our project aims to explore the change in patients’ anxiety levels following implantable loop recorder (ILR) placement. Methods This is a survey-based observational study that was performed in an outpatient clinic and hospital using validated General Anxiety Disorder-7 (GAD-7) questionnaires. Individuals who met indications to undergo ILR implantation including palpitations, syncope, subclinical atrial fibrillation, and cryptogenic stroke underwent baseline assessment of anxiety prior to implantation. Individuals had repeat assessments at 6 weeks and 12 weeks post-implantation to evaluate the effect of ILR placement. Results Our study included 50 individuals. Out of the initial subjects, 10/25 females and 11/25 males were lost to follow-up. The average initial GAD-7 score was 3.3 (Range 0, 15), average 6-week score was 1.6 (Range 0, 14), and average 12-week score was 0.9 (Range 0, 10). Total decrease in GAD-7 score after 6 weeks of having ILR was 50%. Total decrease in GAD-7 score after 12 weeks of ILR was statistically significant at 73% (P=0.03). Females showed greater improvement of GAD-7 scores in comparison to males at 6 weeks (67% vs 36%) and 12 weeks (81% vs 66%). Conclusion Studies have suggested an overall decreased level of anxiety in patients receiving implantable devices that have the potential to treat arrhythmias such as implantable cardiac defibrillators and pacemakers. Our results suggest that the benefit may extend to implantable devices that seek to provide further diagnostic information and aid in the prognostication of disease burden. As seen in our study population, GAD-7 scores showed dramatic improvement with greater percentage in female than male population. After the placement of loop recorders, many patients experience a sense of security with having a device that monitors them. Our study is the first to address the association between ILR and anxiety. Future studies evaluating this association would help increase the power of the study.Figure 1:Bar graph of GAD-7 Scores

Impact of Applying PDCA Circulation Method on Surgical Care Interventions in the Operating Room on Patients Undergoing Cardiothoracic Surgery: A Retrospective Study

Background: The Plan-Do-Check-Act (PDCA) cycle is a widely recognized methodology for continuous quality improvement. This study evaluated the impact of applying the PDCA cycle on surgical care interventions in the operating room for patients undergoing cardiothoracic surgery. Methods: A retrospective study was conducted on the treatment of patients who underwent continuous cardiothoracic surgery in our Hospital from July 2020 to June 2023. Participants were divided into control and PDCA groups on the basis of the application of the PDCA cycle in their surgical care. Various outcomes were assessed, including psychological well-being (Hospital Anxiety and Depression Scale [HAMA] and Hamilton Depression Rating Scale [HAMD] scales), quality of life (using the QLQ-C30 tool), patient satisfaction, incidence of adverse accidents, clinical parameters, and laboratory measures. Results: The study comprised 133 patients, with 62 in the control group and 71 in the PDCA group. The psychological well-being, as measured by the HAMA and HAMD scales, of the PDCA group showed significant improvements compared with that of the control group (p &lt; 0.05). The Quality-of-Life scores were higher in the PDCA group than in the control group (p &lt; 0.05). In the PDCA group, the patient satisfaction scores related to hospital satisfaction were significantly higher than that in the control group, and the incidence of adverse accidents was lower (all p &lt; 0.05). No significant differences were noted in clinical parameters (ejection fraction and B-type natriuretic peptide levels) nor laboratory measures (serum protein and C-reactive protein (CRP) levels) between the groups (p &gt; 0.05 for all). Conclusion: The implementation of the PDCA cycle in the operating room for patients undergoing cardiothoracic surgery significantly improved psychological well-being and patient satisfaction and reduced the incidence of adverse accidents in the operating room, indicating that this quality improvement approach can enhance patient care experience. Although no significant differences were observed in clinical and laboratory parameters, the findings suggest that the PDCA cycle's strengths lie in its systematic approach to care process optimization and patient-centered outcomes.

Primary Care Informatics: Vitalizing the Bedrock of Health Care.

Primary care informatics (PCI) professionals address workflow and technology solutions in a wide spectrum of health, ranging from optimizing the experience of the individual patient in the clinic room to supporting the health of populations and augmenting the work of frontline primary care clinical teams. PCI overlaps uniquely with 2 disciplines with an impact on societal health-primary care and health informatics. Primary care is a gateway to health care access and aims to synthesize and coordinate numerous, complex elements of patients' health and medical care in a holistic manner. However, over the past 25 years, primary care has become a specialty in crisis: in a post-COVID-19 world, workforce shortages, clinician burnout, and continuing challenges in health care access all contribute to difficulties in sustaining primary care. Informatics professionals are poised to change this trajectory. In this viewpoint, we aim to inform readers of the discipline of PCI and its importance in the design, support, and maintenance of essential primary care services. Although this work focuses on primary care in the United States, which includes general internal medicine, family medicine, and pediatrics (and depending on definition, includes specialties such as obstetrics and gynecology), many of the principles outlined can also be applied to comparable health care services and settings in other countries. We highlight (1) common global challenges in primary care, (2) recent trends in the evolution of PCI (personalized medicine, population health, social drivers of health, and team-based care), and (3) opportunities to move forward PCI with current and emerging technologies using the 4Cs of primary care framework. In summary, PCI offers important contributions to health care and the informatics field, and there are many opportunities for informatics professionals to enhance the primary care experience for patients, families, and their care teams.