What can trauma patients’ experiences and perspectives tell us about the perceived quality of trauma care? a qualitative study set within the UK National Health Service
•Patient perspectives and experiences of care are important and absent from existing quality of care frameworks.•Present study shows that traumatic injury patients struggle with the distressing nature of their injury and resultant vulnerability.•Patients valued having the psychological impact of the...
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Veröffentlicht in: | Injury 2020-05, Vol.51 (5), p.1231-1237 |
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creator | Kellezi, B. Earthy, S. Sleney, J. Beckett, K. Barnes, J. Christie, N. Horsley, D. Jones, T. Kendrick, D. |
description | •Patient perspectives and experiences of care are important and absent from existing quality of care frameworks.•Present study shows that traumatic injury patients struggle with the distressing nature of their injury and resultant vulnerability.•Patients valued having the psychological impact of their injuries recognised and addressed in their care.•Patients valued competence, empathetic care and being cared for, and had different expectations for different professionals.•Our study suggests that patients care experience and psychological needs must be incorporated into existing care frameworks.
The global drive for improvements in the efficiency and quality of healthcare has led to the development of frameworks to assist in defining and measuring ‘good quality care’. However, such frameworks lack a systematic or meaningful definition of what ‘good quality care’ means from the patients’ perspective. The present research provides an in-depth analysis of patients’ experiences in a hospital setting from a quality of care perspective. Forty-five adults (aged 16–70) hospitalised in one of four UK NHS trusts following an unintentional injury were interviewed about their experiences of care. The findings show variability in perceived quality of care within the same hospital episode which cannot be meaningfully captured by existing frameworks. The context of trauma care (e.g. distressing nature of injury, patient vulnerability, expectations of hospitalisation and participants’ interaction with different service providers) defined the care experience and the value of being ‘cared for’. Participants identified some aspects of good and care which related to holistic, person-centred and personalised care beyond the medical needs. Participants discussed the value of being understood, staff thinking of their needs beyond hospitalisation, staff trying ‘their best’ despite constrains of current care, having their emotional needs recognised and addressed and staff competence.
Patients reported also poor quality of care and ‘not being cared for’ by specific staff groups which they expected to fulfil this role, rushed and unsympathetic care, lack of recognition for emotional impact of injury mapped onto existing quality frameworks e.g. safety, equity, accessibility and patient-centeredness as well as quality of interaction with providers, empathetic care which extended beyond medical needs, coordination of care, and the positivity of care delivery as important dimensions of q |
doi_str_mv | 10.1016/j.injury.2020.02.063 |
format | Article |
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The global drive for improvements in the efficiency and quality of healthcare has led to the development of frameworks to assist in defining and measuring ‘good quality care’. However, such frameworks lack a systematic or meaningful definition of what ‘good quality care’ means from the patients’ perspective. The present research provides an in-depth analysis of patients’ experiences in a hospital setting from a quality of care perspective. Forty-five adults (aged 16–70) hospitalised in one of four UK NHS trusts following an unintentional injury were interviewed about their experiences of care. The findings show variability in perceived quality of care within the same hospital episode which cannot be meaningfully captured by existing frameworks. The context of trauma care (e.g. distressing nature of injury, patient vulnerability, expectations of hospitalisation and participants’ interaction with different service providers) defined the care experience and the value of being ‘cared for’. Participants identified some aspects of good and care which related to holistic, person-centred and personalised care beyond the medical needs. Participants discussed the value of being understood, staff thinking of their needs beyond hospitalisation, staff trying ‘their best’ despite constrains of current care, having their emotional needs recognised and addressed and staff competence.
