|By Society of Hospital Medicine|
In this sense, the James Lind Alliance initiative stands out; here patients, caregivers and professionals prioritize unresolved questions about the effects produced by some treatments so that the organizations that finance the research can discover the problems that people value most. Along the same lines, the Patient-Centered Outcomes Research Institute (PCORI) has worked and shared standards to formulate patient-centred clinical research questions. The methodology used can be found in the article recently published in the journal BMJ.
The steering committee that oversaw this work, made up of patients in collaboration with health professionals and researchers, also invited other patients and interest groups to answer a questionnaire that would allow prioritizing the three main aspects to be answered to improve care hospitably.
Eleven research questions were selected, classified in order of importance, which can be consulted at this link or in this list:
- What actions ensure shared decision-making?
- What are the most effective practices for the transition between the hospital and other assistive devices after discharge?
- How can the healthcare team better educate on drug use and medical conditions to reduce possible errors during hospital care and in coordination at discharge?
- What do patients understand by a collaborative discharge process that empowers them and allows them to effectively manage their health once they are at home?
- How can patients identify and overcome barriers to understanding the information provided during hospitalization and at discharge?
- Can telemedicine be used to decrease readmissions or to improve transition in inpatient care?
- Who should the patient call after discharge if she has questions, concerns, or needs to contact the appropriate resources?
- How can patients and professionals collaborate effectively so that information related to diagnosis, testing and treatment after discharge is understandable?
- What are the patient's expectations regarding pain management?
- What are the best interventions to optimize treatment across the entire patient care?
- Would be providing clearer and more accessible information on hospital routines, such as parking, cafeteria or protocols for entering rooms, would it mean a better experience for the patient compared to normal practices?
If we analyze the questions considered as priorities by the respondents, three main themes stand out:
a) Patients and caregivers wish to participate in the shared decision making. An issue that worries us all and that presents important areas for improvement also in the larger clinical services with more workload.
b) Patients want to have a reference professional whom they can contact if problems or doubts arise after discharge or during the transition between the different healthcare devices.
c) Lastly, patients warn us that providing them with educational material without a complementary and adequate explanation from the health team does not by itself improve their understanding of the care they have to follow.
From this study, the scientific community and health professionals will be able to focus research questions on everything that matters most to patients. On the other hand, those responsible for health policies, as well as funding agencies, will be able to use the results of this study to promote more appropriate improvements that favour a better patient experience.