Patients’ experiences in Australian hospitals: a systematic review of evidence
Reema Harrison A F , Merrilyn Walton A , Elizabeth Manias A C , Steven Mears D and Jennifer Plumb E
+ Author Affiliations
- Author Affiliations
A School of Public Health, University of Sydney, NSW 2006, Australia. Email: merrilyn.walton@sydney.edu.au
B The University of Melbourne, Parkville, Vic. 3010, Australia. Email: emanias@unimelb.edu.au
C Deakin University, 75 Pigdons Road, Waurn Ponds, Vic. 3216, Australia.
D Hunter New England Medical Library, New Lambton, NSW 2350, Australia. Email: steve.mears@hnehealth.nsw.gov.au
E Australian Commission on Safety and Quality in Health Care, 200 Elizabeth Street, Sydney, NSW 2000, Australia. Email: jennifer.plumb@safetyandquality.gov.au
F Corresponding author. Email: reema.harrison@sydney.edu.au
Australian Health Review 41(4) 419-435 https://doi.org/10.1071/AH16053
Submitted: 23 February 2016 Accepted: 29 June 2016 Published: 19 August 2016
Abstract
Objective Patients are uniquely positioned to provide insightful comments about their care. Currently, a lack of comparable patient experience data prevents the emergence of a detailed picture of patients’ experiences in Australian hospitals. The present study addresses this gap by identifying factors reported in primary research as relating to positive and negative experiences of patients in Australian hospitals.
Methods Evidence from Australian qualitative studies of patients of all ages reporting their experiences in any hospital or day procedure centre was synthesised. A range of text words, synonyms and subject headings was developed and used to undertake a systematic search of seven electronic databases from January 1995 to July 2015 and the grey literature. Two reviewers independently screened the titles, abstracts or executive summaries and applied the inclusion criteria. Data were synthesised in a meta-narrative.
Results Thirty-nine publications were included: 33 articles from database searches and six from the grey literature. Quality improvement researchers produced the dominant narrative and the nursing perspective was strong. Six themes emerged: ‘Reciprocal communication and information sharing’, ‘Interpersonal skills and professionalism’, ‘The care environment’, ‘Emotional support’, ‘Discharge planning and process’ and ‘Correct treatment and physical outcomes’.
Conclusion Tangible opportunities to enhance the patient experience are apparent. Small changes to the way that the health system operates and is resourced and the way that health professionals engage with patients could substantially improve care. Examples include inviting patients and carers to contribute to decision making and discussions about their treatment options and care preferences.
What is known about the topic? Patient experience is identified as a key component of an optimal health system, along with improving the health of populations and reducing the per capita costs of care. The use of patient experience data has been associated with improved clinical effectiveness and patient safety.
What does this paper add? Patient experience data are currently not routinely captured and difficulties exist as to where this information is available. These data are gathered using a variety of different methods that prohibit the development of a national picture. As a step towards overcoming this barrier, the present study identifies the common elements of healthcare experience reported by patients in Australia as being positive or negative.
What are the implications for practitioners? Ensuring that patients and carers are active partners in their care is at the centre of a positive patient experience. Health professionals should provide patients with opportunities to make decisions about their care and ask questions, and to provide clear information before, during and after hospitalisation to enhance patients’ experiences in Australian hospitals.
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