Patients reported also poor quality of care and ‘not being cared for’ by specific staff groups which they expected to fulfil this role, rushed and unsympathetic care, lack of recognition for emotional impact of injury mapped onto existing quality frameworks e.g. safety, equity, accessibility and patient-centeredness as well as quality of interaction with providers, empathetic care which extended beyond medical needs, coordination of care, and the positivity of care delivery as important dimensions of quality care with implications for their recovery. The findings have implications for quality frameworks and theoretical definitions of quality of care; they demonstrate the importance of patient experience in addition to clinical effectiveness and safety as an essential dimension of quality care. In terms of practice, the findings support the need to incorporate knowledge and training of injured adults’ psychological needs, and the value of interaction with professionals as a patient defined dimension of the quality of care.</description><identifier>ISSN: 0020-1383</identifier><identifier>EISSN: 1879-0267</identifier><identifier>DOI: 10.1016/j.injury.2020.02.063</identifier><identifier>PMID: 32127201</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Adolescent ; Adult ; Aged ; Experience of care ; Female ; Health Knowledge, Attitudes, Practice ; Health Personnel - standards ; Humans ; Interviews as Topic ; Male ; Middle Aged ; Patient perspective ; Patient-Centered Care - methods ; Psychological needs ; Qualitative Research ; Quality of Health Care - organization & administration ; Trauma ; Trauma Centers - standards ; United Kingdom ; Vulnerability ; Wounds and Injuries - psychology ; Young Adult</subject><ispartof>Injury, 2020-05, Vol.51 (5), p.1231-1237</ispartof><rights>2020 Elsevier Ltd</rights><rights>Copyright © 2020 Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-99f62156ee99a8ab0b3f54df5f6aa3a65a7047cea4b11c6cf3c81a757ef364653</citedby><cites>FETCH-LOGICAL-c408t-99f62156ee99a8ab0b3f54df5f6aa3a65a7047cea4b11c6cf3c81a757ef364653</cites><orcidid>0000-0003-3603-6542 ; 0000-0003-4825-3624</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.injury.2020.02.063$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27926,27927,45997</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32127201$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kellezi, B.</creatorcontrib><creatorcontrib>Earthy, S.</creatorcontrib><creatorcontrib>Sleney, J.</creatorcontrib><creatorcontrib>Beckett, K.</creatorcontrib><creatorcontrib>Barnes, J.</creatorcontrib><creatorcontrib>Christie, N.</creatorcontrib><creatorcontrib>Horsley, D.</creatorcontrib><creatorcontrib>Jones, T.</creatorcontrib><creatorcontrib>Kendrick, D.</creatorcontrib><title>What can trauma patients’ experiences and perspectives tell us about the perceived quality of trauma care? a qualitative study set within the UK National Health Service</title><title>Injury</title><addtitle>Injury</addtitle><description>•Patient perspectives and experiences of care are important and absent from existing quality of care frameworks.•Present study shows that traumatic injury patients struggle with the distressing nature of their injury and resultant vulnerability.•Patients valued having the psychological impact of their injuries recognised and addressed in their care.•Patients valued competence, empathetic care and being cared for, and had different expectations for different professionals.•Our study suggests that patients care experience and psychological needs must be incorporated into existing care frameworks.
The global drive for improvements in the efficiency and quality of healthcare has led to the development of frameworks to assist in defining and measuring ‘good quality care’. However, such frameworks lack a systematic or meaningful definition of what ‘good quality care’ means from the patients’ perspective. The present research provides an in-depth analysis of patients’ experiences in a hospital setting from a quality of care perspective. Forty-five adults (aged 16–70) hospitalised in one of four UK NHS trusts following an unintentional injury were interviewed about their experiences of care. The findings show variability in perceived quality of care within the same hospital episode which cannot be meaningfully captured by existing frameworks. The context of trauma care (e.g. distressing nature of injury, patient vulnerability, expectations of hospitalisation and participants’ interaction with different service providers) defined the care experience and the value of being ‘cared for’. Participants identified some aspects of good and care which related to holistic, person-centred and personalised care beyond the medical needs. Participants discussed the value of being understood, staff thinking of their needs beyond hospitalisation, staff trying ‘their best’ despite constrains of current care, having their emotional needs recognised and addressed and staff competence.
