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PATIENT AND CAREGIVER
PERSPECTIVES DURING
TRANSITIONS OF SURGICAL
CAREBenjamin S. Brooke MD, PhD1; Stacey L. Slager, MS2;
Charlene R. Weir, PhD, RN2
Departments of Surgery & Biomedical Informatics, University of
Utah School of Medicine, Salt Lake City, UT USA
11th Annual Utah Health Services Research Conference
Surgeon Perspective
Patient & Caregiver Perspective
Transitions of Surgical Care
Community
Access
PCP
Hospital
Acute Surgical Care
Services
Surgeon
Community
Follow-up
PCP
Utah Intermountain-West Partnership to Improve
Surgical Care Transitions (U-IMPACT) http://www.uimpactsurgery.com/
Goals:
• 1) To gain a better understanding of the factors that commonly influence the experience and expectations of surgical patients and their caregivers during transitions of care.
• 2) Identify areas for quality improvement & comparative effectiveness research
Surgical Patient & Caregiver Focus
Groups
• Eight focus group sessions
conducted among surgical
patients and caregivers located
in different geographic regions
within Utah and the surrounding
Intermountain West
• Discussions were conducted by
moderator using a semi-
structured schedule, recorded,
and transcribed
Methods – Content Analysis
• Content analysis of focus group transcripts used to
understand the main factors perceived by patients and
caregivers to influence their experience and expectations
of care coordination during transitions before, during and
after surgery.
• Deductive (a priori) and inductive (emerging) themes were
coded from transcripts & analyzed using Atlas.ti software.
• Five-rounds of iterative review involving three co-
investigators used to identify, refine and build consensus
around themes.
Results – 5 Themes
Results – Theme 1
1) The relationship between surgeon and patient is
guided by an unique and unwritten social contract.
Results – Theme 2
1) The relationship between surgeon and patient is guided
by an unique and unwritten social contract.
2) Surgery is a team process and patients expect that all
healthcare providers are on the same page.
Results – Theme 3
1) The relationship between surgeon and patient is guided
by an unique and unwritten social contract.
2) Surgery is a team process and patients expect that all
healthcare providers are on the same page.
3) Patients are frightened to have surgery whether they
let on or not.
Results – Theme 4
1) The relationship between surgeon and patient is guided
by an unique and unwritten social contract.
2) Surgery is a team process and patients expect that all
healthcare providers are on the same page.
3) Patients are frightened to have surgery whether they let
on or not.
4) Surgery is very disruptive and patients need to have
accurate expectations of their care plan.
Results – Theme 5
1) The relationship between surgeon and patient is guided
by an unique and unwritten social contract.
2) Surgery is a team process and patients expect that all
healthcare providers are on the same page.
3) Patients are frightened to have surgery whether they let
on or not.
4) Surgery is very disruptive and patients need to have
accurate expectations of their care plan.
5) Surgery is a skilled function and patients expect that
surgeons and the surgical team are competence,
experienced, and knowledgeable.
Translation
• Patient and caregivers experience during
transitions of surgical care is dependent upon:
• Feeling that they could trust their surgeon
• Being able to communicate with the surgical team
• Knowing what to expect during the episode of care
• Feeling that their care is being effectively coordinated.
How do we use this information?
U-IMPACT Patient & Caregiver Advisory
Group
• Meet Quarterly
• Discuss ideas for
quality improvement
and comparative
effectiveness research
(CER) related to
surgical care
coordination
Potential Areas for Patient-Centered
Comparative Effectiveness Research
• Surgical care navigators
• Enhanced discharge planning
• Customizing health information resources
• Providing risk data to surgical patients
Future Directions for U-IMPACT
• Applying for Continued funding through PCORI
Tier III P2P Contract
• Targeting PCORI ‘Improving Healthcare
Systems’ Grant – Cycle 3, 2016
• Continue to build partnerships with patients &
caregivers along with healthcare and
community stakeholders
Thank You
Website: http://www.uimpactsurgery.com/
Email: [email protected]
Twitter: @BenjaminSBrooke
