Becker's Clinical Quality & Infection Control

13 PATIENT & CAREGIVER EXPERIENCE How you stand can affect patients: Study By Paige Twenter C linician leaders might want to enourage their teams to meet hospitalized patients at their eye level, according to a meta-analysis published in the Journal of General Internal Medicine. Compared to standing by an adult patient's bedside, sitting or crouching was associated with more trust and satisfaction, the study authors found. The researchers, who work in Maryland-based health systems and medical schools, evaluated 14 studies that examined how patients perceived clinicians who stood versus those who sat down. The studies were notably different in terms of study design, interventions, measurement types and outcomes, and most had an elevated bias risk. Also, some interventions require standing, and some clinicians lack seating options. In spite of these conditions, the meta-analysis revealed that patients favor clinicians who sit while communicating. Ten of the 14 studies noted better perceptions of clinician compassion and time spent, plus high satisfaction scores, among those who were seated. Three showed no difference, and one reported higher patient ratings of communication for clinicians who stood. The preference for seated clinicians might be because communication at eye level indicates shared power, the study authors said. "For those healthcare systems that wish to promote this behavior, it is likely that several changes would be necessary such as adjusting local culture to one that expects clinicians to sit, role modeling patient-centered posture in clinician teams, and eliminating physical barriers," the study said. In their conclusion, the researchers recommended this practice because of the potential benefits and easy implementation. n Nurse workflow, Gen Z enter the patient experience spotlight By Mariah Taylor P atient experience measures are showing signs of rebounding aer falling dramatically during the pandemic, and a few elements are entering the spotlight aer having notable effects on hospital scores. Leapfrog's spring safety grade update, released May 1, shows the first signs of improvement in these measures since COVID-19, though figures are still down from prepandemic levels, the organization said. e composite measures for staff responsiveness and communication about medicines fell the most in Leapfrog's spring 2022 update, with average HCAHPS scores in those categories decreasing by 2.21 and 2.43 points, respectively. e latest data shows these measures ticked up by 0.16 and 0.23 points, respectively, at hospitals between fall 2023 and spring 2024. An increased focus on nurse satisfaction and workflow could be contributing to the increase in scores. A recent study found hospitals can improve HCAHPS scores by investing in the nursing work environment, nurse education and staff levels. e study, published in Medical Care, analyzed HCAHPS scores for 540 hospitals in California, Florida, New Jersey and Pennsylvania in 2016. Researchers found the most strongly related factor to ratings was the work environment. For each standard-deviation increase in work environment score, hospitals were 2.42 times more likely to be in a higher patient experience performance category. Within the work environment category, staff development and continuing education, as well as nurse participation in hospital affairs, appeared to have the greatest impact on scores. e frequency of nurse rounding can also significantly affect hospitals' patient experience performance, with hourly nurse rounding linked to a 19.4-point increase in hospitals' "likelihood to recommend score" as measured by HCAHPS. Nearly 82% of patients were likely to recommend their hospital when nurses rounded every hour. is figure fell to 73.2% when nurses rounded every two hours and just 41.8% when nurses rounded only a couple of times. Patient experience is also shiing as the younger generations enter adulthood and begin taking over healthcare decisions for children and aging parents. Generation Z and millennial patients have far less brand loyalty and significantly higher expectations for fast, convenient care compared to previous generations, Press Ganey found in a June 26 report. More Gen Z patients are making their own healthcare decisions as they enter adulthood. Meanwhile, millennial patients are managing healthcare not only for themselves but also for their children and aging parents. Scores also vary by specialty. Press Ganey found the specialties with the highest patient experience scores in 2023 were cardiac surgery (79.3%), obstetrics (76.7%), obstetrics/gynecology (75.9%), neurosurgery (75.9%) and orthopedics (75.5%). e specialties with the lowest scores were medical telemetry (63.8%), medical (64.4%), telemetry (65.4%) and trauma (65.8%). n

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