Patients reported also poor quality of care and ‘not being cared for’ by specific staff groups which they expected to fulfil this role, rushed and unsympathetic care, lack of recognition for emotional impact of injury mapped onto existing quality frameworks e.g. safety, equity, accessibility and patient-centeredness as well as quality of interaction with providers, empathetic care which extended beyond medical needs, coordination of care, and the positivity of care delivery as important dimensions of quality care with implications for their recovery. The findings have implications for quality frameworks and theoretical definitions of quality of care; they demonstrate the importance of patient experience in addition to clinical effectiveness and safety as an essential dimension of quality care. In terms of practice, the findings support the need to incorporate knowledge and training of injured adults’ psychological needs, and the value of interaction with professionals as a patient defined dimension of the quality of care.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Experience of care</subject><subject>Female</subject><subject>Health Knowledge, Attitudes, Practice</subject><subject>Health Personnel - standards</subject><subject>Humans</subject><subject>Interviews as Topic</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patient perspective</subject><subject>Patient-Centered Care - methods</subject><subject>Psychological needs</subject><subject>Qualitative Research</subject><subject>Quality of Health Care - organization & administration</subject><subject>Trauma</subject><subject>Trauma Centers - standards</subject><subject>United Kingdom</subject><subject>Vulnerability</subject><subject>Wounds and Injuries - psychology</subject><subject>Young Adult</subject><issn>0020-1383</issn><issn>1879-0267</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU2O1DAQhS0EYpqBGyDkJZsE_yR2sgGhETCIESxgxNKqOBW1W-kk458eesc1uALH4iS4p3tYsrLK79UrVX2EPOes5IyrV5vSTZvk96VggpVMlEzJB2TFG90WTCj9kKxYVgouG3lGnoSwYYxrJuVjciYFF1owviK_v68hUgsTjR7SFugC0eEUw5-fvyj-WNDnymKgMPU0V2FBG90uf0QcR5qy0M0p0rjGg2wxaz29STC6uKfzcB9rweMbCicFDhE0xNTvacBIb11cu-ku5PoT_ZzleYKRXiKMcU2_ot85i0_JowHGgM9O7zm5fv_u28VlcfXlw8eLt1eFrVgTi7YdlOC1QmxbaKBjnRzqqh_qQQFIUDVoVmmLUHWcW2UHaRsOutY4SFWpWp6Tl8fcxc83CUM0Wxds3hYmnFMwQmqej9o2Mluro9X6OQSPg1m824LfG87MgZLZmCMlc6BkmDCZUm57cZqQui32_5rusWTD66MB8547h94Ee8ehdz7f3_Sz-_-Ev8hnqjo</recordid><startdate>202005</startdate><enddate>202005</enddate><creator>Kellezi, B.</creator><creator>Earthy, S.</creator><creator>Sleney, J.</creator><creator>Beckett, K.</creator><creator>Barnes, J.</creator><creator>Christie, N.</creator><creator>Horsley, D.</creator><creator>Jones, T.</creator><creator>Kendrick, D.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3603-6542</orcidid><orcidid>https://orcid.org/0000-0003-4825-3624</orcidid></search><sort><creationdate>202005</creationdate><title>What can trauma patients’ experiences and perspectives tell us about the perceived quality of trauma care? a qualitative study set within the UK National Health Service</title><author>Kellezi, B. ; Earthy, S. ; Sleney, J. ; Beckett, K. ; Barnes, J. ; Christie, N. ; Horsley, D. ; Jones, T. ; Kendrick, D.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-99f62156ee99a8ab0b3f54df5f6aa3a65a7047cea4b11c6cf3c81a757ef364653</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Experience of care</topic><topic>Female</topic><topic>Health Knowledge, Attitudes, Practice</topic><topic>Health Personnel - standards</topic><topic>Humans</topic><topic>Interviews as Topic</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patient perspective</topic><topic>Patient-Centered Care - methods</topic><topic>Psychological needs</topic><topic>Qualitative Research</topic><topic>Quality of Health Care - organization & administration</topic><topic>Trauma</topic><topic>Trauma Centers - standards</topic><topic>United Kingdom</topic><topic>Vulnerability</topic><topic>Wounds and Injuries - psychology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kellezi, B.</creatorcontrib><creatorcontrib>Earthy, S.</creatorcontrib><creatorcontrib>Sleney, J.</creatorcontrib><creatorcontrib>Beckett, K.</creatorcontrib><creatorcontrib>Barnes, J.</creatorcontrib><creatorcontrib>Christie, N.</creatorcontrib><creatorcontrib>Horsley, D.</creatorcontrib><creatorcontrib>Jones, T.</creatorcontrib><creatorcontrib>Kendrick, D.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Injury</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kellezi, B.</au><au>Earthy, S.