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What can trauma patients' experiences and perspectives tell us about the perceived quality of trauma care? A qualitative study set within the UK National Health Service

journal contribution
posted on 13.02.2020 by Blerina Kellezi, Sarah Earthy, Jude Sleney, Kate Beckett, Jo Barnes, Nicola Christie, Daniel Horsley, Trevor Jones, Denise Kendrick
The global drive for improvements in the efficiency and quality of healthcare has led to the development of frameworks to assist in defining and measuring ‘good quality care’. However, such frameworks lack a systematic or meaningful definition of what ‘good quality care’ means from the patients’ perspective. The present research provides an in-depth analysis of patients’ experiences in a hospital setting from a quality of care perspective. Forty-five adults (aged 16-70) hospitalised in one of four UK NHS trusts following an unintentional injury were interviewed about their experiences of care. The findings show variability in perceived quality of care within the same hospital episode which cannot be meaningfully captured by existing frameworks. The context of trauma care (e.g. distressing nature of injury, patient vulnerability, expectations of hospitalisation and participants’ interaction with different service providers) defined the care experience and the value of being ‘cared for’. Participants identified some aspects of good and care which related to holistic, person-centred and personalised care beyond the medical needs. Participants discussed the value of being understood, staff thinking of their needs beyond hospitalisation, staff trying ‘their best’ despite constrains of current care, having their emotional needs recognised and addressed and staff competence. Patients reported also poor quality of care and ‘not being cared for’ by specific staff groups which they expected to fulfil this role, rushed and unsympathetic care, lack of recognition for emotional impact of injury mapped onto existing quality frameworks e.g. safety, equity, accessibility and patient-centeredness as well as quality of interaction with providers, empathetic care which extended beyond medical needs, coordination of care, and the positivity of care delivery as important dimensions of quality care with implications for their recovery. The findings have implications for quality frameworks and theoretical definitions of quality of care; they demonstrate the importance of patient experience in addition to clinical effectiveness and safety as an essential dimension of quality care. In terms of practice, the findings support the need to incorporate knowledge and training of injured adults’ psychological needs, and the value of interaction with professionals as a patient defined dimension of the quality of care.

Funding

National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Nottinghamshire, Derbyshire, and Lincolnshire

History

School

  • Design

Published in

Injury

Volume

51

Issue

5

Pages

1231 - 1237

Publisher

Elsevier

Version

AM (Accepted Manuscript)

Rights holder

© Elsevier Ltd

Publisher statement

This paper was accepted for publication in the journal Injury and the definitive published version is available at https://doi.org/10.1016/j.injury.2020.02.063.

Acceptance date

12/02/2020

Publication date

2020-02-13

Copyright date

2020

ISSN

0020-1383

Language

en

Depositor

Dr Jo Barnes. Deposit date: 12 February 2020

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