Michelle J Berning1, Lucas Oliveira J E Silva1, Nataly Espinoza Suarez2, Laura E Walker1, Patricia Erwin3, Christopher R Carpenter4, Fernanda Bellolio5. 1. Department of Emergency Medicine, Mayo Clinic, Rochester, MN, United States of America. 2. Knowledge Evaluation Unit, Mayo Clinic, Rochester, MN, United States of America. 3. Mayo Clinic Libraries, Rochester, MN, United States of America. 4. Department of Emergency Medicine, Washington University School of Medicine in St. Louis, MO, United States of America. 5. Department of Emergency Medicine, Mayo Clinic, Rochester, MN, United States of America; Department of Health Science Research, Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN, United States of America. Electronic address: Bellolio.fernanda@mayo.edu.
Abstract
STUDY OBJECTIVE: To summarize interventions that impact the experience of older adults in the emergency department (ED) as measured by patient experience instruments. METHODS: This is a systematic review to evaluate interventions aimed to improve geriatric patient experience in the ED. We searched Ovid CENTRAL, Ovid EMBASE, Ovid MEDLINE and PsycINFO from inception to January 2019. The main outcome was patient experience measured through instruments to assess patient experience or satisfaction. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to evaluate the confidence in the evidence available. RESULTS: The search strategy identified 992 studies through comprehensive literature search and hand-search of reference lists. A total of 21 studies and 3163 older adults receiving an intervention strategy aimed at improve patient experience in the ED were included. Department-wide interventions, including geriatric ED and comprehensive geriatric assessment unit, focused care coordination with discharge planning and referral for community services, were associated with improved patient experience. Providing an assistive listening device to those with hearing loss and having a pharmacist reviewing the medication list showed an improved patient perception of quality of care provided. The confidence in the evidence available for the outcome of patient experience was deemed to be very low. CONCLUSION: While all studies reported an outcome of patient experience, there was significant heterogeneity in the tools used to measure it. The very low certainty in the evidence available highlights the need for more reliable tools to measure patient experience and studies designed to measure the effect of the interventions.
STUDY OBJECTIVE: To summarize interventions that impact the experience of older adults in the emergency department (ED) as measured by patient experience instruments. METHODS: This is a systematic review to evaluate interventions aimed to improve geriatric patient experience in the ED. We searched Ovid CENTRAL, Ovid EMBASE, Ovid MEDLINE and PsycINFO from inception to January 2019. The main outcome was patient experience measured through instruments to assess patient experience or satisfaction. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to evaluate the confidence in the evidence available. RESULTS: The search strategy identified 992 studies through comprehensive literature search and hand-search of reference lists. A total of 21 studies and 3163 older adults receiving an intervention strategy aimed at improve patient experience in the ED were included. Department-wide interventions, including geriatric ED and comprehensive geriatric assessment unit, focused care coordination with discharge planning and referral for community services, were associated with improved patient experience. Providing an assistive listening device to those with hearing loss and having a pharmacist reviewing the medication list showed an improved patient perception of quality of care provided. The confidence in the evidence available for the outcome of patient experience was deemed to be very low. CONCLUSION: While all studies reported an outcome of patient experience, there was significant heterogeneity in the tools used to measure it. The very low certainty in the evidence available highlights the need for more reliable tools to measure patient experience and studies designed to measure the effect of the interventions.
Authors: Ester Risco; Glòria Sauch; Anna Albero; Nihan Acar-Denizli; Adelaida Zabalegui; Belchin Kostov; Paloma Amil; Albert Alonso; Ana Rios; Jaume Martín; Núria Fabrellas Journal: Int J Environ Res Public Health Date: 2020-09-11 Impact factor: 3.390