</au><au>Sleney, J.</au><au>Beckett, K.</au><au>Barnes, J.</au><au>Christie, N.</au><au>Horsley, D.</au><au>Jones, T.</au><au>Kendrick, D.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>What can trauma patients’ experiences and perspectives tell us about the perceived quality of trauma care? a qualitative study set within the UK National Health Service</atitle><jtitle>Injury</jtitle><addtitle>Injury</addtitle><date>2020-05</date><risdate>2020</risdate><volume>51</volume><issue>5</issue><spage>1231</spage><epage>1237</epage><pages>1231-1237</pages><issn>0020-1383</issn><eissn>1879-0267</eissn><abstract>•Patient perspectives and experiences of care are important and absent from existing quality of care frameworks.•Present study shows that traumatic injury patients struggle with the distressing nature of their injury and resultant vulnerability.•Patients valued having the psychological impact of their injuries recognised and addressed in their care.•Patients valued competence, empathetic care and being cared for, and had different expectations for different professionals.•Our study suggests that patients care experience and psychological needs must be incorporated into existing care frameworks.
The global drive for improvements in the efficiency and quality of healthcare has led to the development of frameworks to assist in defining and measuring ‘good quality care’. However, such frameworks lack a systematic or meaningful definition of what ‘good quality care’ means from the patients’ perspective. The present research provides an in-depth analysis of patients’ experiences in a hospital setting from a quality of care perspective. Forty-five adults (aged 16–70) hospitalised in one of four UK NHS trusts following an unintentional injury were interviewed about their experiences of care. The findings show variability in perceived quality of care within the same hospital episode which cannot be meaningfully captured by existing frameworks. The context of trauma care (e.g. distressing nature of injury, patient vulnerability, expectations of hospitalisation and participants’ interaction with different service providers) defined the care experience and the value of being ‘cared for’. Participants identified some aspects of good and care which related to holistic, person-centred and personalised care beyond the medical needs. Participants discussed the value of being understood, staff thinking of their needs beyond hospitalisation, staff trying ‘their best’ despite constrains of current care, having their emotional needs recognised and addressed and staff competence.
Patients reported also poor quality of care and ‘not being cared for’ by specific staff groups which they expected to fulfil this role, rushed and unsympathetic care, lack of recognition for emotional impact of injury mapped onto existing quality frameworks e.g. safety, equity, accessibility and patient-centeredness as well as quality of interaction with providers, empathetic care which extended beyond medical needs, coordination of care, and the positivity of care delivery as important dimensions of quality care with implications for their recovery. The findings have implications for quality frameworks and theoretical definitions of quality of care; they demonstrate the importance of patient experience in addition to clinical effectiveness and safety as an essential dimension of quality care. In terms of practice, the findings support the need to incorporate knowledge and training of injured adults’ psychological needs, and the value of interaction with professionals as a patient defined dimension of the quality of care.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>32127201</pmid><doi>10.1016/j.injury.2020.02.063</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-3603-6542</orcidid><orcidid>https://orcid.org/0000-0003-4825-3624</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Adolescent Adult Aged Experience of care Female Health Knowledge, Attitudes, Practice Health Personnel - standards Humans Interviews as Topic Male Middle Aged Patient perspective Patient-Centered Care - methods Psychological needs Qualitative Research Quality of Health Care - organization & administration Trauma Trauma Centers - standards United Kingdom Vulnerability Wounds and Injuries - psychology Young Adult |
title | What can trauma patients’ experiences and perspectives tell us about the perceived quality of trauma care? a qualitative study set within the UK National Health Service |
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