Becker's Clinical Quality & Infection Control

42 PATIENT EXPERIENCE Poll: How patients define 'good' healthcare across conditions By Megan Knowles P atients with certain conditions, particularly those with fibromyalgia, post-traumatic stress disorder and major depressive disorder, are least satisfied with their provider or care, while those with Lou Gehrig's disease, multiple sclerosis and Parkinson's disease are among the most satisfied, according to a poll from the patient network and research platform PatientsLikeMe. To determine how opinions about care and provider performance varied across patient groups, PatientsLikeMe gathered data from 2,559 of its members in a six-question online poll administered in February. Overall, poll respondents indicated differing care experiences based on their condition. Here are four poll findings. 1. Only 47 percent of fibromyalgia and PTSD patients and 53 percent of MDD patients believed their provider fully explained treatment options, compared to 63 percent of patients living with ALS, MS and Parkinson's disease. 2. Only 40 percent of fibromyalgia patients, 49 percent of PTSD patients and 45 percent of MDD patients thought they were getting the best possible care for their condition, compared to 66 percent of ALS patients, 61 percent of MS patients and 57 percent of Parkinson's disease patients. 3. More than half — 53 percent of PTSD and 56 percent of both MDD and fibromyalgia patients — stayed with their providers, despite thinking they were not receiving the best care, compared to only 31 percent of ALS patients and 36 percent of MS and Parkinson's patients. 4. "A positive or negative experience with care could be provider-related, but also related to the fact that patients living with ALS, MS and Parkinson's oen have access to condition-specific specialists or centers of excellence while those living with other conditions do not," said PatientsLikeMe's Vice President of Policy and Ethics Sally Okun, RN. "is makes it even more important that patients advocate on their own behalf to ensure all avenues to get good care are being used." n Viewpoint: Patients' death pronouncements should promote healing, comfort By Megan Knowles A lthough a physician's pronouncement of a patient's death often carries tre- mendous impact for a patient's family during end-of-life care, these moments are often impersonal, Betty Ferrell, PhD, RN, argued in a Medscape opinion piece. "The realities of hospitals often mean that the death pronouncement happens at times when only an on-call physician is present, a person who is often unknown to the family and who has never met the patient," Dr. Ferrell wrote. Dr. Ferrell cited a study, which compared reactions to two video clips showing death pronouncements. The video clips displayed a terminally ill man in his 70s with a chronic, incur- able illness who was expected to die. His wife, son and daughter were shown at his bedside. One version of the video clip showed a stan- dard, business-like death pronouncement, while the other showed a death pronouncement with five behaviors meant to convey compassion. These behaviors included waiting until the family members calmed down, explaining the physician received a sign-out of information about the patient's condition, performing a re- spectful examination of the patient, ascertaining the patient's time of death with a wristwatch as opposed to a smartphone and reassuring fami- lies the patient did not experience pain. The outcomes of the study included a physician compassion score, trust in the physician and viewer emotions — such as sadness, fear, anger or disgust. The study found the video with a more compassionate death pronouncement was linked to positive outcomes in all of these areas. Dr. Ferrell suggested replicating this study in other countries to see whether these compas- sion behaviors can be generalized and whether the perceptions of the families witnessing the death pronouncements are also comparable. "[The study] also demonstrates that clinician behaviors have lasting impact and that the time of death should promote healing and comfort, [which are] often not the norm," Dr. Ferrell wrote. "The compassionate behaviors are simple in some respects yet profound in others." n High physician ratings linked to shorter patient wait times By Megan Knowles P hysicians with five-stars — the highest rating on Vitals — had about a 13-minute average patient wait time, while physicians with one-star — Vitals' lowest rating — had about a 34-minute average patient wait time, according to Vitals' ninth annual Physician Wait Time Report. To compile the report, Vitals gathered data from patient-re- ported wait times from 2008 through the end of 2017. Vitals also surveyed more than 675 online respondents in a March 2018 poll. Here's the correlation between the average patient wait time and a physician's average rating on Vitals. Five-star rating: 13 min, 17 sec Four-star rating: 21 min, 32 sec Three-star rating: 22 min, 11 sec Two-star rating: 29 min, 34 sec One-star rating: 34 min, 11 sec n

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